Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
|
Total |
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Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 14,139 | 28,869 | 24,700 | 34,117 | 68,534 | 170,359 |
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | 50,865 | 39,247 | 39,592 | 28,890 | 24,470 | 183,064 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | 65,004 | 68,116 | 64,292 | 63,007 | 93,004 | 353,423 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | 0 | |||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | 0 | |||||
| c | Add lines 7a and 7b.. | 0 | |||||
| 8 | Public support. (Subtract line 7c from line 6.) | 353,423 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 65,004 | 68,116 | 64,292 | 63,007 | 93,004 | 353,423 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | 1,172 | 1,172 | ||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 66,176 | 68,116 | 64,292 | 63,007 | 93,004 | 354,595 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
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| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2018 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2018 |
(iii) Distributable Amount for 2018 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2018 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2018: | ||||
| a From 2013....... | ||||
| b From 2014....... | ||||
| c From 2015....... | ||||
| d From 2016....... | ||||
| e From 2017....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2018 distributable amount | ||||
|
i
Carryover from 2013 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2018 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2018 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2018, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2019. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2014...... | ||||
| b Excess from 2015..... | ||||
| c Excess from 2016..... | ||||
| d Excess from 2017..... | ||||
| e Excess from 2018..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: PAMANA 6 HINALARAN MULTI-PURPOSE HALL. Grantee Name: CONSTITUENTS OF HINALARAN VILLAGE. Grantee Address: ST. JAMES APOSTLE PARISH SILAGO, SOUTHERN LEYTE, PHILIPPINES. Date of Gift: 11/08/08. Amount Given: 8,048. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: SMALL PROJECT HINALARAN FEEDING & MAINAGA FEEDING & DISTRIBUTION OF GOODS. Grantee Name: CONSTITUENTS OF HINALARAN & PUPILS OF MAINAGA Grantee Name: CONSTITUENTS OF HINALARAN & PUPILS OF MAINAGA. Grantee Address: ST. JAMES APOSTLE PARISH SILAGO, SOUTHERN LEYTE, PHILIPPINES. Date of Gift: 10/01/18. Amount Given: 2,000. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: YOUTH FESTIVAL SPIRITUAL FORMATION. Grantee Name: 700 DELEGATES/YOUTH STO. NINO CATHEDRAL & Grantee Name: 700 DELEGATES/YOUTH STO. NINO CATHEDRAL &. Grantee Address: STO. NINO CATHEDRAL, CALAPAN, ORIENTAL MINDORO, PHILIPPINES. Date of Gift: 10/01/18. Amount Given: 460. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: DISTRIBUTION OF SCHOOL SUPPLIES. Grantee Name: 150 SCHOOLCHILDREN OF BAGUBAD ELEMENTARY SCHOOL. Grantee Address: BAGUBAD ELEMENTARY SCHOOL GINGOOG CITY, MISAMIS ORIENTAL, PHILIPPINES. Date of Gift: 10/01/18. Amount Given: 362. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: PARISH RENOVATION. Grantee Name: PARISHIONERS OF SAN ISIDRO LABRADOR PARISH. Grantee Address: SAN ISIDRO LABRADOR PARISH BURU-UN, ILIGAN CITY, LANAO DEL NORTE, PHILIPPINES. Date of Gift: 10/01/18. Amount Given: 262. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: MEDICAL ASSISTANCE. Grantee Name: AALIYAH FERNANDO. Date of Gift: 10/07/18. Amount Given: 412. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: SMALL PROJECT -FEEDING PROGRAM. Grantee Name: INDIGENTS, MALNOURISHED CHILDREN, ELDERLY BRGY Grantee Name: INDIGENTS, MALNOURISHED CHILDREN, ELDERLY BRGY. Grantee Address: HINUNDAYAN SOUTHERN LEYTE, PHILIPPINES. Date of Gift: 10/19/18. Amount Given: 400. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: SHELTER, HEALTH & NUTRITION. Grantee Name: KAMANGGAGAWA FOUNDATION,. Grantee Address: 43 EAST LAWIN ST. PHILAM HOMES QUEZON CITY, PHILIPPINES. Date of Gift: 01/01/19. Amount Given: 500. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: SMALL PROJECT ELECTRICITY FOR MULTI-PURPOSE HALL. Grantee Name: CONSTITUENTS OF BRGY. CONSOLACIO. Grantee Address: BRGY. CONSOLACION, DAPA SIARGAO, PHILIPPINES. Date of Gift: 01/23/19. Amount Given: 500. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: SMALL PROJECT FEEDING & DISTRIBUTION OF SCHOOL SUPPLIES. Grantee Name: RONA ELEMENTARY SCHOOL & BAYUIN ELEMENTARY SCHOOL. Grantee Address: MANSALAY, ORIENTAL MINDORO & BAYUIIN SOCORRO, ORIENTAL MINDORO, PHILIPPINES. Date of Gift: 03/04/19. Amount Given: 400. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: SMALL PROJECT MEDICAL & DENTAL CHECK UP. Grantee Name: ELDERLY OF PARIANCILLO VILLA. Grantee Address: PARIANCILLO VILLA VALENZUELA CITY, PHILIPPINES. Date of Gift: 03/24/19. Amount Given: 500. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: MEDICAL ASSISTANCE. Grantee Name: JESSICA DATOY. Date of Gift: 05/03/19. Amount Given: 100. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: PAMANA 7 LAMPANUSAN MULTI-PURPOSE HALL. Grantee Name: CONSTITUENTS OF LAMPANUSAN. Grantee Address: STO. NINO MISSION CHAPEL LAMPANUSAN, KALILANGAN, BUKIDNON, PHILIPPINES. Date of Gift: 08/16/19. Amount Given: 10,040. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: FENCE CONSTRUCTION. Grantee Name: SAN JOSE PARISH CHURCH. Grantee Address: HINUNDAYAN SOUTHERN LEYTE, PHILIPPINES. Date of Gift: 06/24/19. Amount Given: 13,500. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: SMALL PROJECTS FEEDING PROGRAM. Grantee Name: AN-AN ELEMENTARY SCHOOL. Grantee Address: HINUNDAYAN SOUTHERN LEYTE, PHILIPPINES. Date of Gift: 05/14/19. Amount Given: 500. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: SMALL PROJECTS FEEDING PROGRAM. Grantee Name: CONSTITUENTS OF AN-AN, AMBAO, SABANG. Grantee Address: HINUNDAYAN SOUTHERN LEYTE, PHILIPPINES. Date of Gift: 05/14/19. Amount Given: 500. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: MEDICAL ASSISTANCE. Grantee Name: ELLEN FAJARDO. Date of Gift: 06/23/19. Amount Given: 100. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: SMALL PROJECTS FEEDING, MEDICAL & DENTAL CHECK UP, GIFT GIVING. Grantee Name: CONSTITUENTS OF BRGY. PAWILI. Grantee Address: BRGY. PAWILI, BULA CAMARINES SUR, PHILIPPINES. Date of Gift: 07/14/19. Amount Given: 500. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: FEEDING PROGRAM & DISTRIBUTION OF SCHOOL SUPPLIE. Grantee Name: BAGUBAD ELEMENTARY SCHOOL. Grantee Address: BAGUBAD ELEMENTARY SCHOOL, GINGOOG CITY, MISAMIS ORIENTAL, PHILIPPINES. Date of Gift: 07/22/19. Amount Given: 200. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: LAVATORY RENOVATION & FEEDING PROGRAM. Grantee Name: CABINET ELEMENTARY SCHOOL. Grantee Address: CABADBARAN AGUSAN DEL NORTE, PHILIPPINES. Date of Gift: 07/22/19. Amount Given: 200. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: SMALL PROJECT FEEDING PROGRAM & DONATION OF REFRIGERATOR. Grantee Name: COGON CENTRAL ELEMENTARY SCHOOL. Grantee Address: BRGY 1, BUENAVISTA AGUSAN DEL NORTE, PHILIPPINES. Date of Gift: 07/22/19. Amount Given: 500. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: PAMANA 7 LAMPANUSAN FEEDING. Grantee Name: CONSTITUENTS OF LAMPANUSAN. Grantee Address: STO. NINO MISSION CHAPEL LAMPANUSAN, KALILANGAN, BUKIDNON, PHILIPPINES. Date of Gift: 08/16/19. Amount Given: 400. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: SHORT TERM REHABILITATION FACILITY. Grantee Name: NATHANIEL WITHERELL (NURSING HOME). Grantee Address: 70 PARSONAGE ROAD GREENWICH, CT 06830. Date of Gift: 10/28/18. Amount Given: 200. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: MEDICAL ASSISTANCE. Grantee Name: ELVIRA GUMANOY. Date of Gift: 03/10/19. Amount Given: 100. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: SMALL PROJECT HOME ECONOMICS/CANTEEN BUILDING. Grantee Name: NEW VISAYAS ELEMENTARY SCHOOL. Grantee Address: COMPOSTELLA VALLEY DAVAO DEL NORTE, PHILIPPINES. Date of Gift: 04/25/19. Amount Given: 1,212. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: DEATH AID. Grantee Name: ELLA SUNGA. Date of Gift: 01/13/19. Amount Given: 300. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: DEATH AID. Grantee Name: PATRICIA RUIZ. Date of Gift: 04/04/19. Amount Given: 300. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: DEATH AID. Grantee Name: JOSE DAVID. Date of Gift: 06/12/19. Amount Given: 300. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: DEATH AID. Grantee Name: MABEL ARDINAZO. Date of Gift: 07/06/19. Amount Given: 150. Total included on Form 990-EZ, line 10: 42,946. |
| Form 990-EZ, Part I, Line 16 - Other Expenses | Description: Supplies. Amount: 9,704. Description: Food. Amount: 5,134. Description: Prizes. Amount: 1,143. Description: Advertisement. Amount: 921. Description: Equipment. Amount: 1,328. Description: Miscellaneous. Amount: 6,115. Description: Uniform. Amount: 469. Total to Form 990-EZ, line 16: 24,814. |
| Form 990-EZ, Part II, Line 24 - Other Assets | Description: Accounts receivables. Beg. of Year Amount: 1,095. End of Year Amount: 595. |
| Form 990-EZ, Part II, Line 26 - Other Liabilities | Description: Accrued expenses. Beg. of Year Amount: 1,500. End of Year Amount: 1,800. |
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| Software Version: |