Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| List of grants and similar amounts paid Part I line 10 | Activity Memorial Donation Grantee Middletown Fire and Rescue Street 7855 Main Street City, State, Zip Middletown, VA 22645Relationship None |
| Description of other expenses Part I line 16 | Description AmountCare of grounds 5,250Supplies 158Post Office Box 90Registration fees 25Insurance 432Open and close graves 3,600Bank Fees 48Repairs and maintenance 206Gift Certificate 100 |
| Other changes in net assets or fund balances Part I line 20 | Description AmountUnrealized Gain/(Loss) on inv 467 |
| Description of other assets Part II line 24 | Category Beginning of Year End of YearCemetery 1,000 1,000 |
| Software ID: | |
| Software Version: |