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 4 - OTHER INVESTMENT INCOME | DESCRIPTION: INTEREST INCOME. AMOUNT: 18. |
| FORM 990-EZ, PART I, LINE 8 - OTHER REVENUE | DESCRIPTION: OTHER INCOME. AMOUNT: 1,842. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: . GRANTEE NAME: KID-SAFE DONATIONS. DATE OF GIFT: 10/13/21. AMOUNT GIVEN: 7,000. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: . GRANTEE NAME: SCHOLARSHIPS. AMOUNT GIVEN: 4,500. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: . GRANTEE NAME: CRYSTAL LAKE PANTRY. DATE OF GIFT: 12/13/21. AMOUNT GIVEN: 2,500. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: . GRANTEE NAME: VETERANS HOME. AMOUNT GIVEN: 2,000. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: . GRANTEE NAME: CORNERSTONE. DATE OF GIFT: 10/13/21. AMOUNT GIVEN: 3,335. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: . GRANTEE NAME: OTHER SMALL MISCELLANEOUS. AMOUNT GIVEN: 6,422. TOTAL INCLUDED ON FORM 990-EZ, LINE 10: 25,757. |
| FORM 990-EZ, PART I, LINE 16 - OTHER EXPENSES | DESCRIPTION: NATIONAL AND STATE DUES. AMOUNT: 2,663. DESCRIPTION: BANK CHARGES. AMOUNT: 136. DESCRIPTION: STATIONARY/SUPPLIES. AMOUNT: 736. DESCRIPTION: MEETINGS. AMOUNT: 14,160. DESCRIPTION: TAXES & LICENSES. AMOUNT: 846. DESCRIPTION: OTHER EXPENSES. AMOUNT: 8,613. TOTAL TO FORM 990-EZ, LINE 16: 27,154. |
| FORM 990-EZ, PART II, LINE 24 - OTHER ASSETS | DESCRIPTION: UNCATEGORIZED ASSETS. BEG. OF YEAR AMOUNT: 2,220. END OF YEAR AMOUNT: 5,470. |
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