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OMB Nn 1545~0047
Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung
benefit trust or private foundation)
" The org anization may have to use a copy of this return to satisfy state reporting requiremer
2001 7r, 9runrnt of it,, Tma ;ury
Ir;c" raI Revenge Srrvirr
A For the 2001 calendar ear, or tax ear be innin , 2001, and ending D Employer identification number
8a : o v/ 9 yA8 Room/suite E Telephone number
7S 3 Zn- 31~5 F Aapamng meVqd" 0 Cash Acuuai
D Other (specify)
H and I are not applicable to section 517 or,, ~a, naarions
H(a) Is this a group return for affiliates? LJ Yes [3 No H(b) If "Yes ." enter number of affiliates P . . . . . . . . . . . . . H(c) Are all affiliates included? F-1 Yes [I No
(If "No," attach a list See Instructions) H(d) Is this a separate realm filed by an
organization covered by a group ruling? El Yes 'RHo I Enter 4-digit GEN io. M Check lo- [I if the organization is not required
G Web srte
J Organization type (check only one) " 0 501(c) ( 3) .4 (insert no) 0 4947(a)(1) a 0 527
K Check here P- 0 if the organization's gross receipts are normally not more wan $25,000 The organization need not ale a return with the IRS. but d the organization received a Form 990 Package in the mad, it should file a return without financial data Same states require a complete return .
L Gross receipts Add lines 6b, Bb, 9b, and 10b to line 12 > to attach Sch . B (Form 990 . 990-EZ, or 990-PF) FTM Revenue, Ex arises, and Changes in Net Assets or Fund Balances See S eafic Instructions on oaae 16)
1 Contributions, gifts, grants, and similar amounts received a Direct public support 1a b Indirect public support . . . . . . . . 1b 'd
c Government contributions (grants) 1c 1j;;6
d Total (add lines 1a through 1c) (cash $ noncash $ 2 Program service revenue including government fees and contracts (from Part VII, line 93)
' 3 Membership dues and assessments . . . . . 4 InteiesL tin savings and temporary cash investments 5 Dividends and interest from securities 6a Gross rents . . . . . . . . . . . . . , , . . 6a b Less rental expenses . , . , . 6b c Net rental income or (loss) (subtract line 6b from line 6a)
v ~ 7 Other Investment income (describe " . . . . . . STA (A) Securities (B) Other x ?c Sa Gross amount from sales of assets other
than inventory b Less cost or other basis and sales expenses . c Gain or (loss) (attach schedule) . . . . 8C d Net gain or (loss) (combine brie 8c, columns (A) and (B))
9 Special events and activities (attach schedule) a Gross revenue (not including $ of (;
contributions reported on line 1a) . . . . . , , . : 9a b Less direct expenses other than fundraising expenses 9b c Net income or (loss) from special events (subtract line 9b from line 9a) 9
10a Gross sales of inventory, less returns and allowances . 10a b Less cost of goods sold . . , , . 1Ub /.507--3 c Gross profit or (loss) from sales of inventory (attach schedule) (subtract brie 10b from brie 10a) .
X 11 Other revenue (from Part VII, line 103) . . . .
. , . . , , . . 1 ~ 12 Total revenue (add bites 1d, 2, 3 . 4 . 5, 6c, 7, l3d, 9c, 10c, and 11)
R °' ~ 13 Program services (from line 44, column (B)) . . . . . ~; 14 Management and general (from line 44, column (C)) . . . . .
i ; a 15 Fundraising (from line 44, column (D)) . . . . . . w" 16 Payments to affiliates (attach schedule) . . . . , . , . . , , , , , , 11
~; ~ 17 Total expenses (add lines 16 and 44, column (A)) 18 Excess or (deficit) for the yea '~1~~fpl-plline 12) .
a 19 Net assets or fund balance at be ~ ~ ear (from i~~73, column(A) ) . 20 Other changes i n net asset or and balances (attach e anon) . . . , .2 1
z 21 Net assets or fund balances ~ of ar ( i
,5
~ , and 20
. .
2' For Paperwork Reduction Act Notice, se W44' instruc ' Cat No 11282Y
?~S O
Form 990 (2000 , T
RCVD IN RATCHflNG
0 O N
W
form 990
B Chick d dppliwble Please C N ~a e of organization 1-1 use IRS U
L/e I ,~ I ~ I'/ ~~ Aaaress change uoeior ~ ~ Print of Number and street (or P O box d mail is not delivered to street addri
Name change typ i initial reluin See p~(~~ iY. -5'1~/X.~~' ST~t°'(~.-L.
u Specific Final return insauc- City or town state or count and ZIP + 4
r, lions ~ iJ T'~ 83 ~'3 7 ! ~ Amended return
L .~ Application pending 0 Section 501(c)(3) organizations and " 947(aHl) nonexempt charitable trusts must attach a completed Schedule A (Form 990 or 990 " EZ) .
,.
-v7 W ~ ~ 6VEC)
2015
i
~~ y 9S/ av.s9~a,
22 Grants and allocations (attach schedule) (cash $ noncash E ) 22
23 Specific assistance to individuals (attach schedule) 23 24 Benefits paid to or for members (attach schedule) . 24
25 Compensation of officers, directors, etc . , 25
26 Other salaries and wages . . . . . . . 26 '2G / / S//
27 Pennon plan contributions 28 Other employee benefits . . . , , 28
29 Payroll taxes . 30 Professional fundraising fees . . . . . 30
31 Accounting fees 32 Legal fees . . . . . . . . . . . 32
33 Supplies . . . . . . . . . , , , 33
34 Telephone . . . . . . . . , , , , 34 35 Postage and shipping . . . . , , , 35 36 Occupancy . . . . . . . . . , , 36 37 Equipment rental and maintenance . . . , 37 8
38 Printing and publications . . . , . . , 38 39 Travel . . . . . . , . . , , , , 39 OO 5 -40 Conferences, conventions, and meetings 40 41 Interest . . . , . . . , . , , , , 41
42 Depreciation, depletion, etc . (attach schedule) 42 Vd. 43 Other expenses not covered above (itemize) . a . . . . . . . . . 43a
b .~Q!tjP`X~Oret~rtS~---- . 43b c 43c
d . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43d ~ / e . ~'!'JJ'~Y//IT-" npccZ 43e G89 -
44 Total functional expenses (add fines 22 through 43) Organ¢sUons cog" colurrins (sprit, carry these raals co Ibles 13-1a . as Z1io i ploy 95/ .'1
Joint Costs . Chack " [I if you are following SOP 98-2 Are any point costs from a combined educational campaign and fundraising solicitation reported in (B) Program services? . " [] Yes ~ No It "Yes." enter n we aggregate amount of thesejoint costs $-; G) the amount allocated to Program services $ (w) the amount allocated to Management and general S , and (rv) we amount allocated to Fundraising S " Statement of Program Service Accom lishments See Specific Instructions on page 24 What is the organization's primary exempt purpose? ~RQ~~-~rnb~!rS. .416. . ~ikl . . ~rtfSa . Program Service
Expenses All organizations must describe their exempt purpose achievements in a clear and concise manner State the number (H�W�ed for w1(c)(s) arw of chants served, publications issued, etc Discuss achievements that are not measurable (Section 501(c)(3) and (4) (4) ags, and 4sa7(a)(i)
opti organizations and 4947(a)(1) nonexempt charitable trusts must also enter the amount of grants and allocations to others ) ~' ~,)°`al f°
mcnbv, r.a . . . P .+_~ rd~es~. .'~~-'~`C7. . . . ---r.Uor. .Ks-E-,o.~a5 .-- .lec~_+v,re.~_ .1 .~vru~rns . . .~=.v~_ . .d_~ s cu s~-'~''-~=---.` .:~.ur-4-her-- ~-r~~v~~----- °,n ~e~~ Ik~ ------~----------~-----~ /60 y 95/ (Grants and allocations $
(Grants and allocations $ )
(Grants and allocations $ 1
(Grants and allocations $ ) e Other program services (attach schedule) (Grants and allocations $ ) t Total of Program Service Expenses (should equal line 44, column (B), Program services) .
form 9W (2001)
Form 990 (2001) Page 2
statement of All organizations must complete column (l). Columns (B). (C), and (D) are required for section 501(cK3) and (4) organizations Functional Ex enses and serum ese7(aNi) nonexempt charitable vests an optional for others. (see Specific Instructions on page zt )
Do not include amounts reported on line (e) Program (c) Management 6b, 8b, 9b, 10b, or 16 O( Pert 1 ~
(A) Total services and general (D) Fundraising
-----
Form 00 (2001) Page
Balance Sheets (See Specific Instructions on page 24 .)
(B) End of year
71-10-74
48a Pledges receivable . . . . . . . . 40a b Less allowance for doubtful accounts . . 48b
49 Grants receivable . . . . . . . . 50 Receivables from officers, directors, trustees, and key employees
(attach schedule) . . . . . . . . 51a Other notes and loans receivable (attach
schedule) . . . . . . 51a
b Less allowance for doubtful accounts . . 51b
a 52 Inventories for sale or use . . . . . 53 Prepaid expenses and deferred charges 54 Investments-securities (attach schedule) . . . " El cost El FMV . . 55a Investments-land, buildings, and
equipment basis . . , . . . , , , SSa
b Less . accumulated depreciation (attach schedule). . . . . 55b
56 Investments-other (attach schedule) . 57a Land, buildings, and equipment : basis . , 57a
b Less' accumulated deprecation (attach schedule). . . . . . . . . , , , 57b 3~ 3
58 Other assess (describe " )
59 Total assets (add lines 45 through 58) (must equal line 74) . 6 / 59 60 Accounts payable and accrued expenses . . . . . . . . . . 60 61 Grants payable . . . , . . . , 62 Deferred revenue . . . , . . .
a 63 Loans from officers, directors, trustees, and key employees (attach = schedule) . . . . . . . . . . . . . . . . . . . . . 63
2 64a Tax-exempt bond liabilities (attach schedule) . . . . . . . . 64a b Mortgages and other notes payable (attach schedule) . . . . . IAP 64b /
65 Other liabilities (describe " ) 65
66 Total liabilities (add lines 60 through 65) . . 76 3~ 66 ~ S~O
Organizations that follow SFAS 117, check here " 11 and complete lines 67 through 69 and lines 73 and 74 .
67 Unrestricted . . . . . . . . . . . . . . . . . . . . / 67 ?+ 68 Temporarily restricted . . . . . . . . . . . . . , , . . 68 m 69 Permanently restricted . . . . . . . . . .
. . . . . 69
Organizations that do not follow SFAS 117, check here " El and complete lines 70 through 74 .
`0 70 Capital stock, oust principal, or current funds 71 71 Paid-in or capital surplus, or land, building, and equipment fund .
N ,~ 72 Retained earnings, endowment, accumulated income, or other funds a
72
73 Total net assets or fund balances (add lines 67 through 69 OR lines z 70 through 72,
column (A) must equal line 19 ; column (B) must equal line 21), , . O 73 .r/5 74 Total liabilities and net assets / fund balances (add lines 66 and 73) ~ .--46,8 rJ/ 9 ~ 74 ~aC~ O_3 Jl
Form 990 is available for public inspection and, for some people, serves as the primary or sole source of information about a particular organization . How the public perceives an organization in such cases may be determined by the information presented on it return . Therefore, please make sure the return is complete and accurate and fully describes, in Part 111, the organization's programs and accomplishments .
Note . Where required, attached schedules and amounts within the description (A) column should be for end-of-year amounts only Beginning of year
45 Cash-non-interest-bearing . . . . 46 Sarongs and temporary cash investments . , , . , . . . . , y
47a Accounts receivable . b Less allowance for doubtful accounts .
Form 990 (2007) 4
= Reconciliation of Expenses per Audited Financial Statements with Expenses per Return
a Total expenses and posses per audited financial statements
7/0 b Amounts included on line a but not on line 17, Form 990
i (1) Donated services
and use of facilities $ i
(2) Prior year adjustments reported on line 20, Form 990 . . . . E
(3) Losses reported on line 20, Form 990 . $
(4) Other (specify)
` Reconciliation of Revenue per Audited Financial Statements with Revenue per Return (See Specific Instructions, a e 2
a Total revenue, gains, and other support per audited financial statements . . " a
b Amounts included on line a but not on fine 12, Form 990 :
(1) Net unrealized gams on investments .
(2) Donated services and use of facilities $
(3) Recoveries of prior year grants
(4) Other (specify)
Add amounts on lines (1) through (4) " b
75 Did any officer, director, trustee, or key employee receive aggregate compensation of more than E100,000 from your organization and all related organizations, of which more than $10,000 was provided by the related organizations? " El Yes 10 No I( "YPS," attach srr,eauie-sPe Specific Instructions on page 27
form 9W (2001)
c Line a minus line b. . . . . . " c c Line a minus line b 10, C d Amounts included on line 12, d Amounts included on line 17,
Form 990 but not on line a: Form 990 but not on line a :
(1) Investment expenses (1) Investment expenses not included on line not included on line 6b, Form 990 . . . S 6b, Form 990 .
(2) Other (specify) (2) Other (specify)
Add amounts on lines (1) and (2) " d Add amounts on lines (1) and (2) Ill. d
e Total revenue per line 12, Form 990 e Total expenses per line 17, Form 990 (line c plus line d .
. . " e line c plus line d . " e
List of Offices, Directors, Trustees, and Key Employees (List each one even H not compensated ; see Specific Instructions on page 26.)
(A) Name and address I (B) Title and average hours per I ~~ ~t paid, ent r I ~layce be~cefrt plans d I account E xp en se
week devotCd to position _0-.) deterred cortoasatron allowances
14-14 /Xl~ . .~n4aQl.-4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . ~---- Fl"+c31 art.--7c / I
4VAP11Q . . . . e~5!. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TrPaSttrt r-
/ .. ~l"'e1_~t.lWAW. leY,~-- ---- ------ - . . .------ ut~rs1 "(r/ ~:cde/ %"
161 We 4a,
------~- ------ 0 . . . . . . . . . . . . . . . . . . . . . . . . .
C~ S~~NIi^ /O
88 At any time during the year, did the organization own a 50% or greater interest in a taxable corporation or partnership, or an entity disregarded as separate from the organization under Regulations sections 301 7701-2 and 301 7701-3*? If "Yes," complete Pan IX . . , . , . . , . , , , , , , 88
89a 501(c)(3) organizations Enter Amount of tax imposed on the organization during the year under . section 4911 " ; section 4912 " , section 4955 "
b 501(c)(3) and 501(c)(4) orgs Did the organization engage in any section 4958 excess benefit transaction during the year or did it become aware of an excess benefit transaction from a prior year? If "Yes," attach a statement explaining each transaction . . . . . . . . . . . . . . 89b
c Enter Amount of tax imposed on the organization managers or disqualified persons during the year under sections 4912, 4955, and 4958 . . . . . . . . . . . . . . .
d Enter Amount of tax on line 89c, above, reimbursed by the organization . 90a List the states with which a copy of this return is filed " . . . . . . . . . . . . . . . . . . . . . . . . . . ._____ ._ . ._ .__ .__ .__ . . ._ .__ . . . .__ . ._ . ._ ._ . . .___ . .
b Number of employees employe in the pa ~ en~od,that includes March 12, 2001 (See instructions .) 190b I 91 The books are in care of "~ .____,_ .__ . . . . . . . . Telephone no . " (~?S
Located at " Q?DY.!v~-~hr5~ner~~--~~11t~? -~ ,,--.~---------------- ZIP + 4 " ----------------92 Section 4947(a)(1) nonexempt charitable trusts filing Form 990 in lieu of Form 1041-Check here .
and enter the amount of tax-exempt interest received or accrued during the tax year . " I 92 I Farm 990 c200>>
Form 990(2001) Page
Other Information See Specific Instructions on page 27 . Yes No
. Did the organization engage in any acuity not previously reported to the IRS? If 'Yes," attach a detailed description of each activity . 76 76 77 Were any changes made in the organizing or governing documents but not reported to the IRS? . . . »
If "Yes," attach a conformed copy of the changes. 78a Did the organization have unrelated business gross income of $1,000 or more during we year covered by this return? . 78a
b if "Yes," has it filed a tax return on Form 990-T for this year? . . . . . 79 Was there a liquidation, dissolution, termination, or substantial contraction during the years If "Yes," attach a statement 79
80a Is the organization related (other than by association with a statewide or nationwide organization) through common membership, governing bodies, trustees, officers, etc ., to any other exempt or nonexempt organization? . . . 80a X
b If "Yes " enter the name of the organization " . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ._ . . . . . . . . . . . . . . ._ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . and check whether it is D exempt OR 0 nonexempt.
81a Enter direct or indirect polrtiCal expenditures See line 81 instructions . b Did the organization file Form 1120-POL (or this year?. . . . . , . . . . . . . , , , , , 81b
82a Did the organization receive donated services or the use of materials, equipment, or facilities at no charge or at substantially less than fair rental value? . . . . . . . . . . . . . . , . . , , , , 82a
b If "Yes ." you may indicate the value of these items here . Do not include this amount as revenue in Part I or as an expense in Part II . (See instructions in Part III .) .
83a Did the organization comply with the public inspection requirements for returns and exemption applications 83a
b Did the organization comply with the disclosure requirements relating to quid pro quo contributions? . , 83b 84a Did the organization solicit any contributions or gifts that were not tax deductible? . . . . . . . . 84a X
b If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? . . . . . . . . . , . . . . . , , . . . , , , , , 84b
85 501(c)(4), (5), or (6) organizations a Were substantially all dues nondeductible by members? . . . . , , , 85a
b Did the organization make only in-house lobbying expenditures of $2,000 or less? . . . . . , , . 85b
If "Yes" was answered to either 85a or 85b, do not complete 85c through 85h below unless the organization received a waver for proxy tax owed for the prior year
c Dues, assessments, and similar amounts from members . . . . . . , , 85c d Section 162(e) lobbying and political expenditures . . . . . . , , , . 85d e Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices . . . 85e ^'
f Taxable amount of lobbying and political expenditures (line 85d less 85e) . , 85f A/
g Does the organization elect to pay the section 6033(e) tax on the amount on line 85f? , h If section 6033(e)(1)(A) dues notices were sent, does the organization agree to add the amount on line 85f to it
reasonable estimate of dues allocable to nondeductible lobbying and political expenditures for the following tax year. . . . . . . . . . . . . . . . . . . . . . . . . . . . 85h
86 501(c)(7) orgs . Enter : a Initiation fees and capital contributions included on line 12 .86a . 2101
b Gross receipts, included on tine 12, for public use of club facilities . . . , , 86b N 87 501(c)(12) orgs. Enter a Gross income from members or shareholders . . . , $7a "VIA
b Gross income from other sources . (Do not net amounts due or paid to other sources against amounts due or received from them .) . . . . . . , , , 87b
Form 990 ' (2001) Page s
Analysis of Income-Producing Activities See Specific Instructions on page 32 .
Note : Enter gross amounts unless otherwise Unrelated business income Excluded by section 512, 513, a 514 (E)
indicated (A) (B) (C) (p) Related or
exempt function
93 Program service revere : Business code Amount Exclusion code Amount income
a AIZZ17.4Q l G~o~{rrcn«_ - /(0 3 A~S~
b c d e f Medicare/Medicaid payments . g Fees and contracts from government agencies
94 Membership dues and assessments 95 Interest on savings and temporary cash investments 96 Dividends and interest from securities . 97 Net rental income or (loss) from real estate.
a debt-financed property . b not debt-financed property .
98 Net rental income or (loss) from personal property 7 99 Other investment income 100 Gain or (loss) from sales of assets other than inventory 101 Net income or (loss) from special events 102 Gross profit or (loss) from sales of inventory . 103 Other revenue . a
b c d e
104 Subtotal (add columns (B), (D), end (E7) 105 Total (add line 104, columns (B), (D), and (E)) . . . . . . . . . . . " Note : Line 105 plus line 1d, Part 1, should equal the amount online 12, Part l. " Relationshi of Activities to the Accomplishnient of Exempt Purposes (See Specific Instructions on page 32 . ) Line No Explain how each activity for which income is reported in column (E) of Part VII contributed importantly to the accomplishment
of the organization's exempt purposes (other than by providing funds for such purposes).
< -VC7. -rri, ina 6/a oZZ). /s - ,Lr-rf,is1n ~eqarded Entities (SL5t
(c) Nature of activities
Information Regarding Taxable Subsidiaries and DI Name, address, and FEIN of corporation, PercenBage of
partnership, or disregarded entity ownership interest
33
Total income I End
~ mrormauon rcegaraing iransrers wssociatea wan rersonai esenem conyacts p)ee bpecnic instructions on page 33 .) (a) Did the organization, during the year, receive any funds, directly or indirectly, to' pay premiums on a personal benefit contract? . . E]Yes CgNo (b) Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contracts D Yes 'VNo Note : ff "Yes" to (b), ale Form 8870 and Form 4720 (see instructions) .
Paid Preparer's Use Only
r i/!,'
InsWctions on
Please Sign Here
SCHEDULE A (Form 990 or 990-EZ)
Depanmem al tne Treasury
Internal Revenue Service
Organization Exempt Under Section 501(c)(3) (Except Private Foundation) and Section 501(e), 5010, 501(k),
501(n), or Section 4947(a}(1) Nonexempt Charitable Trust Supplementary Information-(See separate instructions .)
" MUST be completed b the above organizations and attached to their Forth 990 or 990-EZ 2001
Total number of others receiving over $50,000 for I professional services .
For paperwork Reduction Act Notice. See the Instructions for Form 990 end Form 990{Z. Cat No 11285E Schedule A (Forth 990 err 990-EZ) 2001
OMB No 1545-0047
Name of the organizauon Employer identdicauon number
e~,~,~ ~~ . ~P oy~ a Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees (See page 1 of the instructions . List each one . If there are none, enter "None.'
(a) Name and address of each employee paid more (b) Title and avaage hours I l~ Contributions to I (e) Expense
than $50,000 per week devoted to posrtlon I ~c) Compensation ~empbyee benefit plans 8~ accourn and other I deferred comcensanon I allowances
/V0
Total number of other employees paid over $50,000
' Compensation of the Five Highest Paid Independent Contracts for Professional Services (See page 2 of the instructions List each one (whether individuals or firms) . If there are none, enter "None ")
(a) Name and address of each independent contracts paid more than $50,000 (b) Type of service (c) Compensation
/'t~Q r~~
3 Does the organization make grants for scholarships, fellowships, student loans, etc .? (See Note below .) . 1 Do you have a section 403(b) annuity plan for your employees? . . . . . , . , . , . , , . . , 4
Note: Attach a statement to explain how the organization determines that individuals or organizations receiving grants or loans from it in furtherance of its charitable rams "qualify' m receive ants. WAM
Reason for Non-Private Foundation Status (See pages 3 through 6 of the instructions.)
The organization is not a private foundation because it is : (Please check only ONE applicable box .)
5 D A church, convention of churches, or association of churches . Section 170(bx1)(f) 0i, 6 D A school. Section 170(bx1)(A6) . (Also complete Part V .) 7 0 A hospital a a cooperative hospital service organization. Section 170(bX1)(A)(Q. 8 C3 A Federal, state, a local government a governmental unit Section 170(bX1)(A)(v). 9 ~ A medical research organization operated in conjunction with a hospital. Section 170(bX1)(f)(ii# . Enter the hospital's name, city,
and state " -----~-----------------~~-----~------------ . . .-------- . . . . .---- . . . . . . .---------------- . . . . . . . . . . . . . . .--- . . .-----~----~~----10 ~ An organization operated for the benefit of a college or university owned or operated by a governmental unit. Section 170(b)(1KA)(v) .
(Also complete the Support Schedule in Part IV-A.) 11a ~ An organization that normally receives a substantial part of its support from a governmental unit or from the general public.
Section 170(bK1)IN(v) . (Also complete the Support Schedule in Part IV-A.) 11b ~ A community trust . Section 170(b)(1x1)(v). (Also complete the Support Schedule in Part IV-A.) 12 ~ An organization that normally receives : (1) more then 596 of its support from contnbuGOns, membership fees, and gross
receipts from activities related to its charitable, etc., functions-subject to certain exceptions, and (?) no more than 33'h% of it support from gross investment income and unrelated business taxable income (less section 511 tai from businesses acquired by the organization after June 30, 1975 . See section 509(ax2). (Also complete the Sport Schedule in Part IV-A .)
13 ~ An organization that is not controlled by any disqualified persons (other than foundation managers) and supports organizations described in: (1) lines 5 through 12 above; a (2) section 501(c)(4), (5), a (6), if they meet the test of section 509(x)(2) . (See section 509(aK3) .)
Provide the following information about the supported organizations . (See page 5 of the instructions.) (b) Line number
from above (a) Name(s) of supported organization(s)
11 [] An organization organized and operated to test far public safety . Section 509(ax4) . (See page 6 of the instructions .) Schedule A dorm 990 or 990-EZ) 2001
Schedulb A (Form 990 a 990-E1) 2001 Page 2
Statements About Activities (See page 2 of the instructions .) Yes No
1 During the year, has the organization attempted to influence national, state, or local legislation, including any attempt to influence public opinion on a legislative matter or referendum? If "Yes," enter the total expenses paid or incurred in connection with the lobbying activities " $ (Must equal amounts on line 313, Part VI-A, or line 1 0l Part VI-B .) Organizations that made an election under section 501(h) by filing Form 5768 must complete Part VI-A . Other organizations checking 'Yes," must complete Part VI-B AND attach a statement giving a detailed description of the lobbying activities .
2 During the year, has the organization, either directly or indirectly, engaged in any of the following acts with any substantial contributors, trustees, directors, officers, creators, key employees, or members of their families, or with any taxable organization with which any such person is affiliated as en officer, director, trustee, majority owner, or principal beneficiary? (If the answer to any question is °Yes,' attach a detailed statement explaining the transactions.)
a Sale, exchange, or leasing of property? . . . . . . . . . . . . .
b Lending of money or other extension of credit? . . . . . . . . . .
c Furnishing of goods, services, or facilities? . . . . . . . . . . . .
d Payment of compensation (or payment a reimbursement of expenses rf more than 11,000)? . .1 .
e Transfer of any part of its income or assets? . . . . . . . . . . . . . ,
c Add . Amounts from column (e) for lines : 15 0~73/8~ 16 V597141,10 77 G foo15v' 20 PA9 21 yfi;6 . , , , , , " 27c l
d Add . Line 27a total , d' and line 27b total . . ~ , , , , , , " 2 e Public support (line 27c total minus line 27d total) . . . . , , , , . , , , , , , , " 2.70 9/ f Total support for section 509(a)(2) test Enter amount from line 23, column (e) . . " .27f WE. MW5117/1 g Public support percentage (line 27e (numerator) dhrlded by Une 27f (denominator)) . . . , , " 27 98 % h Investment income percentage Pine 18, column (e) (numerator) divided line 27i (denominator) " 27h %
28 Unusual Grants For an organization described in line 10, 11, a 12 that received any unusual grants during 1997 through 2000, prepare a list for your records to show, for each year, the name of the contributor, the date and amount of the grant, and a brief descripti on o f the nature of the gr a nt. Do not tale this list wkh your return. Do not include these grants in line 15 .
SdhedWe A (Form 890 v 980-En 2001
Schedule A (Form 990 or 990-EA 2001 Page 3
Support Schedule (Complete only if you checked a box on line 10, 11, or 12 .) Use cash method of accourtdrg. Note : You ma use the walcsheet in the instructions for converting from the accrual to the cash method of accounting. Calendar r (a fiscal r beginning In) , " (a) 2000 (b) 1999 (c) 1998 (d) 1997 (e) Total 15 Gifts, grants, and contributions received . (Do
not include unusual grants . See line 28 .) . . /loo?O ~O / 7G ~ 3 16 Membership fees received . / ~ / ~8? 9l03 moo? 830 </7 9 17 Gross receipts from admissions, merchandise
sold a services performed, a furnishing of facilities m any activity that is related to the organization's charitable, etc ., /5 /7purpose . O 9i S/
18 Gross income from interest, dividends, amounts received from payments on securities loans (section 512(a)(5)), rents, royalties, and unrelated business taxable income Qess section 511 taxes) from businesses acquired yOb~ by the organization after June 30, 1975 . /770 7 70R 0 S/3
19 Net income from unrelated business activities not included in line 18
20 Tax revenues levied fog the organization's benefit and either paid to it or expended on it behalf. . . . . . . . . . . . B-
21 The value of services or facilities furnished to the organization by a governmental unit without charge. Do not include the value of services or facilities generally furnished to the public without charge . .
22 Other income. Attach a schedule . Do not include am or poss) from sale of cap ital assets 40- ~ ~9 B
23 Total of lines 15 through 22 . , y02 3 7 / /V2, Line 23 minus line 17 . , oZCL"1~ / i 939 (0 38 / 7G S9G
25 Enter 1 % of line 23 . ~'L.+~ a ~~9 y/.5~ 28 Organizations described on lines 10 a 11 : a Enter 2% of amount in column (e), line 24 ,
b Prepare a list for your records to show the name of and amount contributed by each person (other than a governmental unit a publicly supported organization) whose total gifts for 1997 through 2000 exceeded the amount shown in line 26a . Do not file this list with your return . Enter the total of all these excess amounts " 28b
c Total support for section 509(a)(1) test: Enter line 24, column (e) , . . . d Add . Amounts from column (e) for lines . 18 19 WIN
22 26b , , , , , , " 28d e Public support Qine 26c minus line 26d total) . . , . , , " 28e f Public support percentage Qine 28e (numerator) dhrided by Ilne 26c (denominator)) . " ~ 28f r %
27 Organizations described on line 12 a For amounts included in lines 15, 16, and 17 that were received from a "disqualified person,' prepare a list for your records to show the name of, and total amounts received in each yeas from, each "disqualified person ." Do not file this list with your return Enter the sum of such amounts for each year :
(2000) . . . . . . . . C~6 (1999) . . . . . . . . . . (19' (1998) . . . . . . . . . '_ :~' ._ . . . . . . . . . . . (1997) . . . . . . . . d9 . . . . . . . . . . . . . . For any amount included in line 17 that was received from each person (other than 'disqualified persons, prepare a list for your records to show the name of, and amount received for each year, that was more than the larger of (1) the amount on One 25 for the year a (T) $5,000 . (Include in the list organizations described in lines 5 through 11, as well as individuals .) Do not file this list with pour return After computing the difference between the amount received and the larger amount described in (1) or (2), enter the sum of these differences (the excess amounts) for each year . (2000) -----~---6P .. . . . . . . . . . . . . . (1999) --------- .'`------------- (1998) . . . . . . . . . 3~. . . . . . . . . . . . . . . (1997) --------~-------------
A IFnrm 990 nr 990"E71 2001 4 Private School Questionnaire (See page 7 of the instructions .) / (To be completed ONLY by schools that checked the box on line 6 in Part IV)
29 Does the organization have a racially nondiscriminatory policy toward students by statement in it charter, bylaws, other governing instrument, or m a resolution of it governing body? . . . .
30 Does the organization include a statement of its racially nondiscriminatory policy toward students in all its brochures, catalogues, and other written communications wrath the public dealing with student admissions, programs, and scholarships? . . . . . . . . . , . . . . . .
31 Has the organization publicized its racially nondiscriminatory policy through newspaper or broadcast media during the period of solicitation for students, or dunng the registration period if it has no solicitation program, in a way chat makes we policy known to all parts of the general community n serves?. . If "Yes," please describe, if "No," please explain. (If you need more space, attach a separate statement.)
32 Does the organization maintain the following: a Records indicating the racial composition of the student body, faculty, and administrative staff? b Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory
basis? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
c Copies of all catalogues, brochures, announcements, and other written communications to the public dealing with student admissions, programs, and scholarships? . , . . . . . , .
d Copies of all material used by the organization or on it behalf to solicit contributions?
No
35 Does the organization certify that it has complied with the applicable requirements of sections 4 .01 through 4.05 of Rev Proc 75-50, 1975-2 C.B . 587, covering racial nondiscrimination? If "No," attach an explanation , . I 35
Schedule A (Form 990 a 990-En 2001
If you answered "No" to any of the above, please explain . (If you need more space, attach a separate statement .)
33 Does the organization discriminate by race m any way with respect to,
a Students' rights or privileges? . . . . . . . . . , . . . . . .
b Admissions policies? . . , . . . . . . . . , . , , . . . . , . , . ,
c Employment of faculty or administrative staff? . . . , , , . . . , .
d Scholarships or other financial assistance? , . , , , . , , . . , , , , . , , , ,
e Educational policies? . . . , . . , . . . . . . . . . . .
f Use of facilities? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
g Athletic programs? . . . . . . ~ . . . . . . . . . . . . . . . . . . . . . . .
h Other extracurricular activities? , . . . . . . . , , . . . . ,
If you answered "Yes" to any of the above, please explain. (If you need more space, attach a separate statement.)
34a Does the organization receive any financial aid a assistance from a governmental agency? .
b Has the organization's right to such aid ever been revoked or suspended? . . If you answered "Yes" to ether 34a a b, please explain using an attached statement .
Schedule A (Form 990 a 990-EA 2001 5
(b) To be completed for ALL electing organizations (The term "expenditures" means amounts paid or incurred .)
36 Total lobbying expenditures to influence public opinion (grassroots lobbying) 37 Total lobbying expenditures to influence a legislative body (direct lobbying . 38 Total lobbying expenditures (add lines 36 and 37) . . . 39 Other exempt purpose expenditures . . . . . . . 40 Total exempt purpose expenditures (add lines 38 and 39) . 41 Lobbying nontaxable amount. Enter the amount from the following table-
If the amount on line 40 Is- The lobbying nontaxable amount is- Not over E500,000 . . . . . . . 20% of the amount on line 40 . Over $500,000 but not over (1,000,000 . . $100,000 plus 15% of the excess over E500,000 Over E1,000,000 but not over $1,500,000 . $175,000 plus 1096 of the excess over E1,000,000 Over $1,500,000 but not over (17,000,000 . $225,000 plus 5% d the excess over E1,500,000 Over $17,000,000 . . . . . . . . E1 .000 .000 . .
42 Grassroots nontaxable amount (enter 25% of line 41) . . 43 Subtract line 42 from line 36 . Enter -Q if line 42 is more than line 36 . 44 Subtract line 41 from line 38 . Enter -0- if line 41 is more than line 38 .
Lobbying E:pendltures During 4-Year Averaging Period
(b) I W I (d) I cep 2000 1999 1998 Total
48 Grassroots nontaxable amount
49 Grassroots ceding amount (150% of line 48(e))
50 Grassroots lobbying expenditures " Lobbying Activity by Nonelecting Public Charities
(For reporting only b organizations that did not complete Part VI-A) (See page 12 of the instructions .)
During the year, did the organizaUOn attempt to influence national, state or local legislation, including any Yes No Amount attempt to influence public opinion on a legislative matter or referendum, through the use of: a Volunteers . . . . . . . . . . . . . . . . . . . b Paid staff or management (Include compensation in expenses reported on fines c through h.) . c Media advertisements . . . . . . . . . . . . . . . . . . . . . . . . . . d Mailings to members, legislators, or the public . . , , . . , , . . , . . . . , , , e Publications, or published or broadcast statements . . . . . . f Grants to other organizations for lobbying purposes . . . . . . g Direct contact with legislators, their staffs, government officials, or a legislative body . h Rallies, demonstrations, seminars, cornenUans, speeches, lectures, or arty other means . i Total lobbying expenditures (Add lines c through h.)
If "Yes" to any of the above, also attach a statement giving a detaded~descnptjon of the ibbbymg activities . Sdiedule A (Form 990 Q 890-En 2001
" Lobbying Expenditures by Electing Public Charities (See page 9 of the instructions .) (To be completed ONLY b an eligible organization that filed Form 5768)
Check " a~ d the organization belongs to an affiliated group. Check " b 0 if u checked "a" and "limited control* (a)
Limits on Lobbying Expenditures Affiliated group 7 totals
Caution: If there is an amount on either line 43 a line 44, you must file Form 4720 .
4-Year Averaging Period Under Section 501) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below .
See the instructions for fines 45 through 50 on page 11 of the instructions .)
Calendar year (or (a) fiscal yeas beqlnnlnsa In) " I 2001
45 Lobbying nontaxable amount .
46 Lobbying ceiling amount (150% of line 45(e)) .
47 Total lobbying expenditures
Schedule A (Forth 990 w 990-EA 2007 P
" Information Regarding Transfers To and Transactions and Relationships With Noncharitable ~/ Exempt Organizations (See page 12 of the instructions .)
51 Did the reporting organization directly a indirectly engage in any of the following with any other organization described in section 501(c) of the Code (other than secUon 501(c)(3) organizations) or in section 527, relating to political organizations?
a Transfers from the reporting organization to a nonchantable exempt organization of : Yes No
01 Cash . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51a
f1 Other assets . . . . . . . . . . . . . . . . . . . b Other transactions .
(q Sales or exchanges of assets with a nonchantable exempt organization . PQ Purchases of assets from a noncharrtable exempt organization , . . . (i) Rental of facilities, equipment, or other assets . . . , . . . . . (iv) Reimbursement arrangements . . . . . . . . . . . . . . (v) Loans or loan guarantees . . . . . . . . . . . . . . . . . . . . . . , , , , b y
(vi) Performance of services or membership a fundraising solicitations . . . . . . , , . , , , b y
c Sharing of facilities, equipment, marling lists, other assets, or paid employees . d If the answer to any of the above is "Yes," complete the following schedule . Column (b) should always show the fair market value of the
goods, other assets, or services given by the reporting organization. If the organization received less than fair market value in any transaction a sharing arrangemerK, show in column (c) the value of the goods, other assets, a services received .
52a Is the organization directly a indirectly affiliated with, or related to, one or more tax-exempt organizations described in section 501(c) of the Code (other than section 501(c)(3)) or m section 527? . . . . , . " 0 Yes 0 No
%V
I I,,
$117,388.10 $ 40,251 .30 $6,348.40 $6,295.00 $5,501 .00 $4,239.00
Description Date Accumulated Depreciation Acquired Cost Method Life 1997 1998 1999 2000 2001
1 Macintosh Computer Sep-88 $ 3,868.40 S/L 10 $ 3,707.80 $ 160.80 $ - $ - $ - 2 Cannon Fax 230 Jun-89 $ 1,890.03 DDB 7 $ 1,890 .03 $ 0.03 $ - $ - $ - 3 Fax Machine Jun-89 $ 1,312.50 S/L 10 $ 1,159.64 $ 131 .28 $ 66.00 $ 2.00 $ - 4 Copy Machine Mar-90 $ 9,304.05 DDB 7 $ 9,303.84 $ 0.21 $ - $ - $ 5 Computer Jul-92 $ 2,897.30 S/L 7 $ 2,379.81 $ 413.88 $ 206.00 $ - $ - 6 Poweitook 180 Nov-92 $ 4,954.19 S/L 7 $ 3,833.70 $ 707.76 $ 352.00 $ - $ - 7 Powerbook 100 Apr-93 $ 9,450.00 S/L 7 a 1,035.60 $ 207.34 $ 207.00 $ 104.00 $ - 8 HP Fax Machine May-93 $ 1,281 .18 S/L 7 $ 886.15 $ 183.36 $ 183.00 $ 91 .00 $ - 9 Poweitook 145 Jun-93 $ 1,899.72 S/L 7 $ 1,289.34 $ 271 .44 $ 271 .00 $ 138.00 $ 2.00 10 Risograph Sep-93 $ 13,408.50 S/L 7 $ 8,820.02 $1,915.58 $1,918.00 $ 955.00 $ - 11 Copy Machine Sep-93 $ 1,040.00 S/L 7 $ 880.90 $ 148.56 $ 149.00 $ 72.00 $ - 12 Worlcgroup Server 80 Feb-94 $ 3,500.85 S/L 7 $ 2,042.32 $ 500.16 $ 500.00 $ 500.00 $ 250.00 13 Power Mac 7200 Oct-95 $ 2,217.85 SJL 5 $ 1,108.80 $ 443.52 $ 444.00 $ 220.00 $ - 14 Paper Folder Apr-96 $ 1,071 .85 S/L 5 $ 392.92 $ 214.32 $ 214.00 $ 214.00 $ 107.00 15 Performs 6400 Dec-96 $ 2,852.72 S/L 5 $ 863.15 $ 530.52 $ 531 .00 $ 531 .00 $ 284.00 16 Apple Mac Lcii Jul-93 $ 1,397.14 S/L 5 $ 1,257.48 $ 139.66 $ 1 .00 $ - $ - 17 Powerbook 1400/168 Dec-98 $ 1,900.00 SIL 5 $ - $ 380.00 $ 380.00 $ 380.00 $ 380.00 18 Office Building 5/2811999 $ 39,868.00 SJL 39 $ - $ - $ 640.00 $1,022.00 $1,022.00 19 Land 5/26/1999 $ 8,274.00 not 0 $ 20 Furnace for Office 8/9/1999 $ 2,648.00 SJL 7 $ - $ - $ 189.00 $ 378.00 $ 378.00 21 Hot water tank for Off . 7/28/1999 $ 322.00 DDB 7 $ - $ - $ 46.00 $ 79.00 $ 56.00 22 Computer 1/13/2000 $ 500.00 S/L 5 $ 100.00 $ 100.00 23 Letters Copy Machine (E) 2/14/2000 $ 171 .16 S/L 5 $ 31 .00 $ 34.00 24 HP Laser jet printer 3/24/2000 $ 45.45 S/L 5 $ 7.00 $ 9.00 25 Ricoh Zerox Copy Machine 8/8/2000 $ 5,388.00 S/L 5 $ 628.40 $1,077.00 26 Zip Drive 6/1212000 $ 75.00 S/L 5 $ 9.00 $ 15.00 27 Canon Copier (E) 10/13/2000 $ 844.97 S/L 5 $ 42.00 $ 169.00 28 IMAC Computer 2/22/2001 $ 1,380.00 S/L 5 $ 227.00 29 Compac Computer 8 Printer 6/27/2001 $ 1,424.49 S/L 5 $ 142.00 30 Apple Computer 12/3/2001 $ 428.75 S/L 5 $ 7.00
