24
>rm JE ft-A If0 1 , 3eti rn of Otl',ganiza teon Exempt From income ax Under section 501(c ), 527, or 1947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation) Cepartment of the Treasury lntemal Revenue Service > The organization may have to use a copy of this return to satisfy state reporting requirements. OMB No 1545-0047 Oo 11 2 6 A For the 2011 calendar ear, or tax year b eginning On-?0 r=e 2011 , and endin g SC-Pmr(BER 3o , 20 / 2- B Check if applicable . C Name of organization C L.2i FAQ f F} rQ p it SE L t/ L D Employer identification number q Address change Doing Business As C#)FES.T1d O Aieo- 14 L / - Ap 3 1p 6 C) q Name change Number and street (or P.O . box if mail is not delivered to street address) Room/suite 1 W / Z ' M 2 " E Telephone number / 1_ c4 Q q Initial return J. o i /) y 0 X S T4' T> q Terminated City or town , state or country , and ZIP + 4 3A q Amended return G Gross receipts $ q Application pending F Name and address of principal officer Er T ^p^I7`^1 H(a) Is this a group return for affiliates ? O Yes ;ff No /"A v J1:%,-,A tW& . H(b) Are all affiliates included? q Yes q No t-J/A- Tax-exem pt status : 501 (c)(3) q 501 c ) 4 (insert no.) q 4947 (a)( 1 ) or q 527 If " No," attach a list. (see instructs ns) ,f Website: H(c) Group exemption number r"/4- K Form of orgamzahon : Corporation q Trust q Association q Other L Year of formation : /9g M State of legal domicile: A4 a Summary 1 Briefly describe the organization ' s mission or most significant activities: -------------- -------------------------------- ------------ ---------------- ---- A erma _ -- Q 1 ^^- c,S r_1G f1o'^_t- ' e-0 CIE_ ---C - -------- 1riG ---- ---------- ^/^ct1Gf E 0 2 ---------------------------------------------------------------------------------------------------------------------------------------------------------------------- Check this box 10- F1 if the organization discontinued its operations or disposed of more than 25% of its net assets. 0 ad 3 - Number of voting members of the governing body (Part VI, line 1 a) . . . . . . . . . 3 4 Number of independent voting members of the governing body (Part VI, line 1 b) . . . . 4 / 5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) . . . . . 5 6 Total number of volunteers (estimate if necessary ) . . . . . . . . . . . . 6 S N 7a Total unrelated business revenue from Part VIII , column (C), line 12 . . . . . . . . 7a b Net unrelated business taxable income fro 7b O172, Prior Year Current Year ' 8 Contributions and grants (Part VIII, line 1 h ) . 1 i0) . . 17 3 9 C) C 9 Program service revenue (Part VIII , line 2g MAY 0 3 2013 . / '^S /^Slo 10 Investment income (Part Vlll, column (A), li 4, and 7d) . . . /o/ a) 11 Other revenue (Part VIII, column (A), lines , 6d, in e ay/ Q qxq Z 12 Total revenue - add lines 8 through 11 (mu a'P it I R°bt5lum (A), lin 12) a /^ /d c 73 13 Grants and similar amounts paid (Part IX , column (A), lines 1-3) . . . . . 14 Benefits paid to or for members (Part IX, column (A), line 4) . . . . . . 15 Salaries , other compensation , employee benefits (Part IX , column (A), lines 5-10) 97 (F 6Zq 7-7 16a Professional fundraising fees (Part IX, column (A), line 11 e) . . . . . . b Total fundraising expenses (Part IX, column ( D), line 25) Q -------- ------------ 17 Other expenses (Part IX, column (A), lines 11 a-11 d, 11 f-24e) . . . . . O 18 Total expenses . Add lines 13- 17 (must equal Part IX , column (A), line 25) /S' 97J-- 1S3 S11 / 19 Revenue less ex p enses . Subtract line 18 from line 12 30 3-P 3Swg Beginning of Current Year Pri el of Year 20 Total assets (Part X, line 16) 9 , a-g S6 (a 21 Total liabilities (Part X , line 26) . . . . . . . . . . . . . . . . 07 6 a/. 3a zLL 22 Net assets or fund balances . Subtract line 21 from line 20 S7o3 7" alf Signature Block Under penalties qury, I declare that I have examined this return , including accompanying schedules and statements , and to the best of my knowledge and belief, it is true, correct , a d c lets Declatw preps 4 1 r (other!h2 officer) is based on all information of which preparer has any knowledge. ,.^. - Sign Si nature of officer Here Aes A . c CHs r Type or print name and title Paid Pnnt/Type preparer 's name Preparer's signature Preparer Use Only Firm's name Firm's address May the IRS dis cuss this return with the preparer shown above? (s For Paperwork Reduction Act Notice, see the separate instructions.

ft-A OMBNo 1545-0047 26 Oo11990s.foundationcenter.org/990_pdf_archive/411/... · A Forthe2011 calendar ear, ortaxyearbeginning On-?0r=e 2011, andending SC-Pmr(BER 3o, 20 /2-B Checkif

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  • >rm JE

    ft-A

    If0 1 ,3eti rn of Otl',ganiza teon Exempt From income ax

    Under section 501(c ), 527, or 1947(a)(1) of the Internal Revenue Code (except black lungbenefit trust or private foundation)

    Cepartment of the Treasurylntemal Revenue Service > The organization may have to use a copy of this return to satisfy state reporting requirements.

    OMB No 1545-0047

    Oo 1126

    A For the 2011 calendar ear, or tax year beginning On-?0 r=e 2011 , and ending SC-Pmr(BER 3o , 20 / 2-

    B Check if applicable . C Name of organization C L.2i FAQ f F} rQ p itSE L t/ L D Employer identification number

    q Address change Doing Business As C#)FES.T1d OAieo- 14 L / -Ap 3 1p 6 C)

    q Name change Number and street (or P.O . box if mail is not delivered to street address) Room/suite

    1 W/ Z ' M 2 "

    E Telephone number /

    1_ c4Qq Initial return J.o i /) y0 X S T4' T>

    q Terminated City or town , state or country , and ZIP + 4

    3Aq Amended return G Gross receipts $

    q Application pending F Name and address of principal officer Er T ^p^I7`^1 H(a) Is this a group return for affiliates ? O Yes ;ffNo

    /"A vJ1:%,-,A tW& . H(b) Are all affiliates included? q Yes q No t-J/A-

    Tax-exempt status : 501 (c)(3) q 501 c ) 4 (insert no.) q 4947(a)( 1 ) or q 527 If " No," attach a list. (see instructs ns)

    ,f Website: ► H(c) Group exemption number ► r"/4-

    K Form of orgamzahon : Corporation q Trust q Association q Other ► L Year of formation : /9g M State of legal domicile: A4a

    Summary1 Briefly describe the organization ' s mission or most significant activities:

    -------------- -------------------------------- ------------

    ---------------- ----Aerma_ -- Q 1 ^^-c,S r_1G f1o'^_t- ' e-0 CIE_---C - -------- 1riG----

    ----------

    ^/^ct1GfE

    0 2----------------------------------------------------------------------------------------------------------------------------------------------------------------------Check this box 10- F1 if the organization discontinued its operations or disposed of more than 25% of its net assets.

    0ad

    3

    -

    Number of voting members of the governing body (Part VI, line 1 a) . . . . . . . . . 34 Number of independent voting members of the governing body (Part VI, line 1 b) . . . . 4 /5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) . . . . . 56 Total number of volunteers (estimate if necessary ) . . . . . . . . . . . . 6 S

    N 7a Total unrelated business revenue from Part VIII , column (C), line 12 . . . . . . . . 7a

    b Net unrelated business taxable income fro 7b O172,Prior Year Current Year

    '8 Contributions and grants (Part VIII, line 1 h) . 1 i0). . 1739C)C 9 Program service revenue (Part VIII , line 2g MAY • 0 3 2013 . / '^S /^Slo10 Investment income (Part Vlll, column (A), li 4, and 7d) . . . /o/ a)

    11 Other revenue (Part VIII, column (A), lines , 6d, in e ay/ Q qxq

    Z12 Total revenue- add lines 8 through 11 (mu a'P it I R°bt5lum (A), lin 12) a /^ /d c 7313 Grants and similar amounts paid (Part IX , column (A), lines 1-3) . . . . .

    14 Benefits paid to or for members (Part IX, column (A), line 4) . . . . . .

    15 Salaries , other compensation , employee benefits (Part IX , column (A), lines 5-10) 97(F 6Zq 7-716a Professional fundraising fees (Part IX, column (A), line 11 e) . . . . . .

    b Total fundraising expenses (Part IX, column (D), line 25) ► Q-------- ------------

    17 Other expenses (Part IX, column (A), lines 11 a-11 d, 11 f-24e) . . . . . O18 Total expenses . Add lines 13-17 (must equal Part IX , column (A), line 25) /S' 97J-- 1S3 S11 /19 Revenue less expenses . Subtract line 18 from line 12 30 3-P 3Swg

    Beginning of Current Year Pri el of Year

    20 Total assets (Part X, line 16) 9 , a-g S6 (a

    21 Total liabilities (Part X , line 26) . . . . . . . . . . . . . . . . 07 6 a/. 3azLL 22 Net assets or fund balances . Subtract line 21 from line 20 S7o3

    7"alf Signature BlockUnder penalties qury, I declare that I have examined this return , including accompanying schedules and statements , and to the best of my knowledge and belief, it istrue, correct , a d c lets Declatw preps

    4 1r (other!h2 officer) is based on all information of which preparer has any knowledge.

    ,.^. -Sign Si nature of officerHere Aes A . c CHs r

    Type or print name and title

    PaidPnnt/Type preparer's name Preparer's signature

    PreparerUse Only Firm's name ►

    Firm's address ►May the IRS discuss this return with the preparer shown above? (s

    For Paperwork Reduction Act Notice, see the separate instructions.

  • ,'om, 990,(2011) , I ,', < r "-: f b ^r ;'1 > ^to!) Page 3

    1 Checklist of Fleauired SchedulesYes 140

    I Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes,"complete Schedule A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

    2 Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? . . . 2

    3 Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition tocandidates for public office? If "Yes," complete Schedule C, Part I . . . . . . . . . . . . . . 3

    4 Section 501 (c)(3) organizations . Did the organization engage in lobbying activities, or have a section 501(h)? If "Y tti ff t d th t " l S h l P t //i i d C . . . . . . . . . . .n e ax year es, comp e eon ec ur ng e c e u e , arelec 4

    5 Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues,assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,Part 111 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

    6 Did the organization maintain any donor advised funds or any similar funds or accounts for which donorshave the right to provide advice on the distribution or investment of amounts in such funds or accounts? If"Yes, " complete Schedule D, Part I . . . . . . . . . . . . . . . . . . . . . . . 6

    7 Did the organization receive or hold a conservation easement, including easements to preserve open space,the environment, historic land areas, or historic structures? If "Yes, " complete Schedule D, Part 11 . . . 7

    8 Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"complete Schedule D, Part Ill . . . . . . . . . . . . . . . . . . . . . . . . . . g

    9 Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in PartX; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes,"complete Schedule D, Part IV . . . . . . . . . . . . . . . . . . . . . . . . . .

    10 Did the organization, directly or through a related organization, hold assets in temporarily restrictedendowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule 0, Part V . , 10

    11 If the organization ' s answer to any of the following questions Is "Yes ," then complete Schedule D, Parts VI,VII, VIII, IX, or X as applicable.

    a Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes,"complete Schedule D, Part VI . . . . . . . . . . . . . . . . . . . . . . . . . . 11 a

    b Did the organization report an amount for investments-other securities in Part X, line 12 that is 5% or moret t Pf it l t d i t X li 16? If "Yt " ls repors o a asse e n ar , neo es, comp ete Schedule D, Part VII . . . . . . . . 1lb

    c Did the organization report an amount for investments-program related in Part X, line 13 that is 5% or moret P 16? If "Yf it t l t d i t X lt " l h

    ` ,s o asse s repor e n ar , ine compo a es, ete Sc edule D, Part Vlll . . . . . . . . 11 c x

    d Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assetsd i P t X li 16? If "Y h lt " d D Pl t S

    ` ,nrepor e ,ar ne es, c e u e ,comp e e art IX . . . . . . . . . . . . . . 11d x

    e Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule 0, Part X 11ef Did the organization's separate or consolidated financial statements for the tax year include a footnote that addresses

    the organization's liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part X . 11f12 a Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes, " complete

    Schedule D, Parts XI, Xll, and Xlll . . . . . . . . . . . . . . . . . . . . . . . . . 12ab Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if

    the organization answered "No" to line 12a, then completing Schedule D, Parts Xl, XII, and X111 is optional . . . . . 12b

    X

    13 Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E . . . . 1314 a Did the organization maintain an office, employees, or agents outside of the United States? . . . . . 14a

    b Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking,fundraising, business, investment, and program service activities outside the United States, or aggregateforeign investments valued at $100,000 or more? If "Yes, " complete Schedule F, Parts I and IV. . . . . 14b

    15 Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any ` Sorganization or entity located outside the United States? If "Yes," complete Schedule F, Parts 11 and IV . . 15 JC

    16 Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistanceto individuals located outside the United States? If "Yes," complete Schedule F, Parts 111 and IV . . . . 16

    17 Did the organization report a total of more than $15,000 of expenses for professional fundraising services ont IXP l liA 6 d 11 ? If "Y " l S har , co umn ( ), nes an e es, comp ete c edule G, Part I (see instructions) . . . . . 17 x

    18 Did the organization report more than $15,000 total of fundraising event gross income and contributions onPart VIII, lines 1 c and 8a? If "Yes, " complete Schedule G, Part Il . . . . . . . . . . . . . . . 18 x

    19 Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a?If "Y s " m l t S h d l P t IllG, pe co e e c ue e , ar . . . . . . . . . . . . . . . . . . . . . 19

    20 a Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H . . . . . . 20ab If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? 20b

    Form 990 (2011)

  • `orm 990;201 I) ;4-h< o Page 4:

    Checklist of Required Schedules (continued)Yes No

    '21 Did the organization report more than $5,000 of grants and other assistance to any government or organizationIl" I" and . . . . .Yes, complete Schedule 1, Partsin the United States on Part IX, column (A), line 1 ? If 21

    22 Did the organization report more than $5,000 of grants and other assistance to individuals in the United States

    on Part IX, column (A), line 2? If "Yes," complete Schedule I, Parts I and Ill . . . . . . . . . . . . 22

    23 Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the

    organization's current and former officers, directors, trustees, key employees, and highest compensated

    Xemployees? If "Yes," complete Schedule J . . . . . . . . . . . . . . . . . . . . . . 23

    24a Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than$100,000 as of the last day of the year, that was issued after December 31, 2002? If "Yes," answer lines 24b

    through 24d and complete Schedule K. If "No, " go to line 25 . . . . . . . . . . . . . . . . 24a

    b Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception? . . 24b Nykc Did the organization maintain an escrow account other than a refunding escrow at any time during the year

    to defease any tax-exempt bonds? . . . . . . . . . . . . . . . . . . . . . . . . 24c ^-

    d Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year? . 24d

    25a Section 501 (c)(3) and 501 (c)(4) organizations . Did the organization engage in an excess benefit transaction

    with a disqualified person during the year? If "Yes," complete Schedule L, Part I . . . . . . . . . 25a

    b Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prioryear, and that the transaction has not been reported on any of the organization's prior Forms 990 or 990-EZ?If "Yes, " complete Schedule L, Part I . . . . . . . . . . . . . . . . . . . . . . . . 25b

    26 Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, ori f h f i l' f " " /tng as o e end o the organ zation e L, Part ll . .disqualified person outstand s tax year? I complete ScheduYes, 26 x

    27 Did the organization provide a grant or other assistance to an officer, director, trustee, key employee,substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled ^/entity or family member of any of these persons? If "Yes," complete Schedule L, Part Ill . . . . . . . 27 /^

    28 Was the organization a party to a business transaction with one of the following parties (see Schedule L,Part IV instructions for applicable filing thresholds, conditions, and exceptions):

    a A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV . 28ab A family member of a current or former officer, director, trustee, or key employee? If "Yes," complete

    Schedule L, Part IV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28b

    c An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof)was an officer, director, trustee, or direct or indirect owner? If "Yes, " complete Schedule L, Part IV . . .

    29 Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M 2930 Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified

    conservation contributions? If "Yes, " complete Schedule M . . . . . . . . . . . . . . . . 30

    31 Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,PartI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

    32 Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes,"complete Schedule N, Part ll . . . . . . . . . . . . . . . . . . . . . . . . . . 32 X

    33 Did the organization own 100% of an entity disregarded as separate from the organization under Regulationssections 301.7701-2 and 301.7701-3? If "Yes, " complete Schedule R, Part I . . . . . . . . . . . 33

    34 Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Parts ll, ill,d V li 1IV, an , ne . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34

    35a Did the organization have a controlled entity within the meaning of section 512(b)(13)? . . . . . . . 35ab Did the organization receive any payment from or engage in any transaction with a controlled entity within the

    i f i 512 13 ? If "Y l hb "mean ng o sect on ( ) es, comp)( ete Sc edule R, Part V, line 2 . . . . . . . . . . . 35b36 Section 501(c)(3) organizations . Did the organization make any transfers to an exempt non-charitable

    " "related organization? If Yes, complete Schedule R, Part V, line 2 . . . . . . . . . . . . . . 3637 Did the organization conduct more than 5% of its activities through an entity that is not a related organization

    and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R,Part V1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

    38 Did the organization complete Schedule 0 and provide explanations in Schedule 0 for Part VI, lines 11 and ,/19? Note. All Form 990 filers are required to complete Schedule 0 . . . . . . . . . . . . . . 38 A

    Form 990 (2011)

  • .Formuy0\2011) Afll ^rS L{^•'.r^ "s(, -1 i . i^ Page5

    L1 : Statements Regarding Other IRS Filings and Tax ComplianceCheck if Schedule 0 contains a response to any question in this Part V

    Yes No

    4a Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable . . . . 1a

    b Enter the number of Forms W-2G included in line 1 a. Enter -0- if not applicable . . . . lbc Did the organization comply with backup withholding rules for reportable payments to vendors and

    reportable gaming (gambling) winnings to prize winners? . . . . . . . . . . . . . . . . .

    2a Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax

    Statements, filed for the calendar year ending with or within the year covered by this return 2a

    b If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

    Note. If the sum of lines 1 a and 2a is greater than 250, you may be required to e-file (see instructions) .3a Did the organization have unrelated business gross income of $1,000 or more during the year? . . . .

    b If "Yes," has it filed a Form 990-T for this year? If "No,"provide an explanation in Schedule 0 . . . . .

    4a At any time during the calendar year, did the organization have an interest in, or a signature or other authority

    over, a financial account in a foreign country (such as a bank account, securities account, or other financialaccount)? . . . . . . . . . . . . . . . . . . .

    b If "Yes," enter the name of the foreign country: ► .....................6 ------------------------------------------------See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.

    5a Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? . . .

    b Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?

    C If "Yes" to line 5a or 5b, did the organization file Form 8886-T? . . . . . . . . . . . . . . .6a Does the organization have annual gross receipts that are normally greater than $100,000, and did the

    organization solicit any contributions that were not tax deductible? . . . . . . . . . . . . . .b If "Yes," did the organization include with every solicitation an express statement that such contributions or

    gifts were not tax deductible? . . . . . . . . . . . . . . . . . . . . . . . . . .

    7 Organizations that may receive deductible contributions under section 170(c).a Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods

    and services provided to the payor? . . . . . . . . . . . . . . . . . . . . . . . .

    b If "Yes," did the organization notify the donor of the value of the goods or services provided? . . . . .c Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was

    required to file Form 8282? . . . . . . . . . . . . . . . . . . . . . . . .

    d If "Yes," indicate the number of Forms 8282 filed during the year . . . . . . 7d

    e Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?

    f Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? .g If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?h If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?

    8 Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting

    organizations . Did the supporting organization, or a donor advised fund maintained by a sponsoringorganization, have excess business holdings at any time during the year? . . . . . . . . . . .

    9 Sponsoring organizations maintaining donor advised funds.

    a Did the organization make any taxable distributions under section 4966? . . . . . . . . . . . .

    b Did the organization make a distribution to a donor, donor advisor, or related person? . . . . . . .10 Section 501(c)(7) organizations . Enter:

    a Initiation fees and capital contributions included on Part VIII, line 12 . . . . . . . 10a Nb Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities . 10b

    11 Section 501(c)(12) organizations . Enter:

    a Gross income from members or shareholders . . . . . . . . . . . . . . . 11 ab Gross income from other sources (Do not net amounts due or paid to other sources N/

    against amounts due or received from them.) . . . . . . . . . . . . . . . 11b12a Section 4947(a)(1) non-exempt charitable trusts . Is the organization filing Form 990 in lieu of Form 1g41?

    b If "Yes," enter the amount of tax-exempt interest received or accrued during the year. . 12b k-13 Section 501(c)(29) qualified nonprofit health insurance issuers.

    a Is the organization licensed to issue qualified health plans in more than one state? . . . . . . . .Note . See the instructions for additional information the organization must report on Schedule O.

    b Enter the amount of reserves the organization is required to maintain by the states in whichthe organization is licensed to issue qualified health plans . . . . . . . 13b

    c Enter the amount of reserves on hand . . . . . . . . . . . . . . . 13c

    14a Did the organization receive any payments for indoor tanning services during the tax year? . . . . . .b If "Yes," has it filed a Form 720 to report these payments? If No, " provide an explanation in Schedule 0 .

    1c

    2b

    3a3b

    4a X

    5a

    5b

    Sc

    68

    6b

    7a 1 1)(7b

    7c

    7e

    7f

    7

    7h d'

    8 Al

    9a /^

    9b k

    12a1 N,

    13a

    14a I /X14bForm 990 (2011)

  • •F^rm 990 (2Ui 1) P,1ge

    Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a 'No"response to line 8a, 8b, or 1Ob below, describe the circumstances, processes, or changes in Schedule 0. See instructions.Check if Schedule 0 contains a response to any question in this Part VI . q

    Section A. Governing Body and ManagementYes No

    is Enter the number of voting members of the governing body at the end of the tax year. . la

    If there are material differences in voting rights among members of the governing body, or

    if the governing body delegated broad authority to an executive committee or similarcommittee, explain in Schedule 0.

    b Enter the number of voting members included in line 1 a, above, who are independent . lb

    2 Did any officer, director, trustee, or key employee have a family relationship or a business relationship with

    any other officer, director, trustee, or key employee? . . . . . . . . . . . . . . . . . . 2

    3 Did the organization delegate control over management duties customarily performed by or under the directl hi k ?ey empcers, directors, or trustees, or oyees to a management company or ot er personsupervision of off 3

    4 Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? 4

    5 Did the organization become aware during the year of a significant diversion of the organization's assets? 56 Did the organization have members or stockholders? . . . . . . . . . . . . . . . . . . 67a Did the organization have members, stockholders, or other persons who had the power to elect or appoint

    one or more members of the governing body? . . . . . . . . . . . . . . . . . . . . 7a

    b Are any governance decisions of the organization reserved to (or subject to approval by) members,stockholders, or persons other than the governing body? . . . . . . . . . . . . . . . . . 7b

    8 Did the organization contemporaneously document the meetings held or written actions undertaken duringthe year by the following:

    a The governing body? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8ab Each committee with authority to act on behalf of the governing body? . . . . . . . . . . . . 8b

    9 Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached ati i f "Y i' ? " Xthe organ zation s mail ng address es, provI de the names and addresses in Schedule 0 . . . g

    Section B. Policies (T.his Section B requests information about-policies not required by the Internal Revenue Code.)Yes No

    10a Did the organization have local chapters , branches , or affiliates ? . . . . . . . . . . . . . . 10ab If "Yes," did the organization have written policies and procedures governing the activities of such chapters,

    affiliates, and branches to ensure their operations are consistent with the organization ' s exempt purposes? 10bI la Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? 11a

    b

    12a

    Describe in Schedule 0 the process , if any , used by the organization to review this Form 990. k7ifDid the organization have a written conflict of interest policy? If "No," go to line 13 . . . . . . . .

    G

    12ab Were officers , directors , or trustees , and key employees required to disclose annually interests that could give rise to conflicts? 12b

    c Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes,"describe in Schedule 0 how this was done . . . . . . . . . . . . . . . . . . . . 12c

    13 Did the organization have a written whistleblower policy? . . . . . . . . . . . . . . . . . 1314 Did the organization have a written document retention and destruction policy? . . . . . . . . . 1415 Did the process for determining compensation of the following persons include a review and approval by

    independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision? 4.

    a The organization's CEO, Executive Director, or top management official . . . . . . . . . . . . 15ab Other officers or key employees of the organization . . . . . . . . . . . . . . . . . . . 15b

    If "Yes" to line 15a or 15b, describe the process in Schedule 0 (see instructions).16a Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement

    with a taxable entity during the year? . . . . . . . . . . . . . . . . . . . . . . 16ab If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its

    participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard theorganization's exempt status with respect to such arrangements ? . . . . . . . . . . . . . . 16b

    Section C . Disclosure17 List the states with which a copy of this Form 990 is required to be filed ► ----:n,1e,5 ---- --------------------------------------------18

    C--Section 6104 requires an organization to make its Forms 1023 (or 1024 if applicable), 990, and 990-T (Section 501(c)(3)s only)available for public inspection . Indicate how you made these available . Check all that apply.

    q Own website q Another' s website (2l Upon request19 Describe in Schedule 0 whether (and if so , how), the organization mad its gov ming documents, conflict of interest policy,

    and financial statements available to the public during the tax year. a acA

    20 State the name , physical address , and telephone number of the person who possesses the books and records of theorganization : > :rrn Jam Dy as ^o^cf I^c ,. do-/a t'r1,w-, !c 14,1.

    Form 990 (2011)

  • urm 39012011) ; . / ," . a, Z:- iti-L_• T/._/ -' / Page 7

    Compensation of Officers, Directors , trustees , Key Employees, Highest Compensated Employees, and(Independent ContractorsCheck if Schedule 0 contains a response to any question in this Part VII . . q

    Section A. Officers, Directors, Trustees, Key Employees , and Highest Compensated Employees

    la Complete this table for all persons required to be listed. Report compensation for the calendar _year ending with or within theorganization ' s tax year.

    • List all of the organization ' s current officers, directors , trustees (whether individuals or organizations), regardless of amount ofcompensation . Enter -0- in columns (D), (E), and (F) if no compensation was paid.

    • List all of the organization's current key employees, if any. See instructions for definition of "key employee."

    • List the organization ' s five current highest compensated employees (other than an officer, director , trustee , or key employee)who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100 , 000 from theorganization and any related organizations.

    • List all of the organization's former officers, key employees , and highest compensated employees who received more than$100,000 of reportable compensation from the organization and any related organizations. MR--

    • List all of the organization's former directors or trustees that received , in the capacity as a former director or trustee of theorganization , more than $10,000 of reportable compensation from the organization and any related organizations . i JPA c--,List persons in the following order: individual trustees or directors ; institutional trustees ; officers; key employees ; highestcompensated employees ; and former such persons.

    q Check this box if neither the organization nor any related organization compensated any current officer , director, or trustee.(C)

    A( I ^)

    Position(do not check more than one M)M) (E) (F)

    Name and Title Average box, unless person is both an Reportable Reportable Estimatedhours per officer and a director/trustee ) compensation compensation from amount ofweek

    (describe Q a 2 3 ,0 ofromthe

    relatedorganizations

    othercompensation

    hours for a m organization (W-2/1099-MISC) from therelated C: a -0 (W-2/1099 MISC) organization

    organizations and relatedin Schedule 2 organizations

    0)ig

    (1)Dct^/r^ lk P^11[lec'S / X Alo/>l- ^tC_ ^OnZ

    `2` J_^YGLr(6 GCG^C

    ----------------------, s^17l Y "O C /(o M^.2^ ,^a or 0 e -,& A

    AN--------------------------------------

    ___

    4- - -----------------------------------------------------------

    -M-----------------------------------------------------------

    8- - -----------------------------------------------------------

    9- - -----------------------------------------------------------

    SN----------------------------------------------------------

    M?----------------------------------------------------------

    (12?-------------------------------- --------------------------

    fM----------------------------------------------------------

    SA----------------------------------------------------------

    Form 990 (2011)

  • -••i m 19U t2011) v ....` Page t3

    ZME Section A. Officers, Directors , Trustees , Key Employees , and Highest Compensated Employees continued

    (C)

    A()

    g1)

    Position p(1 t^ (Fl(do not check more than one

    Name and title Average box, unless person is both an Reportable Reportable Estimatedhours per officer and a director/trustee) compensation compensation from amount ofweek o _ co

    =-n

    from related other(descnbe a a c the organizations compensationhours for q 55 0 m organization (W-211099-MISC) from therelated o w . (W-2/1099-MISC) organization

    organizations 3 and relatedin Schedule 2 organizations

    0) mM

    m 7

    is Qo-

    -----------------------------------------------------------

    Sis)----------------------------------------------------------

    --1-- ----------------------------------------------------------

    ------------------------------------------------(1s^----------

    ------------- ---------------------------------------------

    (20?----------------------------------------------------------

    -----------------------------------------(21^-----------------

    (22l----------------------------------------------------------

    (23^------------------ ----------------------------------------

    (24^----------------------------------------------------------

    ----------------------------------------------------------

    1b Sub-total . . . . . . . . . . . . . . . . . . . . 3 3G.X or^C

    c Total from continuation sheets to Part VII, Section A . . . . . i

    d Total (add lines lb and 1c . ► (4 1tt ae- o+J t-2 Total number of individuals (including but not limited to those listed above) who received more than $100.000 of

    from the organization ! 0

    3 Did the organization list any former officer, director, or trustee, key employee, or highest compensatedemployee on line 1 a? If "Yes," complete Schedule J for such individual . . . . . . . . . . . .

    4 - For any individual listed on line 1a, is the sum of reportable compensation and other compensation from theorganization and related organizations greater than $150,000? If "Yes," complete Schedule J for suchindividual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

    5 Did any person listed on line 1 a receive or accrue compensation from any unrelated organization or individualfor services rendered to the organization? If "Yes, " complete Schedule J for such person . . . . . .

    No

    Section B. Independent Contractors

    1 Complete this table for your five highest compensated independent contractors that received more than $100,000 ofcompensation from the organization. Report compensation for the calendar year ending with or within the organization's taxyear.

    (A)Name and business address

    (B)Description of services

    (C)Compensation

    D Pi

    2 Total number of independent contractors (including but not limited to tho a listed above) whoreceived more than $100,000 of compensation from the organization ®ll

    Form 990 (2011)

  • Form 090.(201 Page 9

    Statement of Revenue(A) 113) ,C 0

    Total revenue (elatd or Unrelated Pevenueexempt business excluded from taxfunctionrevenue

    revenue under sections512, 513, or 514

    .0 y! 13 Federated campaigns . . . la

    o b Membership dues . . . . 1b0c Fundraising events . . . . 1c

    t^-d Related organizations . . . id

    E e Government grants (contributions) le

    o f All other contributions, gifts, grants,and similar amounts not included above if I .3

    g Noncash contributions included in lines to-1f. $---------------------

    cc h Total. Add lines 1a-1f . ► / 73ar Business Code

    r0 a f2a

    uc olaw o S/o7yar.

    - -------b

    --- -------------d -------------------- -------------c

    z d

    -- ------ -------------- -E

    ------- - --------- -------- -e

    ------ ----o

    ------------------------------------ - --f All other program service revenue.

    g Total. Add lines 2a-2f . ► (a3 Investment income (including dividends, interest,

    and other similar amounts) . . . . . . . ►4 Income from investment of tax-exempt bond proceeds ►5 Royalties . . ►

    (i) Real (n) Personal

    6a Gross rents . .

    b Less: rental expenses

    c Rental income or (loss)

    d Net rental income or loss) . ►7a Gross amount from sales of () Securities (it) Other

    assets other than inventory

    b Less: cost or other basisand sales expenses

    c Gain or (loss)

    d Net gain or (loss) . . . . . ►

    0 8a Gross income from fundraising4) events (not including $

    of contributions reported on line 1 c).See Part IV, line 18 . . . . . a

    b Less: direct expenses . . . . bc - Net income or (loss) from fundraising events ►

    9a Gross income from gaming activities.See Part IV, line 19 . . . . a

    b Less: direct expenses . . . . bc Net income or (loss) from gaming activities . . ►

    10a Gross sales of inventory, lessreturns and allowances . a '20-5-02-

    b Less: cost of goods sold b /O 4773c Net income or (loss) from sales of inventory. . ► /O .29 /D,

    Miscellaneous Revenue Business Code

    11a------------------------------------------------

    b------------------------------------------------

    c------------------------------------------------

    d All other revenue . . . . .

    e Total. Add lines 11 a-11 d . . . . . . . . ►12 Total revenue . See instructions. . . . ► Jl / ,, 33

    Form 990 (2011)

  • rorm 990 (2011 ) 1 r ": ^^ ^f-w Pa e 10

    Statement of Functional Expenses

    Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are notrequired to complete columns (B), (C), and (D).

    Check if Schedule 0 contains a response to any question in this Part IX . qDo not include amounts reported on lines 6b, 7b,

    8b 9b and 10b of Part VIIL> >

    (A)Total expenses

    (B)Program service

    expenses

    (C)Management andgeneral expenses

    (D)Fundraisingexpenses

    1 Grants and other assistance to governments andorganizations in the United States . See Part IV , line 21

    2 Grants and other assistance to individuals inthe United States . See Part IV , line 22 . . .

    3 Grants and other assistance to governments,organizations , and individuals outside theUnited States . See Part IV , lines 15 and 16 . .

    4 Benefits paid to or for members . . . .5 Compensation of current officers, directors,

    trustees , and key employees . . . . . 3 3^7 3^3(v8

    6 Compensation not included above, to disqualifiedpersons (as defined under section 4958(f)(1)) andpersons described in section 4958(c)(3)(B) . .

    7 Other salaries and wages . . . . . .8 Pension plan accruals and contributions (include

    section 401(k) and 403 (b) employer contributions)

    9 Other employee benefits . . . . . . .

    10 Payroll taxes . . . . . . . . . . . /

    11 Fees for services (non-employees):

    a Management . . . . . . . . . .

    b Legal . . . . . . . . . . .

    c Accounting . . . . . . . . . . . 0 3

    d Lobbying . . . . . . . . . . . .

    e Professional fundraising services . See Part IV , line 17

    f Investment management fees . . . . .

    g Other 1114i1)16&w^ . . . . . . O /XO12 Advertising and promotion . . . . . .

    13 Office expenses . . . . . . . . . / L

    14 Information technology . . . . . . .

    15 Royalties . . . . . . . . . . . .

    16 Occupancy . . . . . . . . . . . b ys S17 Travel . . . . . . . . . . . . .18 Payments of travel or entertainment expenses

    for any federal , state, or local public officials

    19 Conferences , conventions , and meetings

    20 Interest . . . . . . . . . . . .

    21 Payments to affiliates . . . . . . . .

    22 Depreciation , depletion , and amortization . 9

    23 Insurance . . . . . . . . . . . . /8,07 67,

    24 Other expenses . Itemize expenses not coveredabove . ( List miscellaneous expenses in line 24e. Ifline 24e amount exceeds 10% of line 25 , column(A) amount , list line 24e expenses on Schedule 0.)

    a 7f? l --!tt------------------------------------b _Ll _;, 7P

    --------------- -------------------o CAT

    c Yo ) eee-'- fs--------------------------- p a 33d_-('i^ ; scP/lg gip, ----------------------------- I r Se All other expenses

    ----------------------- -----------25 Total functional expenses. Add lines 1 through 24e / 3 5Z I 326 Joint costs . Complete this line only if the

    organization reported in column (B) joint costsfrom a combined educational campaign andfundraisin g solicitation . Check here 0, q iffollowing SOP 98-2 (ASC 958-720) . . . .

    r^JV

    Form 990 (2011)

  • F)rm:)9O (2011) i ' I'L llr_,^y4^ r ; - °r _::2, j Page i I

    (A) (B)Beginning of year End of year

    I Cash-non-interest-bearing . . . . . . . . . . . . . . S S^ 1 /

    2 Savings and temporary cash investments . . . . . . . . . . 2

    3 Pledges and grants receivable, net . . . . . . . . . . . . 3 °4 Accounts receivable, net . . . . . . . . . . . . . . . 4

    5 Receivables from current and former officers, directors, trustees, key

    employees, and highest compensated employees. Complete Part II of

    Schedule L . . . . . . . . . . . . . . . . . . . . 5

    6 Receivables from other disqualified persons (as defined under section4958(f)(1)), persons described in section 4958(c)(3)(B), and contributingemployers and sponsoring organizations of section 501(c)(9) voluntaryemployees' beneficiary organizations (see instructions) . . . . . 6

    7 Notes and loans receivable, net . . . . . . . . . . . . . 7

    8 Inventories for sale or use . . . . . . . . . . . . . . . 8

    9 Prepaid expenses and deferred charges . . . . . t. 3 9 v10a Land, buildings, and equipment: cost or

    other basis. Complete Part VI of Schedule D 10a Sd 37

    b Less: accumulated depreciation . . . . 10b ' 10 10c 7j

    11 Investments-publicly traded securities . . . . . . . . . . 11

    12 Investments-other securities. See Part IV, line 11 . . . . . . . 12

    13 Investments-program-related. See Part IV, line 11 . . . . . . . 13

    14 Intangible assets . . . . . . . . . . . . . . . . . . 14

    15 Other assets. See Part IV, line 11 . . . . . . . . . . . . . 15

    16 Total assets . Add lines 1 through 15 (must equal line 34) . icy 16

    17 Accounts payable and accrued expenses . . . . . . . . . . o? 1(0(40 17

    18 Grants payable . . . . . . . . . . . . . . . . . . . 18

    19 Deferred revenue . . . . . . . . . . . . . . . . . . 19

    20 Tax-exempt bond liabilities . . . . . . . . . . . . . . . 2021 Escrow or custodial account liability. Complete Part IV of Schedule D . 21

    22 Payables to current and former officers, directors, trustees, keyemployees, highest compensated employees, and disqualified persons.Complete Part II of Schedule L . . . . . . . . . . . . . 22

    . 1 23 Secured mortgages and notes payable to unrelated third parties 23

    24 Unsecured notes and loans payable to unrelated third parties . . . 24

    25 Other liabilities (including federal income tax, payables to related thirdparties, and other liabilities not included on lines 17-24). Complete Part Xof Schedule D . . . . . . . . . . . . . . . . . . . 25

    26 Total liabilities . Add lines 17 throug h 25 c9 , / (0 26 3)-IOrganizations that follow SFAS 117, check here ► q and completelines 27 through 29, and lines 33 and 34.

    ro 27 Unrestricted net assets . . . . . . . . . . . . . . . . 2728 Temporarily restricted net assets . . . . . . . . . . . . . 2829 Permanently restricted net assets . . . . . . . . . . . . . 29

    Organizations that do not follow SFAS 117, check here ► X andcomplete lines 30 through 34.

    30 Capital stock or trust principal, or current funds . . . . . . . . 30y 31 Paid-in or capital surplus, or land, building, or equipment fund . . . 31a 32 Retained earnings, endowment, accumulated income, or other funds . 8 O. S6 3 32

    01 33 Total net assets or fund balances . . . . . . . . . . . . . 33 3 //34 Total liabilities and net assets/fund balances . .P 9 7.2 34 / Sb 3

    Form 990 (2011)

  • F rmY9O(2011) (/LLl^ f )1/1J r)^^c^ P ge1)2

    Reconciliation of Net AssetsCheck if Schedule 0 contains a response to any question in this Part XI . q

    1 Total revenue (must equal Part VIII, column (A), line 12) . . . . . . . . . . . . . . 1

    2 Total expenses (must equal Part IX, column (A), line 25) . . . . . . . . . . . . . 2

    3 Revenue less expenses. Subtract line 2 from line 1 . . . . . . . . . . . . . . . 3

    4 Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . . . 4

    5 Other changes in net assets or fund balances (explain in Schedule 0) . . . . . . . . . 5

    g Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33,

    column (B)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

    LL-!2 73S3 S 2-/3S 870,

    EEZM Financial Statements and ReportingCheck if Schedule 0 contains a response to any question in this Part XII . q

    Yes No

    1 Accounting method used to prepare the Form 990: q Cash Accrual El Other

    If the organization changed its method of accounting from' a prior year or checked "Other," explain in

    Schedule O.

    2a Were the organization's financial statements compiled or reviewed by an independent accountant? . . 2a

    b Were the organization's financial statements audited by an independent accountant? . . . . . . . 2b

    c If "Yes" to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight

    of the audit, review, or compilation of its financial statements and selection of an independent accountant? 2c XIf the organization changed either its oversight process or selection prgcess during the tax year, explain inSchedule O. Z/^

    d If "Yes" to line 2a or 2b, check a box below to indicate whether the fi ancial statements for the year wereissued on a separate basis, consolidated basis, or both:

    Separate basis q Consolidated basis El Both consolidated and separate basis

    3a As a result of a federal award, was the organization required to undergo an audit or audits as set forth in Jthe Single Audit Act and OMB Circular A-133? . . . . . . . . . . . . . . . . . . . . . 3a

    b If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the ^J ^^required audit or audits, explain why in Schedule 0 and describe any steps taken to undergo such audits 3b f

    Form 990 (2011)

  • . ;3CHEDUILE A (--'MB No. 15,15-0047

    form 090 or 990-M ? i hdac (charity Status and Public SupportComplete if the organization is a section 501 (c)(3) organization or a section

    1947(a)(1) nonexempt charitable trust .InternalInternal Revenue

    of thetheServiceTreasury

    > Attach to Form 990 or Form 990-FZ. Do- See separate instructions. o . .Intern

    Name oW te organization Employer identification number( Ug rh1p, C ara ^ Ja r:. -d6 3 4)0

    Reason for Public Charity Status (All organizations must complete this part.) See instructions.

    The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

    1 q A church, convention of churches, or association of churches described in section 170(b)(1)(A)().

    2 q A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

    3 q A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).4 q A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(/U(iiuJ. Enter the

    hospital's name, city, and state:------------------------------------------------------------------------------------------------------------------------•

    5 q An organization operated for the benefit of a college or university owned or operated by a governmental unit described insection 170(b)(1)(A)(iv). (Complete Part II.)

    6 q A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).7 q An organization that normally receives a substantial part of its support from a governmental unit or from the general public

    described in section 170(b)(1)(A)(vi). (Complete Part II.)

    8 q A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

    9 An organization that normally receives : (1) more than 331/3% of its support from contributions, membership fees, and gross,receipts from activities related to its exempt functions-subject to certain exceptions , and (2) no more than 331/3% of itssupport from gross investment income and unrelated business taxable income (less section 511 tax) from businessesacquired by the organization after June 30, 1975 . See section 509(a)(2). (Complete Part 111.)

    10 q An organization organized and operated exclusively to test for public safety . See section 509(a)(4).

    11 q An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out thepurposes of one or more publicly supported organizations described in section 509(a)( 1) or section 509(a)(2). See section509(a)(3). Check the box that describes the type of supporting organization and complete lines 11 a through 11 h.

    a q Type I b q Type II c q Type Ill-Functionally integrated d q Type III--Othere q By checking this box , I certify that the organization is not controlled directly or indirectly by one or more disqualified persons

    other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1)or section 509(a)(2).

    f If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supportingorganization , check this box . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . q

    g Since August 17, 2006 , has the organization accepted any gift or contribution from any of thefollowing persons?

    (i) A person who directly or indirectly controls, either alone or together with persons described in (ii) and Yes No(iii) below , the governing body of the supported organization ? . . . . . . . . . . . . . .

    f1g0,(ii) A family member of a person described in (i) above? . . . . . . . . . . . . . . . . .1190.1

    (iii) A 35% controlled entity of a person described in (i) or (ii) above? . . . . . . . . . . . . .h Provide the following information about the supported organization(s).

    (i) Name of supportedorganization

    n EIN (Iii) Type of organization(described on lines 1-9above or IRC section(see instructions ))

    (iv) Is the organizationin col () listed in yourgoverning document?

    (v) Did you notifythe organization in

    col () of yoursupport?

    (vi) Is theorganization in col(1) organized in the

    U.S.?

    (vii) Amount ofsupport

    Yes No Yes No Yes No

    (A) 0

    (B)

    (C)

    (D)

    (E)

    Total

    For Paperwork Reduction Act Notice, see the Instructions for Cat. No. 11285E Schedule A (Form 990 or 990- EZ) 2011Form 990 or 990-EZ.

  • Schedule (Form b9O or 99O-E2) 2011 Page 2

    Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1 )(A)(vi)(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under

    Part HI. If the organization fails to qualify under the tests listed below, please complete Part III.)

    Section A. Public SupportCalendar year (or fiscal year beginning in) ► (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 f) Total

    I Gifts, grants, contributions, andmembership fees received. (Do notinclude any 'unusual grants.') . . .

    2 Tax revenues levied for theorganization's benefit and either paidto or expended on its behalf . . .

    3 The value of services or facilitiesfurnished by a governmental unit to theorganization without charge . . . .

    4 Total. Add lines 1 through 3 . . . .

    5 The portion of total contributions byeach person (other than agovernmental unit or publiclysupported organization) included online 1 that exceeds 2% of the amountshown on line 11, column (t) . .

    6 Public support. Subtract line 5 from line 4.

    Section B. Total SupportCalendar year (or fiscal year beginning in) ►

    7 Amounts from line 4 . . . . . .

    8 Gross income from interest, dividends,payments received on securities loans,rents, royalties and income from similarsources . . . . . . . . . .

    9 Net income from unrelated businessactivities, whether or not the businessis regularly carried on . . . . .

    10 Other income. Do not include gain orloss from the sale of capital assets(Explain in Part IV.) . . . . . . .

    1112

    13

    Total support . Add lines 7 through 10Gross receipts from related activities, etc. (see instructions) . . . . . . . . . . . . 12First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3)organization, check this box and stop here . . . . . . . . . . . . . . . . . . . . . . . . . ► E]

    Section C. Computation of Public Support Percentage14 Public support percentage for 2011 (line 6, column (f) divided by line 11, column (f)) . . . . 14 %

    15 Public support percentage from 2010 Schedule A, Part II, line 14 . . . . . . . . . . 15 %16a 331/3% support test-2011 . If the organization did not check the box on line 13, and line 14 is 331/3% or more, check this

    box and stop here. The organization qualifies as a publicly supported organization . . . . . . . . . . . ! 0

    b 331,3% support test-2010. If the organization did not check a box on line 13 or 16a, and line 15 is 331n% or more,check this box and stop here. The organization qualifies as a publicly supported organization . . . . . . . ►

    17a 10%-facts-and-circumstances test-2011 . If the organization did not check a box on line 13, 16a, or 16b, and line 14 is10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain inPart IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supportedorganization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ► 0

    b 10%-facts -and-circumstances test-2010. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publiclysupported organization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . !a J

    18 Private foundation . If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and seeinstructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ► 0

    a 2007 (b) 2008 c 2009 (d) 2010 (a) 2011 Total

    Schedule A (Form 990 or 990-EZ) 2011

  • `schedule A kForm 99O or 990-EZ) 2011 , ,•' + e, f , ► - ,

    Support Schedule for Organizations Described in Section 509(a)(2)

    (Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II.

    If the organization fails to qualify under the tests listed below, please complete Part II.)

    Section A. Public SupportCalendar year (or fiscal year beginning in) ► (2) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total

    1 Gifts, grants, contributions, and membership feesreceived. (Do not include any 'unusual grants.') 63 1 / 0 ?j

    ^ 708

    2 Gross receipts from admissions, merchandise ^sold or services performed, or facilitiesfurnished in any activity that is related to the

    '/o

    Odj /60(41-- / I^S7 /37 a 3, /a ro / l ^a 8^^s tax-exempt purpose . . .organization eGross receipts from activities that are not an3unrelated trade or business under section 513

    4 Tax revenues levied for theorganization's benefit and either paidto or expended on its behalf . . .

    5 The value of services or facilitiesfurnished by a governmental unit to theorganization without charge . . . .

    6 Total . Add lines 1 through 5 . . . . /8 YI /,17( l^ S / 38 I - a 7 g'X0 55 S197a Amounts included on lines 1, 2, and 3

    received from disqualified persons

    b Amounts included on lines 2 and 3received from other than disqualifiedpersons that exceed the greater of $5,000or 1 % of the amount on line 13 for the year

    c Add lines 7a and 7b . . . . . .

    8 Public support (Subtract line 7c from

    line 6.) . . . . . . . . . W,7y^ 3

    Section B. Total SupportCalendar year (or fiscal year beginning in) ►9 Amounts from line 6 . . . . . .

    10a Gross income from interest, dividends,payments received on securities loans, rents,royalties and income from similar sources .

    b Unrelated business taxable income (lesssection 511 taxes) from businessesacquired after June 30, 1975. . . .

    c Add lines 10a and 10b . . . .

    11 Net income from unrelated businessactivities not included in line 10b, whetheror not the business is regularly carried on

    12 Other income. Do not include gain orloss from the sale of capital assets(Explain in Part IV.) . . . . . . .

    13 Total support. (Add lines 9, 10c, 11,and 12.) . . . . . . . . . .

    (a) 2007 ) 2008 c 2009 (d) 2010 a 2011 Totalf8L 8.^sz a-75 to 7S s

    O/o b160 4/v R7fY

    /3`/c) _fL ( o a all 791i_

    / 0?ff jY$1 76, /, .3/4-14 First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a'sectiprt 501(c)(3)

    organization, check this box and stop here . . . . . . . . . . . . . . . . . . . 4 ,1k [

    iection C. Computation of Public Support Percentage

    15 Public support percentage for 2011 (line 8, column (f) divided by line 13, column (f)) . . . 15 cj . o %16 Public support percentage from 2010 Schedule A, Part III, line 15 16 99. V 8 %iection D. Computation of Investment Income Percentage

    17 Investment income percentage for 2011 (line 1 Oc, column (f) divided by line 13, column (f)) . . 17 -37 %18 Investment income percentage from 2010 Schedule A, Part III, line 17 . . . . . . . . 18 . 3'3-19a 331/3% support tests-2011 . If the organization did not check the box on line 14, and line 15 is more than 331/3%, and line

    17 is not more than 331,3%, check this box and stop here . The organization qualifies as a publicly supported organization . ► jfb 331/3% support tests-2010. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 331/3%, and

    line 18 is not more than 331,3%, check this box and stop here. The organization qualifies as a publicly supported organization ► /20 Private foundation . If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions 7 q

    WASchedule A (Form 990 or 990-EZ) 2011

  • chedule.A (Form S90 or 990-EZ) 201 I !' ^^: = '^+ +^- . Page4 4

    supplemental Information . Complete this part to provide the explanations required by Part II, line 10;Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See

    • instructions).

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    Schedule A (Form 990 or 990-EZ) 2011

  • :;CHEDIULE D oNMB No 1545-0047

    ,Form y9O) !uppiementai Financial StatementsI

    ^O ,^> Complete if the organization answered "Yes," to Form 990,

    Department of the TreasuryPart IV , line 6, 7, 8, 9, 10, h a, 11 b, 11 c, lid, Ile , l i f, 12a , or 12b . a

    Internal Revenue Service > Attach to Form 990. > See separate instructions. x

    92-me o t organisation Employer i dentification number

    Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts . Complete if theorganization answered "Yes" to Form 990, Part IV, line 6. V

    (a) Donor advised funds (b) Funds and other accounts

    I Total number at end of year . . . . .

    2 Aggregate contributions to (during year) .

    3 Aggregate grants from (during year) . .

    4 Aggregate value at end of year . . . .

    5 Did the organization inform all donors and donor advisors in writing that the assets held in donor advised

    funds are the organization's property, subject to the organization's exclusive legal control? . . . . . . q Yes q No6 Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used

    only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose

    conferring impermissible private benefit? . . . . . . . . . . . . . . . . . . . . . . q Yes

    ZMEM Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

    1 Purpose(s) of conservation easements held by the organization (check all that apply).

    q Preservation of land for public use (e.g., recreation or education) q Preservation of an historically important land area

    q Protection of natural habitat q Preservation of a certified historic structure

    q Preservation of open space2 Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation

    easement on the last day of the tax year.

    No

    i I Held at the End of the Tax Year

    a Total number of conservation easements . . . . . . . . . . . . . . . . . 2a

    b Total acreage restricted by conservation easements . . . . . . . . . . . . . . 2b

    c Number of conservation easements on a certified historic structure included in (a) . . . . 2c

    d Number of conservation easements included in (c) acquired after 8/17/06, and not on ahistoric structure listed in the National Register . . . . . . . . . . . . . . 2d

    3 Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during thetax year ►

    ---------------------------4 Number of states where property subject to conservation easement is located ►

    ----------------------5 Does the organization have a written policy regarding the periodic monitoring, inspection, handling of

    violations, and enforcement of the conservation easements it holds? . . . . . . . . . . . . . q Yes q No

    6 Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year

    ê-

    211^----------------------7 Amount of expenses incurred in monitoring, inspecting , and enforcing conservation easements during the year

    D11. $----------------------

    8 Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? . . . . . . . . . . . . . . . . . . . . . . . . . . q Yes q No

    9 In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, andbalance sheet , and include , if applicable, the text of the footnote to the organization's financial statements that describes theorganization 's accounting for conservation easements.

    Organizations Maintaining Collections of Art, Historical Treasures , or Other Similar Assets. /Complete if the organization answered "Yes" to Form 990 , Part IV, line 8.

    1a If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheetworks of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance ofpublic service, provide, in Part XIV, the text of the footnote to its financial statements that describes these items.

    b If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheetworks of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance ofpublic service, provide the following amounts relating to these items:

    (i) Revenues included in Form 990, Part VIII, line 1 . . . . . . . . . . . . . . . . > $-----------------------------

    (ii) Assets included in Form 990, Part X . . . . . . . ► $-----------------------------

    2 If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide thefollowing amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

    a Revenues included in Form 990, Part VIII, line 1 . . . . . . . . . . . . . . . . . ► $-----------------------------

    b Assets included in Form 990, Part X ► $For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No 52283D Schedule D (Form 990) 2011

  • ci``dule U +Fo,m X90) 2011 (^ 1 , '^ y' _. 3 ^/ ^'ige 2

    (° • Organizations Maintaining Collections of Art, -Iistorical Treasures , or Other Similar Assets (continued)

    3 'Using the organization's acquisition, accession, and other records, check any of the following that are a significant use of its':ollectlon items (check all that apply):

    a q Public exhibition ii q Loan or exchange programs

    b q Scholarly research e q Other -----------------------------------------------------------------c q Preservation for future generations

    4 Provide a description of the organization's collections and explain how they further the organization's exempt purpose in Part

    XIV.

    5 During the year, did the organization solicit or receive donations of art, historical treasures, or other similar

    assets to be sold to raise funds rather than to be maintained as part of the organization's collection? . . q Yes q No

    Escrow and Custodial Arrangements . Complete if the organization answered "Yes" to Form 990, Part IV„ /

    line 9, or reported an amount on Form 990, Part X, line 21. /v

    1a Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets notincluded on Form 990, Part X? . . . . . . . . . . . . . . . . . . . . . . . . . . q Yes q No

    b If "Yes," explain the arrangement in Part XIV and complete the following table:Amount

    c Beginning balance . . . . . . . . . . . . . . . . . . . . . . 1c

    d Additions during the year . . . . . . . . . . . . . . . . . . . 1d

    e Distributions during the year . . . . . . . . . . . . . . . . . . le

    f Ending balance . . . . . . . . . . . . . . . . . . . . . . . if

    2a Did the organization include an amount on Form 990, Part X, line 21? . . . . . . . . . . . . . q Yes q No

    b If "Yes," explain the arran gement in Part XIV.Endowment Funds . Complete if the organization answered "Yes" to Form 990, Part IV , line 10. ^^

    (a) Current year (b) Prior year (c) Two years back (d) Three years back a Four years back

    1a Beginning of year balance

    b Contributions . . . . . . .c Net investment earnings, gains, and

    losses . . . . . . . . . .

    d Grants or scholarships . . . .e Other expenditures for facilities and

    programs . . . . . . . . .

    f Administrative expenses . . . .

    g End of year balance . . . . .

    2 Provide the estimated percentage of the current year end balance (line 1 g, column (a)) held as:

    a Board designated or quasi-endowment ►-------------------

    %

    b Permanent endowment ► %c Temporarily restricted endowment ► %

    -------------------The percentages in lines 2a, 2b, and 2c should equal 100%.

    3a Are there endowment funds not in the possession of the organization that are held and administered for theorganization by: Yes No(i) unrelated organizations . . . . . . . . . . . . . . . . . . . . . . . . . . . 3a(i)

    (ii) related organizations . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3a ii)

    b If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? . . . . . . 3b4 Describe in Part XIV the intended uses of the organization's endowment funds.

    + ' Land, Buildings , and Equipment. See Form 990, Part X, line 10.Description of property (a) Cost or other basis

    (investment)(b) Cost or other basis

    (other)(c) Accumulated

    depreciation(d) Book value

    la Land . . . . . . . . . . .

    b Buildings . . . . . . . . . .

    c Leasehold improvements . . . .

    d Equipment . . . . . . . . . / fpm rG>oe Other . . . . . . . . . . . 911-13

    Total . Add lines 1 a through 1 e. (Column (d) must equal Form 990, Part X, column (B), line 10(c)) . ► q7Schedule 0 (Form 990) 2011

  • Schedule U (Form 990) 2011 jf X i}/1L •,r ^1^.: ^, ^i^ ,^ %^`^ J ^^ •1 J .^ r eye 3

    a,r. Investments - Other Securities . See Form 990 . Part X . tine 12.

    ti) Description or security or category(including name of security)

    (b) Book value (c) Method of valuationfi& 9/Cost or end of-year market value

    (1) Financial derivatives . . . . . . . .

    (2) Closely-held equity interests . . . . . .

    (3) Other---------------------------

    (A)-------------------------------------------------------------------(B)

    -------------------------------------------------------------------(C)

    --------------- ---------------------------------------(D)

    --------------------------------------------------------(E)----------------------------------------------------^----(---------

    - ------------------------------------------------------------------(G)

    -------- -----------------------------------------------(H)-------------------------------------------------------------------

    Total. Column must ual Form 990, Part X, cot. line 12.) IN-

    III Investments -Pro ram Related. See Form 990, Part X, line 13.

    (a) Description of investment type (b) Book value (c) Method of valuation: fflACost or end-of-year market value1

    (2)

    (3)(4)

    (5)(6)(7)

    (8)

    (9)

    ( 10)Total. (Column (b) must equal Form 990, Part X, col. (B) line 13.) 10-

    I

    Other Assets. See Form 990, Part X, line 15.(a) Description (b) Book value

    Total . (Column (b) must equal Form 990, Part X, col. (B) line 15.) . . . . . ►Other Liabilities . See Form 990, Part X, line 25.

    1. (a) Description of liability (b) Book value

    (1) Federal income taxes

    (4)

    (5)

    (7)

    (9)

    (10)

    (11)

    Total. (Column (b) must equal Form 990, Part X, col. (B) line 25.) Do.

    2. FIN 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports theorganization ' s liability for uncertain tax positions under FIN 48 (ASC 740).

    Schedule 0 (Form 990) 2011

  • chedule O (For in 990) 2011 (/ ya L r 4

    '1econciliation of Change in Net Assets from Form 990 to Audited Financial Statements

    I Total revenue (Form 990, Part VIII, column (A), line 12) . . . . . . . . . . . . . I

    2 rotal expenses (Form 990, Part IX, column (A), line 25) . . . . . . . . . . . . . I 2

    a Excess or (deficit) for the year. Subtract line 2 from line 1 . . . . . . . . . . . . .

    4 Net unrealized gains (losses) on investments . . . . . . . . . . . . . . . . .

    5 Donated services and use of facilities . . . . . . . . . . . . . . . . . . .

    6 Investment expenses . . . . . . . . . . . . . . . . . . . . . . . . .

    7 Prior period adjustments . . . . . . . . . . . . . . . . . . . . . . . .

    8 Other (Describe in Part XIV.) . . .

    9 Total adjustments (net). Add lines 4 through 8 . . . . . . . . . . . . . . . . .

    10 Excess or (deficit) for the year per audited financial statements. Combine lines 3 and 9 . . .

    Reconciliation of Revenue per Audited Financial Statements With Revenue

    1 Total revenue, gains, and other support per audited financial statements . . . . . . . .

    2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:

    a Net unrealized gains on investments . . . . . . . . . . . . 2a

    b Donated services and use of facilities . . . . . . . . . 2b

    c Recoveries of prior year grants . . . . . . . . . . . . . . 2c

    d Other (Describe in Part XIV.) . . . . . . . . . . . . . . . 2d 73

    e Add lines 2a through 2d . . . . . . . . . . . . . . . . . . . . . . . . .

    3 Subtract line 2e from line 1 . . . . . . . . . .

    4 Amounts included on Form 990, Part VIII, line 12, but not on line 1 :

    a Investment expenses not included on Form 990, Part VIII, line 7b . . 4a

    b Other (Describe in Part XIV.) . . . . . . . . . . . . . . . 4b

    c Add lines 4a and 4b . . . . . . . . . . . . . . . . . . . . . . . . . .

    5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part 1, line 12.) . . . . . . .

    Reconciliation of Expenses per Audited Financial Statements With Expenses I

    1 Total expenses and losses per audited financial statements . . . . . . . . . . . . .

    2 Amounts included on line 1 but not on Form 990, Part IX, line 25:

    a Donated services and use of facilities . . . . . . . . . . . 2a

    b Prior year adjustments . . . . . . . . . . . . . . . . 2bc Other losses . . . . . . . . . . . . . . . . . . . . 2c

    d Other (Describe in Part XIV.) . . . . . . . . . . . . . . . 2d / C9 0-75e Add lines 2a through 2d . . . . . . . . . . . . . . . . . . . . . . . . .

    3 Subtract line 2e from line 1 . . . . . . . . . . . . . . . . . . .

    4 Amounts included on Form 990, Part IX, line 25, but not on line 1:

    a Investment expenses not included on Form 990, Part VIII, line 7b . . 4a

    b Other (Describe in Part XIV.) . . . . . . . . . . . . . . . 4b

    c Add lines 4a and 4b . . . . . . . . . . . . . . . . . . . . . . . . . .5 Total expenses. Add lines 3 and 4c. (This must equal Form 990. Part 1, line 18.) . . . . . . .

    Information

    .. .7- 1

    10

    Return

    FT-1-

    2e 1 /v o7,3 //81, c7J

    4c

    5 /l^073Return1 ifo7. S45/

    2e V71

    3 /s:?i21

    4c

    5 /.S3 .ra

    Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1 a and 4; Part IV, lines 1 b and 2b;Part V, line 4; Part X, line 2; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provideany additional information.

    -----------------------------------

    -----------

    -- ------------------------- -----

    P,-'o- x///-------------------------------------------------------- ^- 1-'Ae ------2--60----

    r or (7C-V'* I 'o i--^

    r

    A 49 73

    Schedule D (Form 990) 2011

  • r',qe 5' hedule U(Furin'JU) 2011 J}^ ^ .ti / r r^ 1 = .,, .. ( , ,' '2

    Supplemental Information (continued)1--,:

    -----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

    ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

    ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

    Schedule D (Form 990) 2011

  • :CHE6? /E 0x.380 or J90-EZ)

    liapartment of the TreasuryInternal Revenue Service

    3upp emental in ormaton to Form 990 or 99O-EZComplete to provide information for responses to specific questions on

    Form 990 or 990-EZ or to provide any additional information.

    > Attach to Form 990 or 990-i Z.

    0MB No. 1545-0047

    Name of the organization Employer identification number

    (9ue c114

  • rnnni

    ,Rev January 2013)

    Capanment of the Treasuryinternal Revenue Service

    -AppHcatcon for . xtension o'r lime to File anbxempt Organization Return

    File a separate application for each return.

    OMB No. 1545-1709

    • if you are filing for an Automatic 3-Month Extension, complete only Part I and check this box . . . . . . . . . . ►• if you are filing for an Additional (Not Automatic) 3-Month Extension, complete only Part II (on page 2 of this form).

    Do not complete Part /l unless you have already been granted an automatic 3-month extension on a previously filed Form 8868.

    Electronic filing (e-file). You can electronically file Form 8868 if you need a, 3-month automatic extension of time to file (6 months fora corporation required to file Form 990-1), or an additional (not automatic) 3-month extension of time. You can electronically file Form8868 to request an extension of time to file any of the forms listed in Part I or Part II with the exception of Form 8870, InformationReturn for Transfers Associated With Certain Personal Benefit Contracts, which must be sent to the IRS in paper format (seeinstructions). For more details on the electronic filing of this form, visit www.irs.gov/efile and click on a-file for Charities & Nonprofits.

    I iall Automatic 3-Month Extension of Time. Only submit original (no copies needed).A corporation required to file Form 990-T and requesting an automatic 6-month extension-check this box and completePart I only . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ► qAll other corporations (including 1120-C filers), partnerships, REMICs, and trusts must use Form 7004 to request an extension of timeto file income tax returns.

    Enter filer's identifying number, see instructions

    Type orName of exempt organization or other filer, see instructions. Employer identifi tion number (EIN) or

    print 4 iR L47tuber,

    street,and room or suite no . If a P.O. box , see instructions . Social security number (SSN)

    duebythe/d J

    A L'9)( n1due date for Ivil 1

    WT/`

    filing your City, town or post office, state, and ZIP code. For a foreign address, see instructions.retum. See

    5 l ^ f^ yi tLi/1^ ^f • SI/Oft. A v `rinstructions

    Enter the Return code for the return that this application is for (file a separate application for each return) . . . . . .

    ApplicationIs For

    ReturnCode

    ApplicationIs For

    ReturnCode

    Form 990 or Form 990-EZ 01 Form 990-T (corporation) 07

    Form 990-BL 02 Form 1041-A 08Form 4720 (individual) 03 Form 4720 09

    Form 990-PF 04 Form 5227 10Form 990-T (sec. 401 a or 408(a) trust) 05 Form 6069 11

    Form 990-T (trust other than above) 06 Form 8870 12

    • The books are in the care of ► - ----Sin ^---rf------------------- ----------------------------------------------------------------------------

    Telephone No. ► _____`7J --- FAX No . 10- R7/49(O4 T----------------------------------------------------- ---- ---------------------If the organization does not have an office or place of business in the United States, check this box . . . . . . . . . ►q

    • If this is for a Group Return, enter the organization 's four digit Group Exemption Number (GEN) . If this is

    for the whole group, check this box . . . ► q . If it is for part of the group, check this box . . . . P- q and attacha list with the names and EINs of all members the extension is for.

    I I request an automatic 3-month (6 months for a corporation required to file Form 990-1) extension of time

    until /77/9 - .20 f , to file the exempt organization return for the organization named above. The extension isfor the organization 's return for.

    ►0 calendar year 20 qr

    ► 0 tax year beginning D Erg , 20 /1 , and ending FP Nr_6 JO , 20 ^^.2 If the tax year entered in line 1 is for less than 12 months , check reason : q Initial return q Final return

    q Change in accounting period3a If this application is for Form 990-BL , 990-PF, 990-T, 4720 , or 6069 , enter the tentative tax, less any

    nonrefundable credits. See instructions. 3a $b If this application is for Form 990-PF , 990-T , 4720, or 6069 , enter any refundable credits and

    estimated tax payments made . Include any prior year overpayment allowed as a credit. 3b $c Balance due. Subtract line 3b from line 3a. Include your payment with this form , if required , by using

    EFTPS (Electronic Federal Tax Payment System). See instructions. 3c $Caution . If you are going to make an electronic fund withdrawal with this Form 8868, see Form 8453-EO and Form 8879-EO for payment instructions.

    For Privacy Act and Paperwork Reduction Act Notice, see instructions. Cat. No. 279160 Form 8868 (Rev. 1-2013)

  • OFC Board of Directors

    Peter J. Boehm

    1442 W Iowa Ave

    St Paul , MN 55108

    651-645-2760 H and 065 1-846-4669 Fax

    651-335-7576 Cell

    [email protected]

    Gerard L. Cafesjian

    5 S. 5th Street, #900Minneapolis , MN 55402

    a31- 2-3-/995

    Michelle Furrer, Campus Manager

    Como Park Zoo and Conservatory

    1225 Estabrook Drive

    Saint Paul, MN 55103651-207-0333 0651-755-1661 Cell

    651-487-8255 Faxmichelle [email protected]

    Bob Marabella935 W. Idaho Ave.

    St Paul , MN 551 17651-308-5981

    Mike L Merrick

    4085 Victoria St. NSt. Paul , MN 55126

    651-483-0806 H651-229-1269 Omerncks@usfamily net

    Clyde Boysen

    196 Maple St

    St Paul, MN 55106651-772-4853 Fax651-776-2399 H

    Arthur J. CurtzeP.O. 284

    State College , PA 16804814-234-3273 H814-574-0945 Cellartcurtze @comcast.net

    Trude Harmon

    780 Como Ave.

    St. Paul, MN 55103651-488-2983651-488-8019 Fax

    Carrie Martinson1513 California AveSt Paul, MN 55108612-600-8106 Cell

    Barbara J . Deneen754 W. Iowa Ave.

    St. Paul , MN 551 17651-215-0681 0651-215-0673 Fax651-489-0140 Hbarbara . [email protected])[email protected]

    Peggy Kipka

    1069 Thomas Ave.St Paul , MN 55104651-645-6027 Hpskipka@comcast net

    Linda C. McDonaldW. 10400 Balsam Court

    Frisco, TX 75034972-668-8693 H972-213-7888 [email protected]

    Ed Mishmash

    624 Greenway Avenue NOakdale, MN 55128651-731-3247

    Bill Nunn

    2825 Willow DriveHamel , MN 55340763-475-3350 H612-408-2848 Cbill [email protected]

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  • Nancy A. Peterson

    1442 W Iowa Ave.

    St. Paul , MN 55108651-645-2760 H

    peterson cr macalester edu

    Kevin Points2288 Maple Lane East

    Maplewood, MN 55109

    612-308-4180 Cellkpoints@alltechengineering corn

    James A. Weichert

    P.O. Box 50858Mendota, MN 55150952-484-4245 [email protected]

    John Willy733 Atlantic St.

    Maplewood, MN 5510965 1-776-9642

    Emeritus Member

    Keith Lowinske

    12826 Emmer Place

    Apple Valley, MN 55124

    651-456;,2774 0952-423-6080 H

    klowinske a charter.net

    Emeritus Member

    Lorraine Kenfield

    9550 Collegeview Rd , Apt 121Bloomington, MN 55437952-938-4382 H612-220-4382 Cell952-939.0533 Faxkenfi005@umn edu

    Emeritus Member

    Audrey French

    5450 Nolan Parkway, # 1 10Oak Park Heights , MN 55082651-275-3510 H

    Emeritus Member:

    Keith McCormick

    30 Irvine Park

    St. Paul, MN 55102763-913-2758 O651-224-0678 H

    keith c@i visi com

    Emeritus Member-

    Muriel W PoehlerManyways Ranch16318 93rd StRoyalton, MN 56373320-584-5959 H

    -i414?61E 2-or,- 2,

    Emeritus Member:

    Steven G. Kensinger

    31 1 1 W. 135th CircleBurnsville, MN 55337952-895-9221 0952-895-9180 Fax952-895-9164 H612-221-3400 Cell

    Emeritus Member:

    Robert HerskovitzMN Historical Society345 Kellogg Blvd. W.

    St Paul , MN 55102651-297-3896 0651-296- 9961 Fax651-222-7157 Hrobert herskovitz a mnhs.orgEmeritus Member:

    Victor A . Wittgenstein, Jr.195 Valleyside DriveSt. Paul , MN 551 19651-735-5697 H

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