locating form 990 elements

8/2/2019 Locating Form 990 Elements

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Form 990Department of the TreasuryInternal Revenue Service

Return of Organization Exempt From Income TaxUnder section 501 (c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung

benefit trust or private foundation)The organization may have to use a copy of this return to satisfy state reporting requirements.

OM B No . 1545-004711A For the 2011 calendar year, or tax year beginning , 2011, and ending

Open to PublicInspection,20

B Check if applicable:I I Address change\I Name change\I Initial return "I I TerminatedI I Amended returnr^^MM^tJ^CAppKcation pendingO*)

\Name oforganizat ionpoing Business AsJ^Jumber and street (or P.O. box if mail is not delivered to street address)

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

Room/suite

F Nam e and address of principal of f icer:

J xemptstatus: D501(c)(3) Ds01(c)( )< (insert no.) D4947(a)(1) or D527^ebste:^

D Employer identificationnumber

E Telephone number

G Gross receipts $H(a) Is h is a g r o u p r e t u r n for a f f i l i a t e s ? I I Yes I I NoH(b) Are all affil iates included? DYesDNo

If "No," attach a list, (see instructions)H(c) Group exemption number ^

K Form of organization:dCorporat ion I I Trust I I Assoc iat ion I I Other > L Year of format ion: M State of legal domicile:

Ave&Gn

K

R

E

1!1E Z

1

234567ab

89

10111213141516a

b171819202122BE

SummaryBriefly describe th e organization's mission or most significant activities:

Check this b ox -D if the organization discontinued its operations or disposed of more than 25Number of vot ing m embers of the governing body (Part VI , line 1 a )Number of independent voting members of the governing body (Part VI, line 1 b) . . . .Total number of individuals employed in calendar year 201 1 (Part V, line 2a)Total number of volunteers (estimate if necessary)Total unrelated b usiness revenue from Part VIII, column (C), line 12Net unrelated business taxable income from Form 990-T, l ine 34Contributions and grants (Part VIII, line 1h )Program service revenue (Part VIII, line 2g)Investment income (Part VIII, column (A), lines 3, 4, and 7d)Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 1 0c, and 1 1 e) . . .Total revenue add lines 8 through 11 (mus t equal Part VIII, colum n (A), line 12)Grants and similar a m ou nts pa id (Part IX, colum n (A), lines 1-3)Benefits paid to or for members (Part IX, column (A), line 4)Salaries, other compensation, employee benefi ts (Part IX, colum n (A), l ines 5-10)Professional fundraising fees (Part IX, column (A), line 11 e)Total fundraising expenses (Part IX, column (D), line 25) >Other expenses (Part IX, column (A), lines 11 a-11d, 11 f-24e)Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25)Revenue less expenses. Subtract l ine 18 from line 12Total assets (Part X, line 16)Total liabilities (Part X, line 26)Ne t assets or fund balances. Subtract l ine 21 from l ine 20

Prior Year

% o f3456

7a7b

Beginning of Current Year

Signature Block

its net assets.

Current Year

End of Y e a r

Under penalties of perjury, I declare that I have examined this return, including acco mpa nying sc hedules and statem ents, and to the b est of my know ledge and belief, it istrue, correc t, and complete. D eclaration of preparer (other than officer) is based on all informa tion of which preparer has any kn owledge.

SignHerePaidPreparerUse Only

f Signature of off icer

F Type or print name and tit lePrint/Type prepare r's name Preparer's signature

Firm's name ^Firm's address >

Date

Date , r-, ., PTINCheck [Jifsel f-employedFirm's EIN >Phone no .May the IRS discuss th is return with the preparer sh own ab ove? (see instructions)

For Paperwork R eduction Act Notice, see the separate instructions. Cat. No. 11282Y Form 990 (2011)


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Form 990 (2011) Page 2Statement of Program Service AccomplishmentsCheck if Schedule O contains a response to any question in this Part III D

1 Briefly d escribe the organization's mission:

Did the organization undertake any significant program services during the year which were no t listed on theprior Form 990 or 990-EZ? QYes DNoIf "Yes," describe these ne w services on Schedule O.Did the organization cease conducting, or make significant changes in how it conducts, any programservices? DYes DNoIf "Yes," describe these changes on Schedule O.Describe the organization's program service accomplishments for each of its three largest program services, as measured byexpenses. Section 501(c)(3) and 501(c)(4) organizations an d section 4947(a)(1) trusts are required to report the amount ofgrants an d allocations to othersJUafl4Ptal expenses, an d revenue, if any, fo r each program service reported.

4a (Code: ) (Expenses$*S including grants of $ ) (Revenue $

4b (Code: ) (Expenses $ including grants of $ i (Revenue $

4c (Code: ) (Expenses $ including grants of $ i (Revenue $

4d Other program services (Describe in Schedule O.)(Expenses $ including grants of $ ) (Revenue $4e Total program service expenses

Form 990 (2011)


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990 (2011) Page 3Checklist of Required Schedules

Is the organization described in section 501(c)(3) o r 4947(a)(1) (other than a private foundation)? If "Yes,"complete Schedule A 1Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? . . . 2Did 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 3Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501 (h)election in effect during the tax year? If "Yes," complete Schedule C, Part II 4Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues,assessments, o r similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,Part III 5Did 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 6Did the organization receive or hold a conservation easement, including easements to preserve open space,th e environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part II . . . 7Did the organization maintain collections o f works o f art, historical treasures, o r other similar assets? If "Yes,"complete Schedule D, Part III 8Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in PartX; o r provide credit counseling, debt management, credit repair, o r debt negotiation services? If "Yes,"complete Schedule D, Part IV gDid the organization, directly or through a related organization, hold assets in temporarily restrictedendowments, permanent endowments, o r quasi-endowments? If "Yes," complete Schedule D, Part V . . 10If 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.Did the organization report an amount fo r land, buildings, an d equipment in Part X , line 10? If "Yes,"complete Schedule D, Part VI 11aDid the organization report an amount for investm entsother securities in Part X, line 12 that is 5% or moreof its total assets reported in Part X , line 16? If "Yes," complete Schedule D, Part VII 11bDid the organization report an amount for investmentsprogram related in Part X, line 13 that is 5% or moreo f its total assets reported in Part X , line 16? If "Yes," complete Schedule D, Part VIII 11cDid the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assetsreported in Part X , line 16? If "Yes," complete Schedule D, Part IX 11dDid the organization report an amount fo r other liabilities in Part X, line 25? If "Yes," complete ScheduleD, PartX 11ef Did the organization's separate or consolidated financial statements for the tax year include a footnote that addressesthe organization's liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part X . -\ fDid the organization obtain separate, independent audited financial statements for the tax year? If "Yes," completeSchedule D, Parts XI, XII,an d XIII 12 aW as the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and ifthe organization answered "No" to line 12a, then completing Schedule D, Parts XI, XII, andXIII is optional 12bIs the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E . . . . 13Did the organization maintain an office, employees, or agents outside of the United States? 14aDid 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 o r more? If "Yes," complete Schedule F, Parts I and IV 14bDid the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to anyorganization or entity located outside the United States? If "Yes," complete Schedule F, Parts II and IV .. 15Did the organization report on Part IX , column (A), line 3, more than $5,000 o f aggregate grants o r assistanceto individuals located outside th e United States? If "Yes," complete Schedule F, Parts I I I and IV . . . . - \QDid the organization report a total of more than $15,000 of expenses for professional fundraising services onPart IX , column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see nstructions) 17Did the organization report more than $15,000 total of fundraising event gross income and contributions onPart VIII, lines 1c and 8a?/f "Yes," complete Schedule G, Part II 18Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a?If "Yes," complete Schedule G, Part III 19Did the organization operate one o r more hospital facilities? If "Yes," complete Schedule H 20aIf "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? . 20b

Form 990 (2011)

Yes No


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Form 990 (2011) Page 4Checklist of Required Schedules (continued)

21 Did the organization report more than $5,000 of grants an d other assistance to any government or organizationin the United States on Part IX, column (A), ine 1? If "Yes," complete Schedule I, Parts I and II 21

22 Did the organization report more than $5,000 of grants an d other assistance to individuals in the United Stateson Part IX, column (A), ine 2? If "Yes," complete Schedule I, Parts I and III 2223 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 compensatedemployees? If "Yes," complete Schedule J 2324a 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 wa s issued after December 31, 2002? If "Yes," answer l ines 24bthrough 24d and complete Schedule K. If "No," go to line 25 24 ab Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception? . . 24bc Did the organization maintain an escrow account other than a refunding escrow at any time during the year

to defease any tax-exempt bonds? 24cd 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 transactionwith a disqualified person during the year? If "Yes," complete Schedule L, Parti 25 a

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, ke y employee, highly compensated employee, ordisqualified person outstanding as of the end of the organization's ta x year? If "Yes," complete Schedule L, Part II .. 2627 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% controlledentity or family member of any of these persons? If "Yes," complete Schedule L, Part III 27

28 Was the organization a party to a business transaction with one of the following parties (see Schedule L,Part IV nstructions 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 . , 28 ab A family member of a current or former officer, director, trustee, or key employee? If "Yes," completeSchedule L, Part IV 28 bc 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, Par t IV . . . 28c29 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 qualifiedconservation contributions? If "Yes," complete Schedule M 3031 Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,

Parti 3132 Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes,"complete Schedule N, Part II 3233 Did the organization own 100% of an entity disregarded as separate from the organization under Regulations

sections 301.7701 -2 and 301.7701-3? If "Yes," complete Schedule R, Part I 3334 Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Parts II , III,

IV, and V, line 1 3435a Did the organization have a controlled entity within the meaning of section 512(b)(13)? 35a

b Did the organization receive any payment from or engage in any transaction with a controlled entity within themeaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 35 b

36 Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitablerelated organization? If "Yes," complete Schedule R, Part V, line 2 36

37 Did the organization conduct more than 5% of its activities through an entity that is not a related organizationan d that is treated as a partnership fo r federal income tax purposes? If "Yes," complete Schedule R,Part VI 3738 Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and19? Note. All Form 990 filers are required to complete Schedule O 38

Form 990 (2011)

Yes No


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Form 990 (2011) Page 5Statements Regarding Other IRS Filings and Tax ComplianceCheck if Schedule O contains a response to any question in this Part V . D

' Yes | No1s Enter the number reported in Box 3 of Form 1096. En ter -0- i f not applicable . . . . 1ab Enter the number of Forms W-2 G included in line 1 a. En te r - 0 - i f not applicable . . . . 1bc Did the organization comply with backup withholding rules for reportable payments to vendors andreportable gaming (gambling) winnings to prize winners? 1c

2a Enter the number of employees reported on Form W-3, Transmittal of Wage and TaxStatements, 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 orga nization file all required federal em ployment tax returns? . 2bNote. If the sum of lines 1a and 2a is greater than 250, you m ay be required to e-file (see instructions) .3a Did he organization have unrelated business gross income of $1,000 or more during the year? . . . . 3ab If "Yes," has it filed a Form 990-T for this year? If "No,"provide an explanation in Schedule O | 3b

4a At any time during the calenda r year, did the orga nization have an interest in, or a signature or other authorityover, a financial account in a foreign country (such as a bank account, securities account, or other financialaccount)? 4ab If "Yes," enter the name of the foreign country: ^-See instructions or filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.

5a Was he organization a party to a prohibited tax shelter transaction at any time during the tax year? . . . 5ab Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction? 5bc If "Yes" to line 5a or 5b, did the orga nization file Form 8886-T? | 5c

6a Does the organization have annual gross receipts that are normally grea ter than $100,000, and did theorganization solicit a ny contributions that were not tax deductible? 6ab If "Yes," did the organization include with every solicitation an express statement that such contributions orgifts we re not tax deductible? 6b7 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 goodsand services provided to the payor?

b If "Yes," did the orga nization notify the donor of the value of the goods or services provided? 7bc Did the organiza tion sell, exchang e, or otherwise dispose of tangible pe rsonal property for which it wasrequired to fi le Form 8282? 7Cd If "Yes ," indicate the number of Forms 8282 filed during the year | 7de Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit co ntract? I 7ef Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? . 7fg If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? 7gh If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? I 7h

8 Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supportingorganizations. Did the supporting organization, or a donor advised fund maintained by a sponsoringorganization, have exce ss business holdings at any time during the year? 8

9 Sponsoring organizations maintaining donor advised funds.a Did the orga nization make any taxa ble distributions under section 4966? 9ab Did the organization make a distribution to adonor, donor advisor, or related person? 9b

10 Section 501(c)(7) organizations. Enter:a Initiation fees and capital contributions included on Part VIII, line 12 10ab Gross rece ipts, included on Form 9 90, 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 11ab Gross income from other sources (Do not net amounts due or paid to other sourcesagainst amounts due or received from them.)

12a Section 4947(a}(1) non-exempt charitable trusts. Is the orga nization filing F orm 990 in lieu of Form 1041? 12ab If "Yes," enter the amount of tax-exempt interest received or accrued during the year. . | i2b

13 Section 501 (c)(29) qualified nonprofit health insurance issuers.a Is the organiza tion licensed to issue qualified health plans in more than one state? 13aNote. 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 orga nization is licensed to issue qualified health plans -I3jj

c Enter the amo unt of reserves on hand 13c14a Did the organization rece ive any payme nts for indoor tanning services during the tax year? 114ab If "Yes," has it filed a Form 720 to report thes e payme nts? If "No," provide an explanation in Schedule O . 14b

Form 990 (2011)


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Form 990 (2011) Page 6Governance, Management, and Disclosure Fo r each "Yes" response to lines 2 through 7b below, and for a "Wo"response to line 8a, 8b, or 10 b below, describe the circumstances, processes, or changes in Schedule 0. See instructions.

Section A. Governing Body and Management1a Enter the number of voting members of the governing body at the end of the tax year . . 1a

If there are material di fferences in voting r ights among members of the governing body, orif the governing body delegated broad authority to an executive committee or similarcommittee, explain in Schedule O.b Enter the number of voting members included in line 1a, above, who are independent . 1b2 Did any officer , director, trustee, or key em ployee have a fam ily relationship or a business relationship withan y other officer director trustee or key employee''

3 Did the organization delegate control over managem ent duties customarily performed by or under the directsupervision of officers, directors, or trustees,or key employees o a management company or other person?4 Did the organization make any significant changes to its governing documents since the prior Form 9 90 was filed?5 Did the organization become aware during theyear of asignificant diversion of the organization's assets? .6 Did the organization have mem bers or stockholders?7a Did the organization have mem bers, stockholders, or other persons who had the power to elect or appointon e or more mem bers of the governing body''b Are any governance decisions of the organization reserved to (or subject to approval by) members,stockholders or persons other than the governing body?

8 Did the organization contemporaneously document the meetings held or written actions undertaken duringthe year by the fol lowing:a The governing body?b Each comm ittee with authori ty to act on behalf of the governing body?9 Is there any office r, director, trustee, or key em ployee listed in Part VII, Section A, who can not be reached atthe organization's m ailing address? If "Yes " provide the names and addresses in Schedule O

234567a7b

8a8b9

Yes No

Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)10a Did the organiza tion have local chapte rs, branches, or affil iates?b If "Yes," did the organization have written policies an d procedures governing the activities of such chapters,affiliates, and branches to ensure their operations areconsistent with the organ ization's exempt purposes?1 1a Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form?

b Describe in Schedule O the process, if any, used by the organization to review this Form 990.12a Did the organiza tion have a written con flict of interest policy? If "No," go to line 13b Were officers, directors, o r trustees, and key employees required to disclose annually interests that could give rise to conflicts?

c Did the organization regular ly and consistently m onitor and enforce compliance with the policy? If "Yes,"describe in Schedule O how this wa s done13 Did the organ ization have a written whistleblower policy?14 Did the organization have a written document retention an d destruction policy?15 Did the process fo r determining compensation of the following persons include a review an d approval byindependent persons, com parability data, and contemporaneous substantiation of the deliberation an d decision?

a The organ ization's CEO, Executive Director, or top man agement o ff icialb Other off icers or key employees of the organizationIf "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).16a Did the organiz ation invest in, contribute a ssets to, or participate in a joint ven ture or similar arrangem entwith a taxable entity during the year?

b If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate itsparticipation in joint venture arrangements under applicable federal ta x law, an d take steps to safeguard theorganization's exempt status with respect tosuch arrangements? . . . .

10alOb11a12a12b12c1314

15a15h

16a

16b

Yes No

Section C. Disclosure17 List the states with which a copy of this Form 990 is required to be filed >18 Section 6104 requires an organ ization to m ake its Form s 1023 (or 1024 if applicable), 990, and 9 90-T (Se ction 501(c)(3)s only)available fo r public inspection. Indicate how you made these available. Check al l that apply.

L ~ H Own website EH Ano ther 's website EH Upon request19 Describe in Schedule O whethe r (and if so, how), the organization ma de its gove rning docume nts, con flict of interest policy,and financial statements available to the public during the tax year.

20 State the name, physical address, and telephone number of the person who po ssesses the books and records of theorganization: ^-Form 990 (2011)


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Form 990 (2011) Page?Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, andIndependent Con tractorsCheck if Schedule O contains a response to any question in this Part VII DSection A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees:omplete this table for all persons required to be listed. Report compensation for the calendar year ending with or within theRation's tax year.

.ist all of the organization's current officers, directors, trustees (whether individuals or organizations), regardless of amount ofensation. 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 com pensation from the organization and any related organizations. 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.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highestcompensated employees; an d former such persons.D Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.

(A)Name and Title

(D

(2)(3)(4)(5)(6)(7)(8)

0) ,(10)(11)(12)(13)(14)

(B)Averagehours perweek(describehours forrelatedorganizationsin Schedule0)

(C)Position

(do not check more than onebox, unless person is both anofficer and a director/trustee)

Invd

ue

odreo

Inuo

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O3oCD

Kempo

Hig

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(D)Reportablecompensation

fromtheorganization

(W-2/1099-MISC)

(E)Reportablecompensation fromrelatedorganizations(W-2/1099-MISC)

(F)Estimatedamount ofothercompensationfrom theorganization

and relatedorganizations

Form 990 (2011)


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Form 990 (2011) Page 8Section A. Officers, Directors, Trustees,Ke y Employees,and Highest Compensated Employees (continued)

(A)Name and title

(15)

(16)

(1.7)(18)(19)

(20)(21)

(22)

(23)

(24)

(25)

(B)Averagehours perweek(describehours forrelatedorganizationsin Schedule0)

(C)Position(do not check more than on ebox, unless person is both anofficer and a director/trustee)

Invd

ue

odreo

Inuo

ue

O=co'?Kempo

Hig

cmp

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empo

1b Sub-totalc Total from continuation sheets to Part VII, Section Ad Total (add lines 1 b and 1 c)

Fme

*

*>

(D)Reportablecompensat ionfrom

theorganization(W-2/1099-MISC)

(E)Reportablecompensation fromrelatedorganizat ions

(W-2/1099-MISC)

(F)Estimatedamount ofothercompensat ionfrom theorganizationand relatedorganizations

2 Total number of individuals (including but not limited to those listed above) who received more than $100,000 ofreportable compensation from the organization ^-

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 1a receive or accrue compensation from any unrelated organization or individualfor services rendered to the organization? If "Yes," complete Scheduled for such person

Section B. Independent Contractors1 Complete this table for your five highest compensated independent contractors that received more than $100,000 of

compensation from the organization. Report compensation for the calendar year ending with or within the organization's taxyear.

3

45

Yes No

(A)Name and business address (B)Description of services (C)Compensat ion

2 Total number of independent contractors (including but not limited to those listed above) whoreceived more than $100,000 of compensation fromthe organization^-

Form 990 (2011)


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Form 990 (2011) Page 9Statement of Revenue

CboGsGas

aOhSmaAms

ProamSevcRe

OhRe

1a Federated campaigns . . . 1ab Membership dues .c Fundraising events .d Related organizations

. . . 1b

. . . 1 c

. . . 1de Government grants (contributions) 1ef All other contributions, gifts, grants,

and similar amounts no t ncluded above 1g N o n c a s h contributions i n c l u d e d in lines 1a-1f: $h Total. Add lines 1a-1f

2abcdef All other program service revenue.

. . . . *Business Code

g Total.Add ines 2a-2f >3 Investment income (including dividends, interest,an d other similar amounts) ^~4 Income from investment of tax-exempt bond proceeds>5 Royalties . . . .6a Gross rents . .

b Less: rental expensesc Rental income or (loss)d Net rental income or

7a G r o s s a m o u n t f r o m s a l e s ofa s s e t s o t h e r than i n v e n t o r y

b Less: cost or other basisand sales expenses .

c Gain or (loss) . .d Net gain or (loss)

*(i) Real (ii) Personal

loss) >(i) Securities (ii) Other

>.

8a Gross income from fundraisingevents (not including $of contr ibut ions reported on line 1c).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, ine 19 ab Less: direct expenses . . . . bc Net income or (loss) from gaming activities . . >

10a Gross sales of inventory, lessreturns an d allowances . a

b Less: cost of goods sold . . . bc Net income or (loss) from sales of inventory . . >

Miscel laneous Revenue11a

bcd A l l other revenue

Business Code

e Total.Add lines 11a-11d >12 Total revenue. See nstructions >

(A)Total revenue (B)Related orexempttunctionrevenue

(C)Unrelatedbusinessrevenue(D)Revenueexcluded from taxunder sect ions512, 513, or514

Form 990 (2011)


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Form 990 (2011) Page 10Statement 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 O contains a response to any question in this Part IX D

Do not include amounts reported on lines 6b, 7b,8b, 9b, and 10 b of Part VIII.(A)Total expenses (B)Programserviceexpenses

(C)Management an dgeneral expenses(D)Fund raisingexpenses

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

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

3 Grants an d other assistance to governments,organizations, an d individuals outside theUnited States. SeePart IV, lines 15 and 16 . .4 Benefits paid to or for members . . . .5 Compensation of current officers, directors,

trustees, and key employees6 Compensation not included above, to disqualified

persons (as defined under section 4958(f)(1)) andpersons described in section 4958(c)(3)(B) . .

7 Other salaries and wages8 Pension plan accruals an d contributions (includesection 401 (k) and 403(b) employer contributions)9 Other employee benefits

10 Payroll taxes11 Fees for services (non-employees):

a Managementb Legalc Accountingd Lobbyinge Professional fundraising services. See Part IV , line 17f Investment management feesg Other

12 Advertising and promotion13 Office expenses14 Information technology15 Royalties16 Occupancy17 Travel18 Payments of travel or entertainment expenses

for any federal, state, or local public officials19 Conferences, conventions, and meetings .20 Interest21 Payments to affiliates22 Depreciation, depletion, and amortization .23 Insurance24 Other expenses. Itemize expenses not covered

above. (List miscellaneous expenses in line 24e. fline 24e amount exceeds 10% of line 25, column(A) amount, list line 24 e expenses on Schedule 0.)

ab " " " " " " 'cde All other expenses

25 Total functional expenses.Add lines 1 through 24 e26 Joint costs. Complete this line only if theorganization reported in column (B ) joint costsfrom a combined educational campaign andfundraising solicitation. Check here > D iffollowing S O P 98-2(ASC 958-720) . . . .

Form 990 (2011)


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Form 990 (2011)Balance Sheet

(A)Beginning of year

Page 11

(B)End of year

10a10b

1 Cashnon-interest-bearing2 Savings and temporary cash investments3 Pledges and grants receivable, net4 Accounts receivable, net5 Receivables from current and former officers, directors, trustees, key

employees, an d highest compensated employees. Complete Part II ofSchedule L6 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)7 Notes and loans receivable, net8 Inventories for sale or use9 Prepaid expenses and deferred charges10a Land, buildings, and equipment: cost orother basis. Complete Part VI of Schedule Db Less: accumulated depreciation . . . .

11 Investmentspublicly traded securities12 Investmentsother securities. See Part IV, line 1113 Investments program-related. See Part IV, line 1114 Intangible assets15 Other assets. Se e Part IV, line 1116 Total assets. Add lines 1 through 15 (must equal line 34)17 Accounts payable and accrued expenses18 Grants payable19 Deferred revenue20 Tax-exempt bond liabilities21 Escrow or custodial account liability. Complete Part IV of Schedule D .22 Payables to current and former officers, directors, trustees, key

employees, highest compensated employees, and disqualified persons.Complete Part II of Schedule L

23 Secured mortgages and notes payable to unrelated third parties . .24 Unsecured notes and loans payable to unrelated third parties . . .25 Other liabilities (including federal income tax, payables to related thirdparties, and other liabilities not included on lines 17-24). Complete Part Xof Schedule D26 Total liabilities. Add lines 17 through 25

Organizations that follow SFAS 117, check here^Q andcompletelines 27 through 29, and lines 33 and 34.

27 Unrestricted net assets28 Temporarily restricted ne t assets29 Permanently restricted net assetsOrganizations that do not follow SFAS 117, check here > Q and

complete lines 30 through 34.30 Capital stock or trust principal, or current funds31 Paid-in orcapital surplus, or land, building, or equipment fund . . .32 Retained earnings, endowment, accumulated income, or other funds .33 Total net assets or fund balances34 Total liabilities and net assets/fund balances

10c1112131415161718192021

222324

2526

272829

3031323334

Form 990 (2011)


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Form 990 (2011) Page 12Reconciliation of Net AssetsCheck if Schedule O contains a response to any question in this Part XI D

123456

Total revenue (must equa l Part VIII, colum n (A), line 12)Total expenses (must equal Part IX, colum n (A), line 25)Revenue less expenses. Subtract line 2 from line 1Net assets or fund balances at beginning of year (must equal Part X, line 33 , column (A)) , . .Other changes in net assets or fund balances (explain in Schedule O)Ne t assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33,column (B))

_5^6

Financial Statements and ReportingCheck if Schedule O contains a response to any question in this Part XII D1 Accounting method used to prepare theForm 990: DCash DAccrual DOther

If the organization changed its method of accounting from a prior year or checked "Other," explain inSchedule O.2a Were the organization's financial statem ents com piled or reviewed by an independent accountant? . . .b Were the organization's financial statements a udited by an independent accountant?c If "Yes" to line 2a or 2b, does the organization have a committee that assumes responsibility for oversightof the audit, review , or compilation of its financial statements and selection of an independent acco untant?

If the organization changed either its oversight process or selection process during the tax year, explain inSchedule 0.d If "Yes" to line 2a or 2b, check a box below to indicate w hether the financial statements for the year wereissued on a separate basis, consolidated basis, or both:DSeparate basis DConso lidated basis DBoth consolidated and separate basis3a As a result of a federal award, was the organization required to undergo an audit or audits as set forth inthe Single Audit Act and OMB Circular A-133?

b If "Yes," did the orga nization undergo the required audit or audits? If the organization did no t undergo therequired audit or audits, explain why in Schedule O and describe any steps taken to undergo such auditsForm 990 (2011)

2a2b2c

3a3b

Yes No

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