PUTNAM COUNTY SENIOR CITIZENS: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: PUTNAM COUNTY SENIOR CITIZENS (EIN 62-0959415)
Tax period: 2012-07-01 to 2013-06-30
Filed: 2014-04-08
IRS object ID: 201400989349300515
Schema version: 2012v2.3
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule D
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2014-04-08T12:11:40-05:00	Timestamp
Tax Period End Date	2013-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	TAMARA L BECKMAN CPA	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	6 S MADISON AVE	AddressLine1
City	COOKEVILLE	City
State	TN	State
ZIP Code	385013357	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2012-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	620959415	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	PUTNAM COUNTY SENIOR CITIZENS	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	PUTN	NameControl
Phone	9315269318	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	186 SOUTH WALNUT AVENUE	AddressLine1
City	COOKEVILLE	City
State	TN	State
ZIP Code	38501	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	MAXINE FRASIER	Name
Title	EXECUTIVE DIRECTOR	Title
Phone	9315269318	Phone
Date Signed	2014-04-08	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	TAMARA L BECKMAN	Name
Phone	9315265489	Phone
Date Prepared	2014-04-08	DatePrepared
Self Employed	X	SelfEmployed

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2015-11-30 17:44:51Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	MAXINE FRASIER	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	186 SOUTH WALNUT AVENUE	AddressLine1
City	COOKEVILLE	City
State	TN	State
ZIP Code	38501	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	234883	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1966	YearFormation
State Legal Domicile	TN	StateLegalDomicile
Activity Or Mission Description	TO PROVIDE A PLACE FOR SENIORS TO MEET, FELLOWSHIP AND MAINTAIN ACTIVE WITH OTHER PEOPLE OF SIMILAR AGES AND INTERESTS. SIGNIFICANT ACTIVITIES INCLUDE SOCIAL EVENTS, DAILY ACTIVITIES, EXERCISE PROGRAMS, LUNCHEONS, AND A PLACE TO CONGREGATE AND INTERACT WITH OTHER SENIOR CITIZENS.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	11	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	11	NbrIndependentVotingMembers
Total Nbr Employees	11	TotalNbrEmployees
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Prior Year	129780	ContributionsGrantsPriorYear
Contributions Grants Current Year	111579	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	68468	ProgramServiceRevenuePriorYear
Program Service Revenue CY	120129	ProgramServiceRevenueCY
Investment Income Prior Year	34	InvestmentIncomePriorYear
Investment Income Current Year	27	InvestmentIncomeCurrentYear
Other Revenue Prior Year	6929	OtherRevenuePriorYear
Other Revenue Current Year	3148	OtherRevenueCurrentYear
Total Revenue Prior Year	205211	TotalRevenuePriorYear
Total Revenue Current Year	234883	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	83341	SalariesEtcPriorYear
Salaries Etc Current Year	97541	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	314	TotalFundrsngExpCurrentYear
Other Expense Prior Year	107680	OtherExpensePriorYear
Other Expenses Current Year	114611	OtherExpensesCurrentYear
Total Expenses Prior Year	191021	TotalExpensesPriorYear
Total Expenses Current Year	212152	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	14190	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	22731	RevenuesLessExpensesCY
Total Assets BOY	66962	TotalAssetsBOY
Total Assets EOY	87454	TotalAssetsEOY
Total Liabilities BOY	4706	TotalLiabilitiesBOY
Total Liabilities EOY	2467	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	62256	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	84987	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	TO PROVIDE A PLACE FOR SENIORS TO MEET, FELLOWSHIP AND MAINTAIN ACTIVE WITH OTHER PEOPLE OF SIMILAR AGES AND INTERESTS. SIGNIFICANT ACTIVITIES INCLUDE SOCIAL EVENTS, DAILY ACTIVITIES, EXERCISE PROGRAMS, LUNCHEONS, AND A PLACE TO CONGREGATE AND INTERACT WITH OTHER SENIOR CITIZENS.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	163535	Expense
Description	TO PROVIDE A PLACE FOR SENIOR CITIZENS TO MEET, FELLOWSHIP, AND REMAIN ACTIVE WITH PROPLE OF SIMILAR AGES AND INTERESTS BY PROVIDING FACILITIES, PROGRAMS, RESOURCES AND ORGANIZED ACTIVITIES TO ENABLE SENIORS TO IMPROVE THEMSELVES, THEIR HEALTH AND PROVIDE FOR HEALTHY INTERACTION WITH OTHER SENIORS.	Description
Total Program Service Expense	163535	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	false	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	false	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	false	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	false	ReportOtherAssets
Report Other Liabilities	false	ReportOtherLiabilities
Report Fin48 Footnote	false	ReportFin48Footnote
Independent Audit Financial Stmt	true	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	false	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	false	Hospital
Grants To Organizations	false	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	false	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	false	RelatedEntity
Related Org Controlled Entity	false	RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	1	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Number Of Employees	11	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	false	UnrelatedBusinessIncome
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	11	NbrVotingGoverningBodyMembers
Number Independent Voting Members	11	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	false	MembersOrStockholders
Election Of Board Members	false	ElectionOfBoardMembers
Decisions Subject To Approval	false	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	true	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	false	ConflictOfInterestPolicy
Whistleblower Policy	false	WhistleblowerPolicy
Document Retention Policy	false	DocumentRetentionPolicy
Compensation Process CEO	false	CompensationProcessCEO
Compensation Process Other	false	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
States Where Copy Of Return Is Filed	TN	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	MAXINE FRASIER	NamePerson
Telephone Number	9315269318	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	186 SOUTH WALNUT AVENUE	AddressLine1
City	COOKEVILLE	City
State	TN	State
ZIP Code	38501	ZIPCode

Field	Value	IRS element (for citing)
No Listed Persons Compensated	X	NoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (11 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation
KEITH BILBREY
CHAIRMAN	2.00	X	X	0	0	0
SCOTTIE ROBERTS
VICE CHAIRMA	2.00	X	X	0	0	0
CHARLENE MCCLAIN
SECRETARY	2.00	X	X	0	0	0
JACKIE FARRIS
TREASURER	2.00	X	X	0	0	0
OPAL BOHANNON
BOARD MEMBER	1.00	X		0	0	0
DON BURDEN
BOARD MEMBER	1.00	X		0	0	0
CHARLENE DARTY
BOARD MEMBER	1.00	X		0	0	0
DWIGHT HENRY
BOARD MEMBER	1.00	X		0	0	0
LEE HODGE
BOARD MEMBER	1.00	X		0	0	0
FLO RICH
BOARD MEMBER	1.00	X		0	0	0
DAVIS WATTS
BOARD MEMBER	1.00	X		0	0	0

Field	Value	IRS element (for citing)
Formers Listed	false	FormersListed
Total Comp GT150 K	false	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources
Government Grants	108605	GovernmentGrants
All Other Contributions	2974	AllOtherContributions
Total Contributions	111579	TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescription	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount
FUNDS FROM ACTIVITIES	113339	$113,339
RENTAL INCOME	6351	$6,351
ADVERTISING INCOME	273	$273
VENDING INCOME	166	$166

Field	Value	IRS element (for citing)
Total Program Service Revenue	120129	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	27	TotalRevenueColumn
Related Or Exempt Function Income	27	RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc

Field	Value	IRS element (for citing)
Total Revenue Column	3148	TotalRevenueColumn
Exclusion	$3,148	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	3148	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	234883	TotalRevenueColumn
Related Or Exempt Function Income	27	RelatedOrExemptFunctionIncome
Exclusion	$123,277	ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	88681	Total
Program Services	66511	ProgramServices
Management And General	22170	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	8860	Total
Program Services	6342	ProgramServices
Management And General	2518	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	5688	Total
Management And General	5688	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	1210	Total
Program Services	1210	ProgramServices

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	938	Total
Management And General	938	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	24839	Total
Program Services	18629	ProgramServices
Management And General	6210	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	150	Total
Management And General	150	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	437	Total
Management And General	437	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	1423	Total
Program Services	1067	ProgramServices
Management And General	356	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral	FundraisingFundraising
PROGRAM ACTIVITIES & TRIP	55495	55495
SUPPLIES	6282	3141	2827	314
REPAIRS & MAINTENANCE	5043	3782	1261
CONTRACT SERVICES	4239	3300	939

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	8867	Total
Program Services	4058	ProgramServices
Management And General	4809	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	212152	Total
Program Services	163535	ProgramServices
Management And General	48303	ManagementAndGeneral
Fundraising	314	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	64455	BOY
EOY	80297	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	1488	BOY
EOY	3142	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	4506	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	491	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	1019	BOY
EOY	4015	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	66962	BOY
EOY	87454	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	4706	BOY
EOY	2467	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	4706	BOY
EOY	2467	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	62256	BOY
EOY	84987	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	62256	BOY
EOY	84987	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	66962	BOY
EOY	87454	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	22731	ReconcilationRevenueExpenses
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	false	FSAudited

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Publicly Supported Org170b1 Avi	X	PubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	108647	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	109046	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	139601	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	129780	CurrentTaxYearMinus1Year
Current Tax Year	111579	CurrentTaxYear
Total	598653	Total

Total170 Total170

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	108647	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	109046	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	139601	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	129780	CurrentTaxYearMinus1Year
Current Tax Year	111579	CurrentTaxYear
Total	598653	Total

Field	Value	IRS element (for citing)
Public Support Total170	598653	PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	23	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	17	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	18	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	34	CurrentTaxYearMinus1Year
Total	92	Total

Other Income170 OtherIncome170

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	6322	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	6872	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	10642	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	6929	CurrentTaxYearMinus1Year
Current Tax Year	123277	CurrentTaxYear
Total	154042	Total

Field	Value	IRS element (for citing)
Total Support	752787	TotalSupport
Gross Receipts From Admissions Etc	285779	GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage170	0.79520	PublicSupportPertcentage170
Public Support Pertcent Prior Year	0.96670	PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170	X	ThirtyThreePercntTestsCY170

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1249	OtherCostOrOtherBasis
Depreciation	94	Depreciation
Book Value	1155	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	3257	OtherCostOrOtherBasis
Depreciation	397	Depreciation
Book Value	2860	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	4015	TotalOfBookValueLandBuildings
Tot Revenue Etc Audited Fincl Stmt	234883	TotRevenueEtcAuditedFinclStmt
Revenue Subtotal	234883	RevenueSubtotal
Total Revenue Per Form990	234883	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	212152	TotExpensesEtcAuditedFinclStmt
Expenses Subtotal	212152	ExpensesSubtotal
Total Expenses Per Form990	212152	TotalExpensesPerForm990

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (3 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
ORGANIZATION'S MISSION	FORM 990 - ORGANIZATION'S MISSION	TO PROVIDE A PLACE FOR SENIORS TO MEET, FELLOWSHIP AND MAINTAIN ACTIVE WITH OTHER PEOPLE OF SIMILAR AGES AND INTERESTS. SIGNIFICANT ACTIVITIES INCLUDE SOCIAL EVENTS, DAILY ACTIVITIES, EXERCISE PROGRAMS, LUNCHEONS, AND A PLACE TO CONGREGATE AND INTERACT WITH OTHER SENIOR CITIZENS.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990	FORM 990, PAGE 6, PART VI, LINE 11B	FEDERAL FORM 990 IS REVIEWED BY THE BOARD OF DIRECTORS UPON COMPLETION.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION	FORM 990, PAGE 6, PART VI, LINE 19	ALL GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.

PUTNAM COUNTY SENIOR CITIZENS: Form 990, tax year 2012

Return header ReturnHeader

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Preparer Firm US Address PreparerFirmUSAddress

Filer Filer

Name Name

US Address USAddress

Officer Officer

Preparer Preparer

Form 990 IRS990

Address Principal Officer US AddressPrincipalOfficerUS

The Books Are In Care Of TheBooksAreInCareOf

Address US AddressUS

Form990 Part VII Section A Form990PartVIISectionA (11 entries)

Program Service Revenue ProgramServiceRevenue (4 entries)

Investment Income InvestmentIncome

Other Revenue Misc OtherRevenueMisc

Total Revenue TotalRevenue

Other Salaries And Wages OtherSalariesAndWages

Payroll Taxes PayrollTaxes

Fees For Services Accounting FeesForServicesAccounting

Advertising Advertising

Office Expenses OfficeExpenses

Occupancy Occupancy

Conferences Meetings ConferencesMeetings

Depreciation Depletion DepreciationDepletion

Insurance Insurance

Other Expenses OtherExpenses (4 entries)

All Other Expenses AllOtherExpenses

Total Functional Expenses TotalFunctionalExpenses

Cash Non Interest Bearing CashNonInterestBearing

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Total Assets TotalAssets

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Total Liabilities TotalLiabilities

Unrestricted Net Assets UnrestrictedNetAssets

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Schedule A IRS990ScheduleA

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

Total170 Total170

Gross Investment Income170 GrossInvestmentIncome170

Other Income170 OtherIncome170

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovements

Equipment Equipment

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (3 entries)

Comments