+------------------------------------------------------------------------------+ | | RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX | | | Form 990 | For data identification; not a facsimile of tax form. | 1995 | |------------------------------------------------------------------------------| |A. For 1995 calendar yr, OR tax period beg. and ending E007_3 , 19 E007_1 | |------------------------------------------------------------------------------| |B. | C. Name of organization E002 | D. Employer ident. number E003 | | | Number and street | E. State regis. number | | | City, town or P.O. E009 | F. Check if exempt. appl. pending | | | Zip code E010 | | |------------------------------------------------------------------------------| |G. Type of organization: Exempt under section 501(c) ( E011 ) <............ | |------------------------------------------------------------------------------| |H(a) Is this a group return ..? E012 | I. Group exemption number E014 | | (b) ...number of affiliates | J. Accounting method | | (c) Separate return..group? E013 | | |------------------------------------------------------------------------------| |K ...organization's gross receipts are normally not more than $25,000 | |==============================================================================| |PART I: REVENUE, EXPENSES, AND CHANGES IN NET ASSETS OR FUND BALANCES | |------------------------------------------------------------------------------| | 1 Contributions, gifts, grants, etc |\\\| | | a Direct public support . . . . . |1a |_______E021____|\\\| | | b Indirect public support . . . . |1b |_______E022____|\\\| | | c Government contributions . . . . |1c |_______E023____|\\\| | | d Total (Lines 1(a) - 1(c)) |\\\| | | (cash $______ noncash $______). . . . . . . . . . . | 1d|_____E024______ | | 2 Program service revenue incl. govt. fees . . . . . . | 2 |_____E025______ | | 3 Membership dues & assessments . . . . . . . . . . . | 3 |_____E026______ | | 4 Interest on savings, temp. cash investments . . . . | 4 |_____E027______ | | 5 Dividends & interest from securities . . . . . . . . | 5 |_____E028______ | | 6a Gross rents . . . . . . . . . . |6a |_______E029____|\\\| | | b Less: rental expenses . . . . . |6b |_______E030____|\\\| | | c Net rental income or (loss). . . . . . . . . . . . . | 6c|_____E031______ | | 7 Other investment income______________________________| 7 |_____E032______ | | 8a Gross amount from sale |(A)Securities| | (B)Other |\\\| | | of assets, not invent.|______E033___|8a|____E036____|\\\| | | b Less: cost, sales exp. |______E034___|8b|____E037____|\\\| | | c Gain or (loss) . . . . |______E035___|8c|____E038____|\\\| | | d Net gain or (loss) . . . . . . . . . . . . . . . . . | 8d|_____E039______ | | 9 Special events and activities |\\\| | | a Gross revenue (not incl. contribs) . |9a|____E040____|\\\| | | b Less: direct expense (not fundrais.) |9b|____E041____|\\\| | | c Net income (loss) from special events. . . . . . . . | 9c|_____E042______ | |10a Gross sales of inventory,less return |10a|___E043____|\\\| | | b Less: cost of goods sold . . . . . . |10b|___E044____|\\\| | | c Gross profit (loss)sales of inventory. . . . . . . . |10c|_____E045______ | |11 Other revenue . . . . . . . . . . . . . . . . . . . |11 |_____E046______ | |12 Total revenue . . . . . . . . . . . . . . . . . . . |12 |_____E047______ | |13 Program services . . . . . . . . . . . . . . . . . . |13 |_____E048______ | |14 Management and general . . . . . . . . . . . . . . . |14 |_____E049______ | |15 Fundraising . . . . . . . . . . . . . . . . . . . . |15 |_____E050______ | |16 Payments to affiliates . . . . . . . . . . . . . . . |16 |_____E051______ | |17 Total expenses . . . . . . . . . . . . . . . . . . . |17 |_____E052______ | |18 Excess or (deficit) for the year . . . . . . . . . . |18 |_____E053______ | |19 Net assets or fund balances at beginning of year . . |19 |_____E054______ | |20 Other changes in net assets or fund balances . . . . |20 |_____E055______ | |21 Net assets or fund balances at end of year . . . . . |21 |_____E056______ | +------------------------------------------------------------------------------+ Form 990 (1995) Page 2 +------------------------------------------------------------------------------+ |PART II: STATEMENT OF FUNCTIONAL EXPENSES | |------------------------------------------------------------------------------| | | (A) Total | (B)Program |(C)Management| (D)Fund- | | | | Services | and general | raising | |----------------------+-------------+-------------+-------------+-------------| |Grants/allocations | | | |\\\\\\\\\\\\\|\\\\\\\\\\\\\| | cash___ noncash___|22|_____________|____E057_____|\\\\\\\\\\\\\|\\\\\\\\\\\\\| |Specific assistance|23|_____________|____E058_____|\\\\\\\\\\\\\|\\\\\\\\\\\\\| |Benefits pd to mems|24|_____________|____E059_____|\\\\\\\\\\\\\|\\\\\\\\\\\\\| |Compensation |25|____E060_____|____E061_____|____E062_____|____E063_____| |Other salaries |26|____E064_____|____E065_____|____E066_____|____E067_____| |Pension plan contri|27|____E068_____|____E069_____|____E070_____|____E071_____| |Other empl benefits|28|____E072_____|____E073_____|____E074_____|____E075_____| |Payroll taxes |29|____E076_____|____E077_____|____E078_____|____E079_____| |Fundraising fees |30|____E080_____|\\\\\\\\\\\\\|\\\\\\\\\\\\\|____E080_____| |Accounting fees |31|____E081_____|____E082_____|____E083_____|____E084_____| |Legal fees |32|____E085_____|____E086_____|____E087_____|____E088_____| |Supplies |33|____E089_____|____E090_____|____E091_____|____E092_____| |Telephone |34|____E093_____|____E094_____|____E095_____|____E096_____| |Postage & shipping |35|____E097_____|____E098_____|____E099_____|____E100_____| |Occupancy |36|____E101_____|____E102_____|____E103_____|____E104_____| |Equipment rental |37|____E105_____|____E106_____|____E107_____|____E108_____| |Printing & publica.|38|____E109_____|____E110_____|____E111_____|____E112_____| |Travel |39|____E113_____|____E114_____|____E115_____|____E116_____| |Conferences, mtgs |40|____E117_____|____E118_____|____E119_____|____E120_____| |Interest |41|____E121_____|____E122_____|____E123_____|____E124_____| |Depreciation, depl.|42|____E125_____|____E126_____|____E127_____|____E128_____| |Other expenses |43|____E149_____|____E150_____|____E151_____|____E152_____| |Total func.expenses|44|____E153_____|____E154_____|____E155_____|____E156_____| |------------------------------------------------------------------------------| |Reporting of Joint Costs .................... | |------------------------------------------------------------------------------| |PART III: STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS | |------------------------------------------------------------------------------| |What is the organization's primary exempt purpose? E300/E301 | Program Service| |..exempt purpose achievements.... | Expenses | |-------------------------------------------------------------+----------------| | a.................................................... | | | (Grants & allocations $_______________) |_______________ | |-------------------------------------------------------------+----------------| | b.................................................... | | | (Grants & allocations $_______________) |_______________ | |-------------------------------------------------------------+----------------| | c.................................................... | | | (Grants & allocations $_______________) |_______________ | |-------------------------------------------------------------+----------------| | d.................................................... | | | (Grants & allocations $_______________) |_______________ | |-------------------------------------------------------------+----------------| | e Other program services..(Grants & allocations $_________) |_______________ | |------------------------------------------------------------------------------| | f Total of Program Service Expenses(should equal line 44, col.B) ___________ | +------------------------------------------------------------------------------+ Form 990 (1995) Page 3 +------------------------------------------------------------------------------+ |PART IV: BALANCE SHEETS | |------------------------------------------------------------------------------| | | (A) | | (B) | | |Begin. of year| | End of year | |-------------------------------------------|--------------|---|---------------| | Assets | | | | | 45 Cash--non-interest bearing . . . . . .|______________|45 |_____E161______| | 46 Savings and temp cash invest . . . . .|______________|46 |_____E162______| | | |\\\| | | 47a Accounts receivable .|47a|___________| |\\\| | | b Less: doubtful accts .|47b|___________|______________|47c|_____E163______| | |\\\\\\\\\\\\\\\| |\\\| | | 48a Pledges receivable . .|48a|___________| |\\\| | | b Less: doubtful accts .|48b|___________|______________|48c|_____E164______| | 49 Grants receivable . . . . . . . . . .|______________|49 |_____E165______| | 50 Receivables from officers, etc . . . .|______________|50 |_____E166______| | 51a Other notes and loans |51a|___________| |\\\| | | b Less: doubtful accts .|51b|___________|______________|51c|_____E167______| | 52 Inventories for sale or use . . . . .|_____E168_____|52 |_____E169______| | 53 Prepaid expenses . . . . . . . . . . .|______________|53 |_____E170______| | 54 Investments - securities . . . . . . .|_____E171_____|54 |_____E172______| | 55a Investments - land . .|55a|___________| |\\\| | | b Less: accum. deprecia.|55b|___________|______________|55c|_____E173______| | 56 Investments - other . . . . . . . . .|______________|56 |_____E174______| | 57a Land, bldgs., equip. .|57a|___________| |\\\| | | b Less: accum. deprecia.|57b|___________|______________|57c|_____E175______| | 58 Other assets . . . . . . . . . . . . .|______________|58 |_____E176______| | 59 TOTAL ASSETS (45-58) . . . . . . . . .|_____E177_____|59 |_____E178______| |-------------------------------------------|--------------|---|---------------| | Liabilities | | | | | 60 Accounts payable . . . . . . . . . . .|______________|60 |_____E179______| | 61 Grants payable . . . . . . . . . . . .|______________|61 |_____E180______| | 62 Deferred revenue . . . . . . . . . . .|______________|62 |_____E181______| | 63 Loans from officers, etc . . . . . . .|______________|63 |_____E182______| | 64a Tax exempt bond liabilities . . . . .|______________|64a|_____E214______| | b Mortgages & other notes payable . . .|______________|64b|_____E183______| | 65 Other liabilities . . . . . . . . . .|______________|65 |_____E184______| | 66 TOTAL LIABILITIES (60-65) . . . . . .|_____E185_____|66 |_____E186______| |-------------------------------------------|--------------|---|---------------| | Net Assets or Fund Balances | | | | |Organizations that follow SFAS 117.........| |\\\| | | 67 Unrestricted . . . . . . . . . . . . .|______________|67 |_______________| | 68 Temporarily restricted . . . . . . . .|______________|68 |_______________| | 69 Permanently restricted . . . . . . . .|______________|69 |_______________| |Organizations that do not follow SFAS 117..| |\\\| | | 70 Capital stock, trust prin., cur. fnds.|______________|70 |_______________| | 71 Paid-in or cap. surlus or land fund. .|______________|71 |_______________| | 72 Retained earnings, accum. income . . .|______________|72 |_______________| | 73 TOTAL NET ASSETS OR FUND BALANCES . .|_____E194_____|73 |_____E195______| | | | | | | 74 TOTAL LIAB & NET ASSETS/FUND BALANCES |______________|74 |_____E196______| +------------------------------------------------------------------------------+ Form 990 (1995) Page 4 +------------------------------------------------------------------------------+ |PART IV-A Reconciliation of Revenue per|PART IV-B Reconcil.n of Expenses per | | Audited Financial Statements | Audited Financial Statements | | with Revenue per Return | with Expenses per Return | |----------------------------------------+-------------------------------------| |a Total revenue, gains, and |\|\\\\\\|a Total expenses and losses|\|\\\\\\| | other support per..... |a|______| per audited financial...|a|______| |b Amounts included on line a|\|\\\\\\|b Amounts included on line |\|\\\\\\| | but not on line 12: |\|\\\\\\| a but not on line 17: |\|\\\\\\| |(1) Net unrealized gains |\|\\\\\\|(1) Donated services and use|\|\\\\\\| | on invest. $________ |\|\\\\\\| of facilities $_______ |\|\\\\\\| |(2) Donated services and use |\|\\\\\\|(2) Prior year adjustments |\|\\\\\\| | of facilities $_______ |\|\\\\\\| reptd. on l.20 $_______ |\|\\\\\\| |(3) Recoveries of prior year |\|\\\\\\|(3) Losses reported on |\|\\\\\\| | grants $_______ |\|\\\\\\| line 20. $_______ |\|\\\\\\| |(4) Other $_______ |\|\\\\\\|(4) Other $_______ |\|\\\\\\| | Add lines 1-4 amounts > |b|______| Add lines 1-4 amounts > |b|______| |c Line a minus line b |c|______|c Line a minus line b |c|______| |d Amounts incl. on line 12 |\|\\\\\\|d Amounts incl. on line 17|\|\\\\\\| | but not on line a: |\|\\\\\\| but not on line a: |\|\\\\\\| |(1) Investment expenses not |\|\\\\\\|(1) Investment expenses not |\|\\\\\\| | incl. on l.6b $_______ |\|\\\\\\| incl. on l.17 $_______ |\|\\\\\\| |(2) Other $_______ |\|\\\\\\|(2) Other $_______ |\|\\\\\\| | Add lines 1 & 2 amounts > |d|______| Add lines 1 & 2 amounts >|d|______| |e Total revenue per line 12 | | |e Total expenses per line | | | | (line c plus line d) |e|______| 17 (line c plus line d) |e|______| |------------------------------------------------------------------------------| | PART V: LIST OF OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES | |------------------------------------------------------------------------------| |(A)Name and addr|(B)Title & avg|(C)Compensation|(D)Contributions| (E)Expense | | | hours/week | |to empl.benefit |acct.& allow.| |----------------+--------------+---------------+----------------+-------------| |_____VROW_______| |_____V001______|______V002______|____V003_____| |----------------+--------------+---------------+----------------+-------------| |_____VROW_______| |_____V001______|______V002______|____V003_____| |----------------+--------------+---------------+----------------+-------------| |(NOTE: All rows entered on return are edited) | |------------------------------------------------------------------------------| | Did any officer, director, trustee, or key employee receive aggregate | | compensation of more than $100,000 from your organization ......? | |==============================================================================| |PART V: NUMBER OF PERSONS RECEIVING NO COMPENSATION E201 | +------------------------------------------------------------------------------+ Form 990 (1995) Page 5 +------------------------------------------------------------------------------+ |PART VI: OTHER INFORMATION Yes No | |76 Did the organization engage in any activity not previously |\\\|\\\|\\\| | reported to the IRS? If Yes, attached detailed description... |76 | | | |77 Were any changes made in the organizing or governing |\\\|\\\|\\\| | documents but not reported to the IRS? If Yes, attach..... |77 | | | |78a Did the organization have unrelated business income of $1,000 |\\\|\\\|\\\| | or more during the year covered by this return? . . . . . . .|78a| | | | b If Yes, has it filed a tax return on Form 990-T, Exempt |\\\|\\\|\\\| | Organization Business Income Tax Return, for this year? . . .|78b|_E015__| |79 Was there a liquidation, dissolution, termination or substan- |\\\|\\\|\\\| | tial contraction during the year? If Yes, attach a statement. |79 |_E016__| |80a Is the organization related (other than by assoc...) through |\\\|\\\|\\\| | common membership, governing bodies, trustees, officers, etc.,|\\\|\\\|\\\| | to any other exempt or nonexempt organization? . . . . . . . .|80a|_E017__| | b If Yes, enter the name of the organization . . . . . . . . . .|\\\|\\\|\\\| | . . and check whether it is (___) exempt or (___) nonexempt. .|\\\|\\\|\\\| |81a Enter the amount of political expenditures, direct or indirect|\\\|\\\|\\\| | as described in the instrucs for line 81. |81a|_____E205____|\\\|\\\|\\\| | b Did the organization file Form 1120-POL, U.S. Income Tax |\\\|\\\|\\\| | Return for Certain Political Organizations, for this year? . .|81b|_E206__| |82a Did the org. receive donated services or the use of materials |\\\|\\\|\\\| | equip., or facilities at no charge or ... less than ....... |82a| | | | b If Yes, you may indicate the value of these items here. Do not|\\\|\\\|\\\| | include this amt. as revenue .. or expense..|82b|_____________|\\\|\\\|\\\| |83a Did organization comply with public inspection requirements? .|83a| | | | b Did the organization comply with the disclosure requirements..|83b| | | |84a Did the organization solicit any contributions or gifts that |\\\|\\\|\\\| | were not tax deductible? . . . . . . . . . . . . . . . . . . .|84a| | | | b If Yes, did the organization include with every solicitation |\\\|\\\|\\\| | an express statement that such contribs. were not tax deduct? |84b| | | |85a Sec.501(c)(4-6) orgs: Were .. all dues nondeductible by mems? |85a|_E202__| | b Did the org. make only in-house lobbying expend. of $2000 or..|85b|_E203__| | If Yes .. to 85a or 5b, do not complete 85c through 85h below |\\\|\\\|\\\| | unless the org. received a waiver for proxy tax owed prior yr.|\\\|\\\|\\\| | c Dues, assessments, and sim. amts. from mems.|85c|____E204_____|\\\|\\\|\\\| | d Section 162(e) lobbying & political expends.|85d|____E207_____|\\\|\\\|\\\| | e Aggreg. nonded. amt. of sec 6033(e)(1)(A)...|85e|____E208_____|\\\|\\\|\\\| | f Taxable amt. of lobbying and pol. expends. |85f|____E211_____|\\\|\\\|\\\| | g Does the org. elect to pay the .. 6033(e) tax on ... 85f? . .|85g|__E212_| | h If sec 6033(e)(1)(A) dues notices were sent, does the org. |\\\|\\\|\\\| | agree to add .. 85f to reasonable estimate of dues allocable |\\\|\\\|\\\| | to nondeductible ... for the following tax year? . . . . . . .|85h|__E213_| |86 Section 501(c)(7) organizations.--Enter: |\\\|\\\|\\\| | a Initiation fees and capital contributions .|86a|____E209_____|\\\|\\\|\\\| | b Gross receipts: pub. use of club facilities.|86b|____E210_____|\\\|\\\|\\\| |87 Section 501(c)(12) organizations.--Enter: |\\\|\\\|\\\| | a Gross income from members or shareholders. |87a|_____________|\\\|\\\|\\\| | b Gross income from other sources.(Do not net)|87b|_____________|\\\|\\\|\\\| |88 At any time during the year, did the org. own a 50% or greater|\\\|\\\|\\\| | interest in a taxable corp. or partnership? If Yes, ..Part IX |88_|___|___| |89 Public interest law firms.--Attach info. desc. in instructions. | |90 List the states with which a copy of this return is filed > ...............| |91 The books are in care of > ................. Telephone no.> ...............| | Located at > ........................................... ZIP code> .......| |92 Section 4947(a)(1) nonexempt charitable trusts... Check here........> | | and enter tax-exempt int. recd or accrued during tax year >|92 |___________| +------------------------------------------------------------------------------+ Form 990 (1995) Page 6 +------------------------------------------------------------------------------+ |PART VII: ANALYSIS OF INCOME-PRODUCING ACTIVITIES | |------------------------------------------------------------------------------| | | Unrel. bus. incm.|Excl. Sec. 512...| (E) | | |------------------|-----------------| Related or | | |(A) | (B) |(C) | (D) | exempt | | |Bus. | Amount |Excl| Amount | function | | |code | |code| | income | |--------------------------|-----|------------|----|------------|--------------| | 93a. Prog serv revenue |P601 |____P602____|P603|____P604____| ____P605____ | | 93b. Prog serv revenue |P611 |____P612____|P613|____P614____| ____P615____ | | 93c. Prog serv revenue |P621 |____P622____|P623|____P624____| ____P625____ | | 93d. Prog serv revenue |P631 |____P632____|P633|____P634____| ____P635____ | | 93e. Prog serv revenue |P641 |____P642____|P643|____P644____| ____P645____ | | 93f. Prog serv revenue |P651 |____P652____|P653|____P654____| ____P655____ | | 93g. Fees (Government) |P661 |____P662____|P663|____P664____| ____P665____ | | 94. Dues & assessments |P671 |____P672____|P673|____P674____| ____P675____ | | 95. Interest on savings |P681 |____P682____|P683|____P684____| ____P685____ | | 96. Div & int: secur. |P691 |____P692____|P693|____P694____| ____P695____ | | 97. Net rent:real estate|\\\\ |\\\\\\\\\\\\|\\\\|\\\\\\\\\\\\|\\\\\\\\\\\\\ | | a. Debt-financed prop. |P701 |____P702____|P703|____P704____| ____P705____ | | b. Not debt-finan.prop.|P711 |____P712____|P713|____P714____| ____P715____ | | 98. Net rent: pers.prop.|P721 |____P722____|P723|____P724____| ____P725____ | | 99. Other invest. income|P731 |____P732____|P733|____P734____| ____P735____ | | 100. Sale of assets |P741 |____P742____|P743|____P744____| ____P745____ | | 101. Special events |P751 |____P752____|P753|____P754____| ____P755____ | | 102. Gross: invent. sales|P761 |____P762____|P763|____P764____| ____P765____ | | 103. Other revenue: a ___|_____|____________|____|____________|______________| | b. ____________________|_____|____________|____|____________|______________| | c. ____________________|_____|____________|____|____________|______________| | d. ____________________|_____|____________|____|____________|______________| | e. ____________________|P771 |____P772____|P773|____P774____| ____P775____ | | 104. Subtotal |\\\\ |____P782____| \\ |____P784____| ____P785____ | | 105. Total (add line 104, columns (B),(D), and (E)) . . . > ________________ | |------------------------------------------------------------------------------| |PART VIII: RELATIONSHIP OF ACTIVITIES TO ACCOMPLISHMENT OF EXEMPT PURPOSES | |------------------------------------------------------------------------------| | Line No. | Explain how each activity for which income is reported .......... | |----------|-------------------------------------------------------------------| |__________|___________________________________________________________________| |__________|___________________________________________________________________| |__________|___________________________________________________________________| |__________|___________________________________________________________________| |------------------------------------------------------------------------------| |PART IX: INFORMATION REGARDING TAXABLE SUBSIDIARIES | | Total number of subsidiaries reported on return: _P800_ | |------------------------------------------------------------------------------| |Name, address, and EIN of |Percentage |Nature of| Total | End of Year | |corporation or partnership |of Interest| business| Income | Assets | |------------------------------------------------------------------------------| |________P801_(EIN)__________|___P802___%|_________|____P803____| ____P804____ | |________P805_(EIN)__________|___P806___%|_________|____P807____| ____P808____ | |________P809_(EIN)__________|___P810___%|_________|____P811____| ____P812____ | |________P813_(EIN)__________|___P814___%|_________|____P815____| ____P816____ | +------------------------------------------------------------------------------+ +------------------------------------------------------------------------------+ | SCHEDULE A | ORGANIZATION EXEMPT UNDER SECTION 501(c)(3) | | | (Form 990) | For data identification; not a facsimile of tax form. | 1995 | |------------------------------------------------------------------------------| | Name of the organization | EIN | |------------------------------------------------------------------------------| |PART I: COMPENSATION OF FIVE HIGHEST PAID EMPLOYEES OTHER THAN OFFICERS......| |------------------------------------------------------------------------------| |(a)Name & address|(b)Title/avg hrs|(c)Compensation| (d)Benefits | (e)Expenses | |_________________| | | | | | | | ____S001____ | ____S002____| ____S003____| |-----------------+----------------+---------------+-------------+-------------| |_________________| | | | | | | | ____S004____ | ____S005____| ____S006____| |-----------------+----------------+---------------+-------------+-------------| |_________________| | | | | | | | ____S007____ | ____S008____| ____S009____| |-----------------+----------------+---------------+-------------+-------------| |_________________| | | | | | | | ____S010____ | ____S011____| ____S012____| |-----------------+----------------+---------------+-------------+-------------| |_________________| | | | | | | | ____S013____ | ____S014____| ____S015____| |-----------------+----------------+---------------+-------------+-------------| | Total number of other employees paid over $50,000: _S016_ | |------------------------------------------------------------------------------| |PART II: COMPENSATION OF FIVE HIGHEST PAID INDEPENDENT CONTRACTORS FOR PRO...| |------------------------------------------------------------------------------| |(a)Name and addr of each independent..|(b) Type of Service |(c) Compensation | |--------------------------------------+--------------------+------------------| |______________________________________| | | | | | | |--------------------------------------+--------------------+------------------| |______________________________________| | | | | | | |--------------------------------------+--------------------+------------------| |______________________________________| | | | | | | |--------------------------------------+--------------------+------------------| |______________________________________| | | | | | | |--------------------------------------+--------------------+------------------| |______________________________________| | | | | | | |------------------------------------------------------------------------------| |Total number of others receiving over $50,000 for professional services... | +------------------------------------------------------------------------------+ Schedule A (Form 990) 1995 Page 2 +------------------------------------------------------------------------------+ |PART III: STATEMENTS ABOUT ACTIVITIES |Yes|No | |----------------------------------------------------------------------+---+---| |1 During year, has org. (lobbied re: legislation) . . . . . . . . |1 | | | | If Yes, enter total expenses paid or incurred.... $____S197____|\\|\\\|\\\| | Orgs that made an election under section 501(h)............... |\\|\\\|\\\| |2 During year, has org.,...,engaged in any of the following acts..|\\|\\\|\\\| | a Sale, exchange, or leasing of property? . . . . . . . . . . . . |2a|___|___| | b Lending of money or other extension of credit? . . . . . . . . |2b|___|___| | c Furnishing of goods, services, or facilities? . . . . . . . . . |2c|___|___| | d Payment of compensation ...... . . . . . . . . . . . . . . . . |2d|___|___| | e Transfer of any part of its income or assets? . . . . . . . . . |2e|___|___| | If...Yes, attach a detailed statement..... . . . . . . . . . . |\\|\\\|\\\| |3 Does org. make grants, scholarships, fellowships, etc? . . . . |3 |___|___| |4 Attach statement explaining how org. determines that individuals|\\|\\\|\\\| | ......qualify to receive payments. |\\|\\\|\\\| |------------------------------------------------------------------------------| | PART IV: REASON FOR NON-PRIVATE FOUNDATION STATUS E019/EZ15 | |------------------------------------------------------------------------------| | The organization is not a private foundation because it is (check one) | | 5 A church, convention of churches, or .... Section 170(b)(1)(A)(i) | | 6 A school. Section 170(b)(1)(A)(ii) | | 7 A hospital or a cooperative hospital .... Section 170(b)(1)(A)(iii) | | 8 A Federal, state, or local government or .... Section 170(b)(1)(A)(v) | | 9 A medical research organization operated .... Section 170(b)(1)(A)(iii) | | Enter the hospital's name, city, and state > ____________________________ | |10 An org. operated for the benefit of a college..Section 170(b)(1)(A)(iv) | |11a An org. that normally receives a substantial...Section 170(b)(1)(A)(vi) | |11b A community trust. Section 170(b)(1)(A)(vi) | |12 An org. that normally receives: (a)... & (b).. See section 509(a)(2) | |13 An org. that is not controlled by any .... See section 509(a)(3) | |------------------------------------------------------------------------------| |Provide the following information about the supported organizations. | |------------------------------------------------------------------------------| | (a)Name(s) of supported organization(s) |(b)Line number from above| |----------------------------------------------------+-------------------------| |____________________________________________________|_________________________| | | | |____________________________________________________|_________________________| | | | |____________________________________________________|_________________________| | | |14 An org. organized ... to test public safety. Section 170(b)(1)(A)(ii) | +------------------------------------------------------------------------------+ Schedule A (Form 990) 1995 Page 3 +------------------------------------------------------------------------------+ |PART 1V-A SUPPORT SCHEDULE Use cash method of accounting | |------------------------------------------------------------------------------| |Calendar year (fiscal yr) > | (a)1994 | (b)1993 | (c)1992 | (d)1991 |(e)Total | |----------------------------|---------|---------|---------|---------|---------| |15. Gifts, Grants & Contrib.|__S198___|_________|_________|_________|__S199___| |----------------------------|---------|---------|---------|---------|---------| |16. Membership Fees Received|__S200___|_________|_________|_________|__S201___| |----------------------------|---------|---------|---------|---------|---------| |17. Gross Receipts . . . . .|__S202___|_________|_________|_________|__S203___| |----------------------------|---------|---------|---------|---------|---------| |18. Gross Income . . . . . .|__S204___|_________|_________|_________|__S205___| |----------------------------|---------|---------|---------|---------|---------| |19. Net Income . . . . . . .|__S206___|_________|_________|_________|__S207___| |----------------------------|---------|---------|---------|---------|---------| |20, Tax Revenues . . . . . .|__S208___|_________|_________|_________|__S209___| |----------------------------|---------|---------|---------|---------|---------| |21. Value of Services . . .|__S210___|_________|_________|_________|__S211___| |----------------------------|---------|---------|---------|---------|---------| |22. Other Income . . . . . .|__S212___|_________|_________|_________|__S213___| |----------------------------|---------|---------|---------|---------|---------| |23. Total Lines 15-22 . . .|__S214___|_________|_________|_________|__S215___| |----------------------------|---------|---------|---------|---------|---------| |24. Lines 23 Minus Line 17 .|__S216___|_________|_________|_________|__S217___| |----------------------------|---------|---------|---------|---------|---------| |25. Enter 1% of Line 23 . .|__S218___|_________|_________|_________|\\\\\\\\\| |----------------------------------------------------------------+---|---------| |26. Organizations described in lines 10 or 11: | | | | a Enter 2% of amount in column (e), line 24 . . . . . . . . . |26a|_________| | b Attach a list (which is not open to public inspection).... |\\\|\\\\\\\\\| | .... Enter the sum of all these excess amounts here. . . . |26b|_________| | c Total support for section 509(a)(1) test: Enter l.24 col(e) |26c|_________| | d Add: Amounts from col(e) for lines: 18 $_____ 19 $_____ |\\\|\\\\\\\\\| | 22 $_____ 26b $_____ |26d|_________| | e Public support (line 26c minus line 26d total) . . . . . . |26e|_________| | f Public support percentage (line 26e divided by line 26c). . |26f|________%| |------------------------------------------------------------------------------| |27. Organizations described on line 12: ......................... | | no entries are picked up from lines 27 a-h. | |28. Unusual Grants: For an org desc. in line 10, 11, or 12....attach a list...| +------------------------------------------------------------------------------+ Schedule A (Form 990) 1995 Page 4 +------------------------------------------------------------------------------+ |PART V PRIVATE SCHOOL QUESTIONNAIRE |Yes|No| |-----------------------------------------------------------------------+---+--| |29 Does the org. have a racially nondiscriminatory policy toward | | | | | students by statement in its charter, bylaws, other ........... |29|___|__| | ......................................... | |------------------------------------------------------------------------------| | | | No other entries on page 4 are picked up. | | | +------------------------------------------------------------------------------+ Pages 5 and 6 of Schedule A (Form 990) are not printed; there are no data elements taken from these pages. +------------------------------------------------------------------------------+ | Form | SHORT FORM: RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX | | | 990-EZ | For data identification; not a facsimile of tax form. | 1995 | |------------------------------------------------------------------------------| |A For 1995 calendar yr, OR tax period beg. and ending EZ07_3 , 19 EZ07_1 | |------------------------------------------------------------------------------| |B | C Name of organization EZ02 | D Employer ident. number EZ03 | | | Number and street | E State regis. number | | | City, town or P.O. EZ09 | F Check if exempt. appl. pending | | |____Zip code_________________EZ10____|____________________________________| |G Acctng method: []Cash []Accrual []Other| H Group exemption number | |------------------------------------------------------------------------------| |I Type of organization: Exempt under section 501(c) ( EZ11 ) <............ | |------------------------------------------------------------------------------| |J ...organization's gross receipts are normally not more than $25,000 | |------------------------------------------------------------------------------| |K Enter the organization's 1995 gross receipts . . . > $____________ | |==============================================================================| |PART I: REVENUE, EXPENSES, AND CHANGES IN NET ASSETS OR FUND BALANCES | |------------------------------------------------------------------------------| | 1 Contributions, gifts, grants, etc | 1 |_____EZ17______ | | 2 Program service revenue incl. govt. fees . . . . . . | 2 |_____EZ18______ | | 3 Membership dues & assessments . . . . . . . . . . . | 3 |_____EZ19______ | | 4 Investment income . . . . . . . . . . . . . . . . . | 4 |_____EZ20______ | | 5a Gross amt sale of assets, not invent.|5a|____EZ21____|\\\| | | b Less: cost or other basis & sales exp|5b|____EZ22____|\\\| | | c Gain or (loss) from sale of assets other than invent.| 5c|_____EZ23______ | | 6 Special events and activities |\\\| | | a Gross revenue (not incl. contribs) . |6a|____EZ24____|\\\| | | b Less: direct expense (not fundrais.) |6b|____EZ25____|\\\| | | c Net income (loss) from special events and activities | 6c|_____EZ26______ | | 7a Gross sales of inventory,less return |7a|____EZ27____|\\\| | | b Less: cost of goods sold . . . . . . |7b|____EZ28____|\\\| | | c Gross profit (loss)sales of inventory. . . . . . . . | 7c|_____EZ29______ | | 8 Other revenue (describe >__________________________) | 8 |_____EZ30______ | | 9 Total revenue . . . . . . . . . . . . . . . . . . . | 9 |_____EZ31______ | |10 Grants and similar amounts paid . . . . . . . . . . |10 |_____EZ32______ | |11 Benefits paid to or for members . . . . . . . . . . |11 |_____EZ33______ | |12 Salaries, other compensation, and employee benefits. |12 |_____EZ34______ | |13 Professional fees & other payments to...contractors. |13 |_____EZ35______ | |14 Occupancy, rent, utilities, and maintenance . . . . |14 |_____EZ36______ | |15 Printing, publications, postage, and shipping . . . |15 |_____EZ37______ | |16 Other expenses (describe >_________________________) |16 |_____EZ38______ | |17 Total expenses . . . . . . . . . . . . . . . . . . . |17 |_____EZ39______ | |18 Excess or (deficit) for the year . . . . . . . . . . |18 |_____EZ40______ | |19 Net assets or fund balances at beginning of year . . |19 |_____EZ41______ | |20 Other changes in net assets or fund balances . . . . |20 |_____EZ42______ | |21 Net assets or fund balances at end of year . . . . . |21 |_____EZ43______ | |------------------------------------------------------------------------------| |PART II: BALANCE SHEETS | (A) | | (B) | | |Beginning of yr| | End of year | |--------------------------------------------|---------------|---|-------------| |22 Cash, savings, and investments . . . . |_______________|22 |____EZ44_____| |23 Land and buildings . . . . . . . . . . |_______________|23 |____EZ45_____| |24 Other assets (describe >______________) |_______________|24 |____EZ46_____| |25 Total assets . . . . . . . . . . . . . |_____EZ47______|25 |____EZ48_____| |26 Total liabilities (describe >_________) |_____EZ49______|26 |____EZ50_____| |27 Net assets or fund balances . . . . . . |_____EZ51______|27 |____EZ52_____| +------------------------------------------------------------------------------+ Form 990-EZ (1995) Page 2 +------------------------------------------------------------------------------+ |PART III: STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS | |------------------------------------------------------------------------------| |What is the org's primary exempt purpose?_____________________| | |Describe ... achieved in carrying out org's exempt purposes. | Expenses | |--------------------------------------------------------------+---------------| |28......................................................... | | | (Grants $_______________) |_______________| |--------------------------------------------------------------+---------------| |29..................................................... | | | (Grants $_______________) |_______________| |--------------------------------------------------------------+---------------| |30..................................................... | | | (Grants $_______________) |_______________| |--------------------------------------------------------------+---------------| |31 Other program services . . . . .(Grants $_______________) |_______________| |------------------------------------------------------------------------------| |32 Total program service expenses . . . . . . . . . . > |_______________| |------------------------------------------------------------------------------| |PART IV: LIST OF OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES | | Number of persons receiving no compensation: EZ201 | |------------------------------------------------------------------------------| |(A)Name and addr|(B)Title & avg|(C)Compensation|(D)Contributions| (E)Expense | | | hours/week | |to empl.benefit |acct.& allow.| |----------------+--------------+---------------+----------------+-------------| |______VROW______| |_____V001______|______V002______|_____V003____| |----------------+--------------+---------------+----------------+-------------| |(NOTE: All rows entered on return are picked up) | |------------------------------------------------------------------------------| |PART V: OTHER INFORMATION |Yes|No | |----------------------------------------------------------------------|---|---| |33 Did org. engage in activity not previously reported to IRS? . . . |___|___| |34 Changes made in organizing/governing docs but not reptd to IRS? . |___|___| | If Yes, attach a conformed copy of the changes. |\\\|\\\| |35a During tax year did org.have UBI of $1,000 or more or incur |\\\|\\\| | liability for ... lobbying & political expenditures? . . . . . . |___|___| | b If Yes, has it filed a tax return on Form 990-T for this year?. . |_EZ12__| |36 Was there liquidation, dissolution, termination,etc. this yr? . . |_EZ13__| |37a Enter amount of political expenditures..... |37a|_____EZ205____|\\\|\\\| | b Did organization file Form 1120-POL for this year? . . . . . . . |_EZ206_| |38a Did org. borrow from/make loans to officer, director, (etc) OR |\\\|\\\| | were any such loans made in prior year and still unpaid ...? . . | | | | b If Yes, .... and enter the amount involved . . .|38b|_____________|\\\|\\\| |39 Section 501(c)(7) organizations.--Enter: |\\\|\\\| | a Initiation fees and capital contributions . . .|39a|____EZ209____|\\\|\\\| | b Gross receipts: public use of club facilities. .|39b|____EZ210____|\\\|\\\| | c Does club's governing instrument ... provide for discrimination...| | | |40 List the states with which a copy of this return is filed > ..............| |41 The books are in care of > ................. Telephone no.> ..............| | Located at > .......................................... ZIP code> .......| |42 Section 4947(a)(1) nonexempt charitable trusts... Check here.......> | | and enter tax-exempt int. recd or accrued during tax year >|42 |__________| +------------------------------------------------------------------------------+