Free 2008 Form 990 or 990-EZ (Schedule G) - Federal

SCHEDULE G (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service

Supplemental Information Regarding Fundraising or Gaming Activities
Attach to Form 990 or Form 990-EZ. Must be completed by organizations that answer "Yes" to Form 990, Part IV, lines 17, 18, or 19, and by organizations that enter more than $15,000 on Form 990-EZ, line 6a.

OMB No. 1545-0047

2008
Open To Public Inspection

Name of the organization

Employer identification number

Part I
1 a b c d

Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.

Indicate whether the organization raised funds through any of the following activities. Check all that apply. Mail solicitations e Solicitation of non-government grants Email solicitations f Solicitation of government grants Phone solicitations g Special fundraising events In-person solicitations
Yes No

2a Did the organization have a written or oral agreement with any individual (including officers, directors, trustees or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

b If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is to be compensated at least $5,000 by the organization. Form 990-EZ filers are not required to complete this table.
(i) Name of individual or entity (fundraiser) (ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts from activity (v) Amount paid to (or retained by) fundraiser listed in col. (i) (vi) Amount paid to (or retained by) organization

Yes

No

Total 3 List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2008

Schedule G (Form 990 or 990-EZ) 2008

Page

2

Part II

Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 on Form 990-EZ, line 6a. List events with gross receipts greater than $5,000.
(a) Event #1 (b) Event #2 (c) Other Events (d) Total Events (Add col. (a) through col. (c))

(event type)

(event type)

(total number)

Revenue

1 2 3

Gross receipts Less: Charitable contributions Gross revenue (line 1 minus line 2) Cash prizes Non-cash prizes Rent/facility costs Other direct expenses Direct expense summary. Add lines 4 through 7 in column (d) Net income summary. Combine lines 3 and 8 in column (d) ( )

4 Direct Expenses 5 6 7 8 9

Part III
Revenue

Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
(a) Bingo (b) Pull tabs/Instant bingo/progressive bingo (c) Other gaming (d) Total gaming (Add col. (a) through col. (c))

1 2 3 4 5 6 7 8

Gross revenue Cash prizes Non-cash prizes Rent/facility costs Other direct expenses Volunteer labor Yes No % Yes No % Yes No %

Direct Expenses

Direct expense summary. Add lines 2 through 5 in column (d) Net gaming income summary. Combine lines 1 and 7 in column (d)

(

)

Yes No 9 Enter the state(s) in which the organization operates gaming activities: a Is the organization licensed to operate gaming activities in each of these states? b If "No," Explain: 9a

10a Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? b If "Yes," Explain:

10a

11 12

Does the organization operate gaming activities with nonmembers? Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity formed to administer charitable gaming?

11 12

Schedule G (Form 990 or 990-EZ) 2008

Schedule G (Form 990 or 990-EZ) 2008

Page

3

Yes No 13 a b 14 Indicate the percentage of gaming activity operated in: % 13a The organization's facility % 13b An outside facility Provide the name and address of the person who prepares the organization's gaming/special events books and records: Name Address 15a Does the organization have a contract with a third party from whom the organization receives gaming revenue? b If "Yes," enter the amount of gaming revenue received by the organization $ and the $ . amount of gaming revenue retained by the third party c If "Yes," enter name and address: Name Address 16 Gaming manager information: Name Gaming manager compensation Description of services provided Director/officer Employee Independent contractor $

15a

17 Mandatory distributions: a Is the organization required under state law to make charitable distributions from the gaming proceeds to retain the state gaming license? b Enter the amount of distributions required under state law distributed to other exempt organizations or spent in the organization's own exempt activities during the tax year $

17a

Schedule G (Form 990 or 990-EZ) 2008