Form Schedule A (Form 9 Schedule A (Form 9 Public Charity Status and Public Support

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I.R.S. SPECIFICATIONS

TO BE REMOVED BEFORE PRINTING

INSTRUCTIONS TO PRINTERS
SCHEDULE A (FORM 990, 990-EZ), PAGE 1 of 5
MARGINS: TOP 13 mm (1⁄ 2 "), CENTER SIDES.
PRINTS: HEAD to HEAD
PAPER: WHITE WRITING, SUB. 20.
INK: BLACK
FLAT SIZE: 279 mm (11") x 432 mm (17"),
FOLDED TO: 216 mm (81⁄ 2 ") x 279 mm (11")
PERFORATE: NONE

Signature

Revised proofs
requested

OMB No. 1545-0047

Public Charity Status and Public Support

Department of the Treasury
Internal Revenue Service

To be completed by all section 501(c)(3) organizations.

2008

See Instructions.

Open to Public
Inspection

Name of the organization

Part I

Date

O.K. to print

DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

SCHEDULE A
(Form 990 or 990-EZ)

Action

Employer identification number

Reason for Public Charity Status (to be completed by all organizations) (See Instructions)

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The organization is not a private foundation because it is: (Please check only one applicable box.)
1
A church, convention of churches, or association of churches. Section 170(b)(1)(A)(i).
2
A school. Section 170(b)(1)(A)(ii). (Attach Schedule E.)
3
A hospital or a cooperative hospital service organization. Section 170(b)(1)(A)(iii). (Attach Schedule H.)
4
A medical research organization operated in conjunction with a hospital. Section 170(b)(1)(A)(iii). Enter the hospital’s name,
city, and state:
5
An organization operated for the benefit of a college or university owned or operated by a governmental unit. Section
170(b)(1)(A)(iv). (Complete the Support Schedule in Part II.)
6
A federal, state, or local government or governmental unit. Section 170(b)(1)(A)(v).
7
An organization that normally receives a substantial part of its support from a governmental unit or from the general public.
Section 170(b)(1)(A)(vi). (Complete the Support Schedule in Part II.)
8
A community trust. Section 170(b)(1)(A)(vi). (Complete the Support Schedule in Part II.)
9
An organization that normally receives: (1) more than 331⁄ 3 % of its support from contributions, membership fees, and gross
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331⁄ 3 % of its
support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. Section 509(a)(2). (Complete the Support Schedule in Part III.)
10
11

e

f
g

h

An organization organized and operated exclusively to test for public safety. Section 509(a)(4). (See instructions.)
An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the
purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). Section
509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.
a
Type I
b
Type II
c
Type III–Functionally Integrated
d
Type III–Other
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified
persons other than foundation managers and other than one or more publicly supported organizations described in section
509(a)(1) or section 509(a)(2).
If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting
organization, check this box
Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?
Yes
No
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
11g(i)
and (iii) below, the governing body of the supported organization?
11g(ii)
(ii) a family member of a person described in (i) above?
11g(iii)
(iii) a 35% controlled entity of a person described in (i) or (ii) above?
Provide the following information about the organizations the organization supports.

(i) Name of Supported
Organization

(ii) EIN

(iii) Type of organization
(described on lines 1–9
above or IRC section.)

(iv) Is the organization
in (i) listed in your
governing document?

Yes

No

(v) Did you notify
the organization in
(i) of your support?

Yes

No

(vi) Is the
organization in (i)
organized in the
U.S.?

Yes

(vii) Amount of
support

No

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2008

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I.R.S. SPECIFICATIONS

TO BE REMOVED BEFORE PRINTING

INSTRUCTIONS TO PRINTERS
SCHEDULE A (FORM 990, 990-EZ), PAGE 2 of 5
MARGINS: TOP 13 mm (1⁄ 2 "), CENTER SIDES.
PRINTS: HEAD to HEAD
PAPER: WHITE WRITING, SUB. 20.
INK: BLACK
FLAT SIZE: 279 mm (11") x 432 mm (17"),
FOLDED TO: 216 mm (81⁄ 2 ") x 279 mm (11")
PERFORATE: NONE

DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

Schedule A (Form 990 or 990-EZ) 2008

Page

2

Part II

Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I.)
Public Support
Calendar year (or fiscal year beginning in)
1

Gifts, grants, contributions, and
membership fees received. (Do not
include any "unusual grants.")

2

Tax revenues levied for the organization’s
benefit and either paid to or expended on
its behalf

3

The value of services or facilities
furnished by a governmental unit to the
organization without charge
Total

4
5

6

(a) 2004

(b) 2005

(c) 2006

(d) 2007

(e) 2008

(f) Total

(a) 2004

(b) 2005

(c) 2006

(d) 2007

(e) 2008

(f) Total

Amounts included on line 1 from each
person (other than a governmental unit
or publicly supported organization)
whose total payments for the years in
columns (a) through (e) exceeded 2% of
the amount shown on line 11 column (f)
Public Support (line 4 minus line 5)

Total Support
Calendar year (or fiscal year beginning in)
7
8

Amounts from line 4
Gross income from interest, dividends,
payments received on securities loans,
rents, royalties and income from similar
sources

9

Net income from unrelated business
activities, whether or not the business is
regularly carried on

10

11
12
13

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Other income. (Explain in Part IV.) Do not
include gain or loss from the sale of
capital assets
Total Support (Add lines 7 through 11)
Gross receipts from related activities, etc. (See instructions.)

12

First Five Years If the Form 990 is for the organization’s first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
©
check this box and stop here

Computation of Public Support Percentage

14
%
Public Support Percentage for 2008 (line 6 column (f) divided by line 11 column (f))
%
15
15 Public Support Percentage from 2007 Schedule A, Part IV-A, line 26f
16a 331⁄ 3 % Test - 2008 If the organization did not check the box on line 13, and line 14 is 331⁄ 3 % or more, check this box
14

and stop here. The organization qualifies as a publicly supported organization

©

b 331⁄ 3 % Test - 2007 If the organization did not check a box on line 13 or 16a, and line 15 is 331⁄ 3 % or more, check this

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

©

17a 10% Facts and Circumstances Test - 2008 If the organization did not check a box on line 13, 16a or 16b, and line 14

is 10% or more, and if the organization meets the “facts and circumstances” test, check this box and stop here. Describe
in Part IV how the organization meets the “facts and circumstances” test. The organization qualifies as a publicly supported
©
organization
b 10% Facts and Circumstances Test - 2007 If the organization did not check a box on line 13, 16a, 16b or 17a and line

18

15 is 10% or more, and if the organization meets the “facts and circumstances” test, check this box and stop here.
Describe in Part IV how the organzation meets the “facts and circumstances” test. The organization qualifies as a publicly
©
supported organization
Private Foundation If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
©
instructions
Schedule A (Form 990 or 990-EZ) 2008

1
I.R.S. SPECIFICATIONS

TO BE REMOVED BEFORE PRINTING

INSTRUCTIONS TO PRINTERS
SCHEDULE A (FORM 990, 990-EZ), PAGE 3 of 5
MARGINS: TOP 13 mm (1⁄ 2 "), CENTER SIDES.
PRINTS: HEAD to HEAD
PAPER: WHITE WRITING, SUB. 20.
INK: BLACK
FLAT SIZE: 279 mm (11") x 432 mm (17"),
FOLDED TO: 216 mm (81⁄ 2 ") x 279 mm (11")
PERFORATE: NONE

DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

Schedule A (Form 990 or 990-EZ) 2008

Page

3

Part III

Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I.)
Public Support
Calendar year (or fiscal year beginning in)
1

Gifts,
grants,
contributions,
and
membership fees received. (Do not
include any "unusual grants.")

2

Gross receipts from admissions,
merchandise
sold
or
services
performed, or facilities furnished in any
activity that is related to the
organization’s tax-exempt purpose

3

Gross receipts from activities that are not an
unrelated trade or business under section 513

4

Tax revenues levied for the organization’s
benefit and either paid to or expended on
its behalf
The value of services or facilities
furnished by a governmental unit to the
organization without charge

5

6

Total

(a) 2004

(b) 2005

(c) 2006

(d) 2007

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(e) 2008

(f) Total

(e) 2008

(f) Total

7a Amounts included on lines 1, 2, and 3
received from disqualified persons
7b Amounts included on lines 2 and 3
received from other than disqualified
persons that exceed the greater of 1%
of line 13 for the year or $5,000
7c Total of lines 7a and 7b
8 Public Support (line 6 minus line 7c)

Total Support

Calendar year (or fiscal year beginning in)

(a) 2004

(b) 2005

(c) 2006

(d) 2007

9 Amounts from line 6
10a Gross income from interest, dividends,
payments received on securities loans,
rents, royalties and income from similar
sources

10b Unrelated business taxable income (less
section 511 taxes) from businesses
acquired after 6/30/75
10c Total of lines 10a and 10b
11 Net income from unrelated business
activities not included in line 10b,
whether or not the business is regularly
carried on
12

13
14

Other income. (Explain in Part IV.) Do not
include gain or loss from the sale of
capital assets
Total Support (Add lines 9, 10c, 11 and 12)

First Five Years If the Form 990 is for the organization’s first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
©
check this box and stop here

Computation of Public Support Percentage
15
16

Public Support Percentage for 2008 (line 8 column (f) divided by line 13 column (f))
Public Support Percentage from 2007 Schedule A, Part IV-A, line 27g

15
16

%
%

Computation of Investment Income Percentage
%
17
17 Investment Income Percentage for 2008 (line 10c column (f) divided by line 13 column (f))
%
18
18 Investment Income Percentage from 2007 Schedule A, Part IV-A, line 27h
19a 331⁄ 3 % Tests - 2008 If the organization did not check the box on line 14, and line 15 is more than 331⁄ 3 % and line 17 is

not more than 331⁄ 3 %, check this box and stop here. The organization qualifies as a publicly supported organization ©
b 331⁄ 3 % Tests - 2007 If the organization did not check a box on line 14 or line 19a, and line 16 is more than 331⁄ 3 % and line 18
©
is not more than 331⁄ 3 %, check this box and stop here. The organization qualifies as a publicly supported organization
20 Private Foundation If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions ©
Schedule A (Form 990 or 990-EZ) 2008

1
I.R.S. SPECIFICATIONS

TO BE REMOVED BEFORE PRINTING

INSTRUCTIONS TO PRINTERS
SCHEDULE A (FORM 990, 990-EZ), PAGE 4 of 5 (PAGE 5 BLANK)
MARGINS: TOP 13 mm (1⁄ 2 "), CENTER SIDES.
PRINTS: HEAD to HEAD
PAPER: WHITE WRITING, SUB. 20.
INK: BLACK
FLAT SIZE: 279 mm (11") x 432 mm (17"),
FOLDED TO: 216 mm (81⁄ 2 ") x 279 mm (11")
PERFORATE: NONE

DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

Page 4
Supplemental Information. Complete this part to provide the information required by Part II, line 17a or
17b, the explanation for Part II, line 10, or Part III, line 12, and any other additional information.

Schedule A (Form 990 or 990-EZ) 2008

Part IV

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Schedule A (Form 990 or 990-EZ) 2008