Form Schedule N-1 Schedule N-1 Continuation Sheet of Schedule N

SCHEDULE N-1
(Form 990
or 990-EZ)

2009

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Attach to Form 990 or 990-EZ to list additional information for
Schedule N (Form 990 or 990-EZ) Part I, line 1; or Part II, line 1.

Department of the Treasury
Internal Revenue Service

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Open to Public
Inspection

See instructions for Schedule N (Form 990 or 990-EZ).

Name of the organization

Part I

OMB No. 1545-0047

Continuation Sheet for Schedule N (Form 990 or 990-EZ)

Employer identification number

Continuation of Liquidation, Termination, or Dissolution (Schedule N (Form 990 or 990-EZ), Part I, line 1.)
(a) Description of asset(s)
distributed or transaction
expenses paid

(b) Date of
distribution

(c) Fair market value of
asset(s) distributed or
amount of transaction
expenses

(d) Method of
determining FMV for
asset(s) distributed or
transaction expenses

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

(e) EIN of recipient

Cat. No. 51028S

(f) Name and address of recipient

(g) IRC section of
recipient(s) (if
tax-exempt) or type
of entity

Schedule N-1 (Form 990 or 990-EZ) 2009

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Continuation of Sale, Exchange, Disposition, or Other Transfer of More Than 25% of the Organization’s Assets (Schedule N (Form 990 or 990-EZ), Part II, line 1.)

Schedule N-1 (Form 990 or 990-EZ) 2009

Part II

(a) Description of asset(s)
distributed or transaction
expenses paid

(b) Date of
distribution

(c) Fair market value of
asset(s) distributed or
amount of transaction
expenses

(d) Method of
determining FMV for
asset(s) distributed or
transaction expenses

(e) EIN of recipient

(f) Name and address of recipient

(g) IRC section of
recipient(s) (if
tax-exempt) or type
of entity

Schedule N-1 (Form 990 or 990-EZ) 2009