Return of Organization Exempt From Income Tax
990 ,
Form
Dep~nt o1 the irmuh
InUenal Rwmue Serviw
A For *92W
B cn . n
applicm0e
Aeeras
~cna~a .
o
o
ONama
tax year period beginning
~ C Name of organization
Pi~
~xm ERSHAW COUNTY
o.
P, EXUAL ASSAULT
°
fi.
IIISbYP
bon,
inipw
TNm
realm
Onmenaee
rtNm
JUL
1,
COALITION
2001
and ending
JUN
30,
2C
D Employer identification number
AGAINST
Number and street (or P 0 box d mail is not delivered to sheet address)
.O . BOX 282
RooMsude
City or town, state or country, and ZIP + 4
C AMDEN , SC
29020
0 Section 501(0)13) organizations and 4947(a)(1) nonexempt charitable trusts
must attach a completed Schedule A (Form 990 or 990-E2)
O=d 940n
2001
Under section 501/c/, 527, or 4947(a)(1) of the Internal Revenue Code (except black lung
benefit trust or private foundation)
" The organization may have to use a copy of this return to satisfy state reporting requirements
1
E Telephone number
803-425-4357
F A..mvr,,mw o c-n o A..
H and 1 are not applicable to section 527 organizations
H(a) Is this a group return for affiliates'?
Yes EXI No
H(b) It 'Yes,' enter number of affiliates 10,
N/A
Hoc) Are all affiliates included
N/A
[L] Yes E::] No
(It'NO ; attach a fist )
) " Pnxn .oi04947(a)(t) orL-L) 527
Hid) Is this a separate return filet by an orK Check here " L-i d the organization s gross receipts are normally not more than $25,000 The
organization need not file a return with the IRS, but it the organization received a Forth 990 Package
in the mail A should file a return without financial data Same slates require a complete return
I
Enter 4,i
110.
M Check
J 0 the organization is not required to attach
5 .325
$th B 1F
990 990-EZ,or990-PF)
L Gross
Organization type ro~mNme1 .O 501(c)(3
J
Contributions, gifts grants, and similar amounts received
1
13
a Direct public support
0 Indirect public support
N
f\
c
N
2
Government contributions (grants)
d Total (add lines 1a Ihrougth 7c)
215 , 2 51 .
(cash E
Membership dues and assessments
Z
5
1c
noncasn E
Dividends and interest from securities
U
6 a Gross rants
fia
6b
h Less rental expenses
7
i
215,251 .
)
Interest on savings and temporary cash investments
d
d
98,783 .
43 .077 .
Program service revenue including government fees and contracts (from Part VII line 93)
3
Cn
1h
c
Net rental income or (loss) (subtract line 6b from line 6a)
Other investment income (describe 10,
B a Gross amount from sale of assets other
A Securities
than inventory
Be
b Less cast or other basis and sales expenses
all
Be
c Gain or (loss) (attach schedule)
d Net gain or (loss) (combine line 8c columns (A) and (B))
Special events and activities (attach schedule)
9
of contributions
a Gross rev
reported
c
Sir
line 1REC
enses other than lundraisin
6 Less dire t e
Net incom Qil IosS~~ .l-frpq~ sPef~l es
nses
70 a Gross sale yrt nvel~im~less returns and all D6 ces
b less cost
11
N
y
c
tg
~/~t'1t-A~~~T
Gross pro( or (IOSfiyR~n .~~a9~t~inbdnlb
Other reven
m
u"
13
Program services (from line 44 column (B))
Management and genera) (from line 44 column (C))
15
Fundraising (/turn line 44, column (D))
iy
16
Payments to affiliates (attach schedule)
18
19
20
Excess or (deficit) for the year (subtract line 17 from line 12)
Net assets or fund balances at beginning of year (from line 73, column (A))
Other changes in net assets or fund balances (attach explanation)
N
a
27
owoz
f
lob
a VII, line 103)
Total revenue add lines 1d 2 3 4 j 5, 6c , 7, Ed , 9c , 10c, and 11 )
a
mo
t0a
^ h schedule) (subtract fine 10b from fine 10a)
12
14
9b
~~a t line 9b from line 9a)
Net assets of fund balances at end of year (combine lines 18 19 and 20)
LHA
For Paperwork Reduction Act Notice, see tie separate instructions
1
Form 990 (2001)
KERSHAW COUNTY COALITION AGAINST
Page 2
SEXUAL ASSAULT
57-08].4217
All organizations must complete column (A) Columns (B), (C), and (D) are required for section 501(c)(3) and
Statement o
Part
~~ Functional Ex pe nses
(4) organizations and section 4947(a)(1) nonexempt charitable trusts but optional for others
Do not include amounts reported on line
(B) Program
(C) Management
g
(D) Fundraising
(A) Total
66, 8v, 96, 106, or 76 0l Part I
services
and eneral
Farm QW (2013 1)
22
Grants and allocations (attach schedule)
cash s
rravasn s
Specific assistance to individuals (attach schedule)
Benefits paid to or for members (attach schedule)
Compensation of officers, directors, etc
23
24
25
2s
27
28
2s
30
31
32
33
34
35
36
37
38
39
40
11
42
43
44
Other salaries andwages
Pension plan contributions
Other employee benehis
Payroll taxes
Professional fundraising lees
Accounting fees
Legal fees
Supplies
Telephone
Postage and shipping
a
6
c
0
e
Occupancy
Equipment rental and maintenance
Printing andpublications
Travel
Conferences conventions and meetings
Interest
Depreciation, deplelion,etc (attach schedule)
Other expenses not covered above (itemize)
SEE STATEMENT 1
Total mnuimai e .amses (aaa iines x.^ mrou9o 43)
mlasmbLnes13~5etingcolumns~B)(D)c~ .,,i~«
22
23
24
25
2s
27
28
2s
30
31
32
33
34
35
36
37
38
39
40
41
42
43a
43b
43c
43d
43e
116
0 .
030 .
58
0 .
926 .
0 .
57 , 104 .
8
575 .
376 .
4
495 .
24 2 .
80 .
4 , 13- 4 .
2
314 .
2
314 .
6
7
4
3
23
099 .
273 .
769 .
600 .
.
.
.
.
2
686 .
415 .
193 .
739 .
6
558 .
6 , 558 .
59
008 .
865
850
331
20 , 762
33
374 .
1
3
2
234 .
423 .
438 .
838 .
1
493 .
676 .
25
634 .
Q .
44
233,703 .
136,649 .
97,054 .
Joint Costs Check Jill
if you are following SOP 98 2
Are any joint casts from a combined educational campaign and fundrasinq solicitation reported in (B) Program services
"
If Yes ; enter (i) the aggregate amount of these joint costs $
( ) the amount allocated to Program services $
What is the organization s primary exempt purposes 111"
0 .
Yes
1
SUPPORT SERVICES FOR VICTIMS OF RAPE AND SEXUAL ABUSE
All w3anizauons must aoso~ee tnair eaemoi purpose xnievanents in a ties and Concise manna State one number of minis saveE oublirzuons ~swee etc Discuss
achievements that ale not measutaDle
dlloCdtlOO5tDO11175)
TO ENSURE VICTIMS ARE PROVIDED
and allocations $
,
`xPen5e5
50 t(c,~7~ .
(A~o~~ `~ ~a
trusts
a VICTIM ADVOCATES PROGRAM IS
No
Pro ptramService
MI
(SeCiim 50 l(cX7) W . (a) ugarvialions and 49i7(aX 1) nMeaCmpl chaitable Vusis must also -1. the amount J qants arm
X
95
and 19nl
Out Optional 101011
)I
6 , 832 .
INELI
c VICTIM SERVICES
COORDINATOR PROVIDES
d PROVIDE CRISIS HOTLINE,
e Other program services (attach schedule)
SERVICES
56 .026 .
RESOURCE ASSI
Grants and allocations $
20
(G r an ts and allocations $
Total of Program Service Expenses (should equal line 44 column (B) . Program services)
12301
of 02 02
5
I
"
, 498
13 6 , 6 4 9
.
Form 990 (2001)
Form99q(200t)
.
KERSHAW COUNTY COALITION AGAINST
SEXUAL ASSAULT
57-0814217
Page 3
part IY Balance Sheets
Note Whet required, attached schedules end amounts within the description column
should be for end-of-year amounts only
45
46
N
m
47 a Accounts recerva6la
6 Less allowance for doubtful accounts
47a
Pledges receivable
Less allowance for doubtful accounts
Grants receivable
49
Recervables tram officers directors, trustees
50
and key employees
51 a Other notes and loans receivable
6 Less allowance for doubtful accounts
52
Inventories for sale or use
Prepaid expenses and deterred charges
53
Investments-securities
54
55 a Investments-land, buildings and
equipment basis
4Ba
4BG
b
56
57 a
h
58
Less accumulated depreciation
Investments - other
Land, buildings, and equipment basis
STMT
Less accumulated depreciation
Other assets (describe "
SSh
59
60
61
Total assets add lines 45 throu g h 58 must e q ual line 74
Accounts payable and accrued expenses
Grants payable
a
J
62
63
64
65
m
m
c
,°
R
67
68
69
26 f 773 .
47c
233 .
48c
49
8,504 .
50
51a
51b
1111- ~ Cosh
51c
52
53
54
0 FMV
SSa
3
57a
57b
49 f 225 .
29 E 901 .
)
SSs
56
13,915 .
57e
58
19 , 324 .
87 , 990 .
1 , 014 .
59
60
61
74 , 291 .
552 .
62
141 .
Loans from officers directors trustees and key employees
a Tax-exempt bond liabilities
h Mortgages and other notes payable
Other liabilities (describe 0-
Unrestricted
Temporariy restricted
Permanently restricted
46,230 .
23 3 .
07h
Deterred revenue
66
Total liabilities add lines 60 thiou h 65
Organizations that follow SFAS 117, check here "
69 and lines 73 and 74
(B)
End of year
47,302 . 45
46
Cash-non-interest-bearing
Savings and temporary cash investments
40 a
6
m
N
(A)
Beginning of year
64a
646
65
)
OX
and complete lines 67 through
Organizations that do not follow SFAS 117, check here ~ ~ and complete lines
70 through 74
70
Capital stock gust principal or current funds
71
Paid-in or capital surplus, or land building and equipment fund
72
Retained earnings endowment accumulated income, or other funds
73
Total net assets or fund balances (add lines 67 Through fig OR lines 70 through 72,
column (A) must equal dine 79 column (B) must equal dine 21)
74
Total liabilities and net assets / fund balances (add lines 66 and 73)
5
63
1 , 014 .
66
5 1 693 .
86 , 976 .
67
68
69
56, 127 .
12,471 .
70
71
72
68 , 598 .
73
74
74 , 291 .
Form 990 is available for public inspection and for some people serves as the primary or sole source of information about a particular organization How tie public
pe "Cenes an olganratlon m such a :es may be determined by the Infc " ma(lon Rresen'ed or as " eNrv, Therefore please make sure the velum is complete and accurate
and fully describes in Part III, the organization s programs and accomplishments
123021
0, 02 m
B6
87
9 16 .
9 90 .
KERSHAW COUNTY COALITION
SEXUAL ASSAULT
Reconciliation of Revenue per Audited
pa
Financial Statements with Revenue per
Return
Total revenue, pains, and other support
a
" a
215 , 32 5 .
per audited financial statements
D
Amounts included on line a but not on
line 12, Form 990
(1)
Net unrealized gins
~ "
(2)
on investments
$
Donated services
and use of facilities $
~
(3)
Recoveries of Onor
year grants
(4)
Other (specify)
Form99o 200t
Part tY-A
a
h
(1 ~
(2)
(3)
(4)
c
d
s
Add amounts on ones (1) through (3)
dine a minus line 6
Amounts included on line 12, Form
990 Out not on line a
"
"
h
c
(1) Investment expenses
not included on
line 6b Form 990
$
(2) Other (specify)
e
f
Ado amounts an lines (t) and (2)
Total revenue per line 12, Form 990
dine c plus line d)
0 .
2151325 .
~
"
d
- -0.
o
d
AGAINST
57-0814217
Pa g e a
Reconciliation of Expenses per Audited
Financial Statements With Expenses per
Return
Total expanses and losses per
" a
233, 703 .
audited financial statements
Amounts included on line a but not on
line 17, Form 990
Donated services
and use of facilities S
Prior yeas adjustments
~ `
reported on line 20,
Form 990
$
Losses reported on
line 20, Form 990
f
N-8
Other (specify)
s
Ado amounts on lines (1) through (a)
Lineaminus line D
Amounts included on line 11, Farm
990 bud not on line a
" 0
" c
(1) Investment expenses
not included on
line 6D, Form 990
$
(2) Other (specify)
f
Add amounts on lines (1) and (2)
a Total expenses per line 17 Form 990
(line c plus line d)
"
0 .
233,703 .
0 .
d
1, e
215 , 325 .
mi~ B
233 , 703 .
List of Officers, Directors, Trustees, and Key Employees List each one even if not compensated)
ro
(B) Title and average hours C) Compensation (D~canmounon.
(E) Expense
oeneMt
account and
per week devoted to
'It not pDI , enter
Pp~~ yasda
(A) Name and address
-0m6 eon
other allowances
p osition
DIRECTOR
PENELOPE D . BAKER
5630 ELLERHE MILL RD
0 .
0 .
0 .
SC
35
REMBERT
pplit y(
SALLIE
SNIDER
--------------------------------SC
CAMDEN
DONNA RUDD
31 RAMCHUTKA LN
CAMDEN
SC
INGRID LARSEN
11218 OLD ENGLISH RD
LUGOFF
SC
SAMANTHA BAUMBACH
220 JEFFERS CIRCLE
SC
ELGIN
TAMMY THOMAS
1303 KINGS AVE
CAMDEN
SC
S ECRETARY
35
0 .
0 .
0 .
0 .
0 .
0 .
0 .
CO OR DINATOR
0 .
0 .
0.
0 .
0 .
0 .
0 .
EE
CTY
ADVOC A TE
15
EE
CTY
ADVOCATE
35
EDUCATION
35
ICTIM
35
SVS
COORDINATOR
0 .
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------75 Die any officer, director trustee or key employee receive aggregate compensation of more than $00 OOO from your o r aniuuon and all related
organizations of which mole than $10,000 was provided by the related organizations 11 Yes' attach schedule " u Yes ~X No
Form 990 (200 1
Form 990
KERSHAW COUNTY COALITION AGAINST
5
Did the brganization engage in any acirviry not previously reported to the IRS II Yes; attach a derailed description of each activity
Were any changes made in the organizing or governing documents but not reposed to the IRS
It 'Yes' attach a conlormed copy of the changes
78 a Did the organization have unrelated business gross income of $1,000 of more during the year covered 6y this return
N /A
b II Yes' has it filed a tax return on form 990-T for this years
79
Was (here a liquidation, dissolution, termination, or substantial contraction during the year
11 'Yes,* attach a statement
80 a Is the organization related (ocher than by association with a statewide or nationwide organization) through common membership,
76
77
b
81 a
b
82 a
b
83 a
b
84 a
b
BS
b
governing bodies, pustees, officers, etc , to any other exempt or nonexempt Organization?
If 'Yes,' enter the name of the organization
ll~
and check whether it is
exempt OR
nonexempt
812 1
Enter direct of indirect political expenditures See line 81 instructions
Did the organization rile Form 1120-POL for this year
did the organization receive donated services or the use of materials, equipment, or facilities al no charge or at substantially less than
fair rental value
II Yes; you may indicate the value of these items here Do not include this amount as revenue in Part I or as an
I 826 I
expense in Part II (See instructions in Part 111 )
N/A
Did the organization comply with the public inspection requirements for returns and exemption applications?
Did the organization comply with the disclosure requirements relating to quid pro quo contributions?
N/A
Did the organization solicit any contributions or gifts that were not tax deductible?
II "Yes ; did the organization include with every solicitation an express statement that such contributions or gifts were not
tax deductible?
N/A
507(c)(4) (5), or (6) organizations a Were substantially all dues nondeductible 6y members
N/A
Did the organization make only in house lobbying expenditures of $2,000 or less
N/A
II "Yes was answered to either B5a or 85b, do not complete 85c through 85h below unless the organization received a waiver for proxy tax
owed for the prior yeas
c Dues assessments and similar amounts from members
d Section 162(e) lobbying and political expenditures
e Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices
0
h
86
87
b
b
BB
89 a
85c
BSd
Taxable amount of lobbying and political expenditures (line BSd less 85e)
~
He
85,1
Does the organization elect to pay the section 6033(e) lax on the amount in 85f?
N/ A
N/ A
N /A
N/A
N/A
If section 6033(e)(1 )(A) dues notices were sent, does the organization agree to add the amount in 85f to its reasonable estimate of dues
allocable to nondeductible lobbying and political expenditures for the following lax years
N/A
50 1(c)(7) organizations Enter a Initiation lees and capital contributions included on line 12
Gross receipts, included on line 12, for public use of club facilities
501(c)(12) organizations Enter a Grass income from members or shareholders
863
N /A
86b
N/A
B7a
Gross income from other sources (Do not tier amounts due or paid to other Sources
against amounts due of received ITom them )
87D
At any time during the year did the organization own a 50% or greater interest in a taxable corporation or partnership
or an entity disregarded as separate from the organization under Regulations sections 301 7701 2 and 301 7/01 3?
II'Yes complete Part IX
501(c)(3) organizations Enter Amount of tax imposed on the organization during the year under
section 49111
0 .
section 4912 1
0 .
N /A
N /A
section 4955 1
Q
b 501(c)(3) and 501(c)(4) organizations Dill the organization engage in any section 4958 excess benefit
transaction during the year or did d become aware of an excess benefit transaction from a prior year
11 Yes attach a statement explaining each transaction
90 a
h
Enter Amount of lax imposed on the organization managers or disqualified persons during the year under
sections 4912, 4955 and 4958
Enter Amount of lax on line 89c above reimbursed 6y the organization
List the states with which a coot of this return is tiled "
SOUTH CAROLINA
Number of employees employed in the pay period chat includes March 12 2001
91
Thebooksareincareol " PENELOPE D .
c
d
Locaiedat " 1111 BROAD STREET,
92
90b
Telephoneno " 803-425-4337
BAKER
CAMDEN,
1
SC
Section ag47(a)(1) none rempr charitable vests filing Form 990 in 6eu o! Form 1011
and enter the amount of tax-exempt interest received or accrued dunnp the lax VBar
ZIP +4 . 29020
Check here
1111.
F orm 990(2001)
Y COALITION AGAINST
T
57-0814217
tlvitles (See Specific Instructions on page 32 )
Unrelated business income
e .cwea e, ~uon 512 513 v s, .
E(C)
Related or exempt
(D)
Business
(B)
^o:
Amount
Amount
function income
code
Form 590
Note Enter gross amounts unless otherwise
mdiqaled
93
a
b
c
d
e
f
p
9"
95
Program service revenue
Medicare/Medicaid payments
Fees and contracts (ram government agencies
Membership dues and assessments
Interest on sarongs and temporary
cash investments
Dividends and interest from securilies
Net rental income or (loss) horn real estate
debt-financed property
not debt financed property
Net rental income or (loss) from personal properly
96
97
a
b
98
99 Other investment income
100 Gain or (loss) horn sales of assets
other than inventory
101
102
103
Net income or (loss) from special events
Gross prow or (loss) from sales of inventory
Other revenue
a
b
e
d
e
104 Subtotal (add columns (B) (D), and (E))
105 Total (add line 104, columns (B), (D) and (E))
Note
1111.
Line 105 plus fine 7d. Part l . should eoual the amount on line 12. Part I
Part VIII neianonsmp of Acnvines co cne iaccompusnmenc or cxempc ru fF705 e5 ( 58B 5pBCrtiC I nStf uCll On9 on page J2 I
Line No
Explain how each activity for which income is reported m column (E) at Part VII contributed importantly to the accomplishment of the Organization s
exempt purposes (other than by providing hinds for such purposes)
Part IX
Specific Instructions on
Name address and EIN of
of
Nature ~ol'acirvilies
(a) Did the organization dunng the year, receive any hinds directly or inairec
(h) Did the organization, during the year pay premiums, directly or indirectly,
Node
Please
Sign
Here
It 'Yes' to b
file Form 8870 and Form 4 720 see instructions
Under penaihes of peqmy I ewlar e IFaI I have e .amired this return dcluaing a
nttt and cOmpIGIP i of OnCObb (OImH Iha, OM¢P) 5 bas[C dl all
/-)
~ ~Igrfature
Preparer s '
Paid
signature
Preparei's v ms ,meco
if
Use Only
foal .emoioyl
Rns ~
m r? no
sell
aae~ess ana
ZIP .
/~:)
A
Sam ,, ~q
SHEHEEN, I-IANCOCK
'P .O .
DRAWER
('nMT1FU
C
r
428
I
& G(
70f1-)f1
income
I
End
6
SCHEDULE A
(Form 990 or 990-EZ)
oeoY+mmt of Me fr~~n
interal aavmue ~~
Organization Exempt Under Section 501(c)(3)
OMB No t5a5-OOa7
(Except Private Foundation) and Section 501(e), 501f1), 501(k) .
501(n), or Section 4947(a)(1) Nonexempt Charitable Trust
2001
Supplementary Information-(See separate instructions .)
" MUS T be co mpl e t ed by th e ab ove orga ni zations and atta ched to their Form 990 or 990-EZ
Name of the organization KERSHAW COUNTY COALITION AGAINST
Employer identification number
Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees
(See page 1 of the instructions List each one II there are none, enter'NOne')
(a) Name and address of each employee paid
more than $50,000
(b) ale and average hours
per week devoted to
(e) Compensation
un ~oy~U~na~~o
(e
p 5 a ag,e, acco
NONE
Total number of other employees paid
over $50 .000
II
" 1
Compensation of the Five Highest Paid Independent Contractors for Professional Services
(See page 2 0l the instructions List each one (whether individuals or firms) If there are none, enter None')
(a) Name and address of each independent contractor pain more than $50 000
(6) Type of service
I (c) Compensation
NONE
Total number of others receiving over
$50,000 for professional services
11
LHA
For Paperwork Reduction Act Notice, see the Instructions for Form 990 and Form 990 EZ
23101
,z 29 01
Schedule A (Form 990 of 990 EZ) 2001
COALITION AGAINST
Schedule A (Form 990 or 990 EZ) 2001
Part III
Statements About Activities See page 2 0l the instructions )
No
During theyear, has the organization attempted to influence national, state, or local legislation, including any attempt to influence
public opinion on a legislative matter or referendums If Yes; enter the foul expenses paid or incurred in connection with the
(Must equal amounts on line 38, Part VI A,
lobbying atuwles 1 $
$
1
or line i of Part Vl-B
Organizations that made an election under section 501(h) 6y filing Form 5768 must complete Part VIA Other organizations checking
'Yes ; must complete Part VI B AND attach a statement giving a detailed description of the lobbying activities
During the year, has the organization, either directly or indirectly, engaged m any of the following acts with any substantial contributors,
trustees, directors, officers, creators, key employees, or members of (heir families, or with any Imble organization with which any such
person is affiliated as an officer, director, trustee majority owner, or principal beneficiary? (if the answer to any question is 'Yes,'
2
attach a detailed statement explaining the transactions
a Sale, exchange, or leasing of properly
b lending of money or other extension of credit?
e Furnishing of goods, services, or lacilities9
d Payment of compensation (or payment or reimbursement of expenses it more than $1000)?
e Transfer of any part of its income or assets
Does the organization make grants for scholarships, fellowships, student loans, etc 9 (See Note below
Do you have a section 403(b) annuity plan for your employees
3
4
Note Attach a statement to explain how the organization determines that individuals or organizations receiving grants or loans
from it m furtherance of its charitable programs quality' to receive payments
6 of the instructions
The organization is not a private foundation because it is (Please check only ONE applicable box )
A church, convention of churches, or association of churches Section 170(b)( 1)(A)(i)
5
6
A school Section 170(b)(1)(A)(n) (Also complete Part V )
7
A hospital or a cooperative hospital service organization Section 170(6)(1)(A)(w)
8
A Federal, state or local government or governmental unit Section 170(b)(1)(A)(v)
A medical research organization operated in conjunction with a hospital Section 170(b)(1)(A)(ni) Enter the hospital s name, city,
9
and slate
An organization eperaled for the benefA of a college or university owned or operated by a governmental and Section 170(b)(1)(A)(iv)
10
(Also complete the Support Schedule in Part IV A )
11a
An organization that normally receives a substantial pail of ids support from a governmental unit or from the general public
Section 170(b)( 1)(A)(vi) (Also complete the Support Schedule in Part IV A )
116
A community (rust Section 170(b)(1)(A)(vq (Also complete the Support Schedule m Part IV A)
12
X
An organization that normally receives (1) more than 33 1/3X of its support from contributions, membership lees and gross
receipts from activities related to its charitable etc luncuons subject to certain excPpuons, and (2) no more than 33 113% of
its support from gross investment income and unrelated business taxable income (less section 511 lax) from businesses acquired
by the organization after June 30, 1975 See section 509(a)(2) (Also complete the Support Schedule in Part IV A )
13
An organization that is riot controlled by any disqualified persons (other than foundation managers) and supports organizations described in
(1) lines 5 through 12 above, or (2) section 501(c)(4) (5), or (6) it they meet the test of section 509(a)(2) (See section 509(a)(3) )
Provide the following information about the supported organizations (See page 5 0l the msuucions I
(b) Line number
from above
Ja) Name(s) of supported organization(s)
14
An organization organized and operated to lest for public safely Section 509(a)(4) (See page 6 of the instructions )
Schedule A (Form 990 or 990-EZ) 2001
rat 01 07 02
KERSHAW COUNTY COALITION AGAINST
SchedaIen(Forrrr990orss0-EZ)200l SEXUAL ASSAULT
online 10 11, or 12) Use cash
Part IV-A Support Schedule (Complete only if you checked a box
for
Note You ma use the worksheet m the mstruc(rons
convemn
Calendar year (or fiscal year
(b) 1999
a) 2000
be g innin g m
"
Gifts Quits anarnnoinutronsrecerved
$
Coo
line ~~~u"unuy'~v'""s"
11
Gross receipts from admissions,
merchandise sold or services
performed, or furnishing 01
facilities in any activity that is
related to the organization's
charitable, etc, purpose
18
Gross income from interest
dividends, amounts received from
payments on securities loans (sec
lion 512(a)(5)), rents, royalties, and
unrelated business taxable income
(less section 511 taxes) tram
businesses acquired by the
orpanualion alter June 30 1975
19
Net income from unrelated business
O
activities not included in line 18
Tax ICrTUlS levilG for IA! vpani[abon 5
Oenelit and either paid to It or expanded
0I1 IBS bN1Ll
21
The value of services or facilities
furnished to the organization by a
governmental unit without charge
Do not include the value of services
or facilities generally furnished to
the public without charge
oma mcwna a,t,n, a schedule Do nor
include gait a posts rtom sale of cao~tal
assets
Total ollines 15through 22
pp
23
24
Line 27minus line t7
25
Enter 1% of line 23
26
b
(e) Total
127,780 .
155,962 .
703,347 .
234
1-85
, 64-9,
127
805 .
156
132 .
704
805 .
156
132 .
704
1 , 278 .
1
561 .
Organizations described on tines 10 or 11
633 .
633 .
2 , 346 .
a
185
649 .
127
1 , 856 .
Enter 2% of amount m column (e), line 24
Prepare a list for your records to show the name of and amount contributed by each person (other than a governmental
219 .
219 .
. 26e
N/A
1 26b
1 26c
- N/A
N/A
" 26e
N/A
unit or publicly supported organization) whose total gifts for 1997 through 2000 exceeded the amount shown in line 26a
Enter the total of all these excess amounts
Total support for section 509(a)( 1) test Enter line 24, column (e)
Add Amounts horn column (e) for lines
e
Public support (line 26c minus line 26d total)
27
(d) 1997
185,297 .
d
f
c) 1998
Pape3
234,308 .
234
Do not file this list with your return
c
57-0814217
method o1 accounting
from the accrual to the cash method of accounting
IB
19
22
26b
1 ~ 26e ~
Public support percentage (line 26e (numerator) divided 6y line 26c (denominator))
Organizations described on fine 12
1 261
N/A
NBA
a For amounts Included in lines 15, 16, and 17 that were received from a'disqualAied person ; prepare a list for your records
to show the name of and total amounts received in each year from each disqualified person ' Do not file this list with your retain Enter the sum of such amounts
poi each year
(2000)
b
0 .
(1999)
0.
(1998)
0 .
(1997)
For any amount included m line 17 that was received tram each pe5on (other than 'disqualified persons"), prepare a lisp for your records to show the name of, and
amount received for each year that was mare than the larger of ( t) the amount on tine 25 for the year or (255,000 (Include in the list organizations described in
lines S through 11, as well as individuals ) Do not tale this list with your return Alter computing the difference between the amount received and the larger
amount described m (1) or (2~ enter the sum of these differences (the excess amounts) for each year
(2000
c
0 .
Add Amounts from column (e) for lines
17
d
e
t
p
(999)
0.
15
20
(1998)
703,347 .
Add Line 27a total
0 .
and line 27b total
support
(line
minus
line
total)
Public
27c total
27d
Total support for section 509(a)(2) rest Enter amount on line 23 column (e)
0 .
16
21
872 .
1111- 27c
1111~ 27d
1 27e
70 4 ~
21 9
0.
"
271
Public support percentage (line 27e (numerator) divided byline 27f (denominator))
h Investment income percentage (line 18, column (e) (numerator) divided by line 27f (denominator))
28
(1997)
1 27
1 27h
0 ,
704 , 21
704F21
100 .0000%
.0000%
Unusual Grants for an organization described in tine 10, 11, or 17, that received any unusual grants during 1997 through 2000, prepare a list for yaw records to
show for each year the name of the contribute, the dare and amount of the gram and a net description of the nature of the grant Do not file this list with your
return Do not include these grams m line 15
NONE
123,2, 12 29 01
Schedule A (Form 990 or 990-EZ) 2001
KERSHAW COUNTY COALITION AGAINST
Schedule n(FOrmss0or99o-EZ)200t SEXUAL ASSAULT
Private School Questionnaire See page 7 of the instructions)
Part V
'(To be completed ONLY by schools that checked the box on line 6 in Part IV)
90
31
33
Papea
N/A
Does ire organization have a racially nondiscriminatory policy toward students by statement in its charter, bylaws, other governing
instrument, or in a resolution of its governing ho0y9
Does the organization include a statement of its racially nondiscriminatory policy toward students in all as brochures, catalogues,
and other written communications with tie public dealing with student admissions, programs, and scholarships
Has the organization publicized its racially nondiscriminatory poly through newspaper or broadcast media during the period of
solicitation for students, or during the registration period if it has no solicitation program, in a way that makes the policy known
to all parts of the general community it serves
If -Yes' please describe, if No; please explain (II you need more space, attach a separate statement )
29
32
57-0814217
Yes No
29
30
31
Does the organization maintain the following
a Records indicating the racial composition of the student body, faculty, and administrative staft9
b Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory basis
c Copies of alt catalogues, brochures, announcements and other written communications to the public dealing with student
admissions, programs, and scholarships
d Copes of ail material used by the organization or on its behalf to solicit contributions?
If you answered 'No'to any of the above please explain (If you need more space, attach a separate statement )
Does the organization discriminate by race in any way with respect to
a Students rights or privileges?
b Admissions policies
c
Employment of faculty or administrative staff?
d Scholarships or other financial assistance?
e
Educational oolicies9
f
Use of facilities?
h
Other extracurricular activities?
p
Athletic programs
If you answered 'Yes' to any of the above please explain ;II you need more space, attach a separate Statement
34 a
6
Does the organization receive any financial aid or assistance from a governmental agency?
Has the organization's right to such aid ever been revoked or suspended
35
Does the organization cenity that it has complied with the applicable requirements of sections 4 01 Through 4 05 0l Rev Proc 75-50,
1975 2 C B 581, covering racial nondiscrimination? If No, attach an exDlanauon
If you answered 'Yes to either 34a or b please explain using an attached statement
Schedule A (Form 990 or 990-EZ) 2001
+ ; 29 01
KERSHAW COUNTY COALITION AGAINST
Schedule A(FOrm990or990-EZ)2001 SEXUAL ASSAULT
Part VI-A Lobbying Expenditures by Electing Public Charities See page 9 of the instructions)
(To be completed ONLY by an eligible organization that fil ed F o rm 5 768)
Check " G
d the oroanizauon belongs to an atfiluted group
"
Check " s
Limits on Lobbying Expenditures
(The term expenditures' means amounts paid or incurred
it you checked 'a' and limited conuor provisions aoolv
(a)
(b)
Affiliated group
To be completed for ALL
electing organizations
totals
N/A
36 Total lobbying expenditures to influence public opinion (grassroots lobbying)
37 Total lobbying expenditures to influence a legislative body (direct lobbying)
38 Total lobbying expenditures (add hoes 36 and 37)
39 Other exempt purpose expenditures
40 Total exempt purpose expenditures (add lines 38 and 39)
41 Lobbying nontaxable amount Enter the amount from the following fable If the amount an line 40 is-
The lobbying nontaxable amount is -
Not ova $500 oaa
:ow of me avnoum om site as
ovn tsoo 00o but not w
.f i aao oW
S too 000 olua 1St of In.
Ors itoaooaatwnot ova $1 50() 000
Sn5o0ooWS+owo1 mee.cessorsitaa.oo0
Over S1 SUOOOObuInolovvS170D0000
$325000pWa5MOllheerceszov>51 500000
Ova f n 000 00o
s+ 000 ow
57-0814217
Page S
N/A
ova S500 0GO
41
12 Grassroots nontaxable amount (enter 25°/. of line 41)
Subtract line 42 from line 36 Enter 0 if line 42 is mare than line 36
43
Subtract line 47 from line 38 Enter 0- if line 41 is more than line 38
44
If them is an amount on ether line 43 or tine 44, you must file Form 4720
Caution
4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the live columns
below See the instructions for lines 45 through 50 on page 11 of the instructions )
Lobbying Expenditures During 4 Year Avenging Period
Calendar year (or
fiscal year beginning in)
45
46
47
48
49
50
Lobbying nontaxable
amount
Lobbying ceiling amount
( 150% of line 45 ( e ))
Total lobbying
ex p enditures
Grassroots nontaxable
amount
Grassroots ceiling amount
( 150% of
'18 ( e ))
Grassrootslo6bying
hid,
ex endilures
Part VI-B
111.
(a)
2001
Ibl
2000
ICI
1999
(4)
1998
(e)
Total
Lobbwna AcUwtv by N
(For reporting only by organizations that did not complete Part VI A) (See gape 12 0l the instructions
During the year, did the organization attempt to influence national slate or local legislation including any attempt to
influence public opinion on a legislative matter or referendum through the use of
Amount
a Volunteers
b
Paid stall or management (Include compensation in expenses reposed on Lneso through h )
c Media advertisements
d Mailings to members legislators or the public
e Publications or published or broadcast statements
f Grants to other organizations for lobbying purposes
q Direct contact with legislators their staffs government ollicials or a legislative body
h Rallies demonslrallons seminars conventions speeches lectures or any other means
i
total lobbying expenditures (Add finest through h )
It 'Yes' to any of the above, also attach a statement giving a detail ed descriphord of the lobbying activities
aou,
2 29 01
Schedule A (Form 990 or 990-EZ) 2001
KERSHAW COUNTY COALITION AGAINST
scneaveA(FOrrrcssoorssoEZ)2ooi SEXUAL ASSAULT
57-0814217
Part VII Information Regarding Transfers To and Transactions and Relationships With Nonchantable
51
a
Exempt Organizations (See page 12 of the instructions)
Did the reporting organization directly or indirectly engage in any of the following with any other organization described in section
501(c) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political organizations
Transfers from the reporting organization to a noncharitable exempt organization of
(q Cash
(u) Other assets
It Other transactions
(i) Sales or exchanges of assets with a noncharitaDle exempt organization
(n) Purchases of assets from a noncharita6le exempt organization
(iii) Rental of facilities equipment or ocher assets
(iv) Reimbursement arrangements
(v) Loans or loan guarantees
(vi) Performance of services or membership or fundraising solicitations
c Sharing of facilities, equipment, mailing lists other asses, or paid employees
d II the answer to any of the above is -Yes,' complete the following schedule Column (b) should always show the fair market slue of the
goods other assets, or services given by the reporting organization If she organization received less than lair market value in any
transaction or sharing arrangement, show in column (d) me value of the goods, other assets, or services received
(a)
Line no
52 a
n
(h)
Amount involved
(c)
Name of noncharitable exempt organization
is 29 0
(b)
Type of organization
Yes
h(i)
b(ii)
No
g
g
]{
]{
b(iii)
b(iv)
b(v)
b(vi)
e
g
g
]{
N /A
(d)
Description of transfers, transactions and sharing arrangements
Is the organization directly or indirectly affiliated with or related to one or more tax exempt organizations described m section 501([) of the
1
Code (other than section 501(c)(3)) or in section 527
II Yes' camolele the lollowino schedule
N /A
(a)
Name of organization
51a(i)
aln)
Pages
Yes
X
No
(c)
Description of relationship
Schedule A (Form 990 or 990 EZ) 2001
,.nn 4562
Depreciation and Amortization
(Rev March 2002)
(Including Information on Listed Property)
omanmat Of manebw .v
inNun,i a,ven. s ..
li~ See separate instructions
Namqs) snovn m 'in..
1 Attach to your tax return
OMS No 1645 017
2001
990
nnachmeni
Seouexe t+0 67
Buvnev a aclnlty io Winch this Corm 'Naies
KERSHAW COUNTY COALITION AGAINST
Part I I Election To Expense Certain Tangible Property Under Section 179 Note If you have any listed
7 Maximum amount See instructions for a higher limit for certain businesses
2 Total cost of section 179 property placed in service (see instructions)
3 Threshold cost of section 179 property before reduction in limitation
nplete Part V before
1
2
3
4
4 Reduction in limitation Subtract line 3 from line 2 If zero or less enter 0
5
(o) Cast (EUVnav use only)
Of propany
(c) Elected cov
7 listed property Enter amount from line 29
8 Total elected cost of section 179 property Add amounts in column (c) lines 6 and 7
9 Tentative deduction Enter the smaller of line 5 or line 8
10 Carryover of disallowed deduction from line 13 0l your 2000 Form 4562
Business income limitation Enter the smaller of business income (not less than zero) or line 5
12 fiction 179 expense deduction Add lines 9 and 10 but do not enter more than line 11
73
13 Carryover of disallowed deduction to 2002 Add lines 9 and 10 les s line 12
milNote Do no( use Part 11 or Part 111 below for listed property Instead use Part V
11
Speoa~ eenrmiauon a~~o .ance for c0tvn or4aenv (omn man ~is6a propsty) acqmrea anew Swtnne> to loot (see msvucums)
14
15 Property subject to section 7680(1) election (see instructions)
17 MACRS deductions for assets placed in service in tax years beginning before 2001
18 II you are electing under section 168()(4) to group any assets placed in service during the tax
aecnon a - iasseis nacea m xr
(b) Mono, and
yea placed
(a) Clatv4caiPon of property
n se,v¢e
c
d
e
(C) eavs for aepxlawn
(ouvnasnn .esmmmuse
only sce'nsvucumsl
I
to) A~~ev
oa,oa
i
19)Dep~enabonaeauct~on
7S
10
15
25
h
Ile)Commiiml ~~ n~emoa
S/L
25,
Residential rental property
Nonresidential real property
27 5
/
27 5 rs
39 yrs
MM
~MM
/
MM
S/L
L
SS/L
Section C - Assets Placed in Service During 2001 Tax Year Using the Alternative Depreciation System
c
40
12
O Vs
rs
Part IVY Summary (See instructions)
21
Lisped property Enter amount from line 28
Enter here and on the appropriate lines of your return Partnerships and S corporations
For assess shown above and placed in service outing the current year enter the
LHA For Paperwork Reduction Act Notice, see separate instructions
S/L
21
22 Total Add amounts from line 12 lines 14 through 17 lines 19 and 20 in column (g) and line 21
23
SQL
MM
see instr
22
Form 4562(2001) (Rev 32002)
Form Crj62 (2W 7 ) (Rev 32002)
Page 2
other
vehicles
cellular
computers,
and
property
Listed
Property
(Include
automobiles
certain
telephones
certain
used
for
entertainment
FP-a-rt V F
recreation, or amusement )
Note For any vehicle for which you are using the standard mileage rate or deducfmg lease expense complete only 24a, tab, columns (a)
through (c) 0l Section A, all of Section B, and Section C d applicable
Section A -Depreciation and Other Information (Caution See instructions for limits for passenger automobiles )
Yes
No 24b If 'Yes," is the evidence written?
24a Do you have evidence to support the businesslinvesiment use claimed
(b) Date
(c)
(e)
(n
(d)
(9)
(h)
(a)
placed in
Type of property
Business/
ate" f° °°a`°°"'°" Recovery
Cosl or
Method/
Depreciation
(list vehicles first )
service
investment
other basis
~°"s"°'""°s""°"
period
Convention
deduction
. . cairi
ucn nnreaNann
Yes
No
Elected
section 179
cost
25 Special depreciation allowance fog listed property acquired after September 10 2001,
26 Property used more than 50°x(, in a qualified business use
27
% I
I
I
I S/L
28 Add amounts in column (h), lines 25 through 27 Enter here and on line 21 page 1
zg
29 Add amounts in column (Q, line 26 Enter here and on line 7 page 1
pg
Section B - Information on Use of Vehicles
Complete this section for vehicles used by a sole proprietor partner or other 'more than 5% owner ' or related person
If you provided vehicles to your employees, first answer the questions in Section C to see if you meet an exception to completing this section for
those vehicles
lal
30 Total businessi~nvestment miles driven during the
Vehicle
I
(b)
Vehicle
I
1c1
I
I
Idl
le)
10
I
year (do not include commuting miles)
31
Total commuting miles driven during the year
32 Total other personal (noncommuting) miles
driven
33 Total miles driven during the year
Add lines 30 through 32
34
Was the vehicle available for personal use
Yes
No
Yes
No
during off duty hours
35
Was the vehicle used primarily by a more
than 5% owner or related person
36 15 another vehicle available for personal
uses
Section C - Questions for Employers Who Provide Vehicles for Use by Their Employees
Answer these questions to determine if you meet an exception to completing Section B for vehicles used by employees who are not more than Si
owners or related persons
37 Do you maintain a written policy statement that prohibits all personal use of vehicles including commuting bit your
employees
38
Yes
N
Do you maintain a written policy statement that prohibits personal use of vehicles except commuting by your
employees See instructions for vehicles used by corporate officers directors, or 1 % or more owners
39 Do you treat all use of vehicles by employees as personal uses
40 Do you provide more than five vehicles to your employees obtain information from your employees about
the use of the vehicles and retain the information received?
41
Do you meet the requirements concerning qualified automobile demonstration uses
Note
II your answer m 37, 38, 39, 40, or 4 1 is 'Yes ' do n ot co mplete Section B for the co v er-red ve hicles
Amortization
lal
00KflOliMOIcosts
42
that
I
Ib1
Oaleamon, nuan
oeains
2001 tan
anni
IC). : 7biP
amount
(d)
COOP
sen.on
(e)
>7~dN17A0~
oenaaoioncen
Amv'Idtron
la IN . yea
43 Amortization of costs that began before your 2001 lax year
44 Total Ado amounts in column (f1 See nns[ruciions for where to
115252
0 20 02
Form 4562 (2001) (Rev 3 2002)
KERS ¬IAW COUNTY COALITION AGAINST SEXUAL
OTHER EXPENSES
FORM 990
(A)
ADVERTISING
PAGER SERVICE
CONTINUING EDUCATION
VOLUNTEER PROGRAM
DUES
PRESENTATIONS
THERAPY
MISCELLANEOUS
EXPENSE
BANK CHARGES
SPECIAL EVENTS
INSURANCE
LICENSES AND PERMITS
MAINTENANCE
TOTAL TO FM 990,
IN 43
STATEMENT
(H)
PROGRAM
SERVICES
TOTAL
DESCRIPTION
FORM 990
57-0814217
633
139
1,430
516
225
1,042
25,049
(C)
MANAGEMENT
AND GENERAL
633
653
1,430
516
225
4,333
44,810
.
.
.
.
.
.
.
.
.
.
.
.
.
.
2,151
33
145
2,606
1,121
352
.
.
.
.
.
.
2,151 .
33 .
145 .
538 .
1,121 .
352 .
59,008 .
33,374 .
COST OR
OTHER BASIS
CANON COPIER
TYPEWRITER
CHAIRS
STOOLS
SOFA & LOVE SEAT
OFFICE FURNITURE
OAK DESK
PAGERS
OFFICE DESK
WORD PROCESSOR
PHONES
FILE CABINET
IBM COMPUTER
PRINTER
CHAIR
CABINET & BOOKCASE
VCR
LEATHER CHAIR
PENTIUM 133, SCANNER &
TELEPHONE EQUIPMENT
PRINTER
986 .
896 .
427 .
105 .
1,055 .
828 .
300 .
192 .
104 .
229 .
210 .
146 .
1,000 .
300 .
146 .
273 .
229 .
200 .
3,571 .
1,941 .
(D)
FUNDRAISING
514 .
3,291 .
19,761 .
2,068 .
25,634 .
DEPRECIATION OF ASSETS NOT HELD FOR INVESTMENT
DESCRIPTION
1
STATEMENT
ACCUMULATED
DEPRECIATION
986
896
427
105
1,055
828
300
192
104
229
210
146
1,000
300
146
273
229
185
3,571
1,804
2
BOOK VALUE
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
STATEMENT S)
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
15
0
137
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
1,
2
KERSi`IP.W COUNTY COALITION AGAINST SEXUAL
AUDIO VISUAL
FAX MACHINE
LAPTOP COMPUTER
COPIER
PORTABLE PROJECTOR
KODAK SLIDE PROJECTOR
4 DRAWER FILE CABINET
AUDIO STORAGE
BOOKCASES
EQUIPMENT
13" TV/VCR
COPIER STAND
OVERHEAD PROJECTOR
CHAIR
CABINETS
CABINETS
SOFA
DESK & CHAIR
BOOKCASE
SOFA
LAPTOP COMPUTER
HP PORTABLE PRINTER
CASSAETTE RECORDER
PREMIO COMPUTER
HP PRINTER
PRINTER
DESK
COUCH, CHAIR, TABLE AND
CHAIRS
LEASEHOLD IMPROVEMENTS
KONICA 7020 COPIER
PREMIO COMPUTER
HP960 DESKJET
2 DESKS
4
LEASEHOLD IMPROVEMENTS
TOTAL TO FORM
990,
PART
IV,
LN
57
57-0814217
2,386 .
605 .
2,172 .
802 .
500 .
600 .
1,007 .
172 .
257 .
318 .
470 .
157 .
162 .
75 .
552 .
48 .
449 .
377 .
180 .
175 .
1,706 .
367 .
222 .
2,078 .
330 .
313 .
162 .
2,237
569
2,031
754
470
564
625
106
159
299
441
147
152
42
311
27
253
212
101
99
1,215
261
158
1,480
235
223
91
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
1,350 .
6,128 .
4,568 .
1,700 .
244 .
831 .
4,624 .
420
1,348
914
340
49
119
463
.
.
.
.
.
.
.
49,225 .
29,901 .
149 .
36 .
141 .
48 .
30 .
36 .
382 .
66 .
98 .
19 .
29 .
10 .
10 .
33 .
241 .
21 .
196 .
165 .
79 .
76 .
491 .
106 .
64 .
598 .
95 .
90 .
71 .
930
4,780
3,654
1,360
195
712
4,161
.
.
.
.
.
.
.
19,324 .
STATEMENT S)
2
Form
$68
1December
!:01
lreasu,y
Department (
Internal Revenue Sennce
I
Application for Extension of Time To File an
Exempt Organization Return
OMB No 7545 1709
10 File a separate application for each return
1 21
" If you are filing for an Automatic 3-Month Extension, complete only Part I and check this box
" If you are filing for an Additional (not automatic) 3-Month Extension, complete only Part II (on page 2 of this form)
Note Do no[ complete Part 11 unless you have already been granted an automatic 3-month extension on a previously fled
Form 8868
Automatic 3-Month Extension of Time-Only submit original (no copies needed)
" 0
Note Form 990-T corporations requesting an automatic 6 month extension-check this box and complete Part 1 only
All other corporations (including Form 990-C filers) must use Form 7004 to request an extension o! time 1o ale income tax
returns Partnerships REMICs and trusts must use Form 8736 to request an extension o/ time to file Farm 7065 7066 or 7041
Employer identification number
Name of Exempt Ou9amzation
Type or
KERSHAW COUNTY COALITION AGAINST SEXUAL ASSAULT
pant
File by the
due dale to,
liking your
velum See
msuucuons
57
0814217
Number street and room or suite no R a P 0 box see instructions
P O DRAWER 428
C/O SHEHEEN, HANCOCK d GODWIN, LLP
City town or post office slate and ZIP code For a foreign address see instructions
CAMDEN, SC 29020-048
Check type of return to be filed (rile a separate application for each return)
Ej Form 990-T (corporation)
990
990-BL
~ Form 990-T (sec 401(a) or 408(a) trust)
990-EZ
~ Form 990-T (trust other than above)
99f1-PF
n Form 7041 A
EJ
El
[j
n
0 Form
Form
Form
rl Fnrm
Form
Form
Form
Form
4720
5227
6069
8870
" It the organization does not have an office or place of business in the United States check this box
If [his is
" If this is for a Group Return, enter the organizations four digit Group Exemption Number (GEN)
for the whole group check this box " 0
If it is for part of the group check this box " [I and attach a list with the
names and EINs of all members the extension will cover
15
,
1
I request an au[omatiu 3-month (6 month for 990-T corporation) extension of time until FEBRUARY
20 03
to file the exempt organization return for the organization named above The extension is for the organizations return for
0 calendar year 20
or
Ill 0 tax year beginning
DULY 7
ZO 01
and ending
2
If this tax year is for less than 12 months check reason
3a
If this application is for Form 990-BL 990-PF 990-T 4720 or 6069 enter [he tentative tax less any
nonrefundable credits See instructions
II this application is for Form 990 PF or 990-T enter any refundable cretins and estimated tax payments
made Include any prior year overpayment allowed as a credit
b
El initial return
DUNE 30
20 02
El Final return El Change in accounting period
S
$
Balance Due Subtract line 31) irom line 3a Include your payment with this torn Or if required deposit
with FTD coupon or d required by using EFTPS (Electronic Federal Tax Payment System) See
instructions
Signature and Verification
Under penalues of perjury i declare roar I nave examined inis lam including acLnmpanying schedules and siaiennrins a nd to one best of nay knowledge and belie)
d s Uue correct and complete and gnat ' am auihonxeJ to PneVare this loan
C_ 1,4
For Paperwork Reduction Act Notice, sec Instruction
SHEHEti9 Ii,rJCOLk . (,UI~' :i~l LLF, t,f41'9
1140, BOX 423, CAMUC11, SC 29020
Cal No 279t6D
RECEIVED
FEB 1 6 2003
OGDEN, UT
07B nz zoooi