''
9 90
Form
~
Extension to 11/15/05 Attached
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung
Department of the Treasury
benefit trust or private foundation)
0- The organization may have ,c use a copy of this return to satisfy state reporting requirements
mtpmai Revenue s ervice
udriil3r'y
i
Dec 31,
b for ire 2G44 calendar ear , or tax ear be g innin g
in
B check d .poldable-- Please C Name of organization
Add
uSe iRS
Eagles Fly for Leukemia, Inc .
changes
label or
Name `"age pool or
Number and street (or P 0 box if mail is not delivered to street address)
maia1 rerun
From rewn
Amended
return
Aovlicatan
InstNc_
dons
pending
92 West
610-254-2201
Lancaster Avenue
G
Website~
J
Organization type (check only one) lip- 1 X
F
501(c) (
3
) .4 (insert no )
4947(a)(1) or
4
5
V
1
The
395 ,144
M
Check
1
"
N/A
if the organization is not required
to attach Sch B (Forth 990, 990-EZ, or 990-PF)
29,807
b Indirect public support , . . . . . .
1b
6, 979
c Government contributions (grants) , , , , , , , , , , , , , , , , .
1c
d Total (add lines 1a through 1c) (cash S
noncash $
)
Program service revenue including government tees and contracts (from Part VII, line 93)
Membership dues and assessments
Dividends and interest from securities
, , , , , , _ , , , , . , , , _ , . , ,
, , , , , , , , , , , , , , ,
36,7 86
3
4
, , , , , , , , , , , , , ,
332
5
.6a .
, , , , , , , , , , , , , , , . , , , , , , ,
c Net rental income or (loss) (subtract line 6b from line 6a)
Other investment income (describe
"
6b
, , , , , , , , , , , , , , , , , , , , , , ,
(B) Other
ga
15,000
8b
16,720
(1,720)
8c
Special events and activities (attach schedule) If any amount is from gaming, check here
a Gross revenue (not including $
eporte
C
b Less cost of g
i
of
on line 1a), , , , , , , , , , , , , , , , , ,
from special events (subtract line 9b from line 9a)
Qt ry, less returns and allowancc_
, , , , , , , ,
~ d ~
, .
8d
(1 ,720 )
9c
61,720
" . F-1 '
343,026
9a
other than fundraising expenses , , , , , , , , ~ 9b j
c Net income or (I
~(~os$s
26,590
6c
7
(A) Secunties
d Net gain or (loss) (combine line 8c, columns (A) and (B)) . . . . . . . . . , . . _ , . . . .
R ~P,$
1d
2
, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,
Interest on savings and temporary cash investments
c Gain or (loss) (attach schedule) , , , . , , ,
ep
Group Exemption Number
1a
b Less cost or other basis and sales expenses .
9
I
Contributions, gifts, grants, and similar amounts received
8 a Gross amount from sales of assets other
than inventory , , . , , . . . Sch AX . ,
V
I-XI No
N/A
H(c) Are all affiliates included
Yes ~ No
(If "No," attach a list See instructions
Is this a separate velum fried by an
H
organization covered by a group rulings 7 Yes n No
a Direct public support,,,,,,,,,,,,,,,,,,,,,,,,
b Less rental expenses
N
Accrual
Revenue, Ex penses, and Changes in Net Assets or Fund Balances See page 18 of the instructions
6a Gross rents
7
X
H(a) Is this a group return far affiliates ?F-]Yes
527
if the organization's gross receipts are normally not more than $25,000
Gross receipts Add lines 6b, 8b, 9b, and 10b to line 12 .
3
Cash
H and I are not applicable to section 527 organizations
in the mail, it should file a velum without financial data Some states require a complete return .
2
rrrthod
71Other (specify) 1
organization need not file a return with the IRS, but if the organization received a Form 990 Package
1
Accounting
H(b) If "Yes ." enter number of affiliates 01
Check here
L
E Telephone number
City or town, state or country, and ZIP + 4
Devon , PA
19333
Section 501(c)(3) organizations and 4947(a)(1) nonexempt charitable
trusts must attach a completed Schedule A (Form 990 or 990-EZ).
K
#23-7326253
Room/suite
type
see
Specific
2004
D Employer identification number
281,306
~ ~ ~ ~ ~ ~ - ~ ~ ~ . . . .
oa .
ob
~p
rs~rqf(loss) from sales of inventory (attach .schedule) (subtract line 10b from line 10a). : : ; : : toc
12
d
y
a~~ u
from
art VII, line 103)
11
12
97, 118
Program services (from line 44, column (B)) , , , , , , , , , , , , , , , , , . , , . , , , , ,
13
87,810
Management and general (from line 44, column (C)) , , , , , , , , , , , , , , , , , , , , ,
14
2,920
15
Fundraising (from line 44, column (D))
Payments to affiliates (attach schedule) , .
15
9, 087
16
13
a
tTf2
14
Total revenue add lines 1d, 2, 3, 4, 5, 6c, 7, 8d, 9c, 10c, and 11
~
. , , , , , , , , , , , , , , , , , , , , , ,
17
Total ex penses add lines 16 and 44, column A .
18
Excess or (deficit) for the year (subtract line 17 from line 12) , . . . . . . . . . . .
19
20
, , , , , , , ,
.
Net assets or fund balances at beginning of year (from line 73, column (A)) , ,
Other changes in net assets or fund balances (attach explanation) . , , , , Unrealized
, ,re, ,ali,z . .ed . Gain
. . , . ,
21
Net assets or fund balances at end of ear combine lines 18, 19, and 20
For PnvacY Act and Paperwork Reduction Act Notice, see the separate instructions .
JSA
4E1010 1 000
.
~ ~
~ ~
~ ~ ~ ~
16
17
99,83.7
18
(2, 699 )
19
67,226
20
21
, ~
~(
2, 884
67, 411
Form 990 (2004)
J
Eagles Fly for Leukemia, Inc .
#23-7326253
Form 990 ( 2004)
Page 2
All organizations must complete column (A) Columns (B), (C), and (D) are required for section 501(c)(3) and (4) organizations
Statement of
and section 4947(a)(1) nonexempt chantable trusts but optional for others (See page 22 of the instructions )
Functional Ex p enses
Do not include amounts rep orted on line
~
M Program
I
(C1 Management
(D) runora~sing
6b 8b 9b 106 or 16 of Part I
~=4i'"' a~ T°i°~
services
and eneral
22 Grants and avocations (attach schedule)
~ 22
84 , 855
84 , 855
~y:~s=""~-+y,}
~
(cash s
noncasnS
23 Specific assistance to individuals (attach schedule) 23
24
24 Benefits paid co 0r for members (attach schedule)
.. ....
25 Compensation of officers, directors, etc 25
26
8,615
8,615
26 Other salaries and wages , , , , . , ,
27 Pension plan contributions , ,
27
28
Other employee benefits , ,
Payroll taxes , , , , , , , , ,
Professional fundraising fees
Accounting fees , , , , , , ,
29
30
31
32
33
34
35
36
37
38
Legal fees , , , , , , , , , , , , , , ,
Supplies Telephone , , , , , , , , , , , , , , ,
Postage and shipping , , , , , , , , ,
Occupancy . ,
Equipment rental and maintenance, .
Printing and publications , , , , , , ,
Travel 39
40
41
42
43
e
44
,
, , , , ,
, , , , ,
, , , , ,
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43d
3b
Conferences, conventions, and meetings .
Interest , , , , , , , , , , , , , , , , ,
Depreciation, depletion, etc (attach schedule), ,
Other expenses not covered above (itemize) a
Payroll Transfer (DX)
GSA Allocation (DX)
43c
Misc-------------------3d
-------------Total functional expenses (add lines 22 tnrouyn a3~
Organizations completing columns (B){D), carry
1,560
1,560
11,710
11,710
946
3,101
141
14,740
689
946
9
1 , 217
se
these totals to lines 1s-15 , ,
, 44
Joint Costs. Check "
if you are following SOP 98-2
14,740
689
9
(8,140)
(38,554)
18,928
99 , 817
3,101
141
1 , 217
-
509
2,410
36
(9,666)
(45,783)
18,892
1,017
4,819
87,810
2,920
9,087
Are any joint costs from a combined educational campaign and fundraising solicitation reported in (B) Program services
" F] Yes a No
N/A
, (u) the amount allocated to Program services 5
N/A
If "Yes," enter (i) the aggregate amount of these point costs $
(iii) the amount allocated to Management and general $
N/A
, and (iv) the amount allocated to Fundraising S
N/A
MIT Statement of Pro g ram Service Accomplishments (See page 25 of the instructions .)
Program Service
Expenses
(Required for 501 (c)(3) and
(a) or9s , and 4947(a)(1 )
trusts, butoptionai for
others 1
Schedule EX
------------------------------------------All organizations must describe their exempt purpose achievements in a clear and concise manner State the number
of clients served, publications issued, etc Discuss achievements that are not measurable (Section 501(c)(3) and (4)
organizations and 4947(a)(1) nonexempt charitable trusts must also enter the amount of grants and allocations to others )
What is the organization's primary exempt purposes "
a
b
--------------------------------------------------------------------------Grants (Sch CX)
-----------------------------------------------------------(Grants and allocations $
Allocated Payroll
Allocated GAP.
Other Expenses (Sch CX)
c
(Grants and allocations $
) I
)
84,855
2,955
---------------------------------------------------------------------------
d
JSA
e
f
--------------------------------------------------------------------------(Grants and allocations $
)
-------------------------------------------------------------------------------------------------------------- -- ------------------------------------Grants and allocations $
Other p ro g ram services attach schedule
Grants and allocations $
Total of Program Service Expenses (should equal line 44, column (B), Program services) . .
. ,"
4E 1020 1 000
87,810
Form 990 (2004)
Form 990 (2004)
Eagles Fly for Leukemia,
#23-7326253
Inc .
Page 3,
~T
-
Balance Sheets (See page 25 of the instructions .)
Note : 'Where required, attached schedules and amounts within the description
column should be for end-of-year amounts only.
45
46
Cash- nort-interest-bearing . . . . . . . . . . . . . , . . , . . . . . , . . . .
Savings and temporary cash investments . . , . . , . . , . . . . , , . . . . .
47a Accounts receivable , , , , , , , , , , , . , , , ,
b Less allowance for doubtful accounts , , , , , ,
d
y
N
~
47a
47b
48a Pledges receivable . . . . . . . . . . . . . . . , , 48a
b Less : allowance for doubtful accounts , , , , , , , 48b
49
Grants receivable , _ , , , , , , , , , , , , , , , , , , , , . , ,
Receivables from officers, directors, trustees, and key employees
50
, . (attach schedule) ,
51a Other notes and loans receivable (attach
51 a
schedule)
51 b
b Less' allowance for doubtful accounts
Inventories for sale or use
. . . . .
52
Prepaid expenses and deferred charges . . . . . . . . . . . . . .
53
Investments - securities (attach schedule) , , , , , , " 0 Cost
54
55a Investments - land, buildings, and
equipment : basis b Less accumulated depreciation (attach
schedule) . , , , , , , , , , , , , , , ,
56
Investments - other (attach schedule) .
57a Land, buildings, and equipment basis ,
b Less : accumulated depreciation (attach
schedule) , . 58 Other assets (describe "
58,934
15,175
, , , . _ , ,
(A)
oeyuining of year
93,973 45
1,122 46
=-E
=`~:-r~
~±~r
47c
"1vw
12,800 48c
49
,
. . . . . . .
FXI FMV
51 C
52
42,192
54,254
39
43, 759
53
54
6,184
28,532
55a
10,674
57b
)
59
Total assets (add lines 45 through 58) (must equal line 74) . .
60
61
62
63
Accounts payable and accrued expenses , , , _ , , , , , ,
Grants payable , . ., . . Deferred revenue . . . . . . . . . . . . . . . . . . . . . . .
Loans from officers, directors, trustees, and key employees
, , , , , , , , , ,
. . . . . . . .
55C
56
3==
,Adq
~.3;4
1,853 57c
58
151,940
84,714
. . . . . . . . . .
(attach
66
Total liabilities (add lines 60 through 65) . .
Organizations that follow SFAS 117, check here " U
67 through 69 and lines 73 and 74
67
Unrestricted , , , , , , , , , , , , , , , , , , , , ,
68
Temporarily restricted m 69
Permanently restricted . . . . . . . . . . . . . . . .
84,714
o Organizations that do not follow SFAS 117, check here t 1:1 and
complete lines 70 through 74
0 70
Capital stock, trust pi incipal, or current funds , , , , , , , , , , , , , , .
, ,
v, 71
Paid-in or capital surplus, or land, building, and aouipment fund , , , _ , , , ,
y 72
Retained earnings, endowment, accumulated income, or other funds
Q 73 Total net assets or fund balances (add lines 67 through 69 or lines
60
61
62
t;_~
136,403
68,992
65
and complete lines
, . , , , , , , , , , , . .
,
. .
. . . . . . . . . .
Sg
3,635
'63a
64a
64b
schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
64a Tax-exempt bond liabilities (attach schedule) . . . . . . . . . . . . . , . . . .
b Mortgages and other notes payable (attach schedule) , , , , , , , . , , , , ,
65
Other liabilities (describe "
)
J 5.\
(B)
Ena or year
50
, , , , , , 55b
. . . . . .
. ,
. . . . . . . . . . .
14,309
, , , , , , . 57a .
~
67,226
66
-='.-mix-*'-:-`ry
67
68,992
67,411
68
69 ,
70
71
72
=<cr3s
70 through 72,
a
67,411
67,226 73 .
column (A) must equal line 19, column (B) must equal line 21) , , , , , , , ,
151,
136,403
74 Total liabilities and net assets I fund balances add lines 66 and 73 .
940 74
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 the public perceives an organization in such cases may be determined by the information presented
on its return . Therefore, please make sure the return is complete and accurate and fully describes, in Part III, the organization's
programs and accomplishments
4 E 10 30 1 000
1
Form 990 (2004)
a,
b
Eagles Fly for Leukemia, Inc .
Reconciliation of Revenue p er Audited
Total revenue, gains, and other support
I
per audited financial statements , , t a
Amounts included on line a but not on
line 12, Form 990 :
7a,
543,210
b
62,074
87,833
$
Add amounts on lines (1) through (4) "
Line a minus line b , , , , , , , , ,
Amounts included on line 12,
Form 990 but not on line a:
(1) Investment expenses
not included on line
6b, Form 990 , , , $
(2) Other (specify)
Donated Sp E vent (11, 995)
Spec Events $
(281,306)
"
e
75
b
c
152,791
Total expenses and losses per
audited financial statements , , , , " a
Amounts included on line a but not
on line 17, Form 990
543,025
62,074
reported on line 20,
Form 990 , , , , , $
(3) Losses reported on
line 20, Form 990 $
(4) Other (specify)
Don Tuition
Spec Events g
390,419 c
d
~Pae 4
Financial Statements with Expenses per
Return
(1) Donated services
and use of facilities $
(2) Prior year adjustments
2,884
(4) Other (specify) :
Donated
Tuition
d
Reconciliation of Expenses p er Audited
Financial Statements with Revenue per
Return See p age 27 of the instructions
(1) Net unrealized gains
on investments , , $
(2) Donated services
and use of facilities $
(3) Recoveries of prior
year grants , , , , $
c
#23-7326253
87,833
293,301
443 ,208
99,817
Add amounts on lines (1) through (4) , , " b
Line a minus line b , , , , , , , , , t c
Amounts included on line 17,
Form 990 but not on line a :
(1) Investment expenses
not included on line
6b, Form 990 , , , $
(2) Other (specify)
g
(293,301)
Add amounts on lines (1) and (2) , , " d
Add amounts on lines (1) and (2) , , " d
Total revenue per line 12, Form 990
e
Total expenses per line 17, Form 990
line c p lus line d .
97,118 1
99,817
. 0- 1 e
line c p lus line d ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ t e
~/
List of Officers, Directors, Trustees, and Key Employees (List each one even if not compensated ; see page 27 of
Did any officer, director, trustee, or key employee receive aggregate compensation of more than $100,000 from your
organization and all related organizations, of which more than $10,000 was provided by the related organizations?
If "Yes," attach schedule - see page 28 of the instructions
"
E] Yes
Fx-] No
Form 990 (2004)
JSA
1E1040 1 G00
Eagles Fly for Leukemia, Inc .
Form 990 2004
EMM Other Information (See p a g e 28 of the instructions .
76
77
#23-7326253
Did the organization engage in any activity not previously rsro " !ed to the IRS If "Yes," attach a detailed description of each activity , ,
Were any changes made in the organizing or governing documents but not reported to the IRS
, , , , , , , , , , , , , , , , , , ,
I ;,"Yes, attach a conformed copy of the changes
78 a Did the organization have unrelated business gross income of $1,000 or more during the year covered by this returns , , , . , , , , ,
b If "Yes," has it fled a tax return on Form 990-T for this years , , , , , , , , . . . , , , , , , , . . , , , , , _ , , , , , . , , , , ,
79 Was there a liquidation, dissolution, termination, or substantial contraction during the years If "Yes," attach a statement , , , , , , , ,
80a Is the organization related (other than by association with a statewide or nationwide organization) through common
membership, governing bodies, trustees, officers, etc , to any other exempt or nonexempt organization? . . . . , , . . . . .
Yes
76
77
ag e 5
No
X
X
78a
78 b
79
X
80a
X
X
b If "Yes," enter the name of the organizationt
and check whether it is
exempt or
nonexempt
81 a Enter direct and indirect political expenditures See line 81 instructions. , , , , , , , , , , , , , , , 81a
b Did the organization file Form 1120-POL for this years , . , . , . . . . , . . . , . . . . , . . . . . . . .
82a Did the organization receive donated services or the use of materials, equipment, or facilities at no charge
or at substantially less than fair rental values
b If "Yes," you may indicate the value of these items here Do not include this amount
as revenue in Part I or as an expense in Part II (See instructions in Part III ) . , . , , , , , , , , , , , 82b
83a Did the organization comply with the public inspection requirements for returns and exemption applications? ,
b Did the organization comply with the disclosure requirements relating to quid pro quo contributions? , , , , ,
84a Did the organization solicit any contributions or gifts that were not tax deductibles , , , , , , , , , , , ,
b If "Yes," did the organization include with every solicitation an express statement that such contributions
or gifts were not tax deducUble? , , , . , . . . . . . , . . . . . . . . . . . . . . . . . . , . , . . . . .
85 501(c)(4), (5), or (6) organizations a Were substantially all dues nondeductible by members . , , . . , . . .
b Did the organization make only in-house lobbying expenditures of $2,000 or less . . , . . . . . . . . . . .
If "Yes" was answered to either 85a or 85b, do not complete 85c through 85h below unless the organization
received a waiver for proxy lax owed for the prior year
c Dues, assessments, and similar amounts from members
85c
d Section 162(e) lobbying and political expenditures
85d
, , , , , , , , , , , , , , , , , , , , , , , , ,
e Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices , , , . , , , , , , , , , , ,
f Taxable amount of lobbying and political expenditures (line 85d less 85e)
, , , . . . . . . . _ . . ,
. . . . . . . . . . . .
, , , , , ,
81b
82a
62,074
, , , , , , ,
. , , , , , , ,
83a
83b
84a
, . . . . . . . . . . .
84b
85a
85b
, . _ . . , .
. . . . . . . . . . . .
85e
85f
g Does the organization elect to pay the section 6033(e) tax on the amount on line 85f? _ , , ,
h If section 6033(e)(1 )(A) dues notices were sent, does the organization agree to add the amount on line 85f to its reasonable
estimate of dues allocable to nondeductible lobbying and political expenditures for the following tax year . ,
. , , . . , . . . . . .
86 501(c)(7) orgs Enter . a Initiation fees and capital contributions included on line 12 . . . . . . . . . . 86a
b Gross receipts, included on line 12, for public use of club facilities
86b
87 501(c)(12) orgs Enter a Gross income from members or shareholders . . . . . . . . . , . . . . . .
87a
b Gross income from other sources . (Do not net amounts due or paid to other
sources against amounts due or received from them ) . . . . . . , . . . , . . . , . . . . . . . . . 87b
88 At any time during the year, did the organization own a 50% or greater interest in a taxable corporation or
85
, . , .
88
partnership, or an entity disregarded as separate from the organization under Regulations sections
301 7701-2 and 301 7701-3? If "Yes," complete Part IX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
89a 501(c)(3) organizations Enter Amount of tax imposed on the organization during the year under
NONE
NONE
NONE
section 4911 1
, section 4912 "
, section 4955 "
b 501(c)(3) and 501(c)(4) wgs Did the organization engage in any section 4958 excess benefit transaction
during the year or did it become aware of an excess benefit transaction from a prior years If "Yes," attach
a statement explaining each transaction
. , . . . . . . . . . , . . . . , . _ . , . . . . . . , . . . . . . . . . . . . . . . . . .
c Enter Amount of tax imposed on the organization managers or disqualified persons during the year under
sections 4912, 4955, and 4958 . . . . . , . . . . . . . . , . , . , . , . . , . . . . . . . , . . . . . . . . . . .
d Enter Amount of tax on line 89c, above , reimbursed by the organization
90a List the states with which a copy of this return is filed III,.
Pennsylvania, .New . Jersey .
.
. . .
.
b Number of employees employed in the pay period that includes March 12, 2004 (See instructions ) , , , , , , , , , , ,
Joseph Colgan
91 The books are in care of 1
Telephone no
92
West
Lancaster Ave, Devon, PA
Located ac10.
ZIP +a ,
92
Section 4947(a)(1) nonexempt chantable trusts filing Form 990 in lieu of Form 1041 - Check here . . _ . . . . . . . , .
and enter the amount of tax-exempt interest received or accru°ci during the tax year
.
. . . .
"
. .
"
00.
85h
89b
NONE
NONE
, , , , , , , I 90b
" 610-254-2201
19333
. .
t .192
.1
. .
N/A
. . . ,
Form 990 (2004)
JSA
4E1041 1 000
Eagles
Form 990 2004
Fly for Leukemia,
Inc .
#23-7326253
FEFrIM Analysis of Income-Producing Activities (See page 33 of the instructions )
Unrelated business insane
Note : Enter gross amounts unless otherwise
indicated
(q)
Auvnncer_~o
Program service revenue
~3
(B) 4
Amount.
Excluded by section 512, 513, or 514
(C)
EAGu aiuncoae
(D)
Amount
pl a_ e 6
(E)
exempt fu~rct :or,
income
a
b
c
d
e
f Medicare/Medicaid payments , , , ,
g Fees and contracts from government agencies ,
94
Membership dues and assessments . . .
95
Inleresl on savings and temporary cash investments
96
Dividends and interest from securities
14
332
Net rental income or (loss) from real estate
97
a debt-financed property
. . . . . . . .
b not debt-financed property
. . . . . . .
9$
Nel rental income or (loss) from personal properly
99
Other investment income . . . . . . ,
100
Gain or (loss) from sales of assets other than inventory .
18
101
Net income or (loss) from special events
01
102
Grass profit or (loss) from sales of inventory ,
103
,
(1,720)
61,720
Other revenue a
b
c
d
104
60,332
Subtotal (add columns (B), (D), and (E)) . . ~
1
105 Total (add line 104, columns (B), (D), and (E)) . . . . . . . . . . . . . .
( 60~, 332+36 , 78 6) _$ 97 , 118
Note : Line 105 plus line 1d, Part I, should equal the amount on line 12, Part l
60,332
FERIM Relationship of Activities to the Acco~nplishment of Exempt Purposes (See page 34 of the instructions )
Line No ~ Explain how each activity for which income is reported in column (E) of Part VII contributed importantly to the accomplishment
of the organization's exempt purposes (other than by providing funds for such purposes)
The Special Events held involved activities that made the public more
aware of the need for research for
r leukemia victims . They included Golf
All
tournaments anti
several award dinners .
Information Regarding Taxable Subsidiaries and Disregarded Entities See page 34 of the instructions .
Name, addre
~S-ar,(A)
,
of corporation,
partnership, or disrega e
iy,
(B)
Perceniayeor
ownersh~ m~eresi
(C)
Nature of activities
(~)
Total income
(Ef
End-o-year
assets
Information Re garding Transfers Associated with Personal Benefit Contracts (See page 34 of the instructions )
(a) Did the organization, during the year, reserve any funds, directly or indirectly, to pay premiums on a personal benefit contracts
(b) Did the organization, during the year, pay premiums, direct
Note : If "Yes" to (b), file Form 8870 and Form 4720 (see instructs
Under penalties of penury, I declare that I have e:~-~~ned this r
and belief, -it is true, correct, and complete Declaration of pre
Please
Sign
Here
I
,
Sig
lure o
d
., fficer
Paid
Preparer's
Use Only
Jsn
4 E105D 1 000
/ !cd
A
Type or pant
ame and tale
Preparers
signature'
~
Firm's name (or your
if self-employed),
address, and ZIP +
I3ilger t13.c10&Co .
, 123 S .
Broad Street
philadelphia,
PA
1
, . . . . . ,
Yes
X
NO
SCHEDULE A
(Form 990 or 990-EZ)
Department b( the Treasury
Inlemal Revenue Service
Name of the organization
a
es
F1
Organization Exempt Under Section 501(c)(3)
(Except Private Foundation) and Section 501(e), 5010, 501(k),
501(n), or Section 4947(a)(1) Nonexempt Charitable Trust
Supplementary Information - (See separate instructions .)
MUST be completed by the above organizations and attached to then Form 990 or 990-EZ
C .~~
for Leukemia
Inc .
OMB Na 1545-0047
2004
num
#23-7326253
Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees
(See page 1 of the instructions. List each one If there are none, enter "None .")
(b) Title and average
hours per week
devoted to position I
(a) Name and address of each employee paid more
than $50,000
(c) Compensation
(d) Contributions to
employee benefit plans &
~ deferred compensation
(e) Expense
account and other
allowances
Schedule BX
----------------------------------
----------------------------------
Total
number
$50,000
of
other
employees
paid
over I
0. I
I
NONE
Compensation of the Five Highest Paid Independent Contractors for Professional Services
(See page 2 of the instructions List each one (whether individuals or firms) If there are none, enter "None ."
(a) Name and address of each independent contractor paid more than $50,000
Total number of others receiving over $50,000 for
profe s sion a l serv ices
. "
1
4E12101000
(c) Compensation
NONE
For Paperwork Reduction Act Notice, seethe Instructions for Form 990 and Form 990-EZ .
JSA
(6) Type of service
Schedule A (Form 990 or 990-EZ) 2004
Schedule A (Form 990 or 990-EZ) 2004
Eagles
Fly for Leukemia,
#23-7326253
C'
-P_~
Statements About Activities
1
Inc .
During the year, has the organization
See page 2 of the instructions .
attempted to
Yes
influence national, state, or local legislation,
No
including any
attempt to influence public opinion on a legislative matter or referendums If 'Yes," enter the total expenses paid
(Must equal amounts on line 38,
or incurred in connection witn the lobbying activities " $
Part VI-A, or line i of Part VI-B ) , , , , , , , , , , .
Organizations that made an election under section 501(h) by filing Form 5768 must complete Part VI-A
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 in any of the following acts with any
2
substantial
contributors, trustees, directors,
officers, creators, key employees,
with any taxable organization with which any such
owner, or principal beneficiary?
or
members of then
families,
or
person is affiliated as an officer, director, trustee, majority
(if the answer to any question is
"Yes," attach a detailed statement explaining
the transactions)
a
Sale, exchange, or leasing of property
b
Lending of money or other extension of credits , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , . , . . , . , , , , I 2 b I
c
Furnishing of goods, services, or facilities? , , , , , , . , , , , , . . . . . , . . , , . . . . . , , , , , . . . . . . , , . . I 2c I
d
Payment of compensation (or payment or reimbursement of expenses if more than $1,000)
e
3a
b
4a
b
, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , . .
2a
, , , , . , . , . . . , . , , . , , I 2d I
X
I
X
I
X
, . . . . . , . , , . .
explanation of how
2e
X
, , , , , , , , , , , ,
, , , , , , , , , , , .
3a
3b
X
X
Did you maintain any separate account for participating donors where donors have the right to provide advice
on the use or distribution of funds, , , , , , , , , , , , , , , , , . , , , , , , , , . . . , . , , , , . . . . . , . , . .
Do y ou p rovide credit counselin g , debt manag ement, credit repair, or debt ne g otiation services? .
4a
4b
X
Transfer of any part of its income or assets
, , , . , , , , . .
Do you make grants for scholarships, fellowships, student
you determine that recipients qualify to receive payments ) , , ,
Do you have a section 403(b) annuity plan for your employees ,
. . . ,
loans,
, , , ,
, , , ,
, , .
etc ?
, , ,
, , ,
,
(If
,
,
, , . ,
"Yes,"
, , , ,
, , , ,
, , . ,
attach
, , , ,
, , , ,
, .
an
, ,
, ,
Reason for Non-Private Foundation Status (See pages 3 through 6 of the instructions .)
The or aniz2tion i5 riot a private foundation because it ;s (Please :6°ck oily ONE applicable box)
5
A church, convention of churches, or association of churches Section 170(b)(1)(A)(i)
7
A hospital or a cooperative hospital service organization Section 170(b)(1)(A)(in)
A school Section 170(b)(1)(A)(n) (Also complete Part V .)
6
8
9
A Federal, state, or local government or governmental unit Section 170(b)(1)(A)(v)
U A medical research organization operated in conjunction with a hospital Section 170(b)(1)(A)(iu) Enter the hospital's name, city,
and state lo-___-_
10
~ An organization operated for the benefit of a college or university owned or operated by a governmental unit Section 170(b)(1)(A)(rv)
11 a El
(Also complete the Support Schedule in Part IV-A )
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) (Also complete the Support Schedule in Part IV-A )
1 1 b B A community trust Section 170(b)(1)(A)(vi) (Also complete the Support Schedule in Part IV-A
An organization that normally receives (1) more than 33 113% of its support from contributions, membership fees, and gross
12
receipts from activities related to its charitable, etc ,functions - subject to certain exceptions, and (2) no more than 33 113% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired
13
X
by the organization after June 30, 1975 See section 509(a)(2) (Also complete the Support Schedule in Part IV-A )
An organization that is not 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), if they meet the test of section 509(a)(2) (See
section 509(a)(3) 1
Provide the following information about the supported organizations (See page 5 of the instructions )
(a) Name(s) of supported organization(s)
(b) Line number
from above
Schedule
14
n An organization organized and operated to test for public safety Section 509(a)(4) (See page 5 of the instructions )
QEA220 1 000
Schedule A (Form 990 or 990-EZ) 2004
Fly for Leukemia, Inc .
#23-7326253
ScneduieA(Formssoorsso-EZ)zooaEagles
Support Schedule (Complete only if you checked a box online 10, 11, or 12 ) Use cash method of accounting.
Note : You may use the worksheet in the instructions for converting from the accrual to the cash method of accounting
C
5
ndar year (or fiscal year beginning in)
~fts, grams, and contributions received (Cc
I
a 2003
b 2002
i
c 2001
i
d 2000
I
e
I
Total
not ~clude unusual grants See line 23 )
16
Memb rship fees received . ,
17
Gross re
ipts from admissions, merchandise
sold or se
ces performed, or furnishing of
facilities in an
activity that is related to the
organization's ch
18
19
Gross
income
stable, etc, purpose .
fr
interest,
dividends,
from
unrelated
ayments on securities
amounts received fro
loans (section 512(a)(5)), ents, royalties, and
unrelated business taxab
income (less
section 511 taxes) from busin ses acquired
by the organization alter June 30, 975
Net
income
activities not included in line 18
us~ness
. . .
. . . .
20 Tax revenues levied for the organizatil~
benefit and either paid to it or expended of
it behalf . . . . . . . . . . . . . . , . .
21 The value of sernces 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 .
22 Other income Attach a schedule Do not
include gain or (loss) from sale of capital assets
23
Total of lines 15 through 22 . . . . . . . . . . .
24
Line 23 minus line 17
25
Enter 1% of line 23
26
Organizations described on lines 10 or 11'
. . . . . . . . . . . . . . .
b Prepare a list for your records to show
governmental
unit
amount shown in
or
publicly
line 26a
a
Enter 2°,% of amount i7 cola
n (a), lire 24
the name of and amount con t
supported organization) whose total
uted
gifts for
Do not file this list with your return . Enter the
c Total support for section 509(a)(1) test Enter line 24, column (e)
d Add Amounts from column (e) for lines
18
by
000
, , , , , , , , , , , , , , , ~ 26a
each
(other
than
a
exceeded the
tal of all these excess amounts " 26b
ll 26c
19
22
26b
e Public support (line 26c minus line 26d total) . . . . . . . . . . . . . . , , . . , , . . , . . .
27
person
through 2003
, , , , , , , , , , , , " 26 d
. . . . . . . . . . . 1 26e
f Public support percentage (line 26e (numerator) divided b line 26c (denominator) .
. " 26f
0 .0000
Organizations described on line 12 : a For amounts included in lines 15, . 16 . .and . 7 . that . were ' received from a "disqualified
person," prepare a list for your records to show the name of, and total amounts received i
each year from, each "disqualified person "
Do not file this list with your return . Enter the sum of such amounts for each year
(2003)
(2002)
(2001)
(2000)
----------------------------------------------- --b For any amount included in line 17 that was received from each person (other than "disqualified person-~ Prepare a
show the name of, and amount received for each year, that was more than the larger of (1) the amount on ne 25 for
(Include in the list organizations described in lines 5 through 11, as well as individuals ) Do not file this list
'th your
the difference between the amount received and the larger amount described in (1) or (2), enter the sum
these
amounts) for each year
(2003) ---------------- (2002) ------------------- (2001) ------------------- (20
c
Add Amounts from column (e) for lines
17
d Add Line 27a total
e
i
15
20
Public support (line 27c total minus line 27d total)
16
21
. . . . . . . . . . . .
and line 27b total , ,
. . . , , . . , . , , .
~ ~ ~ ~ ~ - ~ ~ " ~ ~ " " ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ " "
Total support for section 509(a)(2) lest Enter amount from line 23, column (e) . . . . . . . . . . 1 27f
g Public support percentage (line 27e (numerator) divided 6y line 27f (denominator))
h
28
. . . . . . .
, . . . . , , , , , , , , , , , , ,
-------------list for your records to
the year or (2) $5,000
return . After computing
differences (the excess
) -------
1 27c
"
27d
" 27e
~ Z7
0.
00
Investment income p ercenta g e line 18 column e numerator divided b line 27f denominator .
27h
0 .00'&0
Unusual Grants : For an organization described in line 10, 11, or 12 that received any . unusual " grants " during 2000 through 2-&,03,
prepare a list for your records to show, for each year, the name of the contributor, the date and amount of the grant, and a b f
description of the nature of the grant Do not file this list with your return . Do not include these grants in line 15
JSA
Schedule A (Form 990 or 990-EZ) 2004
4E1221 1 000
Eagles
Fly
for Leukemia,
inc .
#23-7326253
Schedule A,(Form 990 or 990-EZ) 2004
F'&je-¢
Private School Questionnaire (See page i of the instructions j
29
30
31
(To be com p leted ONLY b schools that checked the box on line 6 in Part IV
Yes
Does the orgarnzation have a racially nondiscriminatory policy toward students by statement in its charter, bylaws,
o er governing instrument, or in a resolution of its governing body . . . . .
. . . . . . . . . . , , . , , , ,
Do the organization include a statement of its racially nondiscriminatory policy toward students in all its
broch es, catalogues, and other written communications with the public dealing with student admissions,
program and scholarships? . . . . . . . . . .
. . . . . . . . . . . .
. . . , . . . . . . . . . . . . . . . .
Has the or nization publicized its racially nondiscriminatory policy through newspaper or broadcast media~dunng
the period of licitation for students, or during the registration period if it has no solicitation program, in a way
that makes the lacy known to all parts of the general community it serves . . _ . . . . . . . . . . . . . , ,
If "Yes," please de n be ; if "No," please explain (If you need more space, attach a separate statement )
No
30
31
--------------- ----------------------------------------------------------------------------- ----------------------------------------------------------32
Does the organization maintain
e following
. . . . . .
a Records indicating the racial coin sition of the student body, faculty, and administrative staffs . . .
b Records documenting that scholars h s and other financial assistance are awarded on a racially nondiscriminatory
bass?
32a
rships? .
. . .
. . . . . .
. . .
with student admissions, programs, and sch
all
material
used
by
the
organization
r
on
its
behalf
to
solicit
contributions
d Copies of
32c
32d
c Copies of all catalogues, brochures, anno
cements, and other written communications to the public dealing
. . . . . . _ . . , ,
. . . , . . . . . . . , . . , .
32b
If you answered "No" to any of the above, please ex ain (If you need more space, attach a separate statement )
-------------------------------------- -------------------------------------33
- - - - - - -------- - - - - - - - - -- - - - - - - - -- ---- - Does the organization discriminate by race in any way with
-- - - - - - - --- - --- - - - - - - - - - - - - - - - - - --- spect to
a Students'rights orpriwleges? . . ., . . . . . .,
. . . , . , . i s3al
b Admissions policies
33b
c Employment of faculty or administrative staffs
. . .
, , . . , , . , , , , .
. , , , , , , , , , , , , , , , , , , ,
33c
d Scholarships or other financial assistance
33d
e Educational policies
33e
If Use of facilities?
33f
g Athletic programs
. . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . .
. . . . . . . .
h Other extracurricular activities
33
33h
If you answered "Yes" to any of the above, please explain (If you need more space, attach a separate state
ent )
-------------------------------------------------------------------------- ----------------------------------------------------------------------------- -- - -- - - - - - - - - - - - - - - - -- - - - - - ---- - -- - - -- - -- - -- - - ----- - --- - --- -- -- - - - - - -- - --34a Does the organization receive any financial aid or assistance from a governmental agency
. . . . . . . . . . . -. -.
. . . . . . . . . , . . . . . . . . . . . .
b Has the organization's right to such aid ever been revo ; ;ad or suspended
If you answered "Yes" to either 34a or b, please explain using an attached statement
35
Does the organization certify that it has complied with the applicable requirements of sections 4 01 through 4 .05
of Rev Proc 75-50 1975-2 C B 587 coverin g racial nondiscrimination? If "No , " attach an exp lanation .
JSa
4 E 1230 1 000
34
34b
35
Schedule A (Form 990 or 990-EZ)2004
I d
Eagles
Fly for Leukemia
Inc .
#23-7326253
Schedule A Form 990 or 990-EZ 2004
Lobbying Expenditures by Electing Public Charities (See page 9 of the instructions .)
(To be completed ONLY by an eligible organization that filed Form 5768)
1 if the organization belont.4s to an affiliated group
if v.u checked"a"
Check 10- b rI T_
C hekK 1P-.31
Limits on Lobbying Expenditures
Total lob
ing expenditures to influence public opinion (grassroots lobbying) . . .
expenditures to influence a legislative body (direct lobbying)
Total !OZ
Total lobbying xpenditures (add lines 36 and 37) . . . . . . . . , . . . , . . . . .
Other exempt p
ose expenditures
Total exempt purp -e expenditures (add lines 38 ar- ?9)
Lobbying nontaxable
ount Enter the amount from the following table
If the amount on line 4 's The lobbying nontaxable amount is Not aver $500,000 , , , , , ,
, , , , 20% of the amount on line 40 , , , , , , , , ,
Over $500,000 but not over $1,000, 0 , , , $100,000 plus 15% of the excess over $500,000
Over $1,000,000 but not over $1,500,0
. $175,000 plus 10% of the excess over $1,000,000
Over $1,500,000 but not over $17,000,00
, $225,000 plus 5% of the excess over $1,500,000
$17,000,000
,
.
,
,
,
.
.
.
,
.
,
$1,000,000 . . . . . .
Over
Grassroots nontaxable amount (enter
% of line 41) . . . . . , , . . , . . . , . .
Subtract line 42 from line 36 . Enter -0- if e 42 is more than line 36
Subtract line 41 from line 38 Enter -0- if lin 41 is more than line 38 . . ~ . . . .
42
43
44
Caution: if there is an amount on either line 43
and "limited control" provisions apply
to be completed
for ALL electing
organizations
Affiliated group
totals
(The term "expenditures" means amounts paid or incurred )
36
37
38
39
40
41
}'
36
37
38
39
40
41
42
43
44
line 44, you must file Form 4720 .
4-Year Aver
ing Period Under Section 501(h)
(Some organizations that made a section 501(h election do not have to complete all of the five columns below
See the instructions for lines 5 through 50 on page 11 of the instructions )
Lobbying E*enditures During 4-Year Averaging Period
Calendar year (or fiscal
year beginning in "
Lobbying nontaxable
45
(a)
2004
~
-1` )
2003
(c)
711(1?
(d)
?nn~
1
(e)
amount
Lobbying ceiling amount
46
47
48
150% of line 45 ( e))
Total lobb yi ng ex penditures
Grassroots nontaxable
amount
Grassroots ceding amount
49
50
150% of line 48 (e))
Grassroots lobbying
expenditures . .
Lobbying .Activity by Nonelecting Public Charities
For re p ortin g onl y b or g anizations that did not com p lete Part VI-A ) See p a g e 1
During the year, did the organization attempt to influence national, state or local legislation, including any
attempt to influence public opinion on a legislative matter or referendum, through the use of
a Volunteers
f the instructions
Yes
No
Amount
'
b Paid staff or management (Include compensation in expenses reported on lines c through h
c Media advertisements
d
e
f
g
Mailings to members, legislators, or the public, , . . , . . . , . , . . , . . , . . , . . . ,
Publications, or published or broadcast statements
Grants to other organizations for lobbying purposes , , , ,
, , , , , . , ,
Direct contact with legislators, their staffs, government officials, or a legislative body
h Rallies, demonstrations, seminars, conventions, speeches, lectures, or any other means , , , , , ,
i Total lobbying expenditures (Add lines c through h ), , , , , _ , , . , . . . . , . . . . . , ,
If "Yes" to any of the above, also attach a statement giving a detailed description of the lobbying activities
SSA
4E1240 1 000
Schedule A (Form 990 or990-E2)2004
Schedule A Form 990 or 990-EZ 2004
Eagles
Fly for Leukemia,
#23-7326253
Inc .
Information Regarding Transfers To and Transactions and Relationships With Noncharitable
Exempt Organizations (See page 11 of the instructions .)
5 f\D -id the reporting organization directly or indirectly engage in any of the following with any other organization described in section
' N~1 (c) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political organizations
a T~Nsfers from the reporting organization to a nonchantable exempt organization of
(i )
Sh . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(ii) 0 er assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b Other tra actions
exchanges of assets with a nonchantable exempt organization
(i) Sales
(ii) Purchase of assets from a nonchantable exempt organization . , . . .
(iii) Rental of fa lines, equipment, or other assets . , . , . . . _ . . , . . .
(iv) Reimburseme t arrangements
. . . . . . . . .
(v)
. . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . .
, . . . . . . . . . . . , . , , . . , .
. . . , , . . , , . , . . , , . , . . ,
. . . , . , , , . , . , , , , , , _ , ,
. . . . . . . . . . . . . . . . . . . .
Loans or loan gu rantees
b vi
(vi) Performance of se ices or membership or fundraising solicitations , , , , , . , , , , , , , ,
Sharing
of
facilities,
equip
n
mailing
lists,
other
assets,
or
paid
employees
.
,
,
,
.
,
,
.
.
.
,
,
.
,
,
,
,
,
,
,
c
Ec
d If the answer to any of the abov s "Yes," complete the following schedule Column (b) should always show the fair market value of the
s y the reporting organization If the organization received less than fair market value in any
goods, other assets, or services g I\nl,
transaction or sharing arrangemei i t, s ow in column (d) the value of the goods, other assets, or services received
(a)
line no
I
(b)
Amount involved
e of nonchantable exempt organization
Description of transfers, transactions, and sharing arrangements
T
52a Is the organization directly or indirectly affiliated with, or related to, one or more t
described in section 501(c) of the Code (other than section 501(c)(3)) or in section
b If "Yes," com p lete the followin g schedule
(a)
Name of organization
JSA
4 E 12 50 1 000
.M
Type of organization
-exempt organizations
E] Yes
a No
M
caption of relationship
Schedule A (Form 990 or 990-EZ) 204
EAGLES FLY FOR LEUKEMIA, INC .
Federal Income Tax Return - Year 2004
FORM 990
#23-7326253
Schedule AX - Gain/Loss
from Safes of Securities
Date
Mar. 31,2004
~
Description
Unit Trust
I
I # of Shares I Proceeds ~ CosUShare, Total Cost ,
i
I 1706 .095
16,720
15,000
980
T
15,000
16,720
Gain/Loss
(1,720)
(1,720)
,1
Form 990
EAGLES FLY FOR LEUKEMIA, INC .
Federal Income Tax Return - Year 2004
#23-7326253
Table of Contents
PAGE
Form 990 - Return of Organization Exempt From Income Tax
1 -6
Schedule A - Organization Exempt Under Section 501(c)(3)
7 - 12
Form 4562 - Depreciation and Amortization
Schedule B - Schedule of Contributors
13-14
~
Schedule AX - Gain/Loss from Sales of Securities
Schedule BX - List of Officers, Directors, Trustees, etc
19
~
Schedule CX - Schedule A Support, Part III and Part IV
Schedule DX - Schedule of Allocated Payroll & Management
15- 18
20-22
23
I
Schedule EX - Organizations Primary Exempt Purpose
24
25
Form 8868 - Application for Extension of Time to File
26-27
r
I
FORM 990
#23-7326253
EAGLES FLY FOR LEUKEMIA, INC.
Federal Income Tax Return - Year 2004
Schedule BX - List of Officers, Directors, Trustees, etc. ..
Compensation
Contribution
To Employee
Benefit Plan
Exp
Account/Other
Allowances
President
1 Hour
None
None
None
Kathy Davis
NFL Films
330 Fellowship Road
Mt . Laurel, NJ 08054
Vice-President
1 Hour
None
None
None
James Fleeting
CPG
133 N 23rd Street
Reading, PA 19606
Vice-President
1 Hour
None
None
None
Joe Colgan
Smart & Associates, LLP
92 W Lancaster Ave
Devon, PA 19333
Treasurer
1 Hour
None
None
None
Charlene Beck
Beck Associates
79 Farnwood Road
Secretary
1 Hour
None
None
None
Kathy Bellwoar
PPT Consulting
15 Paper Mill Rd
Newtown Square, PA 15073
Trustee
1 Hour
None
None
None
Michael J. Brennan
Binswanger International
Two Logan Square 4th Floor
Philadelphia, PA 19103
Trustee
1 Hour
None
None
None
Ron Guida
u1 net
123 E Main Street
Box 382
Marlton, NJ 08053
Trustee
1 Hour
None
None
None
Mike Fitzgerald
Sovereign Bank
3 Terry Drive
Newtown, PA 18940
Trustee
1 Hour
None
None
None
James Flanagan
James Flanagan & Associates
5100 State Road, Ste W300
Drexel Hill, PA 19026
Trustee
1 Hour
None
None
None
Name & Address
Joseph J . McHale
Stradley, Ronon, Stevens & Young
30 Valley Stream Parkway
Malvern, PA 19355
Title & Average
Hours Per Week to
Position
vii. Laurel, IVJ VOVJ'F
O~D
FORM 990
#23-7326253
EAGLES FLY FOR LEUKEMIA, INC.
Federal Income Tax Return - Year 2004
Schedule BX - List of Officers, Directors, Trustees, etc .. .
Name & Address
Title & Average
Hours Per Week to
Position
Compensation
Contribution
To Employee
Benefit Plan
Exp
Account/Other
Allowances
Stephen S. Hamilton
PricewaterhouseCoopers
2001 Market St
Two Commerce Square
Philadelphia, PA 19103
Trustee
1 Hour
None
None
None
Ron Jaworski
Jaworski Management Inc
200 Golfview Drive
Blackwood, NJ 08012
Trustee
1 Hour
None
None
None
James Kaiser
PricewaterhouseCoopers
St . Jakobs Strasse 25
CH-4052 Basel, Switzerland
Trustee
1 Hour
None
None
None
Stanley Lane
Lane Financial & Estate Planning
359 96th Street, Ste 102
Stone Harbor, NJ 08247
Trustee
1 Hour
None
None
None
Gary McAneney
SMG World
6 Canterbury Way
Thornton, PA 19406
Trustee
1 Hour
None
None
None
E. Ralph McDevitt, III
Legg Mason Wood Walker
1600 Market Street, Ste 1200
Philadelphia, PA 19103
Trustee
1 Hour
None
None
None
John S. McVeigh
Law Offices of John S McVeigh
1052 Huntington Rd
P O. Box 163
Abington, PA 19001
Trustee
1 Hour
None
None
None
William McKernan
Norman Spencer McKernan
1135 DeKalb Pike
Blue Bell, PA 19422
Trustee
1 Hour
None
None
None
James Murray
Jim Murray Ltd.
296 S. Roberts Rd
Rosemont, PA 19010
Trustee
1 Hour
None
None
None
Thomas Schirmer
Delaware Valley Financial Group
3200 Horizon Drive, Ste 700
King of Prussia, PA 19406
Trustee
1 Hour
None
None
None
&
FORM 990
#23-7326253
EAGLES FLY FOR LEUKEMIA, INC .
Federal Income Tax Return - Year 2004
Schedule BX - List of Officers, Directors, Trustees, etc ...
Name & Address
Title & Average
Hours Per Week to
Position
Compensation
Contribution
To Employee
Benefit Plan
Exp
Account/Other
Al lowances
David Sciolla
Sciolla Agency
1060 Grenoble Rd
Ivyland, PA 18974
Trustee
1 Hour
None
None
None
Marc Smith
Delaware Valley Financial Group
3200 Horizon Drive, Ste 100
King of Prussia, PA 19406
Trustee
1 Hour
None
None
None
Robert Steen
KPMG
1601 Market St
Philadelphia, PA 19103
Trustee
1 Hour
None
None
None
Pamela Specht
Specht Insurance Group, Ltd.
P.O Box 99
Boyertown, PA 19512
Trustee
1 Hour
None
None
None
John J Swanick
Smart & Associates, LLP
Trustee
1 Hour
None
None
None
Susan Vari
MBNA America Bank, N A
M/S 0493
Wilmington, DE 19884
Trustee
1 Hour
None
None
None
Joe Zack
Gollatz, Griffin & Ewing
1600 JFK Blvd
4 Penn Center, Ste 200
Phdadephia, PA 19103
Trustee
1 Hour
None
None
None
47 W I anraStar AvP
Devon, PA 19333
0
990cx doc
FORM 990
#23-7326253
EAGLES FLY FOR LEUKEMIA, INC .
Federal Income Tax Return - Year 2004
SCHEDULE_,CX - Schedule A Support
Part III, Line 4:
Statement About Activities
The organizations receiving awards are required to be exempt organizations under 501
(c)(3) of the Internal Revenue Code. These organizations include medical institutions and
personnel in the care and treatment of leukemia victims, as well as, to assist research
programs In the years 2002-2004, The Family Support Program has assisted individual
families with financial problems arising as a result of having a child under treatment for
leukemia .
Part IV, Line 13 : Reason for Non-Private Foundation Status
Awards have been made in prior years to organizations for their outstanding
contribution to pediatric cancer rest-arch, to scholarship recipients and to family support
recipients .
In 2004 awards were granted to :
DuPont Hospital for Children
Scholarships
$
10,731
8,500
Children Hospital of Philadelphia
51,878
St Christopher Hospital
13,746
848 55
Form 990
EAGLES FLY FOR LEUKEMIA
Federal Income Tax Return - Year 2004
Schedule DX - Allocated Payroll and Management
#23-7326253
Form 990
EAGLES FLY FOR LEUKEMIA
Federal Income Tax Return - Year 2004
Schedule EX Primary Exepmt Purpose
Part III
The purpose for which this corporation was formed is to inform and educate
the public concerning the needs of pediatric leukemia victims and to raise funds
through various means, including solicitation of contributions from public and
other sources. These are distributed in order to assist medical institutions and
personnel in the care and treatment of pediatric leukemia victims, as well as
to assist research programs for the cure and prevention of leukemia, and to
assist in the expansion of facilities for the care and treatment of said victims .
In the year 2000 the Family Support Fund was established to help families
of children with cancer finance the extraordinary costs associated with illness .
This program was continued in the years 2001-2004 .
#23-7326253
05
Form
4562
penartment of the Treasury
Internal Revenue Service
Name(s) shown on return
Depreciation and Amortization
OMB No 1545 .0172
2004
(Including Information on Listed Property)
" See separate instructions .
I
Eagles Fly for Leukemia
Business or activity to which this form relates
Attachment
Sequence No
" Attach to your tax return .
Inc .
#23-7326253
~ Election To Expense Certain Property Under Section 179
Note: If you have an listed property, complete Part V before you complete Part 1.
Maximum amount See page 2 of the instructions for a higher limit for certain businesses
Total cost of section 179 property placed in service (see page 3 of the instructions) , . ,
Threshold cost of section 179 property before reduction in limitation . . . , . . . . . .
Reduction in limitation Subtract line 3 from line 2 If zero or less, enter -0- . . . . . . .
1
2
3
4
Dollar limitation for tax year Subtract line 4 from line 1 If zero or less, enter -0- If mame0
filin g separately. see a e 3 fine instructions .
5
67
Identifying number
(a) Description of property
,
,
_
_
.
,
.
.
.
,
.
.
.
,
.
.
.
,
.
.
.
_
.
.
,
,
.
.
.
,
.
,
,
,
.
.
,
,
,
,
,
,
.
,
,
,
,
,
,
,
,
,
1
2
3
4
,
,
,
,
$102,000
$410,000
5
(b) Cost (business use only)
102,0 00
(c) Elected cost
6
7
Listed property Enter the amount from line 29
8
. . , . . . . . . . . . . . . . . . . . .
7
Total elected cost of section 179 property Add amounts in column (c), lines 6 and 7 . . . . . . . . . . . . . , , ,
8
Carryover of disallowed deduction from line 13 of your 2003 Form 4562 . . . . . . . . _ . . . . . . . . . , . . .
10
Tentative deduction Enter the smaller of line 5 or line 8
9
10
11
Business income limitation Enter the smaller of business income (not less than zero) or line 5 (see instructions)
12
Section 179 expense deduction Add lines 9 and 10, but do not enter more than line 11
13
Carryover of disallowed deduction to 2005 Add lines 9 and 10, less line 12
Note : Do not use Part 11 or Part 111 below (or listed property Instead, use Part V
.
. . .
,
9
11
12
. "
13
Special Depreciation Allowance and Other Depreciation (Do not include listed property .)
14
Special depreciation allowance for qualified property (other than listed property) placed in
15
16
Property subject to section 168(f)(1) election (see page 4 of the instructions) , , , , , . , , , , , , , , , , , , , ,
(lthnr ric~rnri?finn linr_I~iriin~ GrRS~ IGPP na~n d of the inctrii~finncl
service during the tax year (see page 3 of the instructions) , , , , , , , , , , , , , , _ , , , , , , , , , , , , , ,
14
15
1F
7
MACRS Depreciation (Do not include listed grape ~y ) See gaga 5 of the instructions.)
Section A
17
17
MACRS deductions for assets placed in service in tax years beginning before 2004 , , , , , , , , , , ,
If you are electing under section 168(1)(4) to group any assets placed in service during the tax year
18
into one or more general asset accounts check here
Section B - Assets Placed in Service .During 2004 Tax Year Using the General Depreciation System
(c) Basis for depreciation (d) Recovery
(b) Month and
(business/investment use
(e) Convention
(~ Method
(g) Depreciation deducLOn
(a) Classification of property
year placed in
period
service
only - see instructions)
19a
3-year property
b
5-year property
c
7-year property
d 10-year property
e 15-year property
f 20-year property
g 25-year property
25 yrs
h Residential rental
property
i Nonresidential real
property
S/L
27 5 yrs
MM
S/L
27 5 yrs
IVIM
S/L
39 yrs
I MM
T
Mm
I
Section C - Assets Placed in Service During 2004 Tax Year Usin g the Alternative De
20a Class life
12 yrs
b 12-year
40 yrs
c 40-year
MM
S/L
S/L
reciation System
S/L
S/L
S/L
Summary (see page 8 of the instructions)
21
Listed property Enter amount from line 28
22
Total. Add amounts from line 12, lines 14 through 17, lines 19 and 20 in column (g), and line 21
23
Enter here and on the appropriate lines of your return
21
Partnerships and S corporations - see instr .
22
1,217
For assets shown above and placed in service during the current year,
enter the portion of the basis attributable to section 263A costs .
JsA For Pa p erwork Reduction Act Notice, see separate instructions .
4W 8656 , ~~0
F237
Form 4562 (2004)
Eagles
Form 4562 2004
Fly for Leukemia,
Inc .
#23-7326253
Listed Property (Include automobiles, certain other vehicles, cellular telephones, certain computers, and
\ property used for entertainment, recreation, or amusement .)
Note : For any vehicle for which you are using the standard mileage rate or deducting lease expense, complete only
reciation and Other Information Caution : See p a g e 9 of the instructions for limits for passenger automobiles .
evidence to support the business/investment use claimed
Yes
No
24b If "Yes," is the evidence written?
Section A
24a Do yoi
(3)
TYPE~ Of Property
vehicles first
(b)
Date placed in
service
t
(Ift-\t
Business/
investment
use
V ercent-V
(d)
Cos, or other
basis
Basis for(e)
depreciation
(businesslinvestment
use onNI
26
Special deprecation $1I ance for qualified listed property placed in service during the tax
year and used more the 50% in a qualified business use (see page 8 of the instructions) .
Property used more than k0% in a qualified business use (see page 8 of the instructions)
27
Property used 50% or less in a
28
29
Add amounts in column (h), lines 25 through
Add amounts in column (i), line 26 Enter here
25
(g)
Method/
Convention
M
Recovery
period
lNo
(1)
(h)
Depreciation
deduction
Elected
section 179
cost
25
business use (see page 8 of the instructions
S/L SIL S/L
Enter here and on line 21, page 1 , , , , , , , , , , , , , , ,
28
kon line 7, page 1
Se
res I
29
ion B - Information on Use of Vehicles
Complete this section for vehicles used by a sole proprietor, artner, or other "more than 5% owner," or related person
If you provided vehicles to your employees, first answer the
estions in Section C to see if you meet an exception to compleUng this section for those vehicles
30
Total business/investment miles driven during the
year (do not include commuting miles - See page 2
of the instructions) ,
31
Total commuting
32
Total
other
miles driven
personal
during
`(~)
Veh~ a 1
(b)
Vehicle 2
(c)
Vehicle 3
(d)
Vehicle 4
(e)
Vehicle 5
Vehicle 6
the year
(noncommuting)
miles
driven
13
Total miles driven
through 32
34
35
uWUly ih8
year
Add
;,ries
30
Was the vehicle available for personal use during
off-duty hours
Yes
No
Yes
o
Yes
No
Yes
No
Yes
No
Yes
No
, , , , , , , , , , , , , , , , , , ,
Was the vehicle used primarily by a more than
5% owner or related persons , , , , , _ , , , , ,
another
36 Is
vehicle available
for
personal
uses
Section C - Questions for Employers Who Provide Vehicles for
e by Their Employees
Answer these questions to determine if you meet an exception to completing Secti
B for vehicles used by employees who
are not more than 5% owners or related p ersons see p a g e 10 of the instructions
37
38
39
40
41
Do you maintain a written policy statement that prohibits all personal use of ~vehicl , including commuting,
by your employees
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . .
Do you maintain a written policy statement that prohibits personal use of vehicles, except commutin . by your employees
See page 10 of the instructions for vehicles used by corporate officers, directors, or 1 % a more owners . _ . . .
Do you treat all use of vehicles by employees as personal uses . . . . . . . . . , . . . . . . . . . . . , . . . . .
Do
you
provide
more
than
five
vehicles
to
your
employees,
obtain
information
from
your
Yes
No
. , , . . . , . ,
. . . . . . ,
em loyees
the use of the vehicles, and retain the information received
Do you meet the requirements concerning qualified automobile demonstration uses (See page 10 of the instructions ) . . .
Note . I( your answer to 37, 38, 39, 40, or 41 is "Yes,"do not complete Section B (or the covered vehicles
about
. . . ,
C= Amortization
Description of costs
(b)
Date amortization
begins
42
Amortization of costs that begins duri
43
Amortization of costs that began before your 2004 tax year
44
(c)
Amortizable
amount
(d)
Code
section
Amortization
period or
percentage
4X2310 2 000
rtization for
,s year
it 2004 tax vear (see oaae 11 of the instructions)
Total. Add amounts in column (f) See page 12 of the instructions for where to report . , ' . . . . . . . . . . . . .
JSA
A
. ~ q3
Form 4562 (2004)
1
8868
Form
(Rev
De~~etnber2G04)
Department of the Treasury
Application for Extension of Time To File an
Exempt Organization Return
OMB No 1545-1709
" File a separate application for each return
Internal Revenue Smote
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)
Do not complete Parfll unless you have alread y been granted an automatic 3-month extension on a previousl y filed Form 8868
Automatic 3-Month Extension of Time - Only submit original (no copies needed)
Form 990-T corporations requesting an automatic 6-month extension - check this box and complete Part I only . . . . . . . . . .
All other corporations (including Form 990-C filers) must use Form 7004 to request an extension of time to file income fax returns
Partnerships, REMICs, and trusts must use Form 8736 to request an extension of time to file Form 1065, 1066, or 1041
Electronic Filing (e-file) . Form 8868 can be filed electronically if you want a 3-month automatic extension of time to file one of the
returns noted below (6 months for corporate Form 990-T filers) However, you cannot file it electronically if you want the additional
(not automatic) 3-month extension, instead you must submit the fully completed signed page 2 (Part II) of Form 8868 For more
decals on the electronic filing of this form, writ www irs.gov/eiile .
Type or
print
File by the
due dare for
filing your
return See
ms truc1ions
Name of Exempt Organization
Ea g les F1
Employer identification number
for Leukemia
Number, street, and room or su
no . It 0 F' U .
c/o Smart and Assoc
City, town or post office, state,
Devon PA 19333
Check type of return to be filed (file a se
x
Form 990
Form 990-BL
Form 99D-EZ
Form 990-PF
~
The books are m the care of "
crate
Form
Form
Form
Form
1 23-7326253
oox see
t Lancaster Avenue
a foreign address, see mstrucbons
application for each return)
990-T (corporation)
990-T(sec. 401(a) or 408(a) trust)
990-T (trust other than above)
1041-A
Form 4720
Form 5227
Form 6069
Form 8870
Smart and Assoc .
Telephone No No- 610-254-0700
FAX No . "
610-687-3348
If the organization does not have an office or place of business in the United States, check this box . . . . ,
If this is for a Group Return, enter the organization's four digit Group Exemption Number (GEN)
for the whole group, check this box " F-] . If it is for part of the group, check this box "
names and EINs of all members the extension well cover.
1
If this is
and attach a list with the
I request an automatic 3-month (6-months for a Form 990-T corporation) extension of time until August 15
, 2005
to file the exempt organization return for the organization named above The extension is for the organizations return for
x
calendar year 2004 or
t
1110-
tax year beginning
, 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 the tentative tax, less any
nonrefundable credits See instructions . , . , , , , , , . . . . . . . . . . , . . . . . . . . . . , . . . . . . ,
If this application is for Form 990-PF or 990-T, enter any refundable credits and estimated tax payments
made Include any prior year overpayment allowed as a credit , . . , .
, . .
. . . .
. . . .
. . . . .
Balance Due. Subtract line 3b from line 3a . Include your payment with this form, or, if required, deposit
with FTD coupon or, if required, by using EFIPS (Electronic Federal Tax Payment System) . See
instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b
c
a Initial return
a Final return a Change m accounting period
$
$
$
Caution. If you are going to make an electronic fund withdrawal with this Form 8868, see Form 8453-EO and Form 8879-EO
for payment instructions
For Privacy Act and Paperwork Reduction Act Notice, see Instructions .
Form 8868 Rev 12-2ooa)
d
15A
4F8054 3 000
0-1
8868 (Rev 12-2004)
" I~, you are fling for an Additional (not automatic) 3-Month Extension, complete only Part II and check this box, , , _ , , , ,
Note . Ghiy complete Part II if you have already beer granted an automatic 3-month extension on a previously filed Form 8868
" 1f ou are filing for an Automatic 3-Month Extension, complete only Part I (on page 1 ).
Page 2
Additional (not automatic 3-Month Extension of Time - Must File Original and One Copy.
Type or
print
File by the
extended
due date for
filing the
return See
instructions
Name of Exempt Organization
-
Ea les Fl
for Leukemia
Number, street, and room or suite no . If a P .O box see instructions
_
Employer identification number
_,~ 23-7326253
For IRS use only
92 West Lancaster Avenue
c/o Smart and Assoc .
a,
City, town or post office, state, and ZIP code For a foreign address, see instructions .
`
r;
Devori
PA
19333
._~~
Check type of return to be filed (File a se crate application for each return)
Form 990-T(sec 401(a) or 408(a) trust)
Form 5227
x
Form 990
Form 990-T (trust other than above)
Form 6069
Form 990-BL
Form 990-EZ
u Form 1041-A
Form 8870
Form 990-PF
I
I Form 4720
STOP : Do not complete Part II if you were not already granted an automatic 3-month extension on a previously filed Form 8868 .
Smart and Assoc .
The books are in the care of "
Telephone No . "
610-254-0700
FAX No
"
610-687-3348
" If the organization does not have an office or place of business m the United States, check this box, , , , , , , . , , . , , . . .
" If this is for a Group Return, enter the or anization's four digit Group Exemption Number (GEN
. If this is
and attach a list with the
for the whole group, check this box " ~ If it is for part of the group, check this box "
names and EINs of all members the extension is for.
4 I request an additional 3-month extension of time until
November 15, 2005
5 For calendar year 2004 , or other tax year beginning
and ending
-----=Final return ~ Change in accounting period
6 If this tax year is for less than 12 months, check reason' U Initial return
7
State in detail why you need the extension Additional time is required to gather and assemble the
data necessary to properly complete the return .
If this application is for Form 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less any
nonrefundable credits . See instructions . . , , . . , . , , , . . , . , . . , . . . _ _ . . . . . . . . . . . . .
b
If this application is for Form 990-PF, 990-T, 4720, or 6069, enter any refundable credits and estimated
tax payments made . Include any prior year overpayment allowed as a credit and any amount paid
previously with Form 8868 . . . . . , . . .
c
Balance Due . Subtract line 8b from line 8a Include your payment with this form, or, if required, deposit
with FTD coupon or, if required, by using EFTPS (Electronic Federal Tax Payment System) See
instructions
Signature and Verification
Under penalties of penury, I declare that I have examined this form, including accompanying schedules and statements, and to the best
it is true, correct, and complete, and that I am authorized to prepare this form
8a
$
$
$
of my knowledge and belief,
Signature Ili-
Title 00~
Date 1
Notice to Applicant - To Be Completed by the IRS
We have approved this application Please attach this form to the organization's return .
We have not approved this application . However, we have granted a 10-day grace period from the later of the date shown below or the due
date of the organization's return (including any prior extensions) This grace period is considered to be a valid extension of time for elections
otherwise required to be made on a timely return . Please attach this farm to the organization's return .
We have not approved this application After considering the reasons stated in item 7, we cannot grant your request for an extension of lime
to file W e are not granting a 10-day grace period
We cannot consider this application because it was filed after the extended due date of the return for which an extension was requested
Other
BY
Director
Dale
Alternate Mailing Address - Enter the address if you want the copy of this application for an additional 3-month extension
returned to an address different than the one entered above
Name
Type or
print
Number and street (induce suite, room, a apt. no .) or a P.O . box number
-'
City or town, province or slate, and country (including postal or ZIP code)
4F8055 3 000
Form8868 (Rev 12-2ooa)