Y-Ht5 V5/V//LUVS OW NM
-1
1Form 990
s
'
OMB No. 1545-0047
Return of Organization Exempt From Income Tax
2003
Under section 501(c), 527, or 4947(a)(1) of the internal Revenue Code (except black lung
Open to Public ,
Inspection
benefit trust or private foundation)
1 The organization ma have to use a co of this return to satis state re porting re quirements .
A
B
For the 2003 calendar e
Check if applicable: Please
use IRS
Address change
label or
Name change
print or
type.
initial return
See
Final return
$Pecift
Amended return
InstrucApplication pendin
ion .
J
K
L
v
rt 1
1
d
2
3
4
5
6a
b
c
7
8a
b
c
d
9
a
b
c
10a
b
c
17
-
wvV
p
n
e
s
A
NS
e
tt
s
,
and ending
13
14
15
96
17
18
19
26
21
For Paper
DAA
9 / 30 / 04
FITNESS ASSOCIATION OF BLS
Number and street (or P .O . box H mail is not delivered to street address)
2 MASSACHUSETTS AVENUE,
N.E .
G-455
D
Room/suite
Employer ID number
52-1780669
E Telephone number
202 -691-7128
F Accounting method:X Cash
11 Accrual
City or town, state or country, and ZIP + 4
11 Other (specify)
Section 501(c)(3) organizations and 4947(a)(1) nonexempt charitable
H and 1 are not applicable to section 527 organizations .
trusts must attach a completed Schedule A (Form 990 or 990-EZ).
H(a)
Is this a group return for affiliates?
a Yes
H(b)
If -Yes," enter number of affiliates 1
.ID
Gross receipts : Add lines 6b. 8b . 9b. and 10b to line 121
u
Lin
Name of organization
Organization type
4
52 .
check only one 1
501 c
-; (insert no.
4947( a)(1 ) or
Check here 1
if the organization's gross receipts are normally not more than $25,
The organization need not file a return with the IRS ; but if the organization received a
Form 990 Package in the mail, it should file a return without financial data . Some states
a
b
c
R
or tax ear beginning 10 / 01 / 03
C
H(C) Are ail affiliates included?
.. .
1.&I No
.Yes . . a. No
(If "No," att. a list. See instr.)
H(d) Is this a separate return filed by an
...y... . .._...... . . ..
I
M
Grou p Exemption Numberill,
Check 1 V if the organization is not required
Revenue Ex penses, and Chan ges in Net Assets or Fund Balances See page 18 of the instructions .
Contributions, gifts, grants, and similar amounts received :
Direct public support
1a
Indirect public support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Government contributions (grants) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
noncash $
)
Total (add lines 1a through 1c) (cash $
Program service revenue including government fees and contracts (from Part VII, line 93) ,
Membership dues and assessments
Interest on savings and temporary cash investments
Dividends andinterestfromsecurities . ., , , ; , . ., ., ., . . ., ., . . . . ., . . , ., . ., . ., . . . . . ., . . . . .
Gross rents
6a
Less rentalexpenses~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6b
Net rental income or (loss) (subtract line 6b from line 6a)
Other investment income (describes
-- - -- -- -- - --- - . . . .
...
Gross amount from sates of assets other
A Securities
B other
than inventory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8a
Less : cost or other basis and sales expenses . . . . . .
8b
Gain or (loss) (attach schedule)
8c
Net gain or (loss) (combine line 8c, columns (A) and (B))
Special events and activities (attach schedule) . If any amount is from gaming, check here 1
Gross revenue (not including $
of
9a
contributions reported online 1a) . . . . . . . . . . . . . . . . . . . : ., . .
. .. . . ... . ..
9b
Less : direct expenses other than fundraising expenses . . . . . . . . . . .
Net income or (loss) from special events (subtract line 9b from line 9a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Gross sales of inventory, less returns and allowances
10a
less : cost of goods sold
10b
Gross profit or (loss) from sales of inventory (attach schedule) (subtract line 10b from line 10a)
Other revenue (from Part VII, line 103) , .
assets or fund ba'la
at
r
yes~ MU
M or
assets or fund bala
Rqci~~'liql'~~l~otij e~ fee
1rJVVG1~1 W ~
instructions .
s
a
5
187, 867
1,571
sa
9c
10c
11
12
14
15
16
17
., , . . . . .
0
6c
7
13
Program services (from line 44, column (B)) . .
Management and general (from line 44, column (C))
Fundraising (from line 44, column (D))
Payments to affiliates ~ta~.~~^""~ ed ule)
"
act line 17 from line 12) ,
~ning of year (from line 73, column (A))
balances (attach explanation)
7d
2
18
19
20
189,438
181, 917
3, 844
185,761
4,0 //
151,424
Form 990 (2003)
11
Fomi990'(2003j
uz r~q=,j,NE
SS ASSOCIATION OF BLS
Statement of
Part 11
DO not include amounts reported 011 line
6b 8b9b 10b or 16 Of Part I .
22 Grants and allocations (attach schedule) . . . . . . . . . . . . . . . . .
(cash $
noncash $
;
)
23
24
25 Compensation of officers, directors, etc.
(C) Management
(D) Fundraising
and general
26
27
.. . .. . _ . ... . . . ,. . ..
29 Payroll taxes . . . . . : . . . : . . . . ._ . . . . . .
30 Professional fundraising fees . . ,
28
29
..
30
. . . . . . . . . . . :. . . . . . .
. . . . _ .: . . . ._ . . . .. .
34
35
. ... . . ... . .... . . ... .
, . ... _
. ~~~ . , .~ . . . ...
36
37
38
41 Interest
42 Depreciation, depletion, etc . (attach schedule) . . . . . . .
43 Other expenses not covered above (itemize) :a . . . .. .. . . . .
40
41
42
43a
37 Accounting fees . . . . . . ._ .
32 Legal fees
33 Supplies . . . . . . . . . . . ~ ~
Telephone . : . . . . . : . : . . . . . . . . . . . .
Postage and shipping : . . . _ , . . . . . .
Occupancy . . . . . : . . . . . . . . . . . . : . . .
Equipment rental and maintenance
Printing and publications
services
25
. . . . . . .~ .~~ .~~ .
27 Pension plan contributions
34
35
36
37
38
Pale 2
22
24 Benefits paid to or for members
26 Other salaries and wages
(B) Program
(A) Total
23 Specific assistance to individuals
28 Other employee benefits
52-1780669
Ail organizations must complete column (A). Columns (B), (C), and (D) are required for section 501(c)(3) and (4) organizations
31
32
2, 200
33
39 Travel
40 Conferences, conventions, and meetings . . . . . . . . . . . . . .
b, : See. .Statement . .1 . ._ . . . ._ . . . . . . . . . . . .
c
148
823
186
186
1 , 998
39
710
710
43n
179,696
179,061
635
185,761
181,917
3 , 844
43c
43d
e
43e
comp leting columns B D , ca these totals to lines 13-15
Joint Costs. Check 1
if you are following SOP 98-2 .
971
11998
d
44 Total functional expenses (add lines 22 - 43). Organizations
2,200
44
Are any joint costs from a combined educational campaign and fundraising solicitation reported in (B) Program services? . . . . . . . . . . .
If "Yes," enter (i) the aggregate amount of these joint costs$
110-
; (ii) the amount allocated to Program services $
CH I) the amount allocated to Management and generaQ
0
Yes
,
No
; and (iv) the amount allocated to Fundraisinq$
Statement ofProgram Service Accom
Program Service
Expenses
What is the organization's primary exempt purpose?
1 FITNESS CENTER FOR. .EMPLOYEES OF BLS
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Required for 501(c)(3) 8
All orgarnzations must~describe fheir~exem pf purpose achievements in a~clea~ and concise~manner . S
(a) orgs ., & 4947(a)(1)
of clients served, publications issued, etc. Discuss achievements. that are not measurable . (Section 501(c)(3) and (4)
ousts; but optional for
a
See Statement 2
b
c
d
e Other program services (attach schedule)
_
(Grants and allocations
$
(Grants and allocations
$
(Grants and allocations
$
(Grants and allocations
$
$
(Grants and allocations
f Total of Program Service Expenses (should equal fine 44, column (S), Program services) . . . . . . . . . . . . . . . . .. . . . . . . . . . . . .
DAA
1
181 .917
1
)
1
181,917
Fog 990 (2oos)
FAB 05107/2005 5:02 PM
Form 990 (2003)
Part 1V
Note :
A
s
s
e
t
s
Accounts receivable
Less : allowance for doubtful accounts
48a
b
49
50
Pledges receivable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
48a
Less : allowance for doubtful accounts
48b
Grants receivable
. . . . . .. . . .. .
Receivables from officers, directors, trustees, and key employees
(attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other notes and loans receivable (attach
schedule)
51a
Less : allowance for doubtful accounts . . . . . . . . . .
51b
Inventories for sale or use
...
Prepaid expenses and deferred charges . . . . . . . . . . . . .
.. .
. . ..
...
Investments-securities
See Stmt 3. . . . 1 []cost
7 . FMV
Investments-land, buildings, and
equipment : basis . _ . , , _ . . . . . . . . . . . . . . . . , , . . . . . . . .
55a
Less : accumulated depreciation (attach
schedule)
SSb
Investments-other (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Land, buildings, and equipment : basis
57a
Less: accumulated depreciation (attach
schedule)
57b
Other assets (describe 1
)
51a
b
52
53
54
55a
s
59
60
61
62
63
64a
b
65
Page 3
Balance Sheets (See page 25 of the instructions .)
47a
b
58
i
52-1780669
45
46
56
57a
b
i
ASSOCIATION OF BLS
Where required, attached schedules and amounts within the description
column should be for end-of-year amounts only.
Cash-non-interest-bearing
Savings and temporary cash investments
b
a
FITNESS
(A)
B eginning of ear
140
120,612
47a
47b
Total assets add lines 45 throu gh 58 must e q ual line 74 . . . . . . . . . . . . . . . . . . . . . . .
Accounts payable and accrued expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Grants payable . . . . . . . ., . ._ . . . ._ . . . . . . . . .
Deferred revenue
Loans from officers, directors, trustees, and key employees (attach
schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Tax-exempt bond liabilities (attach schedule) .
Mortgages and other notes payable (attach schedule)
Other liabilities (describe 1
)
(B)
End of ear
45
46
140
123,089
47c
48c
49
50
51c
52
53
30,672 54
31,872
55c
56
57c
58
151,424
59
60
61
62
155,101
63
64a
64b
65
0 66
66
Total liabilities add lines 60 throug h 65 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Organizations that follow SFAS 117, check here 1 UX and complete lines .
67 through 69 and lines 73 and 74 .
151,424 67
67
unrestricted
e u 68
Temporarily restricted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
68
t n
69
Permanently restricted
69
q
Organizations that do not follow SFAS 117, check here 1 ~ .and
s B
complete lines 70 through 74 .
s a 70
Capital stock, trust principal, or current funds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
70
e I
Paid-in
capital
surplus,
or
land,
building,
and
equipment
fund
71
71
or
t a
72
Retained
earnings,
endowment,
accumulated
income,
or
other
funds
.
72
s n
.. . . . . . .. . . . .
73
Total net assets or fund balances (add lines 67 through 69 or lines
70 through 72 ;
column (A) must equal line 19 ; column (B) must equal line 21) . . . . . . . . . . . . . . . . . . .
151, 424 73
74
Total liabilities and net assets 1 fund balances add lines 66 and 73 . . . . . . . . . . . . .
151,424 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 .
DAA
0
155,101
155,101
155,101
_a+ vI iaWJ J.VL r-
'
LESS ASSOCIATION OF BLS
Reconciliation of Revenue per Audited
Financial Statements with Revenue per
Return See page 27 of the instructions.
Part IV-A `'
a
Total revenue, gains, and other support
per aucUted financial statements
1
b
Amounts included on line a but not on
line 12, Form 990 :
(1) Net unrealized gains on
investments $
(2) Donated services and use
a
189,43 8
52-17801
Part IV-B ;
Reconciliation of Expenses per Audited
Financial Statements with Expenses per
Return
a
b
e
a
. . . . . . . . ... $
Add amounts on lines (1) through (4) "
b
185,7 61
(4) Other (specify):
E
Add amounts on lines (1) through (4) 1
c
d
R
(1) Donated services and use
of facilities
$
(2) Prior year adjustments
reported on line 20, .
Form 990
$
(3) Losses reported on line 20,
Form 990
$
of facilities
$
(3) Recoveries of prior
year grants $
(4) Other (specify):
.
Total expenses and losses per
audited financial statements
Amounts included on line a but not .
on line 17, Forth 990:
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 :
Add amounts on lines (7) and (2) . . .
Total revenue per line 12, Form 990
1
b
c
-
189, 438 c
d
Line a minus line b
Amounts included on line 17,
R
c
185,761
Form 990 but not on line a :
(1) Investment expenses
not included on line
6b, Form 990 $
(2) Other (specify) :
1
d
e
Add amounts on lines (1) and (2) . . . 1
Total expenses per line 17, Form 990
d
189, 438
185,761
line c plus line d . . . . . . . . . . .. . . . . . . 1 e
line c plus line d) . . . . . . . .
10.
e
Part V `
List of Officers, Directors, Trustees, and Key Employees (List each one even if not compensated; see page 27 of
(u~ ~vonmo, to
(S) Title and average
(C) Compensation
(E) Expense
hours per week devoted to
(If not paid, enter plans "&edefereedt account and other
position
-p-,
allowances
cc Dense ion
J . COLEMAN
PRESIDENT
WASHINGTON DC
3
0
0
0
R . ULICS
.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ACTING PRES .
WASHINGTON .DC
3
0
0
0
A . LOMBARDOZZI
TREASURER
WASHINGTON DC
~~ 3
0
0
0
J FORD
SECRETARY
WASHINGTON DC
2
0
0
0
K . MCNALLY
DIRECTOR
WASHINGTON DC
1
0
0
0
C . ROWAN
DIRECTOR
.
. . . .. . . .. . . . .. . .. .. . . . . .. . . ... . ... . . ... . .
1
0
O
O
VdASHINGTON .DC
. K . DONAHUE .
. : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . DIRECTOR
1
O
O
O
.WASHINGTON .DC
A. WALTER
DIRECTOR
1
WASHINGTON DC
0
0
0
M . SWARTZ .
DIRECTOR
1
0
O
O
. . . . . . . . . . . . . . . . . .-. . . . . . . . . . . . . . . . . . . . . . .
WASHINGTON .DC
(A) Name and address .
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.
DAA
1 a Yes X~ No
Form 990 (2003)
FAB 05/0712005 5:02 PM
Form 990 2003
FITNESS ASSOCIATION OF BLS
Part V1
Other Information See page 28 of the instructions .
76
77
78a
b
79
80a
b
Bia
b
82a
b
83a
b
84a
b
85
b
c
d
e
f
g
h
86
b
87
b
88
89a
b
c
d
90a
b
91
92
DAA
52-1780669
Did the organization engage in any activity not previously reported 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?
If "Yes, ." attach a conformed copy of the changes .
Did the organization have unrelated business gross income of $1,000 or more during the year covered by this return?
. . , . . . ., _
If "Yes," has it filed a tax return on Forth 990-T for this year? . . . . . . . . . _ . . . . . . . . . . . . _ . . . . . . _ . . . . _ . . . . . . . . . . . . . . . . . . ,. . . . . , . . . . .
Was there a liquidation, dissolution, termination, or substantial contraction during the year? If "Yes," attach a
statement
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 organisation? . . . . . . . . . . . . . . . . . . . . . . . . .
If "Yes," enter the name of the organization 1
. . . . , . . . . , . . . . . . . , . . . and check whether it is ~ . exempt or
''nonexempt .
Enter direct and indirect political expenditures . See line 81 instructions , _ . , . . . . . . . . . , . . . . . _ . . , . . .
81a
Did the organization file Form 1120-POL for this year? . . . . . . . . . . . . .
Did the organization receive donated services or the use of materials, equipment, or facilities at no charge
or at substantially less than fair rental value?
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 .) . SAe Stl~lt 4
100,000
82b
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?
Did the organization solicit any contributions or gifts that were not tax deductible?
If "Yes," did the organization include with every solicitation an express statement that such contributions
or gifts were not tax deductible?
N/A
501(c)(4), (5), or (6) organizations . a Were substantially all dues nondeductible by members?
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 tax owed for the prior yeas
Dues, assessments, and similar amounts from members
85c
Section 162(e) lobbying and political expenditures
85d
Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices . . . . . . . . . , . , , . . . . . , . . . . . .
85e
Taxable amount of lobbying and political expenditures (line 85d less 85e) . . . .
,,._.
85f
Does the organization elect to pay the section 6033(e) tax on the amount on line 85f? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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?
501(c)(7) orgs . Enter : a Initiation fees and capital contributions included on line 12
86a
Gross receipts, included on line 12, for public use of club facilities
. .' . . .. . .. . ' . .
86b
501(c)(12) orgs . Enter : a Gross income from members or shareholders. . . . . . . . . . . . . . . . . . . . . . . . 87a
Gross income from other sources. (Do not net amounts due or paid to other
sources against amounts due or received from them .) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
87b
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 .7701-3? If "Yes," complete Part IX
501(c)(3) organizations . Enter: Amount of tax imposed on the organization during the year under:
section 4911 1
; section 4912 1
; section 4955 1
501(c)(3) and 501(c)(4) orgs . 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 year? If "Yes," attach
a statement explaining each transaction
Yes
Pa e 5
76
77
X
X
78a
78b
X
79
X
80a
X
81b
X
82a
X
83a
83b
84a
X
X
84b
85a
85b
X
X
X
8
85h
88
X
X
89b
Enter : Amount of tax imposed on the organization managers or disqualified persons during the year under
0
sections 4912, 4955, and 4958
1
0
Enter : Amount of tax on line 89c, above, reimbursed by the organization
1
List the states with which acopy ofthis return isfiled 1 . . . . . . . . . . DC ., ._ . .
. . . . ., . .__ , . . . ., . . .
. . . ., . . . ., ., . .
Number of employees employed in the pay period that includes March 12, 2003. (See
. . . . . instructions
..
.) . . . . . . . . . . . . . . . . . I 90b . . . . . . . . . .
The books are in care of 1 MR . A . LOMSARDOZZI
located at 1 2 MASSACHUSETTS AVE . , N . E . WASHINGTON, DC
Section 4947(a)(1) nonexempt charitable trusts filing Form 990 in lieu of Form 1041- Check here
Telephone no. 1 202-691-7$95
ZIP + 4 1 20212
and enter the amount of tax-exempt interest received or accrued during the tax year . . . . . . . . . . . . . . . . . . . . . . . . . . .
1 192
Form 990 (2003)
rno va1w ;cwo o.vt nvi
r Part Vl'--'
52-1780669
_-Analysis of Income-Producin Activities See page 33 of the instructions .
Note : Enter gross amounts unless Otherwise
93
94
95
96
97
Excluded b sec. 512, 513, or 51
(p)
tC)
xciusior
Amount
Unrelated business income '
indicated.
Program service revenue:
(A)
Business code
-
a
b
c
d
e
f Medicare/Medicaid payments
g Fees and contracts from government agencies
(B)
Amount
(E)
Related or
exempt function
code
Membership dues and assessments .
Interest on savings and temporary cash investments . . . . . . .
Dividends and interest from securities
Net rental income or (loss) from real estate :
a debt-financed property . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b not debt-financed property . . . . . . .
..
.
98 Net rental income or (loss) from personal
. . . . .property
. . . . . . . . . . ... . .. . . .
99 Other investment income
700 Gain or (loss) from sales of assets .other than .inventory .
101 Net income or (loss) from special events
102 Gross profit or (loss) from sales of inventory . . . . . . . . . . . . . .
103 Other revenue :
a
14
income
187,867
1,571
b
c
d
e
4 Subtotal (add columns (B), (D), and (E)) . . . . . . . . . . . . . . . . . .
0
105 Total (add line 104, columns (B), (D), and (E)) . . . . . . . . . . . . . . . . . . . . . . . . . : .
Note : Line 105 plus line 1d, Part I, should equal the amount on line 12, Part I .
n.. ..a vul
Line No.
"
94
_s w
a_ al'_
w___
1,571
187,867
1
. .~ .~~ :_L ..~_ .~a
`1e
..r a6...
189,438
: ..,.a... . ..a: .. ...,.
X
Explain how each activity for which income is reported in column (E) of Part VII contributed importantly to the accomplishment
of the o anization's exempt pur poses other than b p roviding funds for such purposes ) .
OPERATING FITNESS CENTER FOR MEMBERS TO IMPROVE THEIR
HEALTH AND FITNESS .
Information Regarding Taxable Subsidi
address, an( Ad
of corporation,
nershi , or disre garded entity
N/A
Percentage of
ownershi p intere
Nature of activities
I
Total
art X
Information Regarding Transfers Associated with Personal Benefit Contracts (See page 34 of
(a)
Did the organization, during the year, receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
(b)
Did the organization, during the year, pay premiums, directly or indirect)
Note : If "Yes" to (b) . file Form 8870 and Form 4720 (see instructions) .
Under penalties of perjury, I declare that I have examined this return, includi
and be ' it is true, collect and comp) . Decl ration of preparer (other th
Please
'
Sign
Here
.
ign tof offi r
~Q.P1lZ
l' ("0 Ie/YI" ~ . Are -~ /
' Type or tint name and title
Paid -
signature
/
Preparer's Firm's game (or yours
Use Only
if self-employed),
address, and ZIP + 4
DAA
~u -129
/
"ep h E : Godbout
12 Wayne Ave
ilver Snrina . MD
E
Yes IXI No
FAB 0211412005 8:15 PM
Form
8868
Application for Extension of Time To File an
Exempt Organization Return
(December 2000)
Department of the Treasury
OMB No .
1545-1709
Internal Revenue Service
1 File a sepa rate a pplication for each return.
40 If you are filing for an Automatic 3-Month Extension, complete only Part I and check this box
19 If you are filing for an Additional (not automatic) 3-Month Extension, complete only Part II (on page 2 of this form) .
Note : Do not complete Part II unless you have already been granted an automatic 3-month extension on a previously filed
Form 8868 .
Part I
Automatic 3-Month Extension of Time- Only submit original (no copies needed)
Note : 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 tax
returns . Partnerships, REMiCs and trusts must use Form 8736 to request an extension of time to file Form 1065, 1066, or 1041 .
Type or
Name of Exempt Organization
Employer identification number
print
File by the
due date for
filing your
return . See
instructions .
52-178066
FITNESS ASSOCIATION OF BLS
Number, street, and room or suite no. If a P .O . box, see instructions.
2 MASSACHUSETTS AV'ENZJB, N .B . G-45
City, town or post office, state, and ZIP code . For a foreign address, see instructions .
WASHINGTON
DC 20212
Check type of return to be filed (file a separate application for each return) :
Form 990
Form 990-T (corporation)
Form 990-BL
Form 990-T (sec . 401(a) or 408(a) trust)
Form 990-EZ
Form 990-T (trust other than above)
Form 990-PF
"
Forth 1041-A
, . .
,~
Form 4720
'~;
Form 5227
Form 6069
~ ._ .
,.
Forth 8870
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~~a
~7
. If -t-h--is is . . . . . . . . . . . .
for the whole group, check this box
1 0 . If it is for part of the group, check this box
1 ~ arrci attach a list with the
names and EINs of all members the extension will cover .
1
I request an automatic 3-month (6-month, for 990-T corporation) extension of time until
- 5 / 16 / 05
to file the exempt organization return for the organization named above . The extension is for the organization's return for :
1
calendar year
or
1 ~ tax year beginning
10 / 01 / 03 , and ending - 9 / 30 / 04 .
2
If this tax year is for less than 12 months, check reason:
3a
If this application is for Forth 990-BL, 990-PF, 990-T, 472, 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 EFTPS (Electronic Federal Tax Payment System) . See
b
c
instructions . .
..
_
... .
1 L
0 Initial return
0 Final return
Signature and Verification
. ._
~ Change in accounting period
$
$
., .
... ..
$
Under penalties of perjury, I declare that I have examined this form, including accompanying schedules and statements, and to the best of my
knowledge and belief, it is true, correct, and complete, and that I am authorized to prepare this form .
7
~-
s.
Signature
Title t L ,~f
For Paperwork btedu ion Act Notice, see Instruction
DAA
s~'SE?4i F. G0D6OUT
1172 YrRYNE AVENUE
SILVER SPRING, MARYLAND 20916
Date
002/14/05
Form 8868 (12-2000)
FAB FITNESS ASSOCIATION OF BLS
52-1780669
Federal
FYE: 9/30/2004
5/7/2005 5 :02 PM
Statements
Statement 1 - Form 990, Part 11, Line 43 - Other Functional Expenses
Total
Expenses
Description
Expenses
DC TAXES
BANK SERVICE CHARGES
MANAGEMENT FEES
GROUP EXERCISE INSTRUCTION
PROMOTIONAL EXPENSES
INSURANCE-GENERAL LIABILITY
SOFTWARE
STAFF AWARDS
YOGA AND PILATES INSTRUCTIONS
SMALL EQUIPMENT PURCHASED
MUSIC AND LICENSING FEES
Total
$
$
Program
Service
$
602
33
148,712
12,266
3,213
2,344
1,200
968
9,358
514
486 .
179,696 $
Mgt &
General
S
148,712
12,266
3,213
2,344
1,200
968
9,35$
514
486
179,061 .$
FundRaising
$
602
33
635
$
0
Statement 2 - Form 990 . Part 111, Line a - Statement of Program Service Accomplishments
FAB OPERATES A FITNESS CENTER FOR EMPLOYEES OF THE BUREAU
OF LABOR STATISTICS AND OTHERS TO PROMOTE GOOD HEALTH AND
FITNESS AMONG ITS APPROXIMATELY 800 MEMBERS AND OTHERS
WITH GYM EQUIPMENT AND EXERCISE PROGRAMS .
1-2
FAB FITNESS ASSOCIATION OF BLS
Federal
52-1780669
FYE : 9/30/2004
Statements
5/7/2005 5 :02 PM
Statement 3 - Form 990, Part IV. Line 54 - Investments in Securities
Description
US and State Government
U .S . SAVINGS BONDS
Beginning
of Year
30,672
30,672
End of
Year
31,872
31,872
Basis of
Valuation
Market
3
FAB FITNESS ASSOCIATION OF BLS 52-1780669
federal
FYE: 9/30/2004
5/7/2005 5:02 PM
Statements
Statement 4 - Form 990 . Part VI, Line 82b - Donated Services
DONATED GYM SPACE
Total
Description
$
Amount
100,000
100,000
4
--00000-FITNESS ASSOCIATION OF BLS
WASHINGTON, D.C.
CASH BASIS FINANCIAL STATEMENTS
September 30, 2004
and
September 30, 2003
--00000--
-00000-CONTENTS
Independent Auditor's Report . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . :; . . . . .. .. . . . .:. . . . . . . . . . . . . . . . . . . . . . :Page 3
Statements of Financial Position Arising From Cash
Transactions (Comparative) . . . .. .. . . . .. .. . . . . . . . . . . . . : . . . .. . . . . . . . . . . . . . . .. .. . . . . . . . . . . . ., . . . . . . . . . . . . . . . . : . . . . . 4
Statements of Activities - Cash Basis and Changes in Cash Balances
(Comparative) . . . . . . .. . . . . .. .. . . . . . . . . . . . . . . . . . . . . . .. .. . . . . . . . . . . .. . . . . . . . . .. .:. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . .5 & 6
Notes to Financial Statements . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . :. . . . . . : . . . . .. . . . . 7 8y 8
--00000--
JOSEPH E. GODBOUT
CERTIFIED PUBLIC ACCOUNTANT
1112 WAYNE AVENUE
SILVER SPRING, MARYLAND 20910-5601
TELEPHONE: 301 . 588 . 4555
FAX: 301 . 588 . 9044
joegcpe0erols.com
INDEPENDENT AUDITOR'S REPORT
Officers and Board of Directors
Fitness Association of BLS
Washington, D .C .
I have audited the accompanying statements of financial position arising from cash
transactions of Fitness Association of BLS (FAB) (a District of Columbia corporation
and a section 501(c) (4) non-profit local association of employees for recreational
purposes) as of September 30, 2004 and September 30, 2003, and the related
statements of activities - cash basis and changes in cash balances for the years then
ended. These financial statements are the responsibility of the management of Fitness
Association of BLS . My responsibility is to express an opinion on these financial
statements based on my audits.
I conducted my audits in accordance with generally accepted auditing standards .
Those standards require that I plan and perform the audits to obtain reasonable
assurance about whether the statements are free of material misstatement. An audit
includes examining, on a test basis, evidence supporting the amounts and disclosures
in the financial statements.
An audit also includes assessing the accounting
principles used and significant estimates made by management, as well as evaluating
the overall financial statement presentation .
I believe that my audits provide a
reasonable basis for my opinion .
The organization's policy is to prepare its financial statements on the basis of cash
receipts and disbursements, -which is a comprehensive basis of accounting other than
generally accepted accounting principles ; consequently, certain revenue is recognized
when received rather than when earned, and certain expenses are recognized when
paid rather than when the obligation is incurred . Accordingly, the accompanying
statements are not intended to present the financial position or the changes in
members' equity in conformity with generally accepted accounting principles.
In my opinion, the financial statements referred to above present fairly, in all material
respects, the assets arising from cash transactions of Fitness Association of BLS at
September 30, 2004 and September 30, 2003, and the cash received and expenditures
made and changes in cash balances for the years then ended on the cash basis of
accounting as described in the preceding paragraph .
JOSEPH E. GODBOUT
Certified Public Accountant
Silver Spring, Maryland
December 14, 2004
FITNESS ASSOCIATION OF BLS
STATEMENTS OF FINANCIAL POSITION
ARISING FROM CASH TRANSACTIONS
September 30, 2004
with comparative figures for September 30, 2003
ASSETS
Current Assets :
Cash in checking account
Cash in DOL Credit Union
Cash in equipment fund savings account
Petty cash fund
Card key petty cash
Cash in certificates of deposits
United States Series EE Bonds, at cost,
plus accrued interest (cost $30,000)
Noncurrent Assets: (Note A)
Total Assets
2004
2003
$26,861
31,770
2
100
40
64,456
$34,459
-021,903
100
40
64,250
31,872
155,101
30,672
151,424
NONE
NONE
155 101
15I 424
LIABILITIES AND NET ASSETS
Liabilities :
Account payable, equipment
CASH BASIS
Net Assets :
Members' equity - cash basis
Total Liabilities and Net Assets
The acro
$ 155 , 101
$ 151 ,424
15S 101
151 424
intes are an integral part of these financial statementsPage 4
FITNESS ASSOCIATION OF BLS
STATEMENTS 4F ACTIVITIES - CASH BASIS AND CHANGES IN CASH BALANCES
for the year ended September 30, 2004
with comparative figures for the year ended September 30, 2003
2004
Receipts:
BLS payroll deductions
Non-BLS payments
BLS full payments
Lockers
Initiation fees
Interest income
Service/late/lost ID fees
Class fees
Advance payroll deduction fees
Short-term fees
Incidental income
Card key deposits
Total Receipts
Disbursements:
Program Services
Management fees
Group exercise instruction
Fitness equipment purchased
Promotional expenses
Insurance - general liability
Equipment maintenance
Software
Staff awards
Training and travel
Yoga and Pilates instructions
Group exercise and yoga supplies
Small equipment purchased
Music and licensing fees
Total Program Services Disbursements
Page 5
'
2003
$116,768
40,240
5,800
7,825
2,830
1,571
1,864
10,707
488
185
665
495
$120,736
43,640
6,025
7,635
3,586
2,373
2,029
10,596
808
420
948
560
189,438
199,356
148,712
12,266
-03,213
2,344
1,998
1,200
968
710
9,358
148
514
486
143,805
10,486
3,332
2,363
2,416
2,348
1,200
3,319
455
9,049
167
495
-0-
181 .917
179,435
Supporting Services
Annual audit
Theft loss
Office expenses
Insurance - employee dishonesty
Postage
Taxes
Bank services charges/ printing checks
Total. Supporting Services Disbursements
Total Disbursements
EXCESS OF RECEIPTS OVER DISBURSEMENTS
Cash at beginning of year
Cash at end of year
2004
2003
$ 2,204
-0823
-0186
602
33
3,844
$ 2,000
1,007
863
i ;293
394
835
$6
6,478
185,761
185,913
3,677
13,443
151,424
137,981
101
The accompanying notes are an integral part of these financial statements.
Page 6
`
FITNESS ASSOCIATION OF BLS
NOTES TO FINANCIAL STATEMENTS
September 30, 2004
and
September 30, 2003
Note A. Summary of Significant Accounting Policies
1 . Fitness Association of BLS (FAB) prepares its financial statements on the
cash basis of accounting; consequently, certain revenue is recognized when
received rather than when earned, and certain expenses are recognized when
paid rather than when the obligation is incurred. Accordingly, the
accompanying statements are not intended to present the financial position or
the changes in members' equity in conformity with generally accepted
accounting principles .
2 . Any famed assets purchased by FAB become the property of The Bureau of
Labor Statistics in accordance with the terms of the facilities agreement in Note
E below .
3 . Membership dues are recognized as income in the year in which they are
received.
Note B. Organization
Fitness Association of BLS (FAB) is a non-profit District of Columbia corporation
formed to provide an opportunity for Bureau of Labor Statistics employees and
others to improve their general health through the use of a physical fitness
facility and related programs and activities : FAB is open to all BLS employees,
BLS contractors, BLS interns, and Federal employees within close proximity to
the Postal Square Building. FAB's primary source of income is from
membership dues : The organization served approximately 800 members and
other gym users in 2004 and 2003.
Note C. Income Taxes
The corporation is a Section 501(c) (4) Local Association of Employees for
Recreational Purposes and as such is exempt from both Federal and D .C .
income taxes under the Internal Revenue Service Code and D .C. Income Tax
Rules .
Page 7
y
Note D. Expenses for Program Services
Expenses for program services have been charged with direct costs only, and do
not include overhead costs which may be associated with these functions.
Note E. Facilities
FAB is provided gym space, locker facilities, and almost all of its fitness
equipment free of charge by The Bureau of Labor Statistics (BLS) under an
agreement dated September 14, 1992 . Under the terms of this agreement, BLS
will maintain the facility which will be operated by FAB . FAB will maintain the
equipment and bear the cost of any repairs to the equipment . FAB, at its
discretion ; may purchase new equipment and replace individual pieces of
equipment which wear out or cannot be repaired . Any new equipment
purchased by FAB belongs to BLS: This agreement may be
terminated by either
party upon ninety days written notice .
The equipment furnished to FAB by the BLS is mostly ten years old and it is not
practicable to determine its estimated annual value to FAB . It is estimated that
the annual value of the free space is around $100,000 per year .
Note F. Management Contract
FAB contracts with a management company to operate the gym facilities and to
conduct aerobics and other classes on physical fitness . This contract may be
terminated with 90 days written notice by either party. The terms of this
contract call for monthly payments of approximately $12,500 through July 31,
2007 .
The approximate minimum amounts payable under this contract as of
September 30, 2004 are as follows:
September 30, 2005
September 30, 2006
September 30, 2007 (1O months)
Page 8
$150,000
150,000
125,000
$425 ,000