_,
Farm
990
Return of Organization Exempt From Income Tax
OMB NO 1545-0047
Under section 501(c), 527, or 4997(s)(1) of the Internal Revenue Code (except black lung
benefit vast or private foundation)
Department of Cn Treasury
" The organization may have to use a copy of this return to satisfy state reporting requirements
,mer,ei Revenue Service
A For the 200 calendar ear, or tax year beginning
200 , and ending
B Check d applicable
p~ Address chenge
O
ycv Name change
Initial return
0 Final return
Amended return
0 Application pending
G
Web Site "
Plsw
C Name of organization
h~b~los
pd.t °`
type
~'^e
~mc
~~~40~
K
Centralia Beautiful Clean&Green
Number and street (or P O box if mail is not delivered to street address) PoortJsuite
PO Box 383
222 South Po p lar
City or town, state or country, end ZIP + 4
0 melon 507(c)(9) organizations and 4847(a)(7) nonexempt charitable
trusts must attach a completed Schedule A (Form B00 or 90OE~
J organization type (check only one "
,~S,
L"J 507(c) ( 3 ) 4 (insert no ) 0 4947(a)(1) or 0527
K Check here " 0 i1 the organization's gross receipts ere normally not more than $25,000 The
Ag. an
1
c'7
m
La-
«ra
Contributions, gifts, grants, and similar amounts received
c Government contributions (grants)
d Total (add lines 1 a through 1c) (cash $ 41 , 618
0 Accrual
0 Yea ON.
(II "No," attach a list See instructions)
H(dJ is this a separate return filet by an
organization covered by a group ruling?
I
O
Yes 0 No
Enter 4-digit GEN e,
M Check "
0 if the organization is not required
to attach Sch B (Forth 990, 990-EZ, or 990-PFD
'a
60,18 5
1c
16--, 1 67
1d
noncash $ 34 , 734
1
Program service revenue including government fees and contracts (from Part VII, line 93)
4
5
Interest on savings and temporary cash investments
Dividends and interest from securities
76 , 352
Membership dues and assessments
rja
6a Gross rents
b Less rental expenses
7 Other investment income (describe "
Ba Gross amount from sales of assets other
than inventory
6b
W Securities
88
b Less cost or other basis and sales expenses
c Gain or (loss) (attach schedule)
d Net gain or (loss) (combine line 8c, columns (A) and (B))
9
a
b
c
10a
b
Special events and activities (attach schedule)
Gross revenue (not including $
contributions reported on line 1 a)
R other
'
of
9a
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
12
10b
Less cost of goods sold
Program services (from line 44, column (B))
Management and general (from line 44, column (C))
e 44, column (D))
~affihat s (attach schedule)
Ones 16 and 44, column (A
18 Excess
ore(fdef
A
b
~
fEBJep
p a7s ~~pp fu
7
8b
c Gross prolla or (1055) from sales of inventory (attach schedule) (subtract line 10b from line 10a)
Other revenue (from Part VII, line 103)
Total revenue (add lines 1d, 2, 3, 4, 5, tic, 7, 8d, 9c, 10c, and 11)
13
14
1
4
-r
(A Cave
H(c) Are all affiliates included?
2
17
12
(615 533-761A
Revenue Ex enses and Chang es m Net Assets or Fund Balances See S eafic Instructions on p age 16
c Net rental income or (loss) (subtract line 6b from line 6a)
C~
E Telephone, number
H(b) If "Yes," enter number of affiliates w . . . . . .
-0-
a Direct public support
b Indirect public support
3
37 . 1204207
0 Other (specify)
H and I aye not applicable to section 527 organ-, vatlo,nvs1
H(a) Is this a group return tar aKiliates7
U Yu Ipl No
in the mat it should file a return without financial data Some states require a complete return
Gross receipts Add lines 6b, 8b, 9b, and 10b to line 12 "
D Employer IdantrfieaUOn number
p Accenting oil
organization need not file a return with the IRS but d the organization received a Forth 990 Package
L
.-
r the year (subtract line 17 from line 12)
glances at beginning of year (from line 73, column (A))
20 Other changes I
t assets or fund balances (attach explanation)
a, -'jVL-dW,kq' a .n
wic,ou at end vi year (combine lin 18, 19, and 20)
AlILVeIrAllIuMolt Aq*tice, a" the Separate Instructions
10c
11
12
13
1<
I5
16
17
18
19
20
21
Cat No 11282Y
-V76 , 484
75 , 805
6 , 259
82
064
5,580)
-4 6 -&() 5
F~~O
. 3(-2-OLOI)
66
Forth 990 (2001)
Statement of
Functional Expenses
Page 2
M organizations must complete column (A) Columns (9), (C/, and (D) are required (or section 501(c)(3) and (4) organizations
and sedan »947(aX1) nonexempt, charitable trusts but optional for others (See Specific InsWChons on page 21 )
Do not include amounts reported on line
66, 86, 96, lOb, or 16 0/ Part I
22
23
24
25
28
27
28
29
30
37
32
33
34
35
38
37
38
39
40
41
42
43
b
Grants and allocations (attach schedule)
(cash $
noncash S
)
Specific assistance to individuals (attach schedule)
Benefits paid to or for members (attach schedule)
Compensation of officers, directors, etc
Other salaries and wages
Pension plan contributions
Other employee benefits
Payroll taxes
Professional fundraising fees
Accounting fees
Legal fees
Supplies
Telephone
Postage and shipping
Occupancy
Equipment rental and maintenance
Printing and publications
Travel
Conferences, conventions, and meetings
Interest
Depreciation, depletion, etc (attach schedule)
Other expenses not covered above (itemize) a
The Recycl-iflg- Center -Ne3.ghbor-haod- Roc-k[lp- - --- --
(e) Program
services
(A) Total
22
23
24
25
26
27
28
29
30
31
~
33 _
34 .
35
36
37
38
39
40
41
42
d -Gude--en fo-r_cemen-t -E.dFIf. _ _
e HI.sS/Grea-t- ,4m . Clea-SUP
44 Total functional expenses (addlines 22through 43) Organizations
carrpklng columns (B)qoJ, carry these roan to lures f3-fs
Joint Costs. Check " [] if you are following SOP
43c
43d
43e
qa
98-2
-0- 0- 0- 40 , 2 47
- 0_
-0- - - -0-
-
- - -
- -
_
- -0-
(c) Management
and general
229
2 9f;
91 R
3,693
(D) Fundraising
-0- n-
-
- 0-
-
3,345
1) Q a
-289
-197
q97
--51082
>
__
682
t- 682
82 , 064
7
" El Yes 0 No
Are any point costs from a combined educational campaign and fundraising solicitation reported in (B) Program services
If "Yes," enter () the aggregate amount of these point costs $- , u the amount allocated to Program services $
,
(i) the amount allocated to Management and general $
, and (v) the amount allocated to Fundraising $
FMMM Statement of Program Service Accomplishments See Specific Instructions on page 24
Program Service
What is the organization's primary exempt purpose? oEnvxzQnmenk EdJ1C2.kloil/S2~L'Vice
F~cpenses
All organizations must describe their exempt purpose achievements in a clear and concise manner State the number (peQUnea ion Smlc~~31 ana
orps
and asa7p~p
~
I<I
of chants served, publications issued, etc Discuss achievements that are not measurable (Section 501(c)(3) and (4)
trusts buy opoonai a .
organizations and 4947(a)(1) nonexempt charitable trusts must also enter the amount of grants and allocations to others )
others )
e
.Operate -muf f-county_ rQQycll.ng ._cQnter_ for valuniear . ..
__Man-age
cari tas, _Lranspnrta .tznn,_ _communiLy_
. . a-w_areness .and . edv-catinn__tp -public on_ solid-waste issues
(Gran s and allocations
$
b ___Provide_resitlents-with .a service 6a--proper-ly--depose--of
___unwanted_ a.tems--and
j
debr-is aot--normally eol-leated ettr-bside
---------- - ---- ------(Grants and allocations
$
e Other program services (attach schedule)
(Grants and allocations
(Grants and allocations
$
$
f Total of Program Service Expenses (should equal line 44, column (B), Program services)
4,200
)
'c __ .AQC_ognize
.individuals and _busiensses fog .e-f forts -in - - -maintaining_
attrac tive, . clean and- safe- homes -and/or- - - -businesses----- --------(Grants
----- - and
-~- allocations $
)
d ---Part icipate--ice the-Great -Ame-riean Clean--Up . ---
70,473
----------
"
450
-
)
)
"
682 .
5 , 8~5
Form 990 (zooi)
Form 990 (2001)
Page 3
Balance Sheets (See Specific Instructions on page 24)
Note
45
48
Where required, attached schedules and amounts within the descnphon
column should be (or end-of-year amounts only
(,e,)
Beginning of year
45
46
Cash-non-interest-bearing
Savings and temporary cash investments
47a Accounts receivable
b Less allowance for doubtful accounts
47a
47b
48a Pledges receivable
b Less allowance for doubtful accounts
49
Grants receivable
48a
48b
FNIII
48c
49
Recervables from officers, directors, trustees, and key employees
(attach schedule)
51a Other notes and loans receivable (attach
Sia
schedule)
51b
b Less allowance for doubtful accounts
52
Inventories for sale or use
53
Prepaid expenses and deterred charges
54
Investments securities (attach schedule)
" El Cost 0 FMV
55a Investments-land,
buildings,
and
I 55a
equipment basis
b Less accumulated depreciation (attach
schedule)
58
Investments-other (attach schedule)
57a Land, buildings, and equipment basis
b Less accumulated depreciation (attach
schedule)
58
Other assets (describe "
57a
67 . 266
57b
31
-
59
Total assets add lines 45 throu g h SB) (must eq ual line 74
80
87
62
Accounts payable and accrued expenses
Grants payable
Deferred revenue
317
50
///
51c
52
53
64
41,031
5~c
58
35 , 949
46 , 805
59
60
61
41 , 225
)
82
63
Loans from officers, directors, trustees, and key employees (attach
schedule)
64a Tax-exempt bond liabilities (attach schedule)
b Mortgages and other notes payable (attach schedule)
65
Other liabilities (describe "
)
66
Total liabilities add lines 60 through 65
5P976
47c
50
m
a
(B)
End of year
~
63
65
-0-
gg
-0-
Organizations that follow SFAS 117, check here " ~ and complete lines
67 through 69 and lines 73 and 74
////
87
Unrestricted
m BB
Temporarily restricted
m 69
Permanently restricted
s9
°c Organizations that do not follow SFAS 117, check here " 0 and
12
complete lines 70 through 74
70
0 70
Capital stock, trust principal, or current funds
m 77
Paid-in or capital surplus, or land, building, and equipment fund
»
72
°~ 72
Retained earnings, endowment, accumulated income, or other funds
a 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 fine 2s)
73
46 , 80 5
74
Total liabilities and net assets / fund balances add lines 66 and 73
,
46 805
74
41 2 2 $
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 it return Therefore, please make sure the return is complete and accurate and fully describes . in Part III, the organrzation's
programs and accomplishments
Form 990
a
b
Reconciliation of Revenue per Audited
Financial Statements with Revenue per
Return (See Soeafic Instructions . oaae 2
Total revenue, gains, and other support
per audited financial statements
Amounts included on line a but not on
line 12, Form 990
(7) Net unrealized gains
on investments
(2) Donated services
and use of facilities $
(3) Recoveries of prior
year grants
(4) Other (specify)
Reconciliation of Expenses per Audited
Financial Statements with Expenses per
~~~~~ a
j
b
j
(7)
Donated services
and useoifacilities
j
(2)
Prior year adjustments
j
reported on line 20,
Form 990
(3) Losses reported on
line 20, Form 990
(4) Other (specify)
/
d
Line a minus line b
Amounts included on line 12,
Form 990 but not on line a
j
j
(1)
(2) Other (specify)
/
(2) Other (specify)- ---
------_ .------- -
e
Total revenue per line 12, Form 990
(line c olus line d)
Instructions on page 26)
W Name and address
-
$
/
b
Investment expenses
not included on line
6b, Form 990
$
Add amounts on lines (1) and (2)
--- --------
a
Add amounts on lines (1) through (4)"
Line a minus line b
Amounts included on line 17,
Form 990 but not on line a
c
d
(1) Investment expenses
not included on line
6b, Form 990
per
"
Amounts included on line a but not
on line 17, Form 990
Add amounts on lines (1) through (4)
c
Total expenses and losses
audited financial statements
4
- - - -- -
-
e
Add amounts on lines (1) and (2) "
Total expenses per line 17, Form 990
line c p lus line
"
d
e
Key Employees (List each one even if not compensated, see Specify
(B) Tale and average hours per
week devoted to position
~,c) Compensation
In not geld, enter
(D) ConmMma m
ee bsief~ pan ; 6
(E) Expense
account and other
-
. . ..See. Attached Sheet . . . .
--------
- -
75
- - - - -
-----
- --- ---
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 Speciic
f Instructions on page 27
I
"
El Yes [:] No
Fom, 990 (2001)
Form 990 (2001)
Other Information (See Specific Instructions on page 27
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?
76
77
If "Yes," attach a conformed copy of the changes
78a Did the organization have unrelated business gross income of $1,000 or more during the year covered by this retum9
b If "Yes," has it filed a tax return on Form 990-T for this year?
79
Was there a liquidation, dissolution, termination, or substantial contraction during the yeah If "Yes," attach a statement
BOa 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?
b If "Yes," enter the name of the organization "
. . .. .
and check whether it is
0 exempt OR 0 nonexempt
laia I
81a Enter direct or indirect political expenditures See line 81 instructions
b Did the organization file Form 1120-POL for this yea(
828 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?
b If "Yes," you may indicate the value of these items here Do not include this amount
1 82b I
as revenue in Part I or as an expense in Part II (See instructions in Part III )
B3a 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
Boa Did the organization solicit any contributions or gifts that were not tax deductible
b If "Yes ." did the organization include with every solicitation an express statement that such contributions
or gifts were not tax deductible
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 B5a or 85b, do not complete 85c through 85h below unless the organization
received a waiver for proxy tax owed for the prior year
185c I
c Dues, assessments, and similar amounts from members
d
e
t
g
h
Section 162(e) lobbying and political expenditures
Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices
185f I
Taxable amount of lobbying and political expenditures (line 85d less 85e)
Does the organization elect to pay the section 6033(e) tax on the amount on line 85f9
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?
86a I
86
501(c)(n orgs Enter a Initiation tees and capital contributions included on line 12
86b
b Gross receipts, included on line 12, for public use of club facilities
87a
87
501(c)(72) orgs Enter a Gross income from members or shareholders
b Gross income from other sources (Do not net amounts due or paid to other
87b
sources against amounts due or received from them )
88
At any time during the year, did the organization own a 504'0 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
89a 501(c)(3) organizations Enter Amount of tax imposed on the organization during the year under
section 4911 "
, section 4912 "
, section 4955 10b 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 poor 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
11
d Enter Amount of tax on line 89c, above, reimbursed by the o anization
90a List the states with which a copy of this return is filed " . I TI 1 n O 1 S
91
92
b Number of employees employed in the pay period that includes March 12, 2001 (See instructions)
__ _ __ _ _ _
The books are in care ot " _ Connie Parker
Locacedat~22z South Poplar, C~ntzal_~.a,_ZL
..
1 90b I
B9b
3
Telephone no " (618 ) .533-761Q_ .
ziP+a11~ 628D1+0383
Section 4947(a)(1) nonexempt charitable trusts (long Form 990 in lieu of Form 1041-Check here
and enter the amount of tax-exempt interest received or accrued during the tax year
" I 92 I
Fog 990 (2001)
6
Form 990
Note : Enter gross amounts unless otherwise
indicated
83
Program service revenue
Unrelated business income
(A)
(B)
Business code
Amount
ded by section 512 513 or 514
(C)
,,on code
(D)
Amount
(E)
Related or
exempt function
a
b
c
d
e
f Medicare/Medicaid payments
g
84
95
96
Fees and contracts from government agencies
Membership dues and assessments
97
Interest on savings and temporary cash investments
Dividends and interest from securities
a
Net rental income or (loss) from real estate
debt-financed property
b not debt-financed property
Net rental income or (loss) from personal property
Other investment income
98
98
100
107
Gain or (loss) from sales of assets other than inventory
Net income or (loss) from special events
102 Gross profit or (loss) from sales of inventory
103 Other revenue a
b
c
e
104 Subtotal (add columns (B), (D), and (E))
105
Total (add line 104, columns (B), (D), and (Q)
Note: Line 105 plus line 1d, Part l, should equal the amount on line 12, Part I
Relationship of Activities to the Accom p lishment of Exem pt Purp oses See Sp ecific Instructions on page 3:,
Explain how each activity for which income is reported in column (E) of Part VII contributed importantly to the accomplishment
Line No
of the organization's exempt purposes (other than by providing funds for such purposes)
address, and FEIN of corporation,
of
I
Nature of activities
I
Total income
on
(a) Did the organization, during the year, receive any funds, directly or
(b) Did the organization, during the year, pay premiums,
Note: If "Yes" to (b), 61e Form 8870 and Form 4720 (se
Unde310 alties of pp/~ 1 d;?re that 1 have examined this
this i
and 6R is tru{ corteclcomplete Declaration of prs
Please '
Sign
~
Here
.
ipnature o! otRCer
i.
.
Type or print name and title
Paid
PfEp2RrS
ASE Only
P~aparars '
signature
Firm's name (or your.
if self-employed),
address end ZIP . 4
I
SCHEDULE A
(Form 990 or 990-EZ)
Oepertment of the Treasury
imemai a,.en , s .rvice
Name of the organization
Organization Exempt Under Section 501(c)(3)
(Except Private Foundation) end Section 501(e), 501(f), 501(k),
OMB NO 1545-0047
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 their Forth 990 or 990-EZ
2002
Employer Identification number
37
1204207
Kee p Centralia Beautiful/Clean & Green
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 ")
(a) Name and address of each employee paid more
than $50 000
(b) Title and average fours
per week devoted to position
(c) Compensation
(0) Contributions 10
employee benefit plans 8
deferred compensation
(e) Expense
account and other
allowances
None
Total number of other employees paid
$50,000
FTMM
over
lli
Compensation of the Five Highest Paid Independent Contractors for Professional Services
(See page 2 of the instructions List each one (whether ind ~viduals or firms) If there are none, enter "None "
(a) Name and address of each independent contractor paid more than $50 000
(G) type of service
(c) Compensation
None
Total number of others receiving over $50,000 for
professional services
11
For Paperwork Reduction Act Notice, see the instructional for Form 990 and Form BBo-EZ
Cat No 11285F
Schedule A (Form 990 or BBO-EZ) 2001
Schedule A (Form 990 or 990-En 7001
09 .90
Statements About Activities (See page 2 of the instructions )
I
During the year, has the organization attempted to influence national, state, or local legislation, including any
attempt to influence public opinion on a legislative matter or referendum? If "Yes," enter the total expenses paid
1
or incurred in connection with the lobbying activities
Part VI-A, or line i of Part VI-B )
" $
I Yes
~o
(Must equal amounts on line 38,
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
2
a
During the year, has the organization, either directly or indirectly, engaged in any of the following acts with any
substantial contributors, trustees, directors, officers, creators, key employees, or members of their families, or
with any taxable organization with which any such person is affiliated as an officer, director, trustee, majonty
owner, or principal beneficiary ? Of the answer to any question is "Yes,"attach a detailed statement explaining the
transactions)
Sale, exchange, or leasing of property?
b
Lending of money or other extension of credit?
c
Furnishing of goods, services, or facilities
d
Payment of compensation (or payment or reimbursement of expenses if more than $1,000)
e
Transfer of any part of its income or assets
3
Does the organization make grants for scholarships, fellowships, student loans, etc ? (See Note below )
4
Do you have a section 403(b) annuity plan for your employees
Note Attach a statement to explain how the organization determines that individuals or organizations receiving grants
or loans from it in furtherance o/ its chantable oroa2ms "oualilv" to receive oavments
ORM
Reason for Non-Private Foundation Status (See pages 3 through 6 of the instructions )
The organization is not a private foundation because it is (Please check only ONE applicable box )
5
6
7
B
9
A church, convention of churches, or association of churches Section 170(b)(1)(A)(i)
A school Section 170(b)(1)(A)(n) (Also complete Part V )
A hospital or a cooperative hospital service organization Section 170(b)(1)(A)(iii)
A Federal, state, or local government or governmental unit Section 170(b)(1)(A)(v)
A medical research organization operated in conjunction with a hospital Section 170(b)(1)(A)(u) Enter the hospital's name, city,
and state " _ _
10
El An organization operated for the benefit of a college or university owned or operated by a governmental unit Section 170(b)(1)(A)(rv)
(PJSO complete the Support Schedule in Part IV-A )
11a X M 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)
El
El
0
El
El
11b 0 A community trust Section 170(b)(1)(A)(w) (Also complete the Support Schedule in Part IV-A )
72 D An organization that normally receives (7) more than 33'h% of its support from contributions, membership fees, and gross
receipts from activities related to its charitable, etc , functions-subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired
by the organization attar June 30, 1975 See section 509(a)(2) (Also complete the Support Schedule in Part IV-A )
13
0 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 509a)(3) )
Provide the following information about the supported organizations (See page 5 of the instructions )
I (b) Line number
(a) Name(s) of supported organization(s)
from above
14
0 An organization organized and operated to test far public safety Section 509(a)(4) (See page 6 of the instructions )
Schedule A (Form 990 or 980-EZ) 2001
Schedule A (Form 990 or 990-EZ) 7001
Page 3
~Support Schedule (Complete only if you checked a box on line 10, 11, or 12 ) Use cash method of accounting.
Note : You may use the worksheet in the instructions far converting from the accrual to the cash method o/ accounting
Calendar year (or fiscal year beginning in)
t
75 Gifts, grants, and contributions received (Do
not include unusual grants See line 28 )
Membership fees received
Gross receipts from admissions, merchandise
sold or services performed, or furnishing of
facilities in any activity that is related to the
18
17
18
(a) 2001
20
Tax revenues levied for the organization's
benefit and either paid to it or expended on
its behalf
21
The value of services or facilities furnished to
the organization by a governmental unit
without charge Do not include the value of
services or facilities generally furnished to the
Other income Attach a schedule Do not
include gain or (loss) from sale of capital assets
23
Total oflines 1sthrough 22
24
25
Line 23 minus line 17
Enter t%ofline 23
28
78 , 861
839764
31 2 , 499
132
182
122
166
602
3 600
3- 1 6-0-0-
b
1 80,084
3 600
3,600
14,400
77,264 ~ 82,583
1 87,530
~ 32 7 , 461
R(11
Organizations described on lines 70 or 11 :
a
774
8 2F
875
Enter 2% of amount in column (e), line 24
Prepare a list for your records to show the name of and amount contributed by each person (other than a
governmental unit or publicly supported organization) whose total gifts for 1997 through 2000 exceeded the
amount shown in line 26a Do not file this list with your return Enter the total of all these excess amounts "
0,
c Total support for section 509(a)(1) test Enter line 24, column (e)
d Add Amounts from column (e) for lines
18
22
(e) Total
739482
pubic without charge
22
(0(d) 199 8
769352
Gross income from interest, dividends,
amounts received from payments on securities
loans (section 512(a)(5)), rents, royalties, and
unrelated business taxable income (less
section 511 taxes) from businesses acquired
by the organization after June 30, 1975
Net income from unrelated
business
activities not included in line 18
19
(b)2000
~-
19
26b
N+b
26c
-
-8.-
e-
"
"
28e
gar
e
f
Public support (line 26c minus line 26d total)
Public suonoR oercentaae !line 2fie (numerated divided 6v line 26c (denominator))
b
Organizations described on line 12 .
a For amounts included in lines 15, 16, and 17 that were received from a "disqualified
person," prepare a list for your records to show the name of, and total amounts received in each year from, each "disqualified person "
Do not file this list with your retain Enter the sum of such amounts for each year
i
- (
~ - - -- - -- -- -- - . . . .
("
»
------ -- ---- -- (
~
--For any amount included in line 17 that was received from each person (other than "disqualified persons', prepare a list for your records to
show the name of, and amount received for each year, that was more than the larger of (1) the amount on line 25 for the year or (2) $5,000
(Include in the list organizations described in lines 5 through 11, as well as individuals ) Do not file this list with your return After computing
the difference between the amount received and the larger amount described in (1) or (2), enter the sum of these differences (the excess
amounts) for each year
. . .
l
1 - -- - - - -'1
---- --- -------- l
27
v
c Add Amounts from column (e) for lines
15
16
17
20
21
d Add Line 27a total
and line 27b total
e Public support (line 27c total minus line 27d total
" I 27f
f Total support for section 509(a)(2) test Enter amount from line 23, column (e)
g Public support percentage (line 27e (numerator) divided by line 27f (denominator))
h Investment income oereentaae (line 18. column lel lnumeretorl divided by line 27f (denominator))
28
Unusual Grants For an organization described in line 10, 11, or 12 that received any unusual grants during 1997 through 2000,
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 brief
description of the nature of the grant Do not file this list with yo ur retain . Do not include these grants in line 15
Schedule A (Form 990 w YBdEZ) 2001
Schedule A (Form 990 or 990 ETj 2001
Private School Questionnaire (See page 7 of the instructions )
Page 4
(To be completed ONLY by schools that checked the box on line 6 in Part IV)
29
Does the organization have a racially nondiscriminatory policy toward students by statement in its charter, bylaws,
other governing instrument, or in a resolution of its governing body
30
Does the organization include a statement of its racially nondiscriminatory policy toward students in all its
brochures, catalogues, and other written communications with the public dealing with student admissions,
programs, and scholarships?
Yes
No
30
Has the organization publicized its racially nondiscriminatory policy through newspaper or broadcast media during
the period of solicitation for students, or during the registration period if it has no solicitation program, in a way
that makes the policy known to all parts of the general community it serves?
If "Yes ." please describe, if "No," please explain (If you need more space, attach a separate statement )
37
--- -------- -- - --- - - - -- ----- --- ------- ----- ---- - -- - ----- --- --- - -- -- - --- - -
32
a
b
c
d
- ------ - ------ - ---- ------ -- ----- ------- - - - - - - -- Does the organization maintain the following
Records indicating the racial composition of the student body, faculty, and administrative staff?
Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory
basis?
Copies of all catalogues, brochures, announcements, and other written communications to the public dealing
with student admissions, programs, and scholarships?
Copies of all material used by the organization or on its behalf to solicit contributions
32b
If you answered "NO" to any of the above, please explain (If you need more space, attach a separate statement )
-- - - ---- - ----- ---- ------ -- -- - - - ---- - - -- - - - - - - - - - Does the organization discriminate by race in any way with respect to
33
a
Students' rights or privileges?
b
Admissions policies?
c
Employment of faculty or administrative staff
d
Scholarships or other financial assistance?
e
Educational policies'?
If
Use of facilities?
g
Athletic programs?
h
Other extracurricular activities?
Ii you answered "Yes" to any of fhe above, please explain (Ii you need more space, attach a separate statement )
----- ---- ---- -- -- - -
34a
b
35
-
Does the organization receive any financial aid or assistance from a governmental agency?
Has the organization's right to such aid ever been revoked or suspended?
If you answered "Yes" to either 34a or b, please explain using an attached statement
Does the organization certify that) it has complied with the applicable requirements of sections 4 01 through 4 OS
of Rev Proc 75-50 . 1975-2 C B X587, covering racial nondiscrimination If "No," attach an explanation
Schedule A (Farm 990 or 98(FEZ) 2001
Schedule A (FOim 990 a B90~FZ) 2001
Check " a
U d the organization belongs to an affiliated group
Check "
b
[_-] d you checked °a" and 'limited control' provisions apply
Limits on Lobbying Expenditures
Affiliated group
totals
(The term "expenditures" means amounts paid or incurred )
38
37
38
39
40
41
42
43
44
Page rJ
Lobbying Expenditures by Electing Public Charities (See page 9 of the instructions )
(To be completed ONLY by an eligible organization that filed Form 5768)
to be ~oietee
for ALL electing
organizations
Total lobbying expenditures to influence public opinion (grassroots lobbying)
Total lobbying expenditures to influence a legislative body (direct lobbying)
Total lobbying expenditures (add lines 36 and 37)
Other exempt purpose expenditures
Total exempt purpose expenditures (add lines 38 and 39)
Lobbying nontaxable amount Enter the amount from the following tableif the amount on line 40 isThe lobbying nontaxable amount isNot over $500,000
20% of the amount on line 40
Over $500,000 but not over $7,000,000
$100,000 plus 15% of the excess over $500,000
Over $1,000,000 but not war $1,500,000
$175,000 plus 10% of the excess over $1,000,000
Over $1,500,000 but not over $77,000,000 $225,000 plus 5% of the excess over $1,500,000
Over $17,000,000
$1,000,000
Grassroots nontaxable amount (enter 25% of line 41)
Subtract line 42 from line 36 Enter -0- if line 42 is more than line 36
Subtract line 41 from line 38 Enter -0- if line 41 is more wan line 38
Caution If there is an amount on either line 43 or line 44, you must rile Form 4720
4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five columns below
See the instructions for lines 45 through 50 on page 11 of the instructions )
Lobbying Expenditures Dunng 4-Year Averaging Penod
Calendar year (or
fiscal year beginning m) "
45
Lobbying nontaxable amount
46
Lobbying ceiling amount (150% of line 45(e))
47
Total lobbying expenditures
48
Grassroots nontaxable amount
49
Grassroots ceiling amount (150% of line 48(e))
50
Grassroots lobbying expenditures
(a)
2001
(b)
2000
(c)
1999
(e)
Total
(d)
1998
Lobbying Activity by Nonelecting Public Charities
(For reoortinq onlv by organizations that did not complete Part VI-A) (See oaae 12 of the instructions
During the year, did the organization attempt to influence national, state or local legislation, including any
yes
attempt to influence public opinion on a legislative matter or referendum, through the use of
a Volunteers
b Paid staff or management (Include compensation in expenses reported on lines c through h )
c Media advertisements
d Mailings to members, legislators, or the public
e Publications, or published or broadcast statements
1 Grants to other organizations for lobbying purposes
g Direct tooted 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.)
H "Yes" to any of the above, also attach a statement giving a detailed description o1 the lobbying activities
No
Amount
Schedule A (Form 990 or 990-EE) 1001
Schedule A (Form 990 or 990 En 2001
13M&IN
51
Information Regarding Transfers To and Transactions and Relationships With Noncharrtable
Exempt Organizations (See page 12 of the instructions)
Pa ge 8
Did the reporting organization directly or indirectly engage in any of the following with any other organization described in section
501(c) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political organization ?
Yes No
Transfers from the reporting organization to a noncharitable exempt organization of
51ai
(i) Cash
(n) Other assets
aril) Other transactions
() Sales or exchanges of assets with a nonchantable exempt organization
(i) Purchases of assets from a noncharitable exempt organization
b(iii) _
(fit) Rental of facilities, equipment, or other assets
(n) Reimbursement arrangements
(v) Loans or loan guarantees
b(vQ
(v) Performance of services or membership or fundraising solicitations
Sharing of facilities, equipment, mailing lists, other assets, or paid employees
If the answer to any of the above is "Yes," complete the following schedule Column (b) should always show the fair market value of the
goods, other assets, or services given by the reporting organization If the organization received less than fair market value in any
transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received
a
b
c
d
Isl
Line no
I
NI
Amount involved
I
"c)
(d)
Dasvipbon of transfers, transactions, and sharing amargements
Name of noncharitabla exempt
52a
Is the organization directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
described in section 501(c) of the Code (other than section 501(c)(3)) or in section 5271
"
b Ii "Yes." complete the following schedule
(e)
Name of organlnlion
rot
Type of organ¢alion
D Yes
M
Description of relatioriship
or
El No
Form
4562
DepaNnenl ol the Treasury
Internal Revenue Servce
OMB No 1545 0172
Depreciation and Amortization
Names) shown on ieturn
Keep Centralia Beautifu
&rsineis or aclnity to x1rch in* form reLates
2002
(Including Information on Listed Property)
Stt separate inslrucUOns
" Attach to vour tax velum
I
67
wMOMnq runex
Clean and Green
37-1204207
arty Election To Expenl Certain rangiDie Property under season 179
Note If you have any It ed property, complete Part V before you complete Part I
1
2
3
4
5
Maximum amount See inslruthc
Total cost of section 179 proper(
Threshold cost of section 179 pr
Reduction in limitation Subtract
Dollar limitation for lax vear Sul
s far a higher limit for certain businesses
placed in service (see instructions)
ierly before reduction in limitation
ie 3 from line 2 If zero or less, enter 0
'act line 4 from line 1 It zero or less, enter 0
7
8
9
10
11
12
13
Note
Listed property Enter the amour
Total elected cost of section 179
Tentative deduction Enter the s
Carryover of disallowed deductio
Business income limitation Ente
Section 179 expense deduction
Carryover of disallowed deduclia
Do not use Part II or Part 111 bet
7
from line 29
roperty Add amounts in column (c), lines 6 and 7
alter of line 5 or line 8
from line 13 of your 2001 Form 4562
the smaller of business income (not less than zero) or line 5 (see instrs)
dc! lines 9 and 70, but do not enter more than line 11
74
75
16
Special depreciation allowance
lax year (see instructions)
Properly subject to section 768
Other deoreaahon Gncludmo A
17
18
MACRS deductions for assets pi
If you are electing under section
one or more general asset accoi
1
2
$24
I
If married filing
B
9
10
11
12
!or listed property instead, use Part V
qualified property (other than listed properly) placed in service during the
election (see instructions)
in service in tax years beginning before 2002
)(4) to group any assets placed in service during the tax year into
f/IPfk FIPIP
em
Section B - A! zts Placed m Semce During 2002 Tax Year Using the General I
(a)
(h MonVi and
W Bass la EePne[alion
N~smes5/~nveslmenluSe
CHSSilcalan of property
arpld[e0
R¢CweryMqd
Convenlnn
1.
Method!
nnw - c. . -o-irn-)
(9) DeVrttuton
deduction
19a 3-vear orooertv
d10
e 15
67
h Residential rental
5,082
27 5 vrs I
r5
i Nonresidential real
properly
20a Class life
b 12 vear
21
22
23
12
rs
40 vrs
MM
I
S/
MM
MM
S/L
S/L
MM
S/L
5/L
S/L
Listed property Enter amount fr~m line 28
Total Add amounts from line 12, line IF ttvough 17, lines 19 and ZO in column (g), and line 21 Enter here and on the appropriate lines
of your return Parinerslups and S corporBhons - see imlruchons
For assets shown above and placed in service during the current year, enter
the portion of the basis attributable to section 263A costs
BAA For Paperwork Reduction Ad NoLCe, see instructions
TF231-
Foimeiz 101215102
Form 4562 (2002)
CLEANGR[CIJ Clean 8 qreeii
37-1204207
FYE 12131/199F3
Futui e Depreciation Report
02120/2000 10 17 AM
FYE : 12131199
Regular Deplecialioli
Dale III
Seivlce
Asset
Cusl
Tax
Stale
Amr
-ACE
Olhei Dept Walton ;
I
J
4
S
G
7
8
9
to
II
I?
IJ
E-Additions
E-Bent Sew
E Bend Sew
E Can Gusher
E Glass Crusher
E-Glass Crasher
7/01/98
4,495
45U
450
0
0
7/24/96
10/71/94
I/U1/92
2/18i94
1 /U1/93
I/U1/92
243
715
630
150
11 ()
744
74
32
(3
15
II
74
24
32
63
15
I1
74
0
0
U
0
0
0
0
U
63
0
11
74
4/U1/9f,
E-Ilospile1 Gurneys (G)
E-Paliel Jack
E-raua i,Ock
L-Shelving
V-foikhql
V-Tiuck, P9nd & Ovaheul
1 iu1192
9a1/94
12121195
399
360
7,00u
4o
36
700
25
4u
36
700
ic,zcr,
158
1 ,628
1,628
I otnl ACItS a n d 00a Ui pi ednllun
16,266
1,628
Gruud lolnb
16,266
1 ;i28
e
_
4 ~~I
WD ; I d/tr
X 13 It
j3Attf12
25
1,575
1 utnl Other Uepi ed 0011
5/01i93
245
Font/ a
eT7~~ry fl ~
158
0
0
0
0
0
156
3<6
1,6 28
0
34 6
1,628
0
3<6
~l dy,Qae.C fin' 14q ~
-- I ~ e"t/
4u
0
0
0
SIOU
SI a v u
0
xt ~
~j t3 0
CLEANGREEN Clean
37-1204207
FYE. 12/31/199F3
Asset
Green
Regular Depreciation
Dale
UesUdpllui,
I n Service
Other Uqn ecl loi
1 E-Addiiiou3
4
E Dent Sew
E Band Sew
G
7
E-Glass Gusher
E Glnss Crusher
4,495
IU/!I/'Id
315
245
243
G!U
ISV
I10
I/OIiYJ
EPallet lack
E Pellet Jack
L-S6elvm~j
V-forklift
U V-Iiuck,Poi n t kOvabaul
Ivlnl Vlha UcpicT1111011
7vlnl AUIS mid
7i01/98
I/u1192
2iIR17 "i
8 E-IlospilalGumeys(G)
1
AEI
Cusl
4/U1/9fi
7/24194
5 E-CenCwsber
9
10
11
12
111211999 3 .12 PM
Federal Asset Report
I/i)I/92
I/U1i72
12/21/95
9i2)/94
744
Iti9
360
7,UV0
SIUI/)!
Gra n d latnlf
Lerr Dispositions
Ne1Craud lolnle
Per Cow Will
4,495 10
h1U S/L
HIS IV
NIUS/L
245
243
IU
1U
GJU 10
ISU IU
111) IU
144
399
36U
7,000
10
IV
IU
10
Prior
MU S/L
AIU S/L
AIV Sit
MV Sit
AIVSiL
A1V5/L
HIV SiL
1,11V 5/L
X10 SiL
MUSIL
Cunen i
0
SU
48
127
l78
GU
55
446
240
108
2,AV0
788
I
1 .4
16,266
1,5)5 IU
16,266
16,266
16,266
5,100
16,266
16,266
5,100
16,266
16,266
5,100
1 ,575
Iher Uepiednllun
Basis
5,1U0
I, +
- ~/U O
r
It(
`I% 11
Id11Qt UQiI.~-J
r.V1
~2-I ~~1
3Y
. .
'.
0
CRALIA CLEAN AND GREEN, INC .
P0130 = 3 CENTRALIA, IL 62801 (618) 533-7610
4
BOARD OF DIRECTORS
V
EXECUTIVE COMM TEE
BETSY CURL, Preside t
Curl &. Associat s, Inc
532 Marquis Avenue
226 East Broadway
533-2860
533-4149
12/OS
RICHARD GROUSE, 1 t Vice
Trinity Lutheran School
15 Arhne Drive
203 South Pleasant
532-3545
532-5434
12/05
DAVID AGEE, 2"° V1c9
Raymond James ,Securities
1420 Jonquil
100 South Locust
533-2392
532-6781
12/03
$
209 North Maple
532-0339
12/03
-
640 Sara llnve
222 South Poplar
532-8430
532-7623
12/05
-E1-
BETTY SCARBROUGH. Treasurer
BEV VLROBIK, Recorc
City of Centralia
Sec
SUSAN ICRACHT, Exe
Secretary
533-7610, fax 533-9481
CONNIE PARKER
Executive Cook
P O Box 150
P O Box 383
532-1230
533-7610, fax 532-9694
LINDA AGES, Presidei
Raymond James
1420 Jonquil
100 South Locust
533-2392
532-6781
ties
-Is;,-
/ y-~~E-00,
12/04
MEMBERS AT
KEVIN BAITY
Cory of Centraha
Community Development Director
222 South Poplar
533-7623
Appointed
FLORENCE LOUISE B )ST
31 Holiday Terrace
532-5953
12/04
ELAINE BUSH
118 North Sycamore
533-1403
12/04
-8---
JUDY ESSENPREIS
Kelly's for the Occasion
224 Janet Drive
115 S Locust
532-9096
532-0546
12/04
TOM HAWKINS
Centralia City Schools
211 North Cherry
404 South Elm
532-2842
532-1907
12/04
$'
BETTY 1{RACHT
222 Country Club Road
532-5271
RENE LINDENBERG I
102 Golf Lane
532-6642
12103
$-
SHERRY LOGLTLLO
Field School
7 Bonanza Drive
1100 South Locust
532-5066
533-7133
12/04
65 Park Forest Dnve
533-1087
12/03
I
SUSiE ROBBINS
St Mary's Hospital
1906 Ester
400 North Pleasant
532-6658
12/04
RICHARD RUDMAN I
Rudman Radiology
1520 Woods Lane
1520 Woods Lane
533-2066
12103
222 South Poplar
533-7622
Appointed
Position
505 South Lincoln
533-9327
12/03
640 Nancy Drive
115 North Hickory
532-2910
532-7300
12105
1460 Gragg Street
545-0240
l2/03
DORIS MILLER
i
DAVID SHAW
j
Code Enforcement Office
I
ANGIE SMITH
;
I
KATHY SMITH
~
Coldwell Banker)Allen RE
KATIE STANFORD
!
$
-
KCB/C8G Budget Report 2002
1/1/02 Through 12!31/02
1/4/03
Category Description
1nroz
Actual
Page 1
Budget
1z1e1/0z
Difference
Unassigned
City of Centralia
Clinton County
Code Advisory Committee
Interest
KIB Grant
KIB Inc
.
Marion County
Memorials
i
Other Inc
Recycle Markets
Recycling Center Donations
Washington County I
X-Benefactors
X-Business Partners ~
X-Donors
X-Partners
X-Patrons
X-Sponsors
201-Professional Services
202-Printing
204-Dues
205-Postage
206-Travel
207-Subscnphons
208-Telephone
210-Insurance
1
211-WOrkmens' Compensation
260-Mee4ngs
264-Annual Meeting KAB
301-Office Expenses!
302-Awards
~
303-P I Report
308-Film and Promotions
1
401-Education
402-Educational Library
404-Teachers Workshop
406-EAAC Committee
412-Special Events 1
413-Neighborhood Pick Up
414-Tree City USA ,
416KAB Month
417-Lrtterbags
4188-Equipment
478C-Transportation
418D-UUlroes
~
418E-Rent
41 BF-Other
~
418G-Supplies
419-Other Wages
420
.ReceptaWes
421-Code Advisory Activities
425-KAB-EPA Projects
430-DORM UnR
440-Clean Community Campaign
Payroll
Payroll Taxes
Payroll-Comp FICA
Payroll-Comp MCARE
TOTAL Payroll Taxes
9,98350
000
27000
12375
6,18350
5,00000
4,998 00
5000
1,31450
34,734 12
4 .66990
000
2,06338
82500
2,34500
1 .08500
1,25000
1,00000
000
-19955
-22500
000
000
-8900
-29648
-3,34500
-3,53500
000
326 95
-347 56
-41347
000
-21765
-300
000
000
000
000
-4,20000
000
-26794
000
-2,55000
-8,22750
-2,13291
-6,00000
-20000
E3178
000
000
-446 BB
000
000
000
-40.24700
2,49515
58334
30789
15,000 00
10000
80000
17500
9,56700
000
10,000 00
55000
2,40800
28,500 00
5,200 00
10000
2,50000
1,80000
2,200 00
1,60000
2,00000
1,50000
-80000
-25000
-22500
-40000
-50000
-10000
-80000
-3,50000
-1,60000
-20000
-60000
-30000
-60000
-15000
-30000
-76700
-10000
-10000
-1 .60000
-20000
-3,20000
-80000
-25000
-90000
-55000
-3,60000
-2,00000
-6,00000
-40800
-1,25000
-25000
-10000
-25000
-10000
-2,25000
-60000
-45,00000
-5,01650
-10000
-53000
-5125
-3,38350
5,00000
-5,00200
-50000
-1,09350
6,23412
-53010
-10000
-43662
-97500
14500
-51500
-75000
-50000
80000
5045
000
40000
50000
11 00
50352
15500
-1,93500
20000
27305
-4756
18653
15000
8235
76400
10000
10000
1,60000
20000
-100000
80000
-1794
90000
-2,00000
-4,62750
-13291
000
20800
61822
25000
10000
-19688
10000
2,25000
60000
4,75300
-2,75000
5,24515
1 .23334
-65000
3-400-00 -------6-478_49
d
II
114103
KCBIC&G Budget Report 2002
i
Category Description
Payroll-FWH-~
PayroA-MGARE
I
Payroll-SWH
~
111102 Through 12131102
111102
Actual
21200
-1,09942
30976
Page 2
Budget
000
000
000
52/31102
Difference
21200
-1 ,09942
309 76
TOTAL Unassigned
--2p6"-86 --U00 --20686
OVERALL TOTAL
~06E6
--UIIO -
-2085