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Short Form
Return of Organization Exempt From Income Tax
990-EZ
B
PAGE
404 E Withrow St
••
F Oroto E9emp1ion
Nun ter
P
Ce9N ❑ A=wl
O Accountlng Method :
Oder (eDedf» ^
• 9ectbn Sof (c)(J; one end 49r7(dJ(1) normwarpt C,Wr ob (nwt must Detach
a campilrNO Sche jb A (Form WD w 860-60•
N chock ^ ❑ If the organ otbn [s sot
requred to ettad+ Schedule B (Form 990.
Webe1M
:
^
I
990-EZ. or NO-10F).
601 (c3 ( 7 -4 Omen no. ❑ 4947(g)(1) or ❑ 527
on6 J Tm[-400n199 slaws check
ion 9nd ae grvm nea^Ipta ere normally not moro than p5.0 0. A
K Cftck ^ ❑ a tra organlr m is not a section 509(x)(3) euppenmg orga,
drooae® to NM a ratum, be owe to Me a comlWo slum
ul . but It the
Form 990-¢ or Form 990 reUxn Is not
w
le: a $$00.000 or rrore, fee Form 090 heUgd of Form 0BDt Add Mee SC, 8b Pntl 7 to fir. 9 to oewrmha
the Instructions for
or Fund BalanceB
RavarUo,
ant. and GnanAee In Not Agae
I
2
3
4
6.
Contributions . gifts . grants . and sim ilar amounts received . . . .
Program service revenue Including government fees and contracts
. .
Membership dues end aaeeeements . . . . . . . .
investment Income
. . . .
Oroae amount from sale of eaaete othsr than Inventory
b Less: cost or tither basis and swine eocpenees
c
B
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reported on [Ina 1 ) .
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25.472 71
1
2
3
4
.
37152.25
5a
Sb
.
of contributions
.
.
.
.
.
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.
.
b Lass: direct expenses other than fundralsing expenses
10
11
12
13
14
1S
16
.
..
Gain or (lose) from sale of excels other than inventory (Subtract line 5b from line Se) .
S ecb sheets and a tM0ee (canD a appdrebte pw of Sd,eM Gj. If any wnmot 19 flem gltminp, check We ^ ❑
e Gross revenue (not including S
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b
c
B
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93 ,2.74 96
aft I.)
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Be
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Gb
Not Income or Voss) from epedai events and activities (subtract line Bb from line 69) .
7e
Grow sales of inventory, We returns and elIowencea . . . .
?b
. . . . . . . . . . . . . .
Leas: coat of goods 90d
Gross profit or (loss) from sales of Inventory (Subtract line 7b from One 7a) . . . .
Other revenue (
. . .
Grants and similar amounts paid (attach schedule) . .
Beneflte paid to or for members .
. . . . . . . . .
Salaries , other compensation . end employee benefits . . . .
professional fees end other payments to Independent contractors :
Occupancy , rent , utulttea. and maintenance . . . . . . .
Printing , pubOcatlona , postage, and shipping . . . . . . .
Other exper , (describe ^ Sunk Charger . Accounting Fe0R
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62,102.98
11
.
12
13
14
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16
1
3 180 72
18
(2,129 72
. .
. . .
Excess or (deficit) for the year (Subtract line t 7 from line 9) .
10.
Net assets or fund balances at beginning of year (from Une 27. column (A)) (must agree with
t,05.71
1B
end-of-year figure reported on prior year's return) . . . . .
2t)
Other changes In net assets or fund balances (attach expienat(on) . . .
078,99
21
. ^
at emi 21 Year. Combine Pnes 18 thr otKilh 20
Not MMO or fund
21
25, column (B) are $1250,000 or more, file Fonts 090 Instead of Form 990-Eon
line
Sh
ate.
If
Total
assets
Balance
IN =
W BM" afM End arm
(See the Inatrucflon5 for Part II.)
t8
19
t •>
22
Cash. savings . And Indents
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la idandbulldh
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24
Other e0aets (describe P-
25
Taw assets .
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26
27
Total Ilebliluee (describe Net assns or fund balances P ine 27 of column
s.
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,
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must so.
2,605.71 22
with 6ne 21
For P lvacy Act and Paperwork Reduceon Act Modes . see the erpmete hotrweona .
475.99
Ta
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CUL No 106421
24
2,605.71 2S
d79 99
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20
2.605.71 27
476.99
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G 14 6-
02/15
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PAGE
t«m ei .EZ mom
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$t temerR of Prog ram SeMca Aoconvill9Rman {See the instructions for Part I11.)
15mme Mne nr.d'r n0rtlehlp M Miami Vr-m -rly
Mat Is the organization's primary exempt purpose?
Describe what was achieved In carryh^g out the organ zatbn ' s exempt purposes, In a clew and concise
describe the services provided. the number of persons benefited , and other relevant information for
each program title.
pqp 2
amen es
(ROQub"fOrE cuw
90tmmaid^(`p
9W Oft-Wn
w)o,md
1m ol1 .l
28
20
Grants S
.....
.. -
- - - If thb amount includes fwel '
30
a1
.b check hens
---- .
^ -
29a
-_...r...----------
^Grenta $
1 f file omount Ineludea for¢ n grants check here
Other program services ( attach schedule) . . .
Drente
32 Total p rogra m service s
If this amount Includ foreigin rants check here
ea add tees 28e than, 31
.
.
^ ❑
Xe
^ ❑
^
31a
34
Uet of omwes, otrsemra, Trvstm, a nd Ke Emplolrew, Ust each one even If not compensated . (See the Irmtnicticna for Part IV.
( 14 O"kftm a
te) Experw
T1116 e Xwerwe
( CaTVIRMo m
a^oure and
even plead
hiiSS per week
(q Name "cakh,=
Pf not Pte.
enex ^.)
OVene0 c^+^.v.m' other Mn^nceD
01001"
de-ow to po idon
Form 9F U L
(MQj
03/15
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01/14/2011
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5135233999
Fmti
the statement
✓
Did the organization engage in any activity not previously reported to the IRS? if -fee ," attach a detailed
32
description of each BctMty .
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34
Were any changes made to the organizing or governing documents? B "Yes ," attach a co formed copy of
35
. . . .
the changes . . . . . . . . . . . . . . . . . . . . . . . . . . .
II the organization had Income from bualnsas edlvitlea , suds as those reported oo Ikes 2, 6a, and Ta Iwmng others), but
not reported on Form 990•T. attach a statement exptateing why the orgartt tlon did not report the Income on Form 990-T.
a
Did the organization have unrelated business gross income of $1,000 or more or was it aubyect to section
.
. . . . . . . . . . . . . .
6033(e) notIce. reporting . and proxy tax requirementa7
b If 'Yes.' has It filed a tax return on Form 990-T for this year? .
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✓
3s
3,58
a6
Did the orgenlz tion undergo a rqrldatian , dissotutlon . termination , or significant disposition of not assets
. . . . .
during the year? If "Yea," complete applicable parts of Schedule N
. . . .
3Ta
Enter amount of political expenditures, direct or indirect. as deacribod in the instructions. ^
b
We
Did the organization P ie Form 112D-POL for this year? . . . . . . . . . . . . . . . . . .
Did Me organization borrow from , or make any loans to, any officer. director , tr ustee , or key employee or were
37b
any such loans made In a Ixlor year and still outstanding at the end of the period covered by this return? .
Ma
b
If 'Yes.' complete Schedule L, Part 11 and enter the total amount Invoked
.
.
✓
36b
.
sg
37B
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L
3f
39
Section 501(c)(7) orpanttatlona . Enter:
33,082 25
368
. . .
a Initiation fees and capital contributions Included on line 9 . . . . . .
0
39b ^
b Grose receipts , Included on fine 0, for public use of club facilities . . . . . .
1
40a Section 501(x)(3) organizations. Enter amount of tax Imposed on the organization during the year under
; section 4912 ^
section 4911 ^
: section 4955 INb
Section 501(c)(3) and 501(c)(4) organization . Did the organization engage In any section 4058 excess benefit
transaction during the year or Is It aware that It engaged in an excess benefit transaction with B disqualified
c
person In a prior year , and that the transaction has not been reported on any of the organization ' s prior
Forms 990 or 990-EZ? If 'Yes,' complete Schedule L Pert I . . . . . . . . . . . . . . . .
Section 501(c)(3) and 501 ( x)(4) orgenizatlons. Enter amount of tax Imposed on
organization managers or disqualified persons during the year under sections 4912,
4965 . and 4958 . . . . . . . . . . .
d
Section 501(c)(3) and 501 (cK4) organizations . Enter amount of tax on line 40c
reimbursed by the organization . . . . . . . . . . . . . . . . . ^
e
All organizations . At any time during the tax year, was the organization a party to a prohibited tax shelter
transaction? If *Yes , complete Form 688e-T ..
41
42a
Located at Op-
b
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List the states with which a copy of this return is filed. 10The organization ' s books are in care of ^
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40b
408
.............. Telephone no. ^
ZIP + 4 ^
..__....._...... ..... __......... .
At any time during the calendar year, did the organization have an Interest In or a elgnature or other authority
over a financial account In a foreign country (such as a bank account, eecurltlea account, or other financial
account)? . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . .
It "Yes,' enter the name of the foreign country: ^
,1, Report of Foreign Bank
See the kwtructlone for exception and filing requirements for Form TD F 90
and Rnanclal Accounts.
e At any time during the calendar year, did the organization maintain an office outside of the U.S.? . .
If "Yes,' enter the name of the foreign country: ^
43 SectIon 4947(aX 1) nonexempt charitable trusts filing Form 990-EZ In Oau of For.. 1041-Check here
and enter the amount of tax-exempt Interest received or accrued during the tax year .
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Yea No
42b
42c
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^ ❑
^ 1 40 I
No
44
46
Did the organization maintain any donor advised funds? If "Yes, ' Form 990 must be completed Instead of
Fom+ 990-EZ
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Is any related organization a controlled entity of the organization within the meaning of section 512(b)(13)? If
"Yes,' Form 990 must be completed Instead of Form 990-[Z . . . . . . . . . . . . . . . .
Fan 990-Q Ross
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FmO
4
Section 501(o^ orgbN7rgt(otte eM section 4047(Oft) I+onexemp! dtalnable ttwm only. AU section
501(c)(3)a+^ertfast(o^ and section 494T(v(1) nonexempt charitable trusts must answer questions d&-49b
and complete the tables for li nes 50 e nd '51.
polhha(c mpslgn eetivitles on behalf of or In opposition to
Did the organlzatlon sn949e In direct or h
candldetee for public office? if 'Yes,' complete Schedule C. Part I . . . . . . . . . . . . . .
Did the orgenIWIon angage in lobbying actlvltles? If 'Yes," complete Schedule C. Port II . . . . . .
Is the or©antratlon a school as dusa(bed In section 170(b)(11W(U)? If 'Yes," complain Schedule E . . . .
46
47
48
Yes No
48
47
48
09%
tas DIO the organization make any transfers to an exempt nonCierhable related organization? . . . . . .
4911
. . .
b if'Yes.' was the related organization a section 527 organization? . . . . . . . . . .
50 Complete this table for the organization's flue+dgh et compensated employees (other that. offices. directors. trustees and key
...,,.....,.w --]..A ...- w..... a+m nnn m rnn.n..,eatir n hTVn n.a Ommbaflen if there In none. enterNone.'
(i4 None ad ad
d of ^eA+ employee as
ow t1CO,
TRIP 0%d
Megvi V4 =
dew,0 to
rtde
Total number of other employees paid over S10D.01M
f
.
.
.
beesS o^se 6
ode. ce. pww ft.
INEWSM
a=o+4 old
otherd4we1 1
. ^
Complete this table for the orgm nation's five highest compensated Indopenderrt contractors who each received more than
$100.000 of compensation from the organization if there is none. enterNone.'
51
1d Name and addnaa co Poch a+EoxiAent Contractor vdd mom Own S1OO.OW
d
Total number of other Independent contractors each receiving over $100.000
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