form 990 return of organization exempt from income...
TRANSCRIPT
Form 990 Return of Organization Exempt From Income Tax " Under section 501(c), 527, or 4947(a)(7) of the Internal Revenue Code (except black lung
Department of the Treasury benefit trust or private foundation) internal Revenue Service " The organization may have to use a copy of this velum to satisfy slate reporting requirements
A For the 2002 calendar ear or tax ear be innin 2002 and endln
i BcMan~ pleads, C Name of organization 0 Employer Identification number w.1115 BACKSIDE BENEVOLENCE FUND INC 58-1903239 labai
o wm. ~Nnp. print or Number and street (or P O box if mail is not delivered to street address) Room/suite E Telephone number 1.11 .1 ~ .e. . NPR Fin " ~~ " twn S .. Specific C/O 426 SUMMIT DRIVE
,«���, "'"'"°'a in+nc City or town slate or country and ZIP + 4 ~e % J Cash U Accrue! '^a"a°° " "°^ °°"" BOSSIER CI TY LA 71111 Other s paafy) 411"-ti-
ar Section 501(c)(3) organizations and 1947(a)(7) nonexempt charitable H and I am not applicable to section 527 organizations
trusts must attach a completed Schedule A (Form 990 or 990-FI) Hp) la this a group arum for affiliates? O Yes X No
i G Web site 1 H(b) If "Yes 'enter number ofeRihetn 1
e ~ No J Organization typo (check only one) 1 X 501(c) H ) .4 (insert no ) 917(x)(1) or 527 H(c) Are ell effilmtes included? QYa- - (II'NO' attach a list Sae instructions )
K Check hem 1 d the orpeniZebonB prows receipts am normally not more than 375,000 The Hid) "mnexprua ruumfYadoyai organization need not file a return with the IRS Gut if the orpan¢eUOn received a Forth 990 Package or ganizatmcoAanx!ly in the mail it should file a return without finanual darn Soma states require a complete return I Enter 44ipit GEN 1
M
Check 10.
u if the organization is not required
L G ross receipts Add lines 6b 8b 9b end 10E ID line 13 11A 49 , 2 01 to erred $ch B (Forth 990 990-EZ or 990-PF)
Revenue Expenses, and Changes In Net Assets or Fund Balances See page 17 of the instructions 1 Contributions gills grants and similar amounts received a Direct public support 1 a 25 , 403 b Indirect public support , , 11b c Government contributions (grants) 1 e
d Tout (eaalines is mmupnic) (Msns 25,403 nonuans ) 1d 25 , 403 ', 2 Program service revenue including government lees and contracts (from Part VII, tine 93) , 2 2 , 414
3 Membership dues and assessments 3 4 Interest on savings and temporary cash investments 4 836 5 Dividends and interest from securities 5 6 a Grass rents 6a b Less rental expenses 1 61o l c Net rental income or (loss) (subtract line 6b from line 6a) 6c 0
~ 7 Other investment income (describe 1 7 c m 8 8 Gross amount from sales of assets other (A) Secunbea (B) Other
than inventory Ba b Less cost or other basis and sales expenses 8b C Gain or (loss) (attach schedule) 0 8t 0 d Net gain or (loss) (combine line Bc, columns (A) and (B)) 8d 0
9 Special events and activities (attach schedule) a Gross revenue (not including $ 23, 628 of
contributions reported on line 1a) .
" 9a 20 , 548
b Less direct expenses other than fundraising expenses 9b 24 , 219 A C Net income or (loss) from special events (subtract line 9b from line 9a) 9c -3 , 671
I 10a Gross sales of inventory, less returns and allowances 00 1 b Less cost of goods sold 0b c Gross profit or (loss) from sales of inventory (attach schedule) (subtract line 106 from line 10a) ~ oc 0
11 Other revenue (from Part VII line 103) 11 12 Total revenue add lines 1d 2 3 4 5 6c 7 Bd 9c 10c and 11 . 12 1 24 , 982 13 Program services (from line 44, column (B)) 13 21 , 200
I 14 Management and general (from line 44, column (C)) ^yy/~(~~77_~ 14 1 , 188 tQ, a 15 Fundraising (from line 44, column (D)) +s o
w 16 Payments to affiliates (attach schedule) 6S MAY
, , 16 e-
17 Total expenses add lines 16 and 44, column A ~~p 1 2. ' , 7 22 , 388 18 Excess or (defied) for the year (subtract tine 17 from tine 2) 18 2 594
m , Z� ,J,
19 Net assets or fund balances al beginning of year (Tram If 73, 19 131 , 5 61
a 20 Other changes in net assets or fund balances (attach e~lanahon) ' Up 20 v m z 21 Net assets or fund balances at end o! year combine lines 18 19 and 20 21 134 , 155
JSA For Paperwork Reduction Act Notice, see the separate Instructions Form 990 (zooz) 2E1010 1000 ~
V~
990(2002h BACKSIDE BENEVOLENCE FUND, INC 58-1903239 Page 2
Statement of All organizations must complete column (A) Columns (B) (C) and (D) am required for section 501(c)(3) and (4)organizabons
FunctionalExoenses enasecuon4947(s)(t)nonexemptchentebletrustebutopuonellorothen(Seepepe21o1theinstructiona) (o) Funamisino
22 Grants and allocations (attach schedule) ccaans 15250 nonUsns ~ 22 15 , 250 15 , 250
23 Specific assistance to individuals (attach schedule) _L3_ 548 548
24 Benefits paid to or for members (attach schedule) _L4_
25 Compensation of officers directors, etc 26 0 26 Other salaries and wages 26 0 27 Pension plan contributions 27 0 28 Other employee benefits 28 0 29 Payroll taxes 29 0 30 Professional fundraising fees 30 0 31 Accounting fees 31 625 32 Legal fees 32 0 33 Supplies 73 0 34 Telephone 74 0 35 Postage and shipping , -L6- 0 36 Occupancy 36 2 , 304 2 , 304 37 Equipment rental and maintenance 77 0 38 Printing and publications 38 669 669 39 Travel 39 500 40 Conferences, conventions and meetings 40 0 47 Interest , , 41 0 42 Deprecation depletion etc (attach ache dule) 42 2 , 429 2 , 429
43 Oinere~ymuenotfoeraeeDOw(~,~~:e)B MISC 4$0 25
bHANK FEES 7b 381 9J1: V
d 3d 0 3e 0
44 Total Nncuonai expensa@ (add tines n Nrwpn,1a) ~elodl~miina~af7~DSOlumiu(eNO),ceny 44 22,388 21 , 200 1 , 188 0
Joint Costs Check " u if you are following SOP 9&2 Are any point costs from a combined educational campaign end fundraising solicitation reported in (B) Program services? " a Yes XO No
If "Yes "enter (q the aggregate amount of these point costs $ , (II) the amount allocated to Program services S
---------------------------------------------------------------------------(Grants and allocations $ )
b The organization primarily continued to support the N Louisiana Chaplancy_Exnd with resources to _provide_Bibles,_ traininq, counseling,---
and spiritual and emotional assistance
d --------------------------------------------------------------------------- ---------------------------------------------
e Other program services (attach schedule) (Grants and allocations $ ) I
JS` ( Total of Program Service Expenses (should equal line 44 column (B), Program services) Is 21,200 2E10201 NO Form 990 (2002)
(A) Total
What is the organizations primary exempt purposes " To aid b assist needy individuals Expon~ss
All organizations must describe their exempt purpose achievements in a clear and concise manner State the number (Required tor5oi(c)(a)ena
of clients served, publications issued etc Discuss achievements that are not measurable (Section 507(c)(3) and (4) (4)orps and 4947(a)(1)
organizations and 4947 (a)( 1 ) nonexempt charitable trusts must also enter the amount of grants and allocations to others trusts but optional for
) amen )
a The organization continued to Qrovide_direct_asaietance to -needy . .. . . . . . . individuals for medical andfor living_expensea
c A newsletter was started to make information-available to interested-activities parties abount the organization and_ita_purposes and activities ---------------------
---------------------------------------------------------------------------(Grants and allocations $
BACKSIDE BENEVOLENCE FUND INC 58-1903239 Form 990f20021 . S
A B ing of year End of year
58 . 685 45 63 , 708 46
47c 0
48c 0 49
60
57c 0 52 53 54
72 , 876 55t 70 , 447 56
57c 0 58
131 , 561 69 134 , 155 60 61 62
63 64a 64b 65
0 66 0
67 68 69
Organizations that follow SPAS 717, check here " L_J and complete lines 67 through 69 and lines 73 and 74
d 67 Unrestricted , , , 68 Temporarily restricted ,
- 69 Permanently restricted Organizations that do not follow SFAS 117, check here Ii and
complete lines 70 through 74 u a 70 Capital stock trust principal, or current funds , , u, 71 Paid-in or capital surplus, or land, building, and equipment fund
72 Retained earnings, endowment, accumulated income, or other funds , a 73 Total net assets or fund balances (add lines 67 through 69 or lines 14 70 through 72,
column (A) must equal line 19, column (B) must equal line 21)
JSA 2E 1030 1 000
Note Where required, attached schedules and amounts within the description column should be /or end-of-year amounts only
45 Cash - norrinterest-bearing 46 Savings and temporary cash investments
47a Accounts receivable . . [47a b Less allowance for doubtful accounts 47b
48a Pledges receivable , 48a b Less allowance for doubtful accounts , " 48b
49 Grants receivable 50 Receivables from officers, directors, trustees, and key employees
(attach schedule) 51a Other notes and loans receivable (attach
schedule) , , 61a d b Less allowance for doubtful accounts 61 b N
52 Inventories for sale or use , 53 Prepaid expenses and deferred charges . . 54 Investments - securities (attach schedule) " El Cost a FMV 55a Investments - land, buildings and
equipment basis 65a 76 , 49 . b Less accumulated depreciation (attach
schedule) , , 66b 6 , 04 56 Investments - other (attach schedule) 57a Land, buildings, and equipment basis , , 67a
b Less accumulated deprecation (attach schedule) , , 67b
58 Other assets (describe li~
60 Accounts payable and accrued expenses , 61 Grants payable , 62 Deferred revenue , , 63 Loans from officers, directors, trustees, and key employees (attach
schedule) j 64a Tax-exempt bond liabilities (attach schedule) , , ,
b Mortgages and other notes payable (attach schedule) 65 Other habdities (describe
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 organizations programs and accomplishments
Form 990 (4002) , BACKSIDE BENEVOLENCE FUND INC 58-1903239 4
(List each one even if not compensated, see page 26 of List
75 Did any officer, director trustee, or key employee receive aggregate compensation of more than $700,000 from your organization and all related organizations, of which more than $10 000 was provided by the related organizations? " D Yes O No If "Yes," attach schedule-see page 26 of the instructions
Form yyu (zooz)
JSA 3E 1040 1 000
a Total revenue, gains, and other support per audited financial statements t
b Amounts included on line a but not on line 12 Form 990
(1) Net unrealized gains on investments $
(2) Doomed services and use of faalities $
(3) Recoveries of prior year grants , $
(4) Other (specify)
Add amounts on lines (7) through (4)
c Line a minus line b d Amounts included an line 12
Form 990 but not on line a (1) investment expenses
not included on line 6b Form 990 S
(2) Other (specify)
Add amounts on lines (7) and (2) e Total revenue per line 12, Form 990
a Total expenses and losses per
a N/A audited financial statements , , 11, b Amounts included on line a but not
on line 17, Form 990 (7) Donated services
and use of facilities S (Y) Prior year adjustments
reported on line 20, Form 990 f
(J) Losses reported on line 20 Form 990 S
(4) Other (specify)
s Add amounts on lines (1) through (4) ,
c Line a minus line b , d Amounts included on line 17,
Form 990 but not on line a (1) Investment expenses
not included on line 6b Form 990 $
(2) Other (specify)
Add amounts on lines (1) and (2) , 1 e Total expenses per line 17, Form 990
JSA 2EtOn 1 000
BACKSIDE BENEVOLENCE FUND, INC 58-1903239
EFUM Other Information See page 27 of the instructions Yes no
76 Did the organization engage in any activity not previously reported to the IRS II'Yes"attach a detailed description of each activity 76 X
77 Were any changes made in the organizing or governing documents but not reported to the IRS? 77 X
If "Yes " attach a conformed copy of the changes 78a Did the organization have unrelated business gross income of $1000 w more during the year covered by this return? 78a X
b If "Yes," has it filed a tax return on Form 990"7 (Or this year? , , 78b
79 Was there a liquidation, dissolution, termination or substantial contraction during the yeah II "Yes," attach a statement 79 X
80a Is the organization related (other than by association with a statewide or nationwide organization) through common
membership, governing bodies trustees, officers, etc , to any other exempt or nonexempt organization? 80a X
b If "Yes " enter the name of the organization, and check whether it is exempt or nonexempt
81 a Enter direct or indirect political expenditures See line 81 instructions 1 81, 0
b Did the organization file Form 1120-POL for this year? , , 81 b X
82a Did the organization receive donated services or the use of materials, equipment, or facilities at no charge or at substantially less than fair rental values 82a X
b If "Yes " you may indicate the value of these items here Do not include this amount as revenue in Part I or as an expense in Part II (See instructions in Part III I 82b
83a Did the organization comply with the public inspection requirements for returns and exemption applications? BSa X b Did the organization comply with the disclosure requirements relating to quid pro quo contributions? 83b X
84a Did the organization solicit any contributions or gifts that were not tax deductible? 84a X b If "Yes " did the organization include with every solicitation an egress statement that such contributions
or gifts were nod tax deductibles 81b
85 501(c)(4), (5) a (6) aganizahms a Were substantially all dues nondeductible by members 85a b Did the organization make only in-house lobbying expenditures of E2,000 or less? , , , , , , BSb
If "Yes" was answered to either 85a or 85b, do not complete BSc through 85h below unless the organization received a waver for proxy lax owed for the prior year
c Dues assessments and similar amounts from members B5c d Section 162(e) lobbying and political expenditures BSd e Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices 85e f Taxable amount of lobbying and political expenditures (line 85d less BSe) 85f g Does the organization elect to pay the section 6033(e) tax on the amount on line 8517 85
h If section 6033(e)(1 )(A) dues notices were sent does the organization agree to add the amount on line 85110 its reasonable
estimate of dues allocable to nondeductible lobbying and political expenditures for the following tax year? 85h 86 501(c)(7) ags Enter a Initiation lees and capital contributions included on line 12 86a
b Gross receipts, included on line 12 for public use of dub (aalities 86b 87 501(c)(72) ags Enter a Gross income from members or shareholders . 87s
b Gross income from other sources (Do nod net amounts due or paid to other sources against amounts due or received from them ) 87b
88 At any lime 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 7701-37 I! "Yes"complete Part IX 88 X
89a 507(c)(3) organizations Enter Amount of tax imposed on the organization during the year under section 4911 . 0 , section 4912 . 0 , section 4955 . 0
b 507(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 year? If'rYes," attach a statement explaining each transaction 89b X
c Enter Amount of tax imposed on the organization managers or disqualified persons dunng the, year under sections 4912, 4955, and 4958 0
d Enter Amount of tax on line 89c above reimbursed by the organization " 0 90a List the slates with which a copy of this return is filed
b Number of employees employed in the pay period that includes March 12, 2002 (See instructions) I 90b ~ 0 91 rnebooks amincarod " Sara Harville reiepnmeno " 318-752-2599
Locateaetj~ 3628 George Rd, Shreveport, LA ZIP-4 t 71107 92 Section 4947(a)(i) nonexempt charitable trusts filing Form 990 in lieu of Form 1011 -Check here ~ U
and enter the amount of tax-exempt interest received or accrued during the tax year " 182
Form 990 (2002)
BACKSIDE BENEVOLENCE FUND INC 58-1903239
Note Enter gross amounts unless otherwise Unrelated business inc indicated (A) B
Business Amount 97 Program service revenue code
a RENTAL b NEWSLETTER c d
e
1 Medicare/Medicaid payments
g Fees and contracts from government agencies
94 Membership dues and assessments
95 interest an uwnpe anal temporary trio InwaVrenb
96 Dividends and interest from seventies
97 Net rental income or (loss) from real estate a debt-financed property b not debt-financed property
f8 Net rental income a(lo .&)from personal PrWrnY
99 Other investment income . . .
700 Gain or (loss) from sela$ W easels other then Inwnlay
101 Net income or (loss) from special events
102 Gross profit or (loss) horn roles of inventory
103 Other revenue a 6
c
d
e
104 Subtotal (add columns (B) (D) and (E)) I
105 Total (add line 104, columns (B), (D), and (E)) Note Line 705 plus line id Part I should equal the amount on line 12 Part I
0 -G21
Line No I Explain how each activity for which income is reported in column (E) of Part VII contributed importantly to the accomplishment
(c) (o1
01 Nature of activities Total income End ywr
xMl I ass.
15 address and EIN of corporation
Information Reg arding Transfers Associated with Personal Benefit Contracts See page 33 of the instructions (a) Did the organization during the year, receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? Yes X No (b) Did the organization, during the year, pay premiums, directl
Note If "Yes" to l~le Form 8870 and Form 4720 see instrucfi Under anal es of pequy I Declare that I ham examined this anO be true cortect end complete Declaration of ore
Frtm's name (or yours' d self-employed) address and ZIP+d
2E1050 1 000
512 513 or 514 (E) p Related or
Amount exempt function
240
Please Sign Here
Paid Preparer's Use Only
11, 11 ycat Type or pool name and title
Prepeieh'
signature al
Potal number of others receiving over $50 000 (a, professional servi c e s For Paperwork Reduction Act Notice, gas the Instructions for Foam 990 end Form 990-EL Schedule A (Form 990 or 990EZ) 1003
JSA 2E1210 1 000
SCHEDULEA Organization Exempt Under Section 501(c)(3) OMB NO 155-007
(Form 990 or 990-EZ) (Except Private Foundation) and Section 501~e), 501(f), 607(k), 501(n), or Section 4947(e)(1) Nonexempt Charitable Trust ~oo
Department SupplementaryInformation -(Seeseparate Instructions .) Internal Revenue Service " MUST be completed b the above organizations and attached to their Form 990 or 990"EZ
Name O( the organization Empbyor Identification number
BACKSIDE BENEVOLENCE FUND . INC 58-1903239
LjEFW 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 ")
(o) Name end address of each employee pad mole (b) Title end awiapa (O) Contributions a (e) E*enx hours per week (c) Compensation employee benefit plans 8 ac counl end other
then $50 000 a... . . .~ . . ... . . ... ., w .i.. ..A . .... . . . . . .m~ .~.. .n ..,..
N/A
----------------------------------
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Total number of other employees paid over $50 000 10. LiM{/ Compensation of the Five Highest Paid Independent Contractors for Professional Services
(See page 2 of the instructions List each one (whether individuals or firms) If there are none, enter "None'
(e) Name end address of each independent contractor paid more than $50 000 (b) Type of service I (c) Compensation
N/A
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BACKSIDE BENEVOLENCE FUND INC 58-1903239 Schedule A (Form 990 or B90-EZ) 2002 je Z
No
1 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 or incurred in connection with the lobbying acliHties " S (Must equal amount on line 38, Part VI-A, or line I a Part VI-B ) 7 X
Organizations that made an election under section 501(h) by tiling Form 5768 must complete Part WA Other
organizations checking 'Yes," must complete Part VI-B AND attach a statement giving a detailed description of the lobbying activities
2 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, majority
owner, or principal benefiuaryt (11 the answer to any question is "Yes," attach a detailed statement explaining
the transactions )
a Sale, exchange, or leasing of property 2a X
c Furnishing of goods sernces, w faalilies7
d Payment of compensation (or payment or reimbursement of expenses d more than $1000)? , , ,
e Transfer of any pan of its income or assets?
S Does the organization make grants for scholarships fellowships student loans etc 7 (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 a organizations receiving grants
o-.,mn,~ mnne.~~ro .,r,r~~nnManre ., .�� .~ ..~~^H . . . hn. " m .an.,.~~eM~~t++SEE BELOW
The or anization is not a private foundation because it is (Please check only ONE applicable box) ***Individuals who receive 5 A church, convention of churches, or association of churches Section 170(b)(1)(A)(i) assistance are usually referred by 6 A school Section 170(b)(1)(A)(n) (Also complete Part V ) the chaplain of La Downs Racetrack
7 A hospital or a cooperative hospital sernce organization Section 170(b)(1)(A)(i1i) 8 u A Federal slate, or local government or governmental unit Section 170(b)(1)(A)(v)
9 IJ A medical research organization operated in conjunction with a hospital Section 170(b)(1)(A)(n) Enter the hospital's name, city,
and state 10 O An organization operated for the benefit of a college or university owned or operated by a governmental unit Section 170(b)(1)(A)(rv)
(Also complete the Support Schedule in Part IV-A ) 11 a X An organization that normally receives a substantial part of its support from a governmental unit or from the general public
Section 170(b)(1)(A)(w) (Also complete the Support Schedule in Part IV-A) 11 b B A community trust Section 170(b)(1)(A)(H) (Also complete the Support Schedule in Part IV-A ) 12 An organization that normally receives (7) more than 37 113% of its support from contributions membership lees, and gross
receipts from activities related to its charitable, etc , functions-subbed to certain exceptions and (2) no more than 33 113% of its support from gross investment income and unrelated business !matte income (less section 511 lax) (ran businesses acquired
I F7 by the organization after June 30, 1975 See section 509(a)(2) (Aso complete the Support Schedule in Part IV-A I
3 An organization that is not controlled by any disqualified persons (other than foundation managers) and supports organizations described in (7) lines 5 through 12 above, or (2) section 501(c)(4), (5), or (6) d they meet the lest of section 509(a)(2) (See section 509(a)(3)
(a) Name(s) of supported organization(s) I (6) Line number from above
Schodule A (Form 990 or 990-EZ) 2002 1 000
b Lending o! money or other extension of credits
Reason for Non-Private Foundation Status (See pages 3 through 5 of the instructions )
15 Gifts, grants and contributions received (Do .�, . . ., . .i~~ .~e . . . . . . . . . . i--f. sev1'.e9n1 1 17 0111 I 245741 1 38 .3941 25
781 1
19 Net income from unrelated business activities not included in line 18
22 Other income Attach a schedule Do not include Qain or (loss) from sale of capital assets
1 761 666 2
26 Organizations described on lines 10 or 11 a Enter 2% of amount in column (e), line 24 , , , la. 26e 2 , 111 b 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 gills !a 1998 Through 2001 exceeded the amount shown in line 26a Do not file this list with your return Enter the total of all these excess amounts " 26b 40 , 865
c Total support for section 509(a)(1) lest Enter line 24 column (e) 1 Y6c 105 , 550 d Add Amounts from column (e) for lines 18 0 19 0
22 0 261b 40,885 . 26d 40 , 885 e Public support (line 26c minus line 26d total) " 26a 64 , 665
c Add Amounts from column (e) (or lines 1 5 0 16 0 17 0 20 0 21 0
d Add Line 27a total 0 and line 27b total 0 a Public support (line 27c total minus line 27d total) f Total support (or section 509(a)(2) lest Enter amount from line 23 column (e) . "1 27f I 0
g Public support percentage (line 27e (numerator) divided byline ]7f (denominator))
28 Unusual Grants Far an organization described in line 10 17, or 12 that received any unusual grants during 1998 through 2001 prepare a list (a 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 your return Do not Include these grants In line 16 N/A
Jsn Schedule A (Form 990 or 990EZ) 2003 2E1221 1 000
$cheduleA Form990aB90-EZ 3003 BACKSIDE BENEVOLENCE FUND INC 58-1903239 Pag e 3
" Suppprt Schedule (Complete only d you checked a box on line 10, 11, or 12) Usecash method ofaccounUng Nose You may use the worksheet m the instructions (or convertmq from the accrual to the cash method of accounting
. . lad 181 2001 1 roi 2000 1 (c) 1999 1 (a) 199e
17 Gross receipts from admissions merchandise sold or services performed or furnishing of facilities in any activity that is related to the
18 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 tames) from businesses acquired
20 Tax revenues levied for the organization's
benefit and either paid to it or emended on
21 The value of services or facilities furnished to
the organization by a governmental unit
without charge Do not include the value O(
services or facilities generally furnished to the
27 Organizations described on line 72 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 return Enter the sum of such amounts for each year
(2001) ________________2000) ___________________ (7999) ___________________ (1998) ______________ b 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 (or each year, that was more than the larger of (1) the amount on line 25 (or the year or (2) $5,000 (Include in the list organizations described in lines 5 through 11, as well a5 individuals) Do not file fhb list with your return After computing the difference between the amount received and the larger amount described in (1) or (2), enter the sum of these differences (the excess amounts) for each year (2001) ________________ (2000) ___________________ (1999) ___________________ (1998)_______________
d
b Admissions policies?
c Employment of faculty or administrative staff?
d Scholarships or other financial assistance
e Educational policies?
f Use of facilities?
h Other extracurricular activaies?
3aa Does the organization receive any financial aid or assistance from a governmental agency
b Has the organization's right to such aid ever been revoked or suspended? If you answered "Yes" to either 34a or b, please explain using an attached statement
35 Does the organization certify that it has complied with the applicable requirements of sections 4 01 through 4 OS
Sc hodul* A (Forth 990 or 990EZ) 2002 7E1770 1000
HACK$IDE BENEVOLENCE FUND INC 58-1903239
Schedule A (Form 990 w 990.EZ) 2002 Pa'
Private School Questionnaire (See page 7 of the instructions )
(To be completed ONLY by schools that checked the box on line 6 In Part IV) N
29 Does the organization have a racially nondiscriminatory policy toward students by statement in it charter, bylaws, Yes
other governing instrument or in a resolution of its governing body 29
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 30
31 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 31
If "Yes," please describe, if "No," please explain (If you need more space, attach a separate statement )
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32 Does the organization maintain the following a Records indicating the racial composition of the student body, faculty, and administrative staff? b Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory
basis? c Copies of all catalogues, brochures, announcements and other written communications to the public dealing
with student admissions, programs, and scholarships? , , , , d Copies of all material used by the organization or on its behalf to solicit contributions? , , ,
If you answered "NO" to any of the above please explain (If you need more space, attach a separate statement )
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33 Does the organization discriminate by race in any way with respect to
a Students' rights or privileges
g Athletic programs?
If you answered "Yes" to any of the above, please explain (If you need more space, attach a separate statement ) ----------------------------------------------------------------------------------------------------------------------------------------------------------
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BACKSIDE BENEVOLENCE FUND INC 58-1903239
(See page 9 of the instructions ) Lobbying (fo be completed ONLY by an eligible organization
if the organization belongs to an affiliated group Check Check
01 I
Affiliated group To be completed totals (or ALL electing
organizations
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred )
36 Total lobbying expenditures to influence public opinion (grassroots lobbying) 37 Total lobbying expenditures to influence a legislative body (direct lobbying) 38 Total lobbying expenditures (add lines 36 and 37) 39 Other exempt purpose expenditures 40 Total exempt purpose expenditures (add lines 38 and 39) , 41 Lobbying nontaxable amount Enter the amount from the following table-
If the amount on line 40 Is - The lobbying nontaxable amount is - Not over $500 000 20% a! the amount on line 40 Over $500 000 but not over $1 000 000 $100 000 plus 15% of the excess over $500,000 Over 51,000 000 but not over $1 500,000 S175 000 plug 10% of the excess over $1 000 000 Over E1 500,000 but not over S77 000 000 $225,000 plus 5% M tie excess over S7 500 000 Over $17 000 000 E 1 000 000
42 Grassroots nontaxable amount (enter 25% of line 41) 43 Subtract line 42 from line 36 Enter -0- if line 42 is more than line 36 44 Subtract line 41 from line 38 Enter -0- if line 41 is more than line 38
41
Lobbying Expenditures During 4-Year Averaging Period
Idl let 1999 Tote
Ibl W ooi zoo
Grassroots lobbying
Lobbying Activity by Nonelecting Public Charities For reporting only b org anizations that did not com plete Part VI-A ) See a e 11 of the instructions
During the year, did the organization attempt to influence national, state w local legislation, including any yes No Amount 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 li'ne' s ' c through h ) c Media advertisements d Mailings to members, legislators, or the public e Publications, or published or broadcast statements , , , , , , , , f Grants to other organizations for lobbying purposes g Direct contact with legislators, their staffs, government officials, or a legislative body h Rallies, demonstrations, seminars, conventions, speeches, lectures, or any other means i Total lobbying expenditures (Add lines c through h ) ~ -1 0
If "Yes" to any of the above, also attach a statement giving a detailed description of, wities JSA Schedule A(FOrm 990 or 99U-EZ) 2002 7E 1240 1 000
!on 77 there is en amount on either !me 43 a line 44 you must file Form 4 720 1 1 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 oaoe 11 of the instructions 1
Calendar year (or fiscal I (a)
Lobbying nontaxable
Lobbying ceiling amount
Grassroots nontaxable
Grassroob uilinp amount
BACKSIDE BENEVOLENCE FUND INC 58-1903239
Iqformation Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations (See page 12 of the instructions )
51 Did the reporting organization directly or indirectly engage in any of the following with any other organization described in section
501(c) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
a Transfers from the reporting organization to a noncharilable exempt organization of
(it) Purchases of assets from a noncharitable exempt organization (u) Rental of facilities, equipment, or other assets , , , (rv) Reimbursement arrangements (v) Loans or loan guarantees
(vi) 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
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 527 " E]Yes F]No
(I) Cash (u) Other assets Other transactions
(i) Sales or exchanges of assets with a noncharitable exempt organization , ,
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BACKSIDE BACKSIDE BENEVOLENCE FUND, INC 05/01/2003 11 17 AM 58-1903239 Tax Asset Detail 1/01/02 - 12/31/02 Page i FYE 12/31/2002
Date In Sec 179 Exp Tax Sec Prior Current End Net Asset ' Property Description Service Cost Current = c 168(k) Amt Depreciation Depreciation Depreciation Book Value Method Period
Group 10-BUILDINGS
5 CHURCH BUILDING 9/01/00 71 163 0 0 ?,357 1,825 4 182 66,981 S/L 390 6 STAINED GLASS WINDOWS 3/17/01 2,199 0 0 45 56 101 2,098 S/L 396
10-BUILDINGS 73,362 Oc 0 2402 1,881 4,283 69,079
Group 20-FURNITURE & FIXTURES
I REFRIGERATOR 8/02/00 680 0 0 264 119 383 297 200DB 70 2 TABLES/CHAIRS 8/09/00 881 0 0 342 154 496 385 200D8 70 3 TABLE 9/14/00 736 0 0 285 129 414 322 200DB 70 4 GRILL 9/28/00 833 0 0 323 146 469 364 200DB 70
20-FURNITURE & FIXTURES 3.130 Oc 0 1,214 548 1,762 1368
Grand Total 76,492 Oc 0 3,6 1 6 2,429 6,045 70,447