form return of organization exempt from income tax...

4f50047 OMB No

2002 Open to Public Inspection DepaAnenl of the Treasury

Internal Revenue Service I - The have to use a copy of this return to satisfy state

D Employer Identillcation Number

59-6167630 Name of onpanvaLm

or Number street (w P O box it mad s rot deleereC b street aGEr) RooMSUih I E Telephone number

ZIPcode +4 F =r^Y ~ LJ Cash L

32207 ouKraxc x anal are nor aronrzale to secrron 527 oipan,rabw~s ro H (a) Is this a group reNm for aHdbks° a Yo

H (b) II Yes, enter number of affiliates

H (c) Are all affiliates included? Yes (II No attach a list See irstruchorns

tlons City town or country Slate

` (Jacksonville FL " Section 501(cX3) organizations and 4447(axl) nonexempt chant able trusts must attach a completed Schedule A (Form 990 or 99G-EZ) .

Accrual

No

No G Web site

18 Excess or (deficit) for the year (subtract line 17 from line 12) 18 267 , 642 x 5 19 Net assets or fund balances at beginning of year (from line 73, column (A)) 19 314 , 224 i T 20 Other changes in net assets or fund balances (attach explanation) 20

5~ 27 Net assets or fund balances at end of year (combine lines 18, 19, and 20) ~ 21 1 581 , i-66 - BAA For Paperwork Reduction An Nonce, see the separate Instructions . ~n0101 os~voz Form 990(20 ) 02

I

8

Form 990 Return of Organization Exempt from Income Tax Under section 501(c), 527, or4947(axl) of the Internal Revenue Code

(except black lung benefit trust or private foundation)

A For the 2002 cater B Click if applicable

Address change

Name change

Initial return

Final return

Amended a

Fl Applicabon pending

H Is tha a se crate return pled b an K Check here ~d the organization's gross receipts are normally not more than ~~

w0anvalron covered by a group rulnq7 Yes X No $25,000 The organization need not file a return with the IRS, but if the organization received a Form 990 Package in the mail, it should file a return without financial data I Enter 4 dl it GEN Some states require a complete return . M Check " d the organization is not required

L Gross receipts Add lines 6b, 8b, 9b, and lOb to line 12 ~ 2 455, 413 to attach Schedule B (Form 990, 990.EZ, or 990.PF7

Pan I I Revenue Expenses, and Changes in Net Assets or Fund Balances see instructions 1 Contributions, gifts, grants, and similar amounts received

a Direct public support 1 a 392 , 270 no b Indirect public support 1 b 447. 021

c Government contributions (grants) 1 c 1 383 , 033 d 7a Total

N q (wsn $ ronosh S > i d 2 , 222 , 324 2 Program service revenue including government fees and contracts (from Part VII, line 93) 2 200, 619

V 3 Membership dues and assessments 3 15 , 057 ~W 4 Interest on savings and temporary cash investments 4 1 , 374

5 Dividends and interest horn securities 5

6a Gross rents 6a

b Less rental expenses ~~. 6b c Net rental income or (loss) (subtra line 6 tic

7 Other investment income (describe ~~ 7

8a Gross amount from sales of asset e ~O V rifles (B) Other

,E, than inventory ~. I 6 619 8a If

l b Less cost or other basis and sat e ses 0 86 +' E cGain or(lass)(attachschedule) Se L-~ ¢ 6,619 8c

d Net gain or (loss) (combine line Sc, co Bid 6 , 619 9 Special events and activities (attach schedule)

a Gross revenue (not including $ 72, 274 of contributions

reported on line la) 9a 9 . 420

b Less direct expenses other than fundraising expenses 9b 5 . 244

c Net income or (loss) horn special events (subtract line 9b from line 9a) See L-9 Stint 9c 4 , 176

l0a Gross sales of inventory, less returns and allowances 10a

b Less cost of goods sold 10b

c Gross profit or (loss) (turn sales of inventory (attach schedule) (subtract line IOb from line IOa) 10 c 11 Other revenue (from Part VII, line 103) 11

12 Total revenue add lines l d, 2, 3, 4, 5, tic, 7, Sd, 9c, lOc, and 11 12 2,450,169 13 Program services (horn line 44, column (B)) 13 1 , 853 , 948

x 14 Management and general (from line 44, column (C)) 14 242,173 P 15 Fundraising (horn line 44, column (D)) 15 86 , 406 N 16 Payments to affiliates (attach schedule) 16 E

S 77 7n".1 arnaneac /arid hi-inc 7f, rind 4d roll imn IG\\ 77 7 1 RJ S J7

nssa 2002 Boys & Girls Clubs of Northeast Florida, Inc 59-6167630 Pa It II St8t2rtlent of Functional Expenses All organizations must complete column (A) Columns (B), (C), and (D) are

required for section 501(c)(3) and (d) organizations and section 4947(a)(1) nonexempt charitable trusts but optional for others

(b not include amounts reported on line (B) Program (C) Management 66, 86, 96, I06, or 16 0l Part I (A) Total services and general (D) Fundraising

(cash $ 21,070 non cash $ ) 22

23 Specific assistance to individuals (aft sch) 23 24 Benefits paid to or for members (aft sch) 24 25 Compensation of officers, directors, etc 25 26 Other salaries and wages 26 27 Pension plan contributions 27 28 Other employee benefits 28 29 Payroll taxes 29 30 Professional fundraising tees 30 31 Accounting fees 31 32 Legal fees 32 33 Supplies 33 34 Telephone 34 35 Postage and shipping 35 36 Occupancy 36 37 Equipment rental and maintenance 37 38 Printing and publications 38 39 Travel 39 40 Conferences, conventions, and meetings 40 41 Interest 41 42 Depreciation, depletion, etc (attach schedule) 42 43 Other expenses not covered above (itemize)

a Professional fees 43a b -_t7 iTCT;;6 Co r a or 43b c Supplies & food

- - - - - - - 43c

d Transp(jr~taiLion . . . . . . . [43d 43e e See Other Expenses Stunt Me

4 tal-fu-n - at expenses (add lines 22 43) 4 -T C

4,991 14 .400

80 , 531 46,711 28 , 829. 64 , 336 22,015 27 , 921 40 , 404 134 , 292 6 , 112 82 , 242 77 , 445 2 , 831 40 .285 27 .715 10 .560

e utner p rogram services (urants and allocations z. 1 Total of Program Service Expenses (should equal line 44, column (B), program services) ~ 1,853,948

BAA TEeaoinz oiinw Form 990 (2002)

2 266 20 , 7~1~3 1 1 .228

Joint Costs Check i"U if you are following SOP 98 2 Are any point costs from a combined educational campaign and fundraising solicitation reported in (B) Program serv¢es7 ~~ Yes 0 No If 'Yes,' enter () the aggregate amount of these point casts $ , (u) the amount allocated to program services $ , (in) the amount allocated to management and general $ , and Qv) the amount allocated

What islheorqanizaliorisprimary exempt purpose7 " To provideaPositt_een_ironmentforat_iskchild-en Program Ser All organizations must describe Ihev exempt purpose achievements in a clear and conase manner State the number of ~"a°"`° ro` clients served, publications issued etc Discuss achievements that are not measurable (Section 501(c)(3) & (4) organ ajSp iza6ons and 4947 a 1 nonexem 1 charitable Gusts must also enter the amount of rants & allocations to others oPOw~a i

a Social development programs provided to at risk- chi ldren to improve their_health~_social education _ and vocational well

being---------------------------------------------- (Grants and allocations $ 21,070 ) 1 F

b

------------------------------------------------------ ------------------------------------------------------

(Grants and allocations $ ) c

------------------------------------------------------ ------------------------------------------------------

(Grants and allocations $ ) d

------------------------------------------------------ ------------------------------------------------------

-,

TEEr0103 09104102

Form 99o(2002) Boys & Girls Clubs of Northeast Florida, Inc 59-6167630

Part IV Balance Sheets (see Instructions)

Note Where required, attached schedules and amounts within the description (A) (B) column should be for end-of-year amounts only Beginning of year End of year

45 Cash - non-interest-bearing 22 , 484 _ 4s 48 , 825 46 Savings and temporary cash investments 46

47a Accounts receivable 47a b Less allowance for doubtful accounts 47b 47c

48a Pledges receivable 48a b Less allowance for doubtful accounts 48b 48c

49 Grants receivable 66 , 873 49 69,504

50 Recervables from officers, directors, trustees, and key s employees (attach schedule) 50 e 51 a Other notes 8 loans receivable (attach sch) 51 a s b Less allowance (or doubtful accounts 51 b 51 c

52 Inventories for sale or use 52 53 Prepaid expenses and deterred charges 25 , 747 53 46 321 54 Investments - securities (attach schedule) ~~ Cost[] FMV 54 55a Investments - land, buildings, & equipment basis SSa

b Less accumulated depreciation (attach schedule) SSb SSc

56 Investments - other (attach schedule) 56 57a Land, buildings, and equipment basis 57a 1 , 751 . 121

b Less accumulated depreciation (attach schedule) L-57 Stmt 57b 942 , 519 860 , 045 57c 808 1 .602

58 Other assets (describe - See L1 ne S8 Stmt ) 10,562 58 7,816 59 Total assets add lines 45 through 58 must equal line 74 985,711 59 981 , 068 60 Accounts payable and accrued expenses 190 556 60 46 , 475 61 Grants payable 61 62 Deferred revenue 62 e

i 63 Loans from officers, directors, trustees, and key employees (attach schedule) 63 64a Tax-exempt bond liabilities (attach schedule) 64a

bMortgages andother notes payable (attachschedule) E 370 , 931 64b -3-52- , 727 s s5 Other liabilities (describe - See L i ne 65 Stmt ) 110 , 000 65

66 Total liabilities (add lines 60 through 65) 671,487 66 399,2F2 Organizations that follow SFAS 117, check here ~ U and complete lines 67

through 69 and lines 73 and 74 67 Unrestricted 209 , 057 67 498 , 509 68 Temporarily restricted 105 167 68 83 , 357 69 Permanently restricted 69

Organizations that do not follow SFAS 117, check here ~ ~ and complete lines 70 through 74

70 Capital stock, trust principal, or current funds 70 71 Paid in or capital surplus, or land, building, and equipment fund 71 72 Retained earnings, endowment, accumulated income, or other funds 72

73 Total net assets or fund balances (add lines 67 through 69 or lines 70 through 72, column (A) must equal line 19, column (B) must equal line 21) 314 , 224 73 581,866

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

BAA

Form 990 2002 Boys & Girls CLUbs of Northea,. Part IV-/! Reconciliation of Revenue per Audited

Financial Statements with Revenue per Return (See instructions )

a Total revenue, pains, and other support per audited financial statements ~ a 2 , 452

b Amounts included on line a but not on line 12, Form 990

(1) Net unrealized gains on investments $

(n Donated services and use of facilities

(3) Recoveries of prior year grants $

(4) Other (specify) See stmt -------- S 1 , 942 Add amounts on lines (1) through (1) ~ b 1

c Line a minus line b ~ c 2 , 450

d Amounts included on line 12, Form 990 but not on line a :

(1) Investment expenses not included on line 6b, Form 990 $

(2) Other (specify)

-- - $

Add amounts on lines (7) and (2) ~ d

e Tout revenue per line 12, Form

ioa, inc Dy-Olb/b3U part IV-B Reconciliation of Expenses per Audited

Financial Statements with Expenses per Return

a Total expenses and losses per audited financial statements ~ a 2,18 ~

b Amounts included on line a but not on line 17, Form 990

(1) Donated services and use of facilities s

(2) Prior year adjust- ments reported on line 20, Form 990 $

(3) Losses reported on line 20, Farm 990 $

(4) Other (specify) See stmt --------- S 5 , 244 Add amounts on lines (1) through (4) ~ b

c Line a minus line b ~ c 2 , 17'

d Amounts included on line 17, Form 990 but not on line a

(1) Investment expenses not included on line 6b, Form 990 $

M Other (specify) See stmt ---------5 3 . 302 Add amounts on lines (1) and (2) ~ d

e Total expenses per line 17, Form

469

02

TEEn0104 01ma3

244

(B) Title and average hours (C) Compensation (D) Contributions to (E) Expense (A) Name and address per week devoted (1 not paid, employee benefit account and other

to position enter-0.) plans and deferred allowances compensation

Deborah Verg_es__________ _________ Jacksonville .FL

Executive Director 40 77 , 564 0 0 See attached list

---------------------- Part-time 0 0 0

---------------------- ----------------------

---------------------- ----------------------

---------------------- ----------------------

---------------------- ----------------------

75 Did any officer, director, trustee, or key employee receive aggregate compensation of more than $100.000 from your organization and ail related organizations, of which more than $10,000 was provided by the related organizations -0 Yes ~ No If 'Yes,' attach schedule - see instructions

BAA Form 990 (2002)

TEEn0,05 01122103

~orm99o zooz) Bo y s & Girls Clubs of Northeast Florida Inc 59-6167630 Page s part VI Other Information (See instructions Yes No

76 , Did the organization engage in any activity not previously reported to the IRS If 'Yes,' attach a detailed description of each activity 75 X J

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 $1,000 or more during the year covered by this returns 78a X b If 'Yes,' has it filed a tax return on Forth 990~T (or this years 78b

79 Was there a liquidation, dissolution, termination, or substantial contraction during the -_ __j years If '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 organizations BOa X

b If 'Yes,' enter the name of the organization -__-__--_---_-----_-_----_-__ and check whether It Is -0 exe;Wt or 11 nonexempt

81 a Enter direct or indirect political expenditures See line 81 instructions 81 a 0 b Did the organization file Form 7120.POL for this years 81 b X

82 a 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 B2a X

blf'Yes,' you may indicate the value of these items here Do not include this amount as revenue in Part I or as an expense in Part II (See instructions in Part III ) 82b

83a Did the organization comply with the public inspection requirements for returns and exemption applications 83a 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 express statement that such contributions or gifts were - not tax deductible 846

85 501(c)(4), (5), or (6) organizations a Were substantially all dues nondeductible by members BSa N/ b Did the organization make only in-house lobbying expenditures of $2,000 or less BSb N/

If 'Yes' was answered to either 85a or 85b, do not complete 85c through 85h below unless the organization received a waiver for proxy tax owed for the prior year

c Dues, assessments, and similar amounts from members 85c N/A d Section 162(e) lobbying and political expenditures 85d N/A e Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices 85e N/A f Taxable amount of lobbying and political expenditures (line 85d less 85e) 85f N/A g Does the organization elect to pay the section 6033(e) tax on the amount on line 85f? 85 N/

h If section fi033(exlxA) Dues notices were sent, does the organization agree W add the amount online BSf to its reasonable estimate of dues allocable to nonCeducUble lobbying and political expenditures for the follmnnp lax years 85h N /

86 507(c)(n organizations Enter a Initiation fees and capital contributions included on line 12 86a N/A

b Gross receipts, included on line 12, for public use of club facilities 86b N/A 87 501(c)(12) organizations Enter a Gross income from members or shareholders 87a N/A

b Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them ) 87b N/A

88 At any time during the year, did the organization own a 50% or greater interest in a taxable corporation or partnership, or an entity disregarded as separate from the organization under Regulations sections 301 7701 2 and 301 7701-3? If 'Yes,' complete Part IX 88 X

89a 501(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 50i(c)(3) and 501(c)(4) organizations Did the organization engage in any section 4958 excess benefit transaction during the year or did it become aware of an excess benefit transaction from a prior years If 'Yes, attach a statement explaining each transaction 89b X

c Enter Amount of tax imposed on the organization managers or disqualified persons during the year under sections 4972, 4955, and 4958 ~ 0

d Enter Amount of tax on line 89c, above, reimbursed by the organization ~ 0 90a List the states 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 ) F90 b] 102 91 lhebooks areincare of- Deborah Verges s_---_--_____ Telephone number ~ (904-396=4435-

Loratedatw 1300 Riverelace Blvd-Ste 301-_Jacksonville_FL-__---__zia+a- 32207 -~-~ --------- 92 Section 4947(a)(I) nonexempt charitable trusts tiling Form 990 in lieu of Form 1047 - Check here .LJ

and enter the amount of tax-exempt interest received or accrued during the tax year ~j 92 BAA Form 990 (2002)

rtheast Florida . I

(E) Related or exempt function income

200 .619

Note : Enter gross amounts unless otherwise indicated

93 Program service revenue a Program services b c d e f Medicare/Medicaid payments g Fees 8 contracts from government agencies

94 Membership dues and assessments 95 Interest an savings & temporary cash invmnts % Dividends & interest from securities 97 Net rental income or (loss) from real estate

a debt financed property b not debt financed property

98 Net rental income or (loss) from pers prop 99 Other investment income 100 Gain or (loss) from sales of assets

other than inventory 101 Net income or (loss) from special events 2 Cross profit or (loss) tram sales of imenbry

103 Other revenue a

181 6.61

d e

109 Subtotal (add columns (B), (D), and (E)) c LL 105 Total (add line 104, columns (B), (D), and (E)) tote . Line 105 plus line Id Part l, should equal the amount o~ 'art VIII Relationship of Activities to the Accom Line No. Explain how each activity for which income is repc

of the organization's exempt purposes (other than

93 The or ganization p rovides ro r afYor crhnnl nit4-lint and cnnr

Nature of activities Total End of-year income assets

address, and EIN of corporation, Percentage of nership, or disregarded entity ownership interest

Please I VA-1\1~111,m Y,= Sign spM«oronil Here 111 . \3eacaa.~ V ie 2oEs

Type a print name and title

Pall PmOarers

Pre- signature

parer's Film .~me (w DouRlas'7'-D Use x ~mc~nm ~ 1727 Blandin Only ZIPreQ and Jacksonville ea4

rls Cl

code I Amount I Fxdusion code I Amount

in column (E) of Part VII contributed importantly to the accomplishment ro vi ding funds fo r s u ch purposes)

such as day camps . field trios .

a Did the organization, during the year, receive arty funds, directly or indirectly, fn pay b Did the organization, during the year, pay premiums, directly or inc Note If 'Yes' to , file Form 8870 and Form 4720 see instructions)

Undb penalties 01 OeavO' I DCclire,lhat thaw eumAM this reMm inciWin7

SCHEDULE R Organization Exempt Under °"'B"°'~5~

(Form ssa o. ssa¢) Section 501(cX3) (Except Private Foundation and Section 501(e), 501(Q, 501(k),

501(n), or Section 4947(axl) Nonexempt 50M, 501(f),

Trust 2002

Supplementary Information - (See separate instructions ) D4maryl Rnmnw Se~mce ~ ~ MUST be completed by the above organizations and attached to their Form 990 or 990.EZ Name of the wganazian Employer identification number Boys & Girls Clubs of Northeast Florida, Inc 59-6167630

(c) Compensation (e) Expense account and other

allowances

Total number of other employees paid over $50,000 .I Nonel Part II Compensation of the Five Highest Paid Independent Contractors for Prc

(See instructions List each one (whether individuals or firms) If there are none, enter 'None

Schedule A (Form 990 or 990-EZ) 2002

TEEn0401 01/a

(See instructions List each one If there are none, enter 'None ')

(a) Name and address of each (b) Title and average employee paid more hours per week

than $50,000 devoted to position

None

-------------------------

-------------------------

-------------------------

-------------------------

(a) Name and address of each independent contractor paid more than $50,000

None

-----------------------------------------

-----------------------------------------

-----------------------------------------

-----------------------------------------

others recervinp over

BAA For Paperwork Reduction Act Notice, see the Instructions for Forth 990 and Form 990-EZ

(b) Type of service I (c) Compensation

6167630

Part III Statements About Activities See instructions) Yes l No

2a

See Part V, Form 990

Note Attach a statement to explain how the organization determines that individuals or organizations receiving

14 n An organization organized and operated to test for public safety Section 509(a)(4) (See instructions )

BAA TEEnpeos 01122103 Schedule A (Form 990 or Form 990 EZ) 2002

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 referendums If 'Yes,' enter the total expenses paid or incurred in connection with the lobbying activities ~ $ (Must equal amounts on line 38, Part VI A, or line i of Part VI-B )

Organizations that made an election under section 501(h) by film Form 5768 must complete Part VI-A Other organizations checking 'Yes : must complete Part VI-B AND attacR 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 then families, or with any taxable organization with which any such person is affiliated as an officer, director, trustee, majority owner, or principal benefiaary7 (11 the answer to any question i5 'Yes,' attach a detailed statement explaining the transactions )

a 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) 1 2di X

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

Part IV Reason for Non-Private Foundation Status (See instructions )

The organization is not a private foundation because it is (Please check only ONE applicable box ) 5 A church, convention of churches, or association of churches Section 170(b)(1)(A)(1) 6 A school Section 170(b)(1)(A)pp (Also complete Part V ) 7 I I A hospital or a cooperative hospital service organization Section 170(b)(7)(A)(up 8 ~ A Federal, state, or local government or governmental unit Section 170(b)(1)(A)(v) 9 A medical research organization operated in conjunction with a hospital Section 170(b)(1)(A)piq Enter the hospital's name, city,

and state 10 F]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)(vi) (Also complete the Support Schedule in Part IV-A )

11 b ~ A community trust Section 170(b)(1)(A)(vi) (Also complete the Support Schedule in Part IV-A )

12 ~ An organization that normally receives (1) more than 33-113'.6 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 33.113% of its support from gross investment income and unrelated business taxable income Qess section 511 tax) from businesses acquired by the organization after June 30, 1975 See section 509(a)(2) (Also complete the Support Schedule in Part IV-A )

13 ~ An organization that is not controlled by any disqualified persons (other than foundation managers) and supports organizations described in (1) lines 5 through 12 above, or (2) section 501(c)(4), (5), or (6), if they meet the test of section 509(a)(2) (See section 509(a)(3) )

Provide the following information about the supported organizations (See instructions )

(a) Name(s) of supported organization(5) (b) Line number from above

27 Organizations described on line 12 : a For amounts included in lines 15, 16, and 17 that were reserved from a 'disqualified person,' prepare a list for your records to show the name of, and total amounts reserved 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)----___--___ (1999)_ _--_ (1998)_______

bFor any amount included in line 17 that was reserved 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 reserved 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)-------------c Add Amounts from column (e) for lines 15 16 17 20 21 ~I 27cl

d Add Line 27a total and line 27b total e Public support (line 27c total minus line 27d total) f Total support for section 509(a)(2) test Enter amount from tine 23, column (e) g Public support percentage pine 27e (numerator) divided by line 27f (denominator)) h Investment income percentage pine 18, column (e) (numerator) divided by line 27f Unusual Grants For an organization described in line 10, 11, or 12 that reserved an list for your records to show, for each year, the name of the contributor, the date anc nature of the grant Do not file this list with your return Do not include these grants

unusual grants during 1998 through 2001, prepare a amount of the grant, and a brief description of the in line 15

28

BAA TEEAoao3 oenvoz Schedule A (Form 990 or 990 En 2002

Schedule A orm 990 or 990-En 2002 Boy s & Gt rls Clubs of Northeast Florida, Inc 59-6167630 Page 3 Part IV-A. Support Schedule (Complete only if you checked a box on line 10, 11, or 12 ) Use cash method olaccounting Note . You ma use the worksheet in the instructions for converting from the accrual to the cash method of accounting Calendar year (or fiscal year (e) beginning in) 11~ A 2TO A 1 M Total

nusual Ants ()See line 28 2,513,677 G s, grants a d 0 trb hons 6 nn t includeu re~elved 2 355 116 2,335,387 2 714 316 9,918,496 16 Membership fees reserved 6 , 470 6 , 550 8 695 10 , 993 32 , 708 17 Gross receipts from admissions,

merchandise sold or services performed, or furnishing of facilities in any activity that is related to the organizations charitable, et; purpose 144,410 188 , 077 161 , 402 250,724 744 , 613

18 Gross income from interest, dividends, amounts reserved from payments on securities loans (section 512(ax5)), rents, royalties, and unrelated business taxable income (less section 511 taxes) from businesses acquired by the organ izatian after tune 30, 1975 506 3 , 974 6,387 5,081 15 , 948

19 Net income from unrelated business activities not included in line 18

20 Tax revenues levied for the organizations benefit and either paid to it or expended on its behalf

21 me 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 public without char e

22 Other income Attach a schedule Do not include gain or (loss) from sale of capital assets

23 Total of lines 15 throug h 22 2,665,063 2 , 553 , 717 2 511 871 2,981,114 10 , 711 , 765 24 Line 23 minus line 17 2 , 520 , 653 2 , 365 , 640 2,350,469 2 , 730 , 390 9,967,152 25 Enter 1% of line 23 26,651 I 25 , 537 25 119 29,811 26 Organizations described on lines 70 or 11 a Enter 2% of amount in column (e), line 24 ~ 26a 199,343

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 _ J supported organization) whose total gifts for 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

c Total support for section 509(a)(1) test Enter line 24, column (e) ~ 26c 91967 , 152 d Add Amounts from column (e) for lines 18 15 , 948 19

22 26b ~ 26d 15 , 948 e Public support (line 26c minus line 26d total) ~ 26e 9,951 , 204 ( Public support percentage pine 26e (numerator) divided by line 26c (denominator)) ~ 26f 99 84 %

2002 Boys & Girls Clubs of Northeast Florida, Inc- 59-61

ox on line 6 in Part IV) (To

No

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 Ol through 4 OS of Rev Proc 75-50, 1975-2 C B 587, covering racial

35 or TEenn0404 0112uo3 BAA

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

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 If 'Yes,' please describe, if 'No,' please explain (If you need more space, attach a separate statement )

--------------------------------------------------------- ---------------------------------------------------------

32 Does the organization maintain the following a Records indicating the racial composition of the student body, faculty, and administrative staffs 32a --------------------------------------------------------- - - 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 32c

d Copies of all material used by the organization or on its behalf to solicit contributions 32d

If you answered 'No' to any of the above, please explain (If you need more space, attach a separate statement )

------------------------------------------------------------------------------------------------------------------

33 Does the organization discriminate by race in any way with respect to

a Students' rights or privileges 33a

b Admissions policies

c Employment of faculty or administrative staff

d Scholarships or other financial assistance

e Educational policies

1 Use of facilities

g Athletic programs

h Other extracurricular activities?

If you answered 'Yes' to any of the above, please explain (If you need more space, attach a separate statement )

--------------------------------------------------------- --------------------------------------------------------- ---------------------------------------------------------

34a Does the organization receive any financial aid or assistance from a governmental agency

Schedule A(Form990or990- 2002 Boys &GirlsClubsofNortheastFlorida, Ir

Part VI-A Lobbying Expenditures bay Electing Public Charities (See instructions) (To be completed ONLY by an eligible organization that filed Form 5768)

Check " a if the oroanaa6on belongs to an affiliated group Check " b if you check . 'a' and 'limited control' provisions app l y

Affiliated group To be completed totals for ALL electing

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 -

I( the amount on line 40 is - The lobbying nontaxable amount is - Not over $500,000 20% of the amount on line 40 Over $500,000 Gut not over $1,000,000 $100,000 plus 15% of the e :cess over =500,000 Over $1,000,000 but not over =I,SOO,OOU $175,000 plus 10% of the excess over =1,0OO,ODO Over =1,5(q,000 but not over =11,000,000 :225,000 plus 5% of the excess over =1,500,000 Over $17,000,000 $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

Caution : If there is an amount on either line 43 or line 44, you must file Form 4720

42

Lobbying Activity by Nonelecting Public Charities (For reporting only by organizations that did not complete Part VI-A) (See instructions )

moms 0en2102

41

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 )

Lobbying Expenditures Dunng 4-Year Averaging Penod

Calendar year (a) (b) (c) (d (e) (or fiscal year 2002 2001 2000 1999 Total beginning m)

45 Lobbying nontaxable amount

46 Lobbying ceiling amount (150% of line 45(e))

47 Total lobbying expenditures

48 Grassroots non-taxable amount

49 Grassroots ceiling amount (150'Yo of line 48(e))

50 Grassroots lobbying

During the year, did the organization attempt to influence national, state or local legislation, including any Yes No Amount attempt to influence public opinion on a legislative matter or referendum, through the use of

a Volunteers X b Paid staff or management (Include compensation in expenses reported on lines c through h ) X c Media advertisements X d Mailings to members, legislators, or the public X e Publications, or published or broadcast statements X f Grants to other organizations for lobbying purposes X g Direct contact with legislators, their staffs, government officials, or a legislative body ~ ~ X ~ h Rallies, demonstrations, seminars, conventions, speeches, lectures, or any other means

, .

i Total lobbying expenditures (add lines c through h ) If 'Yes' to any of the above, also attach a statement giving a detailed description of the lobbying activities

gqp Schedule A (Form 990 or 990-En 2002

w

(Form 990 or 990-EZ) 2002 Boys & Girls Clubs of Northeast Florida . Inc 59-6167630 Page ilriforination Regarding Transfers To and Transactions and Relationships With Nonchantable Exempt Organizations see 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 noncharitable exempt organization of Yes No Sl a

fair

Description of transfers, transactions, and sharing arrangements (a) I (b) I Sc)

Line no Amount involved Name of noncharitab e exempt organization

52a Is the organization directly or indirectly affiliated with, or related to, one or more lax-exempt organizations described in section 501(c) of the Code (other than section 501(c)(3)) or in section 527 - [] Yes X No

BAA TEEnoaos oenaioz Schedule A (Form 990 or 990-EZ) 2002

()Cash (H )Other assets

b Other transactions ()Sales or exchanges of assets with a noncharitable exempt organization ()Purchases of assets from a nonchantable exempt organization (i)Rental of facilities, equipment, or other assets (iv) Reimbursement arrangements (v)Loans or loan guarantees (v)Performance of services or membership or fundraising solicitations

c Sharing of facilities, equipment, mailing lists, other assets, or paid employees d If the answer to any of the above is 'Yes ; comDlete the following schedule Cc the goods, other assets, or services given by l Be reporting organization If the m

Public Securities

Publicly Traded Securities

- - - - - - - - - - - - - - --- - - - - - - - - - - - - - - - - -

Total Securities 6, 619 0

Gain or (Loss) from Sale of Securities 6 , 619

Cost Depreciation Basis

TEEV.93015(A 0123103

Form 990 Schedule of Gains and Losses from 2002 Line 8(A) and e(s) Sale of Assets Other than Inventory

Statement ~ Attach to return

Name Employer Identification Number BOYS & Girls Clubs of Northeast Florida, Inc 59-6167630

Part I, Line 8, Column (A) Securities

Nonpublic Securities

Date Acquired Date Sold Description and Method and to Whom

Principal Financial Group - vdftou5 -01/13/03

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Cost, other basis or Gross I FMV when donated

Sales Price (State which on top)

__ Cost basis 0

------------

------------

Part I, Line 8, Column (B) Other Assets

Date Acquired Date Sold Gross Description and Method and to Whom Sales Price

-------------------------------

-------------------------------

Cost, other basis or FMV when donated

Cost Depreciation Basis Donation FMV Cost Depreciation Basis

Total Other Assets

Gain or (Loss) from Sale of Other Assets

1

Form 990, Page 2, Part II, Line 43 Other Expenses Stmt

(D) Fundraising

CAI (B) (C) Other expenses not Total Program Management covered above (itemize) services and general

3,008 1,462 1,546 464 464

18,720 16,965 1,755 7,777 5,220 2,557 3,302 3,302 7,014 4,068 2,946

40,285 27,715 10,560 2,010

Prizes & awards Special events Dues Staff development Loss on disposal of fixed assets

Other

Total

Form 990, Page 3, Part IV, Line 58 Other Assets Statement

Beginning End of of Year I Year Line 58 - Other Assets:

Deferred debt issue costs 7,782 5,036 Deposits 2,780 2,780

Total 10,562 7, 816

Boys & Girls Clubs of Northeast Florida, Inc 59-6167630

Form 990, Page 1, Part I, Line 9 Special Events and Activities Statement

List of Three Largest Net Events and Type and Gross Less Gross Less Direct Income Number of Others Receipts Contributions Revenue Expenses (Loss)

Steak & Steak 71,194 I 64,294 I 6,900 I 644 I 6,256 Matthews Event 10 .500 7 .980 2 .520 4.600 -2 .080

Total 81,694 72,274 9,420 5,244 4,176

Form 990, Page 3, Part IV, Lines 57a & 57b Land, Buildings and Equipment Statement

(a) (b) (c) Cost/Other Accumulated Book Value

Basis Depreciation

Land 104,658 0 104,658 Land improvements 109,079 32,866 76,213 Buildings & improvements 1,052,593 478,839 573,754 Furniture & fixtures 416,043 374,454 41,589 Transportation equipment 68,748 56,360 12,388

Total 1,751,121 942,519 808,602

2

Form 990, Page 6, Part VIII Relationship of Activities to the Accomplishment of Exempt Purposes Statement

Line Explain how each activity for which income is reported in column (E) of Part VII contributed Number importantly to the accomplishment of the organization's exempt purposes (other than by

providing funds for such purposes)

94 en to oarticiDate in the oreanizati rocrams and neio aerr

Boys & Girls Clubs of Northeast Florida, Inc 59-6167630

Form 990, Page 3, Part IV, Line 65 Other Liabilities Statement

Beginning I End of Line 65 - Other Liabilities : of Year Year

Short term loan payable ~ 110,000

Total 110,000

Supporting Statement of :

Form 990 p 2/Line 22 column (B)

Description Amount

River City Playhouse Jacksonville, FL 21,070

Total 21,070


Form 990 p 3/Line 64b, column (A)

Description Amount

AmSouth Bank - mortgage on Lee property 241,180 AmSouth Bank - mortgage on Woodland property 129,751

Total 370,931


Form 990 p 3/Line 64b, column (B)

Description Amount

352,727


Form 990 p 4/Part IV-A, Line b(4)

Description I Amount

Loss on disposal of fixed assets -3,302 Special events expenses 5,244

Total 1,942

Boys & Girls Clubs of Northeast Florida, Inc 59-6167630 3

Payable to AmSouth, 6 25% interest, payments of 81,233 through 4/28/05, remaining balance due at that time, secured by real property at Woodland St

Payable to AmSouth, 6 25% interest, payments of $2,292 through S/11/O5, remaining balance due at that time, secured by real property at Lee St

Total

123 .249

229 .478

Form 990 p 4/Part IV-B, Line b(4)

Description I Amount

Total 5,244

Boys & Girls Clubs of Northeast Florida, Inc 59-6167630 4


Special events expenses

11/06/2003 22 :28 9043965254 BOYS AND GIRLS CLUBS PAGE 02

Executive Committee Members

President Area Executive Director Area Executive Director Human Resource Administrator Executive Assistant Marketing 8 Special Events Administrative Assistant

Deborah J. Verges Jessle Hunter Jose Munoz Charleen Flynn Jennifer Shannon Rebecca Price Kim Troutman

11/07103

BOYS & GIRLS CLUBS OF NORTHEAST FLORIDA

Roster of Board of Governors

2003 - 2004

Chairman Vice Chairman of Board Development Chairman Elect Vice Chairman of Resource Development Vice Chairmen of Finance / Treasurer Secretary

Administrative Stall

Jim Johns Karen Kelley Robert Utsey Mike Liff Sheri Thomas

1300 Riverplace Boulevard, Suits 310 Jacksonville, FL 32207 (904) 398-4435 Fax : (904) 3985254

11107103

11/06/2003 22:28 9043965254 BOYS AND GIRLS CLUBS PAGE 03

ono ' wauuES

Mr . Dane Bradford Smith. dambrell & Russell. LIP 3535 Silvery Lane 50 N Laura Street . Suite 2600 Jacksonville, FL 32217-4227 Jacksonville, FL 32202 Home 636-7748 Phone . 598-6100 Spouse . Donna Fax: 598.8203

E-mail . daWaGfordtr~.Wrlaw eom Admln Asst. Darinda Hall/September

Fax Mr Dan Dablow Adam's Mark Hotel

Director of Catering 225 Coast Line Drive East Jacksonville, FL 32202 Phone: 360.8870 Fax: 633-9988 E-mail : ddeWowAadamamaAc.com

Email Mr Jack Diamond Rink Reynolds Diamond Fisher Wilson 11459 Ft George Rl6ault Road 7301 Rlveryleca Blvd . Suits 600 Jacksonville, FL 32228 Jacksonville, Florida 32207 Home 251-0093 Phone 388-8353 Spouse Elizabeth Fax 346-0787

Email JdiamondCanrrdAv .com Admin Asst : NIA

Email Ms Nancy Edwerds Cell . 671-2332 8634 Christopher Point Road W E-mail nanndw@tg~st,net Jacksonville, FL 32217 Home 737-2289 Spouse . 5pence

Emall Ms . Rea Flackenetaln 2804 Tacito Trail Jacksonville, FL 32223 Phone: 2883487 Fax 280-8328 E-mail* rfsesatt eol.com Spouse Robert (Bob)

Email

Mr. Robert Frenakousky Merrill Lynch Private Client Group 141 Bear Pen Road Rnanaal Advisor Ponte VsAra Beach, FL 32082 610 Highway A1A North Phone 273-6373 Ponta Vedra Beach, FL 32082 Spouse. Jane Phone. 2739877

Fax 273890 Call 233-3412 E-mail, robert franakouekv(Mml eom Asst* Cathy NolanJDecamber

Either

4

11/06/2003 22 :28 9043965254 BOYS AND GIRLS (711 PAGE 04

Mrs. Scottie Gartner 8514 W Cathedral Oaks Place Jacksonville. FL 32217 Phone, 733-8735 Fax . 551-5923 Spouse W.A. . Jr (Win)

Fax

Mr. Larry Glust! Harden & Associates 1316 Treilwood Court Senior Vice President Neptune Beach, FL 32288 808 Riverside Avenue Phone, 242.2413 Jacksonville, Fl 32204 Cell 708-9201 Phone. 421-8360 Spouse Mlkle Fax 634.1302

E-mail lop-t~heMen~etodalesmm Asst NIA

Emell Mr John E. Omnby Alltel 232 Sweetbrier Branch Lane V P 8 General Manager Jacksonville, Florida 32259 601 Riverside Ave Spouse Cynthia Jacksonville, FL 32204

Phone. 854-312 Fox: 854232 Call : 485.0007 E-mail . john a oronbv(dlalltel.eom Aset Wake SpicerMovember

Emed Mr George Grune Farmer Chairmen Reader's Digest Malllne And: PO Box 2348 Association . Inc Ponte vedra Beech, FL 32004-2348 Phy. Add: 1001 Ponte Vedra Blvd . Chairman, DeWltt Wallace-Readers Digest Ponte Vedra Beach, FL 32082 Fund Phone 273.8556 Fax 273-69131555 Spouse Betty Lu Either

Mr James (Jim) Johns Johns 8 Associates Chairman 3842 ReeCpond Drive South 9700 Philips Hwy . Suite 108 Jacksonville, FL 32223 Jacksonville, FL 32268 Home Phone: 262-4251 Phone. 983-2686

Fax: 363-0988 E-mail . nkallayQohnsass cla}ss.net Website " www.lohnsconsultants.oom Asst Nancy Kelley/December

Fax

Mrs Kathryn (Kay) Johnson Brooke Rehab 12138 Mandarin Road Physical Therapist (Part-lima) Jacksonville . FL 32223 Phone 288-4583 E-mail* ,laxbadaertMaol.com Fax. 2B8-4583 Emall Spouse

11107/03

11107103


Ms Karen Kelley Venturi Partners Vice-Chairman of Board 1200 Creel end Road 8428 BaymeaEavs Road Suite #800 DevelopmenU Jacksonville . FL 32225 Jacksonville, FL 32268 Chairman Elect Spouse : Torn Van Ferrite Phone, 636-8100

Fax 73T-0888 E-mail kkelley(Mvedumpartneru rzirn Admln Asst: PJethe GIIUNwamber

Emall Mr, Mike Llff WJW&TV 17 Vice-Chairmen of Finance/ 386 3`° Street 9117 Hogan Rd Treasurer Atlantic Beach, FL 32233 Jacksonville, Fl 32278 Phone, 246-3363 Phone 648-8025

fax 842-0593 E-mail mliHfcZwiwb wm Admln Asst Olnny RoutzehnlMey

Smell Jane Rollineon Blue Cross Blue Shield 8024 Pebble Creek Lane W 4800 Daerwood Campus Parkway Ponte Vedre Beach, FL 32082 DC7.8 Phone: 280-0488 Jacksonville . FL 32248

Phone' 906r1402 Fax 905-9793 E-mail : Iudy.tickerFioofAbcbsfl.com

Small Mr Mare Smith First Coast Sales 11071 Rlverueek Drive E. 9143 Philips Highway Jacksonville, FL 32223 Suite 540 Home . 288-4017 Jacksonville, FL 32258 Spouse Krlata Phone 383-9800

Fax. 3839888 Email" msmithlraflretccmiatsalea.com AEmln Asst: Cindy Myera/Novam6er

Either Ma Sherl Thomas Citibank Secretary 888 Jewel Thomas Road 0787 Baypina Road Cellehan, FL 32071 Jacksonville, FL 32256 Phone 878-4182 Phone 854.7269 Spouse Lonnie Fax 85A-b72011

EmaO sthomasMlticorp.com Adman. Asst.. WA

Small Mr. Robert Ufsey Skanske USA Building, Inc Vice Chairmen of 825 Millers Dam Court 1880 Prudential Drive, Suite 210 Resource Development Ponta Vedra Beech, FL 32082 Jacksonville, FL 32207 Phone: 543-8006 Phone 398.1880 Spouse, Lisa Fax. 386-0361

Cell: 6011137 E-mail* mellto:robert.uteevlMsk nskeusa.eom Adman Asst Tonl JoneslMay

Smell

6

.}

11/06/2003 22:28 9043965254 BOYS AND GIRLS CLUBS PAGE 06

Mr. Van Dyke A. Walker, Jr 24091 Flora Parke Blvd Femendina Beach. FL 32034.8021 Phone, 321-2288 Fax 321-04D9 E-mail. vandykenvalker2ASol coal Spouse .

Emell Neaseu County Repragi fintative Mr Patrick Sabadk Nassau County Soya 8 Girls Club 24 Beach Walker Road Foundation Amelis Island, R 32034 217 Centre Street Phone 261639 Femendina Beach, FL 32034 Fax, n-8878 (please use) Phone 281-8888 Small osetbadle(Mriet-maale no Fax. 261-8878 Spouse 8iay Assist NIA Smell

Associate Board 2003-2004 Mr John Dickinson Conslangy, Brooks 8 Smith, LLC 3747 8 First Street P O Box 41099 Jacksonville Beach, FL 32250 Jacksonville . FL 32203 Home . 285-7680 Phone, 35"900 Spouse Carol Fax. 35"200

E-mail . idicklnson0jconganqy.eom Admln Aset. Pam Zu1JSeptember

Smell Mr . John W. Howard Howard & Company, CPA's 7004 Cypress Bridge Drive N P.O. Box 561300 Ponte Vedre Beach, FL 32082 Jacksonville, Fl $2255 Home. 2738418 Phone- 398-6332 Emeil" looahowerdaaal.com Fax 38&0234 Spouse' Pamela Cell 318-7118

Eme(I. ihowsindAhmor-cma corn Adman set.. Cheri Dole/October Small

Mr Ron Owen Gaker, Myere, &ehiekN, Sorenaon . 10 158 Windward Way North Hlgglnbotham & Omen, PA Jacksonville, FL 32258 P.O . Box 1860 Phone 5&2332 Jacksonville, Florida 32201 E-mail rmowenjQbeltsouth.net Phone, 368-8071 Phone 565-2332 Fax. 353-2425 Fax* 988-7929 (please use) E-Fex" (815) 650942 Spouse Janet Call . 612-3243

E-mail, rowan cokeAaw eom Assistant SusanfFeb

Small Mr Errol Sewell Airline Transport Professionals, Inc 501 Pheasant Run Drlve (ATP) - Executive V P Ponte Vedra Beach, FL 32082 P.O Box 1784 Phone: 280.8883 Ponte Vedra Beach, FL 32004 Spouse, Jacklo Phone: 273-3018

Fax: 273-2714 E-mail: gtrql(Riallatos.eom

Fax

11/07/03

11/07103


Ma Edle Wllliams State Form Insurance 6130105 297 N . Mlllvlew Way Assistant Director Ponte Vedre Beach, FL 32082 8001 Beymeedows Wey Phone 543&t28 Jacksonville, Florida 32258 Spouse . Michael Phone: 443-5178

Fax. 443-511533 Cell : 831-4080 EmelI;edIs.Wllhams cald(BTsWtefarm.com Asat Mary Cheek/April

Either

form return of organization exempt from income tax...

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