Schedule G (Form 990 Or 990-Ez) - Supplemental Information Regarding Fundraising Or Gaming Activities - 2011

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Supplemental Information Regarding
OMB No. 1545-0047
SCHEDULE G
Fundraising or Gaming Activities
2011
(Form 990 or 990-EZ)
Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19, or if the
organization entered more than $15,000 on Form 990-EZ, line 6a.
Open to Public
Department of the Treasury
Inspection
Internal Revenue Service
Attach to Form 990 or Form 990-EZ.
See separate instructions.
Name of the organization
Employer identification number
Fundraising Activities. Complete if the organization answered “Yes” to Form 990, Part IV, line 17.
Part I
Form 990-EZ filers are not required to complete this part.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a
Mail solicitations
e
Solicitation of non-government grants
b
Internet and email solicitations
f
Solicitation of government grants
c
g
Phone solicitations
Special fundraising events
d
In-person solicitations
2 a Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
Yes
No
b If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is to be
compensated at least $5,000 by the organization.
(v) Amount paid to
(iii) Did fundraiser have
(vi) Amount paid to
(i) Name and address of individual
(iv) Gross receipts
(or retained by)
(ii) Activity
custody or control of
(or retained by)
from activity
fundraiser listed in
or entity (fundraiser)
contributions?
organization
col. (i)
Yes
No
1
2
3
4
5
6
7
8
9
10
Total
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.
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3
List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from
registration or licensing.
Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Schedule G (Form 990 or 990-EZ) 2011
Cat. No. 50083H

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