AHA - 501c3 Form 1023 Section IX
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$2,010.00$2,011.002012$2,013.00TotalsItemized List for Line 23$11,000Year 2013
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1. Gifts, grants, contributions received$255.00$1,295.00$1,459.22$3,568.80$6,578.02$2,0001$2,000Purchased Computers
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2. Membership fees received$2,410.00$6,902.00$11,845.00$18,860.00$40,017.00$30012$3,600ConcessionsMonthly
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3. Gross investment income$15012$1,800Office SuppliesMonthly
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4. Net unrelated business income$10012$1,200Hardware MaintenanceMonthly
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5. Taxes levied for your benefit$15012$1,800Supplies for EventsMonthly
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6. Value of services or facilities
furnished by a governmental
unit without charge (not
including the value of services
generally furnished to the
public without charge)
$6001$600Space Improvements
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7. Any revenue not otherwise
listed above or in lines 9–12
below (attach an itemized list
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8. Total of lines 1 - 7$2,665.00$8,197.00$13,304.22$22,428.80$46,595.02
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9. Gross receipts from admissions,
merchandise sold or services
performed, or furnishing of
facilities in any activity that is
related to your exempt
purposes (attach itemized list)
$905.00$11,286.75$28,157.62$31,026.96$71,376.33
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10. Total of lines 8 and 9$3,570.00$19,483.75$41,461.84$53,455.76$117,971.35
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11. Net gain or loss on sale of
capital assets (attach
schedule and see instructions)
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12. Unusual Grants
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13. Total Revenue
Add lines 10 through 12
$3,570.00$19,483.75$41,461.84$53,455.76$117,971.35
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14. Fundraising expenses$258.00
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15. Contributions, gifts, grants,
and similar amounts paid out
(attach an itemized list)
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16. Disbursements to or for the
benefit of members (attach an
itemized list)
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17. Compensation of officers,
directors, and trustees
$2,300.00$500.00$2,800.00
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18. Other salaries and wages
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19. Interest expense
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20. Occupancy (rent, utilities, etc.)$143.00$6,220.00$17,452.00$20,467.00$44,282.00
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21. Depreciation and depletion
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22. Professional fees$7,397.00$13,535.00$11,509.77$32,441.77
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23. Any expense not otherwise classified, such as program services (attach itemized list)$176.00$4,110.00$9,139.00$16,278.81$29,703.81
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24. Total Expenses (Add lines 14 - 23)$319.00$17,985.00$42,426.00$48,755.58$109,485.58
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Net Income$3,251.00$1,498.75-$964.16$4,700.18$9,685.77
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$485.0044283.08Total Expenses
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$1,636.004472.5COGS
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$400.00-11509.77Pro Fees
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$403.00-500Compensation
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$333.00-20467Rent/Util
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$150.00
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$535.00
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$707.0016278.81
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$100.00
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$118.00
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$1,500.00
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