Main Information Sheet 2012

Transcription

1 US 990 Main Information Sheet 202 For calendar year 202 or tax year eginningapr 0, 202 and ending MAR 3, 203 Name: Name line 2: Address: City, State, and Zip Code: COUNCIL ON AMERICAN - ISLAMIC EIN: RELATIONS MINNESOTA (CAIR-MN) 202 E HENNEPIN AVE SUITE 407 Telephone : MINNEAPOLIS MN address We site address List states desired... Fiduciary name, if applicale Name of officer signing return... Title of officer/trustee/fiduciary signing return Group exemption numer Check if exemption application is pending Accounting method INFO@MN.CAIR.COM RAMLA BILE CHAIR Cash: Accrual: Other: Specify: Type of exempt organization: Organization exempt under section 50(c), 527 or 4947(a)() of the Internal Revenue Code (except lack lung enefit trust or private foundation) (Form 990) Organization exempt under section 50(c), 527 or 4947(a)() of the Internal Revenue Code (except lack lung enefit trust or private foundation) with gross receipts less than $200,000 and total assets less than $500,000 at the end of the year (Form 990-EZ) Private foundation or section 4947(a)() nonexempt charitale trust treated as a private foundation (Form 990-PF) Exempt organization with unrelated usiness income (Form 990-T) Preparer ID: Preparer name: Firm's name: Address: City, State, ZIP Code: KL KAZIM LAKHA TA SHOP 232 LOUISIANA AVE S ST LOUIS PARK MN Time in this return: Date: PTIN: Self-employed: Firm's EIN: Phone: 442 minutes //203 P Preparer notes These notes will print and proforma. co 202 CCH Small Firm Services. All rights reserved. US990MI

2 Form Department of the Treasury Internal Revenue Service A B Amended return Application pending The organization may have to use a copy of this return to satisfy state reporting requirements. For the 202 calendar year, or tax year eginning, 202, and ending, 20 Check if applicale: C Name of organization D Employer identification numer Address change Name change Initial return Terminated G Accounting Method: I J Tax-exempt status(check only one) - K Check Sponsoring organizations of donor advised funds, organizations that operate one or more hospital facilities, and certain controlling organizations as defined in section 52()(3) must file Form 990 (see instructions). All other organizations with gross receipts less than $200,000 and total assets less than $500,000 at the end of the year may use this form. Numer and street (or P.O. ox, if mail is not delivered to street address) City or town, state or country, and ZIP US990EZ Room/suite... E Telephone numer F Group Exemption Numer Cash Accrual Other (specify) H Check if the organization is not 50(c)( ) (insert no.) (Form 990, 990-EZ, or 990-PF). if the organization is not a section 509(a)(3) supporting organization or a section 527 organization and its gross receipts are normally not more than $50,000. A Form 990-EZ or Form 990 return is not required though Form 990-N (e-postcard) may e required (see instructions). But if the organization chooses to file a return, e sure to file a complete return. Contriutions, gifts, grants, and similar amounts received Program service revenue including government fees and contracts Memership dues and assessments Investment income 5 a Gross amount from sale of assets other than inventory Less: cost or other asis and sales expenses c Gain or (loss) from sale of assets other than inventory (Sutract line 5 from line 5a) c Gross profit or (loss) from sales of inventory (Sutract line 7 from line 7a) Total revenue. Add lines, 2, 3, 4, 5c, 6d, 7c, and 8 Grants and similar amounts paid (list in Schedule O) Benefits paid to or for memers Salaries, other compensation, and employee enefits Professional fees and other payments to independent contractors Occupancy, rent, utilities, and maintenance Printing, pulications, postage, and shipping Total expenses. Add lines 0 through 6 Excess or (deficit) for the year (Sutract line 7 from line 9) Net assets or fund alances at eginning of year (from line 27, column (A)) (must agree with end-of-year figure reported on prior year's return) Other changes in net assets or fund alances (explain in Schedule O) Net assets or fund alances at end of year. Comine lines 8 through (a)() or 527 OMB required to attach Schedule B L Add lines 5, 6c, and 7, to line 9 to determine gross receipts. If gross receipts are $200,000 or more, or if total assets (Part II, line 25, column (B) elow) are $500,000 or more, file Form 990 instead of Form 990-EZ... $ Part I Revenue, Expenses, and Changes in Net Assets or Fund Balances (See the instructions for Part I) Check if the organization used Schedule O to respond to any question in this Part I Revenue Expenses Net Assets 990-EZ Wesite: Gaming and fundraising events a Gross income from gaming (attach Schedule G if greater than $5,000) Gross income from fundraising events (not including $ from fundraising events reported on line ) (attach Schedule G if the sum of such gross income and contriutions exceed $5,000) c Less: direct expenses from gaming and fundraising events of contriutions d Net income or (loss) from gaming and fundraising events (add lines 6a and 6 and sutract line 6c) 7 a Gross sales of inventory, less returns and allowances... 7a Less: cost of goods sold Other revenue (descrie in Schedule O) Other expenses (descrie in Schedule O) Short Form Return of Organization Exempt From Income Tax For Paperwork Reduction Act tice, see the separate instructions. Under section 50(c), 527, or 4947(a)() of the Internal Revenue Code (except lack lung enefit trust or private foundation) COUNCIL ON AMERICAN - ISLAMIC RELATIONS MINNESOTA (CAIR-MN) MINNEAPOLIS MN (c)(3) 5a 5 6a 6 6c c 6d 7c Open to Pulic Inspection APR 0 MAR E HENNEPIN AVE SUITE ,036. 7, ,26. 90,988. 2,92. 55, , ,30. 5,926. 6,043., ,94. 29, ,824.,32. 49,36. Form 990-EZ (202)

3 Form 990-EZ (202) Page 2 Part II Balance Sheets. (see the instructions for Part II.) Check if the organization used Schedule O to respond to any question in this Part II... (A) Beginning of year (B) End of year 22 Cash, savings, and investments... 0, , Land and uildings Other assets (descrie in Schedule O) Total assets Total liailities (descrie in Schedule O) Net assets or fund alances (line 27 of column (B) must agree with line 2)..., ,995. Part III Statement of Program Service Accomplishments (see the instructions for Part III.) Check if the organization used Schedule O to respond to any question in this Part III... Expenses (Required for section 50(c)(3) What is the organization's primary exempt purpose? CIVIL RIGHTS ADVOCACY/EDUCATION Descrie the organization's program service accomplishments for each of its three largest program services, as and 50(c)(4) organizations and measured y expenses. In a clear and concise manner, descrie the services provided, the numer of persons section 4947(a)() trusts; enefited, and other relevant information for each program title. optional for others.) (Grants $ ) COUNCIL ON AMERICAN - ISLAMIC CAIR-MN DEFENDED 80 CASES SERVING OVER 700 INDIVIDUALS TRAINED 2200 FOR POSITIVE INTERACTION,255 FOR KNOW YOUR RIGHTS AND 25 FOR MEDIA ,32. 49, ,000. If this amount includes foreign grants, check here... 28a 37, (Grants $ ) If this amount includes foreign grants, check here... 29a 3 (Grants $ Other program services (descrie in Schedule O) ) If this amount includes foreign grants, check here (Grants $ ) If this amount includes foreign grants, check here... 3a 32 Total program service expenses (add lines 28a through 3a) ,392. Part IV List of Officers, Directors, Trustees, and Key Employees. List each one even if not compensated. (see the instructions for Part IV.) Check if the organization used Schedule O to respond to any question in this Part IV () Average (c) (d) (e) (a) Name and title hours per week devoted to position RAMLA BILE ABDUL BASIT ABDINASSER HUSSEIN KASHIF SAROYA KAUSAR HUSSAIN LORI SAROYA NAUSHEENA HUSSAIN MUNAZZA HUMAYUN SALY ABDALLA ELLEN LONGFELLOW CHAIR 20 0 TREASURER 30 0 BOARD MEMB 0 0 BOARD MEMB 30 0 BOARD MEM 0 0 STAFF 20 6,236. STAFF 40 3,352. STAFF 20 2,809. STAFF 40 8,363. STAFF 0 4, a... Reportale Health enefits, contriutions to Estimated compensation (For, W-2/099-MISC) employee enefit plans amount of (If not paid, enter-0-.) & deferred comp. other compensation Form 990-EZ (202) US990EZ2

4 Form 990-EZ (202) Page 3 Part V Other Information (te the Schedule A and personal enefit contract statement requirements in the instructions for Part V.) Check if the organization used Schedule O to respond to any question in this Part V a a 43 37a 38a 39 c a 40a c d e c 44a c d 45a 45 Did the organization engage in any activity not previously reported to the IRS? If "," attach a detailed description of each activity in Schedule O section Were any significant changes made to the organizing or governing documents? If "," attach a conformed copy of the amended documents if they reflect a change to the organization's name. Otherwise, explain the change on Schedule O (see instructions)... Did the organization have unrelated usiness gross income of $,000 or more during the year from usiness activities (such as those reported on lines 2, 6a, and 7a, among others)? If "", to line 35a, has the organization filed a Form 990-T for the year? If "", provide an explanation in Schedule O Was the organization a section 50(c)(4), 50(c)(5), or 50(c)(6) organization suect to section 6033(e) notice, reporting, and proxy tax requirements during the year? If "," complete Schedule C, Part III Section 50(c)(3) organizations. Enter amount of tax imposed on the organization during the year under: ; section 492 ; section ABDUL BASIT 202 E HENNEPIN AVE MN MINNEAPOLIS List the states with which a copy of this return is filed The organizations ooks are in care of Telephone no. Located at ZIP + 4 At any time during the calendar year, did the organization have an interest in or a signature or other authority over a financial account in a foreign country (such as a ank account, securities account, or other financial account)? If "," enter the name of the foreign country: See the instructions for exceptions and filing requirements for Form TD F , Report of Foreign Bank At any time during the calendar year, did the organization maintain an office outside of the U.S.? If "," enter the name of the foreign country: Section 4947(a)() nonexempt charitale trusts filing Form 990-EZ in lieu of Form 04 - Check here and enter the amount of tax-exempt interest received or accrued during the tax year Did the organization undergo a liquidation, dissolution, termination, or significant disposition of net assets during the year? If "," complete applicale parts of Schedule N Enter amount of political expenditures, direct or indirect, as descried in the instructions Did the organization file Form 20-POL for this year? Did the organization orrow from, or make any loans to, any officer, director, trustee, or key employee or were any such loans made in a prior year and still outstanding at the end of the tax year covered y this return? If "," complete Schedule L, Part II and enter the total amount involved Section 50(c)(7) organizations. Enter: Initiation fees and capital contriutions included on line 9 Gross receipts, included on line 9, for pulic use of clu facilities Section 50(c)(3) and 50(c)(4) organizations. Did the organization engage in any section 4958 excess enefit transaction during the year, or did it engage in an excess enefit transaction in a prior year that has not een reported on any of its prior Forms 990 or 990-EZ? If "," complete Schedule L, Part I Section 50(c)(3) and 50(c)(4) organizations. Enter amount of tax imposed on organization managers or disqualified persons during the year under sections 492, 4955, and 4958 Section 50(c)(3) and 50(c)(4) organizations. Enter amount of tax on line 40c reimursed y the organization All organizations. At any time during the tax year, was the organization a party to a prohiited tax shelter transaction? If "," complete Form 8886-T and Financial Accounts. Did the organization maintain any donor advised funds during the year? If "," Form 990 must e completed instead of Form 990-EZ Did the organization operate one or more hospital facilities during the year? If "," Form 990 must e completed instead of Form 990-EZ Did the organization receive any payments for indoor tanning services during the year? If "" to line 44c, has the organization filed a Form 720 to report these payments? If "," provide an explanation in Schedule O Did the organization have a controlled entity within the meaning of section 52()(3)?... Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 52()(3)? If "," Form 990 and Schedule R may need to e completed instead of Form 990-EZ (see instructions) COUNCIL ON AMERICAN - ISLAMIC US990EZ3 37a 38 39a a 35 35c a 40 40e 42 42c 44a 44 44c 44d 45a Form 990-EZ (202)

5 COUNCIL ON AMERICAN - ISLAMIC Form 990-EZ (202) Page 4 46 Did the organization engage, directly or indirectly, in political campaign activities on ehalf of or in opposition to candidates for pulic office? If "," complete Schedule C, Part I Part VI Section 50(c)(3) organizations only All section 50(c)(3) organizations must answer questions and 52, and complete the tales for lines 50 and 5. Check if the organization used Schedule O to respond to any question in this Part VI Did the organization engage in loying activities or have a section 50(h) election in effect during the tax Is the organization a school as descried in section 70()()(A)(ii)? If "," complete Schedule... E 48 49a Did the organization make any transfers to an exempt non-charitale related organization?... 49a 50 NONE year? If "," complete Schedule C, Part II If "," was the related organization a section 527 organization? () Average hours per week devoted to position... Complete this tale for the organization's five highest compensated employees (other than officers, directors, trustees and key employees) who each received more than $00,000 of compensation from the organization. If there is none, enter "ne." (a) Name and title of each employee paid more than $00,000 (c) Reportale compensation (Forms W-2/099-MISC) (d) Health enefits, contriutions to employee enefit plans, and deferred compensation (e) Estimated amount of other compensation f Total numer of other employees paid over $00, Complete this tale for the organization's five highest compensated independent contractors who each received more than $00,000 of compensation from the organization. If there is none, enter "ne." (a) Name and address of each independent contractor paid more than $00,000 () Type of service (c) Compensation NONE d Total numer of other independent contractors each receiving over $00, Did the organization complete Schedule A? te: All section 50(c)(3) organizations and 4947(a)() nonexempt charitale trusts must attach a completed Schedule A... Under penalties of perury, I declare that I have examined this return, including accompanying schedules and statements, and to the est of my knowledge and elief, it is true, correct, and complete. Declaration of preparer (other than officer) is ased on all information of which preparer has any knowledge. Sign Here Paid Preparer Use Only k l k l Signature of officer RAMLA BILE Type or print name and title Print/Type preparer's name Preparer's signature KAZIM LAKHA //203 self-employed P Firm's name TA SHOP Firm's EIN Firm's 232 LOUISIANA AVE S Phone no address ST LOUIS PARK MN US990EZ4 Form 990-EZ (202) May the IRS discuss this return with the preparer shown aove? See instructions CHAIR Date /3/203 Date Check if PTIN

6 SCHEDULE A (Form 990 or 990-EZ) Department of the Treasury Internal Revenue Service Name of the organization Part I Reason for Pulic Charity Status (All organizations must complete this part.) See instructions. The organization is not a private foundation ecause it is: (For lines through, check only one ox.) e f g h (A) A church, convention of churches, or association of churches descried in section 70()()(A)(i). A school descried in section 70()()(A)(ii). (Attach Schedule E.) A hospital or a cooperative hospital service organization descried in section 70()()(A)(iii) (iv) Is the organization in col. (i) listed in your governing document? (v) Did you notify the organization in col. (i) of your support? OMB A medical research organization operated in conunction with a hospital descried in section 70()()(A)(iii). Enter the hospital's name, city, and state: An organization operated for the enefit of a college or university owned or operated y a governmental unit descried in section 70()()(A)(iv). (Complete Part II.) A federal, state, or local government or governmental unit descried in section 70()()(A)(v). An organization that normally receives a sustantial part of its support from a governmental unit or from the general pulic descried in section 70()()(A)(vi). (Complete Part II.) A community trust descried in section 70()()(A)(vi). (Complete Part II.) An organization that normally receives: () more than 33 /3 % of its support from contriutions, memership fees, and gross receipts from activities related to its exempt functions - suect to certain exceptions, and (2) no more than 33 /3 % of its support from gross investment income and unrelated usiness taxale income (less section 5 tax) from usinesses acquired y the organization after June 30, 975. See section 509(a)(2). (Complete Part III.) An organization organized and operated exclusively to test for pulic safety. See section 509(a)(4). An organization organized and operated exclusively for the enefit of, to perform the functions of, or to carry out the purposes of one or more pulicly supported organizations descried in section 509(a)() or section 509(a)(2). See section 509(a)(3). Check the ox that descries the type of supporting organization and complete lines e through h. a Type I Type II c Type III - Functionally integrated d By checking this ox, I certify that the organization is not controlled directly or indirectly y one or more disqualified persons other than foundation managers and other than one or more pulicly supported organizations descried in section 509(a)() or section 509(a)(2). If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this ox Since August 7, 2006, has the organization accepted any gift or contriution from any of the following persons? (i) A person who directly or indirectly controls, either alone or together with persons descried in (ii) (ii) and (iii) elow, the governing ody of the supported organization? A family memer of a person descried in (i) aove? (iii) A 35% controlled entity of a person descried in (i) or (ii) aove? Provide the following information aout the supported organization(s). (i) Name of supported organization Pulic Charity Status and Pulic Support Complete if the organization is a section 50(c)(3) organization or a section Attach to Form 990 or Form 990-EZ. (ii) EIN 4947(a)() nonexempt charitale trust. (iii) Type of organization (descried on lines -9 aove or IRC section (see instructions)) See separate instructions. Employer identification numer COUNCIL ON AMERICAN - ISLAMIC Type III - n-functionally integrated (vi) Is the organization in col. (i) organized in the U.S.? 202 Open to Pulic Inspection g(i) g(ii) g(iii) (vii) Amount of support (B) (C) (D) (E) Total For Paperwork Reduction Act tice, see the Instructions for Form 990 or Form 990-EZ. US990A$ Schedule A (Form 990 or 990-EZ) 202

7 Schedule A (Form 990 or 990-EZ) 202 Page 3 Part III Support Schedule for Organizations Descried in Section 509(a)(2) (Complete only if you checked the ox on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed elow, please complete Part II.) Section A. Pulic Support Calendar year (or fiscal year eginning in) (a) 2008 () 2009 (c) 200 (d) 20 (e) 202 (f) Total a Gifts, grants, contriutions, and memership fees received. (Do not include any "unusual grants.")... Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose Gross receipts from activities that are not an unrelated trade or usiness under section 53 Tax revenues levied for the organization's enefit and either paid to or expended on its ehalf... The value of services or facilities furnished y a governmental unit to the organization without charge Amounts included on lines, 2, and 3 received from disqualified persons Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or % of the amount on line 3 for the year c Add lines 7a and Pulic support (Sutract line 7c from line 6.) Section B. Total Support Calendar year (or fiscal year eginning in) (a) 2008 () 2009 (c) 200 (d) 20 (e) 202 (f) Total 9 Amounts from line a c Total. Add lines through 5 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... Unrelated usiness taxale income (less section 5 taxes) from usinesses acquired after June 30,975 Add lines 0a and Net income from unrelated usiness activities not included in line 0, whether or not the usiness is regularly carried on Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) Total support. (Add lines 9, 0c,, and 2.) First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 50(c)(3) organization, check this ox and stop here Section C. Computation of Pulic Support Percentage 5 Pulic support percentage for 202 (line 8, column (f) divided y line 3, column (f))... 6 Pulic support percentage from 20 Schedule A, Part III, line 5 Section D. Computation of Investment Income Percentage 7 Investment income percentage for 202 (line 0c, column (f) divided y line 3, column (f)) 8 9a 20 COUNCIL ON AMERICAN - ISLAMIC Investment income percentage from 20 Schedule A, Part III, line US990A$ /3 % support tests If the organization did not check the ox on line 4, and line 5 is more than 33 /3 %, and line 7 is not more than 33 /3 %, check this ox and stop here. The organization qualifies as a pulicly supported organization /3 % support tests If the organization did not check a ox on line 4 or line 9a, and line 6 is more than 33 /3 %, and line 8 is not more than 33 /3 %, check this ox and stop here. The organization qualifies as a pulicly supported organization Private foundation. If the organization did not check a ox on line 4, 9a, or 9, check this ox and see instructions Schedule A (Form 990 or 990-EZ) 202 % % % %

8 Schedule B (Form 990, 990-EZ, or 990-PF) Department of the Treasury Internal Revenue Service Name of the organization Organization type (check one): Schedule of Contriutors Attach to Form 990, Form 990-EZ, or Form 990-PF. OMB Employer identification numer COUNCIL ON AMERICAN - ISLAMIC Filers of: Form 990 or 990-EZ Section: 50(c)( 3 ) (enter numer) organization 4947(a)() nonexempt charitale trust not treated as a private foundation 527 political organization Form 990-PF 50(c)(3) exempt private foundation 4947(a)() nonexempt charitale trust treated as a private foundation 50(c)(3) taxale private foundation Check if your organization is covered y the General Rule or a Special Rule. te. Only a section 50(c)(7), (8), or (0) organization can check oxes for oth the General Rule and a Special Rule. See instructions. General Rule For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or property) from any one contriutor. Complete Parts I and II. Special Rules For a section 50(c)(3) organization filing Form 990 or 990-EZ that met the 33 /3% support test of the regulations under sections 509(a)() and 70()()(A)(vi) and received from any one contriutor, during the year, a contriution of the greater of () $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line h, or (ii) Form 990-EZ, line. Complete Parts I and II. For a section 50(c)(7), (8), or (0) organization filing Form 990 or 990-EZ that received from any one contriutor, during the year, total contriutions of more than $,000 for use exclusively for religious, charitale, scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. Complete Parts I, II, and III. For a section 50(c)(7), (8), or (0) organization filing Form 990 or 990-EZ that received from any one contriutor, during the year, contriutions for use exclusively for religious, charitale, etc., purposes, ut these contriutions did not total to more than $,000. If this ox is checked, enter here the total contriutions that were received during the year for an exclusively religious, charitale, etc., purpose. Do not complete any of the parts unless the General Rule applies to this organization ecause it received nonexclusively religious, charitale, etc., contriutions of $5,000 or more during the year... $ Caution. An organization that is not covered y the General Rule and/or the Special Rules do not file Schedule B (Form 990, 990-EZ, or 990-PF), ut it must answer "" on Part IV, line 2, of its Form 990; or check the ox on line H of its Form 990-EZ or on Part I, line 2, of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PF). For Paperwork Reduction Act tice, see the Instructions for Form 990, 990-EZ, or 990-PF. Schedule B (Form 990, 990-EZ, or 990-PF) (202) US990B$

9 Schedule B (Form 990, 990-EZ, or 990-PF) (202) Name of organization Part I Contriutors (see instructions). Use duplicate copies of Part I if additional space is needed. Page 2 Employer identification numer COUNCIL ON AMERICAN - ISLAMIC (a). () (c) (d) Name, address, and ZIP + 4 Total contriutions Type of contriution LUBNA MOON & MUHAMMAD AMIN Person Payroll 202 E HENNEPIN AVE $ 5,000. ncash (a). MINNEAPOLIS MN (Complete Part II if there is a noncash contriution.) () (c) (d) Name, address, and ZIP + 4 Total contriutions Type of contriution 2 THE MINNEAPOLIS FOUNDATION Person Payroll 800 IDS CENTER $ 30,000. ncash (a). MINNEAPOLIS MN (Complete Part II if there is a noncash contriution.) () (c) (d) Name, address, and ZIP + 4 Total contriutions Type of contriution 3 ELMER & ELEANOR J FOUNDATION Person Payroll 2424 TERRITORIAL RD $ 25,000. ncash (a). SAINT PAUL MN 554- (Complete Part II if there is a noncash contriution.) () (c) (d) Name, address, and ZIP + 4 Total contriutions Type of contriution 4 GENERAL MILLS FOUNDATION Person Payroll P O BO 9452 $ 0,000. ncash (a). MINNEAPOLIS MN (Complete Part II if there is a noncash contriution.) () (c) (d) Name, address, and ZIP + 4 Total contriutions Type of contriution 5 HEADWATERS FOUNDATION Person Payroll 280 2ST AVE S APT 3 $ 0,000. ncash (a). MINNEAPOLIS MN (Complete Part II if there is a noncash contriution.) () (c) (d) Name, address, and ZIP + 4 Total contriutions Type of contriution 6 THE SAINT PAUL FOUNDATION Person Payroll 0 5TH ST E APT 2400 $ 2,000. ncash SAINT PAUL MN 550- US990B$2 (Complete Part II if there is a noncash contriution.) Schedule B (Form 990, 990-EZ, or 990-PF) (202)

10 SCHEDULE G (Form 990 or 990-EZ) Department of the Treasury Internal Revenue Service Name of the organization Part I 2 a a c d Fundraising Activities. Complete if the organization answered ``" to Form 990, Part IV, line 7. Form 990-EZ filers are not required to complete this part. Indicate whether the organization raised funds through any of the following activities. Check all that apply. Mail solicitations Internet and solicitations Phone solicitations In-person solicitations Solicitation of non-government grants Solicitation of government grants Special fundraising events... OMB 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? If "," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is to e compensated at least $5,000 y the organization. Supplemental Information Regarding Fundraising or Gaming Activities 202 Complete if the organization answered ``" to Form 990, Part IV, lines 7, 8, or 9, or if the organization entered more than $5,000 on Form 990-EZ, line 6a. Open to Pulic Attach to Form 990 or Form 990-EZ. See separate instructions. Inspection Employer identification numer COUNCIL ON AMERICAN - ISLAMIC e f g (i) Name and address of individual (ii) Activity (iii) Did fund- (iv) Gross receipts (v) Amount paid to (or (vi) Amount paid to or entity (fundraiser) raiser have from activity retained y) fundraiser (or retained y) custody or control of listed in col. (i) organization contriutions? Total... 3 List all states in which the organization is registered or licensed to solicit contriutions or has een notified it is exempt from registration or licensing. For Paperwork Reduction Act tice, see the Instructions for Form 990 or 990-EZ. US990G$ Schedule G (Form 990 or 990-EZ) 202

11 COUNCIL ON AMERICAN - ISLAMIC Schedule G (Form 990 or 990-EZ) 202 Page 2 Part II Fundraising Events. Complete if the organization answered ``" to Form 990, Part IV, line 8, or reported more than $5,000 of fundraising event contriutions and gross income on Form 990-EZ, lines and 6. List events with gross receipts greater than $5,000. (a) Event # DINNER/LUNCH (event type) () Event #2 (c) Other events (d) Total events (add col. (a) through (event type) (total numer) col. (c)) Revenue Gross receipts... 63, , Less: Contriutions Gross income (line minus line 2) , , Cash prizes... Direct Expenses ncash prizes Rent/facility costs Food and everages......,99.,99. 2,200. 2, Entertainment ,874. 3, , , Other direct expenses.. 0 Direct expense summary. Add lines 4 through 9 in column (d) Net income summary. Comine line 3, column (d), and line 0 Part III Gaming. Complete if the organization answered ``" to Form 990, Part IV, line 9, or reported more than $5,000 on Form 990-EZ, line 6a. Revenue Gross revenue (a) Bingo () Pull tas/instant (c) ingo/progressive ingo Other gaming (d) Total gaming (add col. (a) through col. (c)) Direct Expenses Cash prizes ncash prizes Rent/facility costs Other direct expenses Volunteer laor..... Direct expense summary. Add lines 2 through 5 in column (d) Net gaming income summary. Comine line, column d, and line % % % Enter the state(s) in which the organization operates gaming activities: a Is the organization licensed to operate gaming activities in each of these states? If "," explain:... 0a Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? If "," explain:... Schedule G (Form 990 or 990-EZ) 202 US990G$2

12 Schedule G (Form 990 or 990-EZ) 202 Page 3 Does the organization operate gaming activities with nonmemers?... 2 Is the organization a grantor, eneficiary or trustee of a trust or a memer of a partnership or other entity formed to 3 administer charitale gaming? Indicate the percentage of gaming activity operated in: a The organization's facility An outside facility 4 Enter the name and address of the person who prepares the organization's gaming/special events ooks and records: Name Address COUNCIL ON AMERICAN - ISLAMIC a % % 5a Does the organization have a contract with a third party from whom the organization receives gaming revenue?... If "," enter the amount of gaming revenue received y the organization $ and the amount of gaming revenue retained y the third party $. c If "," enter name and address of the third party: Name Address 6 Gaming manager information: Name Gaming manager compensation $ Description of services provided Director/officer Employee Independent contractor 7 Mandatory distriutions: a Is the organization required under state law to make charitale distriutions from the gaming proceeds to retain the state gaming license?... Enter the amount of distriutions required under state law to e distriuted to other exempt organizations or spent in the organization's own exempt activities during the tax year $ Part IV Supplemental Information. Complete this part to provide the explanations required y Part I, line 2, columns (iii) and (v), and Part III, lines 9, 9, 0, 5, 5c, 6, and 7, as applicale. Also complete this part to provide any additional information (see instructions). Schedule G (Form 990 or 990-EZ) 202 US990G$3

13 TASHOP 232 LOUSIANA AVE S SAINT LOUIS PARK MN TEL : FA : COUNCIL ON AMERICAN - ISLAMIC INVOICE DATE: /20/203 RELATIONS MINNESOTA (CAIR-MN) ID NUMBER: E HENNEPIN AVE SUITE 407 TELEPHONE: MINNEAPOLIS MN INVOICE NO.: INVOICE D e s c r i p t i o n FORM 990-EZ SCHEDULE A, SUPPLEMENTARY INFORMATION SCHEDULE B, SCHEDULE OF CONTRIBUTORS SCHEDULE G, FUNDRAISING OR GAMING SUPPLEMENTAL DETAIL SHEETS co Remarks: 202 CCH Small Firm Services. All rights reserved. Total Charges Discount Sales Tax Payments Amount Due INVOICE

14 Detail Sheet 202 Name: COUNCIL ON AMERICAN - ISLAMIC ID: Description: OTHER EPENSES Type Amount INTERNS 3,000. INSURANCE 2,692. TRAVEL 4,396. INFORMATION TECHNOLOGY EP 6. CONFERENCES,CONVENTIONS AND MTGS 5,549. OFFICE & OTHER SUPPLIES 3,946. co Total CCH Small Firm Services. All rights reserved. 20,94. USWDET$