-,,990',EZ $15,ooo) j!fl. Short Form

Transcription

1 Shrt Frm Return f Organizatin Exempt Frm lnme Tax -,,990',EZ Department f the Treasury lnternal Revenue Servie A Fr the 20'10 alendar B fl Chek it appliale: Spnsring rganizatins f dnr advised funds, rganizatins that perate ne r mre hspital failities, and ertain nlling rganizatins as defined in setin 51 2f(1 3 must file Frm 990 (see insutins All ther rganizatins with grss reeipts less than $200,000 and ttal assets less than $500,000 at the end f the year may use this frm requirements may have t use a py f this return t satisfy state,2010, and, r tax,20 Minnesta Grund Water Assiatin E Telephne numer Numer and seet (r PO x, if mail is nt delivered t seet address Name hange lnitial return th St N Terminated F City r twn, state r uny, and ZP + 4 Amended return Arual Other (speify H Chek > lll if the rganizatin is nt required t attah Shedule B (Frm 990, 990-EZ, r 990-PF www status J Tax- Grup Exemptin Numer White Bear Lake MN '10 attn G Aunting Methd: Wesite: 2@10 Under setin (l,527, r 4947(aX1 f the lnternal Revenue Cde {exept lak lung enefit ust r private fundatin D Emplyer identifiatin numer Address hange OMB N K Chek > if the rganizatin is nt a setin 509(aX3 suppding rganizatin and its grss reeipts are nrmally nt mre than $50,000 A Frm 990-EZ r Frm 990 return is nt required thugh Frm 990-N (e-pstard may e required (see insutins But ifthe rganizatin hses t file a return, e sure t file a mplete return L Add lines 5, 6, and 7, t line 9 t determine grss reeipts lf grss reeipts are $200,000 r mre, r if ttal assets (Part ll, 76,79785 > $ 990-EZ Revenue, Expenses, and Changes in Net Assets r Fund Balanes (see the insutins fr Part l line 25, lumn j!fl (B elw are $500,000 r mre, file Frm 990 instead f Frm Chek if the rganizatin used Shedule O t respnd t any questin in this Part 1 Cniutins, gifts, grants, and similar amunts reeived 2 Prgram servie revenue inluding gvernment fees and nats 3 Memership dues and assessments 4 lnvestment inme 5a Grss amunt frm sale f assets ther than inveny Lle Less: st r ther asis and sales expenses Gain r (lss frm sale f assets ther than inveny (Suat line 5 frm line 5a 6 Gaming and fundraising events a Grss inme frm gaming (attah Shedule G if greater than, G d $15, z u 17,57100 f niutins Grss inme frm fundraising events (nt inluding $ frm fundraising events reprted n line 1 (attah Shedule G if the sum f suh grss inme and niutins exeeds $15,000 OO Less: diret expenses frm gaming and fundraising events Net inme r (lss frm gaming and fundraising events (add lines 6a and 6 and suat 7a Grss sales f inveny, less returns and allwanes lla Less: st f gds sld Grss prfit r (lss frm sales f inveny (Suat line 7 frm line 7a 8 Other revenue (desrie in Shedule O 9TtalrevenueAddlines1,23,4'56d7,and8> 10 Grants and similar amunts paid (list in Shedule O 11 Benefits paid t r fr memers 12 Salaries, ther mpensatin, and emplyee enefits 13 Prfessinal fees and ther payments t independent nas 14 Oupany, rent, utilities, and maintenane x u 15 Printing, puliatins, pstage, and shipping 16 Other expenses (desrie in Shedule O F 54,05000 Exess r (defiit fr the year (Suat line 17 frm line 9 12,715OO 27, , ,887O2 6,94144 Net assets r fund alanes at eginning f year (frm line 27, lumn (A (must agree with end-f-year figure reprted n prir year's return Other hanges in net assets r fund alanes (explain in Shedule O Net assets r fund alanes at end f vear Cmine lines 18 Fr Paperwrk Redutin At Ntie, see the separate insutins 5, ,79785 Cat N , ,27465 (2010

2 Frm 990-EZ (2010 Page 2 i!flll Balane Sheets (see the insutins fr Part ll Chek if the rganizatin used Shedule O t respnd t any questin in this Part ll Cash, savings, and investments Land and uildings Other assets (desrie in Shedule O Ttal assets Ttal liailities (desrie in Shedule O Net assets r fund alanes (line 27 f lumn (B must agree with line 21 Statement f Prgram Servie Amplishments (see the insutins fr Part lll Chek if the rganizatin used Shedule O t respnd t any questin in this Part lll What is the rganizatin's primary exempt purpse? Grund Water Eduatin Desrie what was ahieved in anying ut the rganizatin's exempt purpses ln a lear and nise renner, the servies prvided, the numer f persns enefited, and ther relevant infnrntin fr eah prgram title (B End f year 37, ,s ,27465 Expenses (Required fr setin ((3 and ((4 rganizatins and setin 4947(a(1 usts; ptinal fr thers _P_9!igy_i_s-:g-e_s_ fthisamuntinludesfreinrantshekhere> 32,02239 lf this amunt inludes hek here > 7, Memer mmuniatins and servie inluding admin:sative supprt f the Minnesta Grund Water Assiatin Fundatin, whih exists t arry ut the grund water siene and eduatin prgrams f the Assiatin s$ lf this amunt inludes ants, hek here > n 16, Other prgram servies (desrie in Shedule O s$ lf this amunt inludes hek here >E 32TtalprgramservieexpenSeS(addlines28athrugh31a> 56,42192 List f Offiers, Dires, Trustees, and Key Emplyees List eah ne even if nt mpensated (see the insutins fr Part lv Chek if the rganizatin used Shedule O t respnd t any questin in this Part lv (a Name and address n (e Expense aunt and ther allwanes 1732 Sheffer Ave St Paul, MN Pt:lY-e!rl-a-e -Eri9-:g-t-y-:-9-9-y-9!9-l-99-'-e-!-9-e-99-t!9t Wdale Dr Munds View MN Galaxie Ave Valfev MN 55' St Paul MN s_99!!4]e-e-lq_el-lu-u_g-e_q19gyl Midlthian Rd, Rseville MN rrm 990-EZ (zt

3 Frm 990-EZ (2010 EEU Page Other lnfrmatin (Nte the statement requirements in the insutins fr Paft Chek if the rganizatin used Shedule O t respnd t any questin in this Part V V 3 n N Did the rganizatin engage in any ativity nt previusly repfted t the RS? lf "Yes," prvide a detailed desriptin f eah ativity in Shedule O Were any signifiant hanges made t the rganizing r gverning duments? lf "Yes," attah a nfrmed py f the amended duments if they reflet a hange t the rganizatin's name Otherwise, explain the hange n Shedule O (see insutins lf the rganizatin had inme frm usiness ativities, suh as thse reprted n lines 2, 6a, and 7a (amng thers, ut nt reprted n Frm 990-T, explain in Shedule O why the rganizatin did nt reprt the inme n Frm 990-T 35 Did the rganizatin have unrelated usiness grss inme f $1,000 r mre r was it a setin ((a, ((5, r (X6 rganizatin sujet t setin 6033(e ntie, reprting, and prxy tax requirements? lf "Yes," has it filed a tax return n Frm 990-T fr this year (see insutins? Did the rganizatin underg a liquidatin, disslutin, terminatin, r signifiant dispsitin f net assets during the year? lf "Yes," mplete appliale parts f Shedule N 37a Enter amunt f plitial expenditures, diret r indiret, as desried in the insutins 37a Did the rganizatin file Frm 1120-POL fr this year? 38a Did the rganizatin rrw frm, r make any lans t, any ffier, dire, ustee, r key emplyee r were any suh lans made in a prir year and still utstanding at the end f the tax year vered y this return? a 38 lf "Yes," mplete Shedule L, Part ll and enter the ttal amunt invlved Setin ((7 rganizatins Enter: lnitiatin fees and apital niutins inluded n line 9 Grss reeipts, inluded n line 9, fr puli use f lu failities 4Oa Setin (X3 rganizatins Enter amunt f tax impsed n the rganizatin during the year under: setin 49'l 1 > ; setin 4955 > ; setin 4912> ((3 ((4 in any setin 4958 exess enef it Did the engage rganizatins rganizatin Setin and ansatin during the year, r did it engage in an exess enefit ansatin in a prir year that has nt een reprted n any f its prir Frms 990 r 990-EZ? lf "Yes," mplete Shedule L, Part Setin ((3 and ((4 rganizatins Enter amunt f tax impsed n rganizatin managers r disqualified persns during the year under setins 4912, Setin ((3 and (X4 rganizatins Enter amunt e 41 f tax n line All rganizatins At any time during the tax year, was the rganizatin a party t a prhiited tax shelter ansatin? lf "Yes," mplete Frm 8886-T List the states with whih a py f this return is filed Minnesta 51_ -_?1 _Dr _J-e_an_e!!g-t1_L-e-g!g---Te e p h n e n 6-6-:9?93 - ZtP+4 Lated al > th St N White Bear Lake MN --9!-'ll_9:-91_q -_--_ At any time during the alendar year, did the rganizatin have an interest in r a signature r ther authrity ver a finanial aunt in a freign uny (suh as a ank aunt, seurities aunt, r ther finanial aunt? lf "Yes," enter the name f the freign uny: See the insutins fr exeptins and filing requirements fr Frm TD F , Reprt f Freign Bank and Finanial Aunts At any time during the alendar year, did the rganizatin maintain an ffie utside f the US? lf "Yes," enter the name f the freign uny: > Setin a9a7@(1 nnexempt haritale usis filing Frm 990-EZ in lieu f Frm Chek here > +S and enter the amunt f tax-exempt interest reeived r arued during the tax year 42a The rganizatin's ks are in are f 4g 40 _ N 44a Did the rganizatin maintain any dnr mpleted instead f Frm 990-EZ d advised funds during the year? lf Frm 990 must e Did the rganizatin perate ne r mre hspital failities during the year? lt "Yes," Frm 990 must e mpleted instead f Frm 990-EZ Did the rganizatin reeive any payments fr indr tanning servies during the year? lf "Yes" t line 44, has the rganizatin filed a Frm 720 t reprt these payments? /f "N," prvide an explanatin in Shedule O rrm 990-EZ (zt

4 Frm 990-EZ ( a 46 ls any related rganizatin a nlled entity f the rganizatin within the meaning f setin 512(X13? Did the rganizatin reeive any payment frm r engage in any ansatin with a nlled entity within the meaning f setin 512(X13? lf "Yes," Frm 990 and Shedule,R may need t e mpleted instead f Frm 990-EZ (see insutins Did the rganizatin engage, diretly r indiretly, in plitial ampaign ativities n ehalf f r in ppsitin t andidates fr puli ffie? lf "Yes," mplete Shedule C, Part Setin (X3 rganizatins and setin 4947(al(11nnexempt haritale usts nly Allsetin (X3 rganizatins and setin 4947(a(1 nnqxempt haritale usts must answer questins and 52, and mplete the tales fr lines 50 and 51 Chek if the rganizatin used Shedule O t respnd t any questin in this Part Vl 47 Did the rganizatin engage in lying ativities? lf "Yes," mplete Shedule C, Part ll 48 ls the rganizatin a shl as desried in setin 170((lXAX? lf "Yes," mplete Shedule E 49a Did the rganizatin make any ansfers t an exempt nn-haritale related rganizatin? lf "Yes," was the related rganizatin a setin 527 rganizatin2 50 Cmplete this tale fr the rganizatin's five highest mpensated emplyees (ther than ffiers, dires, ustees and key emplyees wh eah reeived mre than $100,000 f mpensatin frm the rganizatin lf there is nne, enter "Nne" (a Name and address f eah emplyee paid mre than $100,000 ( Title and average hurs per week Page 4 N N (e Expense aunt and ther allwanes fttalnumerftheremplyeespaidver$100,000> 51 Cmplete this tale fr the rganizatin's five highest mpensated independent nas wh eah reeived mre than $100,000 f mpensatin frm the rganizatin lf there is nne, enter "Nne" (a Name and address f eah independent na paid mre than $1 00,000 ( Cmpensatin dttalnumerftherindependentnaseahreeivingver$100,000> 52 Did the rganizatin mplete Shedule A? Nte: All setin ((3 rganizatins and 4947(aX1 _ nne*"mft haritale usts must attah a mpleted Shedule A ] n Yes f" Under Denalties f eriurv delare that have examined this return, inluding ampanying shedules and statements, and t the est f my knwledge and elief, it is ue, 6rret, and mfiteite Delaratin f preparer (ther than ffier is ased n all infrmatin f whih preparer has any knwledge f /dt, 'a^<* ; 7L tl Paid Preparer Use Only Print/Type preparer's name Tri;ktl, Gete Firm's name > WR Assiatin Firm's address > th St N White the RS disuss this return with the preparer MN ave? See insutins Firm's EN > Phne n PTN P,r{ i { Yes ln rrm 990-EZ (zt

5 SCHEDULE O OMB N (Frm 990 r Supplemental nfrmatin t Frm 990 r 990-EZ Department f the Treasury lnternal Revenue Servie Name f the rganizatln Minnesta Grund Water Assiatin Cmplete t prvide infrmatin fr respnses t speifi questins n Frm 990 r 990-EZ r t prvide any additinal infrmatin Attah t Frm 990 r 2@10 Emplyer identifiatin numer $ Susriptins t Puliatins $ 4,50300 Advertising Revenue Reprted n 9907 $ 5,00100 $12,71500 MGWA Fundatin and Minnesta Envirnmental Partnership Line ,!-tl:l lgJll'ul:!t9-ti-v-9-Ep--el9-q! ,9-Z lr-g-s-9r--El-p-e-t-:-e Fr Paperwrk Redutin At Ntie, see the lnsutins fr Frm 990 r 990-EZ Cat N 51056K Shedule O {Frm 990 r 990-EZ} (2010