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Schedule G (Form 990 or 990EZ) 2010 Page 2 Part II Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990EZ, lines 1 and 6b. List events with gross receipts greater than $5,000. Revenue Direct Expenses 1 2 3 4 5 6 7 8 9 10 11 Part III Revenue Direct Expenses 9 a b 1 2 3 4 5 6 7 8 m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Gross receipts Less: Charitable contributions Gross income (line 1 minus line 2) Cash prizes Noncash prizes Rent/facility costs Food and beverages Entertainment Other direct expenses Direct expense summary. Add lines 4 through 9 in column (d) Net income summary. Combine line 3, column (d), and line 10 (a) Event #1 (b) Event #2 (c) Other Events (event type) (event type) (total number) m m m m m m m m m m m m m m m m m m m m m I ( I (d) Total events (add col. (a) through col. (c)) ) Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990EZ, line 6a. Gross revenue Cash prizes Noncash prizes Rent/facility costs Other direct expenses Volunteer labor m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m (a) Bingo Yes Direct expense summary. Add lines 2 through 5 in column (d) Net gaming income summary. Combine line 1, column d, and line 7 No (b) Pull tabs/Instant bingo/progressive bingo Enter the state(s) in which the organization operates gaming activities: Is the organization licensed to operate gaming activities in each of these states? If "No," explain: (c) Other gaming % Yes % Yes % No 562307147 No m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m I I m m m m m m m m m m m m m m m m m (d) Total gaming (add col. (a) through col. (c)) ( ) Yes No 10 a b Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? If "Yes," explain: m m m m m Yes No Schedule G (Form 990 or 990BEZ) 2010 JSA 0E1282 1.000 8284CI 700P 4/12/2012 3:18:55 PM V 108.3 0166181 PAGE 68
m m m m m m m m m m m m m m m m m m m m m m m m Schedule G (Form 990 or 990EZ) 2010 Page 3 11 Does the organization operate gaming activities with nonmembers? Yes No 12 Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity formed to administer charitable gaming? m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Yes No 13 Indicate the percentage of gaming activity operated in: a The organization's facility 13a % b An outside facility m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m 13b % 14 Enter the name and address of the person who prepares the organization's gaming/special events books and records: Name I Address I 562307147 15 a b c m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Does the organization have a contract with a third party from whom the organization receives gaming revenue? Yes No If "Yes," enter the amount of gaming revenue received by the organization I $ and the amount of gaming revenue retained by the third party I $ . If "Yes," enter name and address of the third party: Name I Address I 16 Gaming manager information: Name I Gaming manager compensation I $ Description of services provided I Director/officer Employee Independent contractor 17 Mandatory distributions: a Is the organization required under state law to make charitable distributions from the gaming proceeds to retain the state gaming license? m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Yes No b Enter the amount of distributions required under state law to be distributed to other exempt organizations or spent in the organization's own exempt activities during the tax year I $ Part IV Supplemental Information. Complete this part to provide the explanation required by Part I, line 2b, columns (iii) and (v), and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also complete this part to provide any additional information (see instructions). Schedule G (Form 990 or 990BEZ) 2010 JSA 0E1503 3.000 8284CI 700P 4/12/2012 3:18:55 PM V 108.3 0166181 PAGE 69
Page 1 and 2:
Form ½½´ Return of Organization
Page 3 and 4:
Form 990 (2010) Page 3 Part IV 1 2
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Form 990 (2010) Page 5 Part V State
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562307147 Compensation of Officers,
Page 9 and 10:
JSA Form 990 (2010) Page 9 Part VII
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Form 990 (2010) Page 11 Part X Asse
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SCHEDULE A (Form 990 or 990BEZ) Dep
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562307147 Support Schedule for Orga
Page 17 and 18: Schedule A (Form 990 or 990EZ) 2010
Page 19 and 20: Schedule B (Form 990, 990EZ, or 990
Page 49 and 50: 562307147 Part IIBA Complete if the
Page 51 and 52: 562307147 Schedule C (Form 990 or 9
Page 53 and 54: 562307147 Organizations Maintaining
Page 55 and 56: Schedule D (Form 990) 2010 56230714
Page 57 and 58: Schedule D (Form 990) 2010 Page 5 P
Page 59 and 60: SCHEDULE F (Form 990) Statement of
Page 61 and 62: 562307147 Grants and Other Assistan
Page 63 and 64: Schedule F (Form 990) 2010 Page 4 F
Page 65 and 66: THE PEW CHARITABLE TRUSTS 562307147
Page 67: SCHEDULE G (Form 990 or 990BEZ) Sup
Page 71 and 72: SCHEDULE I (Form 990) Grants and Ot
Page 91 and 92: 562307147 Grants and Other Assistan
Page 93 and 94: 562307147 Officers, Directors, Trus
Page 95 and 96: SCHEDULE K (Form 990) Department of
Page 97 and 98: SCHEDULE L (Form 990 or 990BEZ) Dep
Page 99 and 100: SCHEDULE M (Form 990) I Noncash Con
Page 101 and 102: SCHEDULE O (Form 990 or 990BEZ) Dep
Page 103 and 104: Schedule O (Form 990 or 990EZ) 2010
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Schedule O (Form 990 or 990EZ) 2010
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SCHEDULE R (Form 990) Department of
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562307147 Identification of Related
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562307147 Schedule R (Form 990) 201
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562307147 Schedule R (Form 990) 201
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Form 990T (2010) Page 2 Part III Ta
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Form 990T (2010) Page 4 Schedule G
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