Short Form Return of Organization Exempt From Income Tax

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Form 990-EZ (2006) Page 2 Statement of Program Service Accom plishments (See pag e 51 of the instructions . ) Expenses Wh at is the organization's primary exempt purpose To unite orphaned children with families thru ado ption . (Required a nd (4) organizations for 501(c)(3) and (4) organizations Des ribe what was achieved in carrying out the organization's exempt purposes. In a clear and concise manner, and 4947(a)(1) trusts, describe the services provided, the number of persons benefited, or other relevant information for each program title. optional for others.) 28 The period ended December 31, 2006 was our final year of business . We_began our agency in 2006 and_were ---- not able to make our agency sustain itself. We needed to close the - - - - ------------------------------- agency due - to - lack of assistance from sister ----------------------------------- agency _ ----------------------------------------------------------------------------------------------------------------- Grants $ If this amount includes forei g n g rants , check here . ► El 28a 500.00 29 -------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------- Grants If this amount includes forei g n g rants , check here ► El 9a 30 -------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------- Grants $ If this amount includes forei g n rants, check here . IN- q 0a 31 Other program services (attach schedule) . . . . . . . . . . . . . . . . . . . . Grants $ If this amount includes forei gn rants, check here . It- 1 311a , 32 Total program service expenses (add lines 28a through 31 a) . NO- 32 500.00 List of Officers , Directors , Trustees , and Key Employees (List each one even if not compensated. See page 52 of the instructions.) (B) Title and average (C) Compensation (D) Contributions to (E) Expense (A) Name and address hours per week Qf not paid, e mployee benefit plans & account and devoted to position enter - 0-.) deferred compensation other allowances Trudy Anderson ____________________________________________ Exec . Director/ 40 1465 Mornin g Sky Court , Lake Oswe go, OR 97034 1750 4592 0 RoxAnderson ___________ 1465 Mornin g S Court , - Lake ------- - DirFamilySvc/40 Oswe g o, OR 97034 500 1021 0 Christina Yarco -------------------------------------- - ____ Secretary 1837 Manchester Court , West Linn , OR 97038 0 0 0 Linda Royer , 14432 S . Livesay, Oregon City, OR Board Members WA Je rry North , 1218 Cherry In, Lake Oswego, OR 97034 0 0 0 Other Information (Note the statement req uirement in General Instruction V. ) Yes No 33 Did the organization engage in any activity not previously reported to the IRS If "Yes," attach a detailed description of each activity . . . . . . . . . . . . . . . . . . . . . . . . . . 33 3 34 Were any changes made to the organizing or governing documents but not reported to the IRS If "Yes," attach a conformed copy of the changes . . . . . . . . . . . . . . . . . . 3 3 35 If the organization had income from business activities, such as those reported on lines 2, 6, and 7 (among others), but not reported on Form 990-T, attach a statement explaining your reason for not reporting the income on Form 990-T. a Did the organization have unrelated business gross income of $1,000 or more or 6033(e) notice, reporting, and proxy tax requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35a 3 b If "Yes," has it filed a tax return on Form 990-T for this year . . . . . . . . . . . . . . . . 35b 36 Was there a liquidation, dissolution, termination, or substantial contraction during the year (If "Yes," attach a statement.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 3 37a Enter amount of political expenditures, direct or indirect, as described in the instructions. Poo- 37a I 0 b Did the organization file Form 1120-POL for this year . . . . . . . . . . . . . . . , 37b 3 38a Did the organization borrow 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 unpaid at the start of the period covered by this return . . 38a 3 b If "Yes," attach the schedule specified in the line 38 instructions and enter the amount involved . . . . . . . . . . . . . . . . . . . 38b 39 501(c)(7) organizations. Enter: a Initiation fees and capital contributions included on line 9 . . . . . . . . . 39a b Gross recei pts, included on line 9, for p ublic use of club facilities . 39b Form 990-EZ (2006)
Forth 990 - EZ (2006) Page 3 Other Information (Note the statement requirement in General Instruction V.) (Continued) 40a 501(c)(3) organizations. Enter amount of tax imposed on the organization during the year under section 4911 ► . 0 ; section 4912 ► 0 ; section 4955 ► 0 b 501(c)(3) and (4) organizations. Did the organization engage in any section 4958 excess benefit transaction during the year or did it become aware of an excess benefit transaction from a prior year If "Yes," attach an explanation . Yes No 40b 3 c Enter amount of tax imposed on organization managers or disqualified persons during the year under sections 4912, 4955, and 4958 . . . . . . . . . . . . . ► d Enter amount of tax on line 40c reimbursed by the organization . . . . . . . ► e All organizations . At any time during the tax year, was the organization a party to a prohibited tax shelter transaction . . . . . . . . . . . . . 40e 3 41 List the states with which a copy of this return is filed . ► Oreyon 42a The books are in care of ► Trudy Anderson ________________________________________________ Telephone no. ► (_503 _) 830-8886 ---- - --------- ---- Located at p. _ 1465 Morning Sky Ct , Lake Oswego_OR WMIA At any time during the calendar year, did the organization hav over a financial account in a foreign country (such as a banl account) . . . . . . . . . . . . . . . . . If "Yes," enter the name of the foreign country: ► See the instructions for exceptions and filing requirements for At any time during the calendar year, did the organization mai If "Yes," enter the name of the foreign country: ► Section 4947(a)(1) nonexempt chartable trusts filing Form 990 and enter the amount of tax-exempt interest received or accrt Form 990-EZ (2006) 0 Printed on Recycled Paper
Page 1: 'J Form 990-E Short Form Return of
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Page 7 and 8: , Schedule A (Form 990 or 990-EZ )
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Short Form Return of Organization Exempt From Income Tax

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