Sister City Program - Laserfiche WebLink

Home

Form v%34 �page 2 ot 21 Aug 1996 ALS 41-1775fiO4 Decemi�er 7 5, 1998 ROSEVRLE SISTER CITY ASSOCIATION 13. Organizations described in section 509ia1[2j: a. Attach a list, from amounts shown on lines 1,2, and 3 showing the name of, and total amounts received in each year frorn each "disqualified person," and enter the sum of such amounts for each year: Year 9 Year 2 Year 3 Year 4 Year 5 Year 6 b. Attach a list showing, for each year, the name and amount included in line 3 for each person Iother than "disqualified persons"1 from whom the organization received more, during that year, than the larger of the amount on line 1 1 for the year or 55,000, Include organizations as well as individuals. Enter the svm of these excess amount� for each year: Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 14. If you received any unusual grants during your advance ruling period, attach a list for each year showing the contributor, the date and amount of the grant, and a brief description of the nature of the grant. Do not include these in line 1 a6ove. 15. List current officers, titles, addresses and telephone numbers. Current Officer Name Title Street Address City �tate Zip Code Telephone Number (please print or type) � ��ode � �5t: C' �'T'T�c�� c•h 1..i S i � I Afitac s eet if more space is needed 16. [ 1 Check block if any of your funds are received from gaming fbingo, pulltahs, Las Vegas Nights, Monte Carlo raffles, etc.l activities. Under penalties of perjury, f declare that I am authorized to sign ti�is schedule on behalf of this organization and that I ha�e exarrzined this schedule, including accompanying statements, and to the 6est of my knowledge and belief it is true, correct, and complete. TJ� ctitA.S %� �r?iA. /.�.e�+�a—'14.��*� �oqas,r7�xi� �a6r��uu SrST��" C�T7 l��d�C�.�i�e�v .�+✓� o� /�.�.�.'.c� 1�9�" �5'1�-5��`9-�'77� iype ar �rint ame ��Qnature �Tit e o� i�orrt�signer -� ate iTe e��e ��la.� .�__.,. Note: We cannot accept N/A as a response. If the correct response is -4- or -none-, please state -0- or -none-. Be sure to enclose financial data for each of the five years in your advance ruling period. If you did nat receive any support for any given year, please t�e sure io show financral data for that year 6y indicating -0- ar -none_. �U.S. GPO; 1996 XXXXXXXX Form $734 te-ssf � a