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Home My WebLink AboutAttch 2j DPIE Bowl-a-Rama~~'.. ~ ~ ~f ~ ( Y~ ITY OF UBLIN COMMUNITY GROUP/ORGANIZATIONAL FUNDING REQUEST APPLICATION PACKET Fiscal Year 2010-2011 12-11-0 9A11:47 RCVD SeCtiOn 2: Application for Community Group/Organizational Funding SECTION 2 ~TT~~f/'n~i'? T Page 1 of 20 a~ CITY OF DUBLIN Fiscal Yecar 2010-2011 COMMUNITY GROUP/ORGANIZATION APPLICATION FOR FUNDS COVER PAGE AGENCY NAME: DUBLIN.PARTNERS IN EDUCATION PROPOSED PROJECT/PROGRAM NAME: NEW FUND RAI5ER DOLLARS FOR SCHOLARS BOWL- A- RAMA~ FUNDING AMOUNT REQUESTED $S,OOO.OO SECTION 2 Page 2 of 20 CI'I'~ OF DUBLIIV Fiscal Yea~ 2010-2011 APPLICATION FOR FUNDS 1. Please select one expense category: ^ Capital ^XX Operating 2. Applicant Information: Organization/Agency Name _Dublin Partners in Education Mailing Address P.O. Box 2307 Street Address 6800 Penn Drive CityDublin Zip_94568 . _Janet Lockhart _LockhartJanet@dublin.k 12. ca. us Executive Director/Chairperson Board President (if applicable) Work Phone 925 828-2551x5431 Work Phone State Ca Email Email Please list the Primary Project Contact Person who would be able to answer questions about this application and project/program during the funding period. Janet Lockhart SECTION 2 Page 3 of 20 Contact Person for Project/Program Job Title 925 828-2551x5431 Director Work Phone Email Federal Tax Identification No. (required) _94- 3207780 City of Dublin Business License No. (required) _10048 Exec. SECTION 2 Page 4 of 20 F~ City of Dublin Fiscal Year 2010-2011 Application for Facnds 3. Proposed Project/Program Information (Do not descr~be organiZation.) Amount of Funds Requested $ _5,000.00 (Maximum $25,000 per project.) Proposed Project/Program Name: Dollars for Scholars Family BowI-A-Rama Proposed Project/Program Date(s): Start _Ol / 30_ / 11 and End _O1_ / 30/11 mo. day yr. mo. day yr. Please notec City Council Grant Funds are distributed on a reimbursement basis. If your Agency needs a 100% disbursement at the beginning of the Fiscal Year, please indicate this below and provide justification for this need. XX^ Agency is requesting 100% disbursement at the beginning of the Fiscal Year. If selecting this option, please provide justification in the blank space below. ^ Agency is not requesting 100% disbursement at the beginning of the Fiscal Year. Please provide the frequency that reimbursements will be submitted to the City in the blank space below; e.g., monthly, quarterly, at project completion, etc. SECTION 2 Page 5 of 20 City of Dublin Fiscal Year 2010-2011 Application for Funds a. How would the requested funds be used? ^ Describe, in detail, the PROPOSED PROJECT/PROGRAM (not the Agency). ^ Bulleted text is acceptable. ^ Identify if the proposed project/program is a new service, or extension of an existing one. ^ An additional page may be added, if needed. This event is a new fundraising effort on behalf of DPIE. Our goal is to work with Small Businesses Only in the City of Dublin to market their services and materials to the Dublin school community. We would like to create new partnerships with smaller businesses in our community. Each sponsoring business will be allowed to supply a coupon to all involved to encourage residents to use their businesses. b. How would the PROPOSED PROJECT/PROGRAM address an unmet community need and improve the quality of life for Dublin residents. Why is this project/program needed? (Additional page may be added, if needed) This program will create a much needed marketing opportunity for our local small businesses. It will also provide a new revenue source far our student programs. It will also give DPIE an opportunity to find new businesses that have not yet become involved with our student population. c. What documentation/data/records support the need for this PROPOSED PROJECT/PROGRAM? Please identify your data sources. (Additional page may be added, if needed.) Just looking at the failure rate of small businesses throughout the Tri- SECTION 2 Page 6 of 20 Valley region is a good indicator of the need to bring together the paying public in need of services and goods and our small business community. SECTION 2 Page 7 of 20 c~cy of n~b<<n Fiscal Year 2010-2011 ~4pplicataon for Funds d. Specify the PROPOSED PROJECT/PROGRAM population to be served. This event will serve the needs of at least 40 small businesses and at least 200 parents and students in the district. e. Projects/programs must be evaluated to determine if they are being carried out efficiently and if project/program goals are being met. Please describe how you plan to monitar your project/program's success and impact. ^ An additional page may be added, if rieeded. As with all other programs supported by DPIE, this program will be worked on by the Fund Raising subcommittee of the DPIE Board and will be evaluated by staff and board members on an ongoing basis. f. Specify numbers of clients served by agency, then by PROPOSED PROJECT/PROGRAM: Y~~. .. 3 " ~~' J ~i ~~ . . ~- 4 P'. ~~ ' A enc "~Partici ~ ant` Information " ~ "~ ~ ~ . .. " ~ ~ Total Number of Participants Served by Agency (if a plicable) 240 Total Number of Dublin Residents Served by Agency (if applicable) 200 lus a =Pro ect'/,Pro ram Partici '~'ant Iqformation , ~'' ~• ~ Total Proposed Participants Served by this Project/Program 240 SECTION 2 Page 8 of 20 s Total Number of Dublin Residents Served by this Project 200 lus SECTION 2 Page 9 of 20 City of Dublin Fiscal Year 2010-2011 Applicatiora for Funds 5. Financial Information - Operating Budget a. Expense Budget PLEASE SEE FIRST SUBMISSION FY 2010 2011 ~ ~ , ~ ,~ ~ ~, , . ` EXPENSE BUD`GETk°~ ~ ~ ,~ 2 .a~ ;~ ,, •-' - ~ ORGAIVIZATION ~. ~ T~us;Piio.rECTL~ ; ;_ ~.~~ . ;'_ . PROGRAM` ° n ~ . . , , . ~ GRANT"REQUEST ~3R'k Person:nel Costs~ ~" ~ ~ ~k ~~ ~ ~ ~~~~ " ~ , 2. ~~~~". :~r?8~' a ~ ~ ~ ~ F U _ s %e Employee Salaries & Benefits _ Non Personnel~Costs ~ ~ , ._ _ .,.~ _ ~-., ~ :~. .~s;:: ~.. ;tt ..~v. .; . ~ 9 .~;, .,. ,~~.~,x.~-.- m:a.~. ~ Services & Supplies Capital Costs Other (please specify) Other (please specify) TOTAL Further Comments/Explanations (if necessary): PLEASE SEE FIRST SUBNIISSION SECTION 2 Page 10 of 20 City of Dublin Fiscal Year 2010-2011 Application for ~'unds b. Revenue Budget - ~ < ~FY< 2010 201~1 3 ~ ~ m ~. ° . : ~ . 4 . .. , , ~ ,, R , REVENUE BITDGET y ORGANIZATION' PROJECT/PROGRAM _. ,. . _ e. ~~ , ..~~_ . .,... ..., ~ , _ =r,' k Committed/Restricted~:Funds b ~ ~~ ,~_~-~ :~~ ~ ' ~ . ~ „ , ~. . ... ... _. f_ ~. (specify~source)._~, _13n r~~; ~ ~ m r , ..: . °} .~ . . ~. ~: ' . ~. . , , _ . ~ . Y. ~ . ~ Non Comrii~ttedlRestricted ~unds ' ~~~ ~~ " ~ ~ ~ ~° ~ ~ (s`pecifv~~source) . ..~.~~r. ,A . ,. . . , . _. u _. 4... ~. ~.~__. . `~p ._ . . }~ .~, . ~ , w , ,. ~, ~ . _ . , , ,. TOTAL Further Comments/Explanations (if necessary): PLEASE SEE FIRST SUBMISSION SECTION 2 Page 11 of 20 City of Dublin Fiscal Year 2010-2011 Application for Funds 6. General Agency Infor-mation XX^ Past grant applicants may check this box in lieu of completing item 6(a-d) if the program/organizational description on file with the City is correct and current. a. List all years that Organization has previously received City of Dublin funding (not Community Development Block Grant - CDBG). b. Describe the population(s) served by the Organization. c. Describe all the services the Organization currently provides to Dublin residents. ^ An additional page may be added, if needed. ~ d. Has your agency ever previously received funds from the City of Dublin? If yes, please specify in what Fiscal Years and the amount received each year. SECTION 2 Page 12 of 20 City of Dublin. Fiscal Year 2010-2011 ~lpplicatio~a for ~'urads 7. Required Attachments: o Onlv one (1) copv ner AEencv of each of the following is required, even with multiple projects/programs submitted. o Applications without the following documents will not be reviewed for funding. o Please label attachments: A, B, C, etc. ^ A. Names of Governing Board; identify current Board officers. ^ B. Current total Organization operating bud~et, iricluding revenue. ^ Clearly label/identify the program that includes the PROPOSED ' PROJECT/PROGRAM. ^ C. Most recent audit report or tax return (if applicable). ^ D. Resolution, letter or other document providing evidence of Board/Organization approval of application, and date approval was granted. ^ Board/Organization approval may be pending. ^ E. Organization's certificate of insurance showing coverage for liability and workers' compensation. ^ F. Application Verification Declaration Signature Page. ^ G. Signed affidavit form from each collaborating agency named in proposed project/program plan (if applicable). ^ H. Copy of IRS Letter of Determination indicating tax exempt status. PLEASE SEE FIRST SUBMISSION SECTION 2 Page 13 of 20 c~ty of n~b~~n Fiscal Year 2010-2011 Applicatio~a for Funds APPLICATION VERIFICATION I attest that the information contained in this FY 2010-2011 grant application is accurate and that the funds requested will not supplant any other monies secured by the organization. Attached is a resolution, letter, or other document providing evidence that the Board of Directors approved the application as submitted. Successful applicants are required to submit a summary report as soon as possible after submitting the reimbursement request, but not later than August 31, 2011. Failure to submit a report will result in ineligibility for future funding. Signature : ecutive Director ~a~~~o9 Date o ~ -,o _ i _ B rd President/Chairp so Date SECTION Z Page 14 of 20 AGREEMENT BETWEEN CITY OF DUBLIN . ~~ i ~~ ~16 `~ ~~uea~v~ inse~~ n~za~ri "na~e THIS AGREEMENT, dated for identification this _ day of 2010, is entered into between the City of Dublin ("City") and (Dublin Partners in Education RECITALS A. ~Dublin Partners in Education has asked City to contribute $_5,000.00 LFive thousand Dollars) for use by (organization) to cover _operating costs in order to provide the services as described in Exhibit A. The services rendered pursuant to this agreement will be for the period July 1, 2010 through June 30, 2011. . B. City has determined that it is in the interest of the residents of the City of Dublin to make a donation of $ 5,000.00 (Five thousand Dollars) for such purpose, provided certain conditions are met to ensure that the services will benefit the residents of City. AGREEMENT City and (DPIE agree as follows: Recitals The foregoing recitals are true and correct and are part of this agreement. 2. City Donation City shall donate $ ( Dollars) to be used by ~DPIE to be used for operational support for _Dollars for Scholars as described in Exhibit A to this Agreement. The donation shall be paid upon invoice to the City. 3. Records DPIE shall maintain records for project/program review, evaluation, audit and/or other purposes and make them available to City upon request. 4. Periodic Reports Upon request by City, (organization) shall provide reports describing the progress made by (organization) accomplishing the goals and objectives outlined in the work plan. CITY OF DUBLIN Dated: By: Joni L. Pattillo, City Manager SECTION 2 Page 19 of 20 Dated: ~~ ~ ' ~ By: Title • ,~~.~_,DI le~6G 0 ~ SECTION 2 Page 20 of 20 .•~; ti` ~ ~Dublin Partncrs In L•'duc:iUon / ~ 2009-2010 BOARD OFFICERS Co-Secretary Chris Bennett WorkVantage, Inc Owner 6773 Oak Court Dublin, CA 94568 Phone: BOARD Of DI REC~ORS (O)925-803-1901 (C) 925-998-2204 Email: chrisna,workvantage.com Co-Secretary Kellee Jones DPIE Co-Secretary/Committee Member 6960 Lancaster Road Dublin, CA 94568 Phone: (H) 925-829-1953 (C)925-580-6646 Email: kelleej~a,vmail.com ~ '~ , ` llublin Partncrs In I~duca[lun "Q-~ Board Members Don Biddle Ted Hoffman City of Dublin Earl Anthony's Dublin Bowl Council Member Owner 100 Civic Plaza 6750 Regional Street Dublin, CA 94568 Dublin, CA 94568 Phone: Phone: (H) 925-828-2827 (O) 925-828-7550 (C) 925-818-2633 (C) 925-719-4022 Email: dondonnabl~a,aol.com Email: thbp@earlanthonysdublinbowl.com Mona Lisa Ballesteros Kathy Rosselle DSRSD Wells Middle School Administrative Techinician Principal 4304 Talle Way 6800 Penn Drive, Dublin, CA 94568 Dublin, CA 94568 Phone: Phone: (C) 510-676-3643 (O) 925-828-6227 X6227 (C) 925-383-7917 Email: artsbvmlb(a~gmail.com Email: RosselleKathy@dublin.kl2.ca.us bal lesteros(a)~dsrsd.com Kathleen Schaub Edy Coleman Sybase DPIE Board Member Vice President Marketing 7822 Bloomfield Terrace 11652 Silvergate Drive Dublin, CA 94568 Dublin, CA 94568 Phone: Phone: (H) 925-8] 8-4276 (H) 925-829-2435 (C) 925-640-9892 (C) 925-989-7784 Email: k.schaub(~comcast.net Email: edocoleman(a~gmail.com Dublin Partners in Education, Inc. Profit & Loss Budget Overview July 2008 through June 2009 ~ Jul 08 Aug 08 ~ Sep 08 Oct 08 - ~ Nov 08 ~ Dec 08 Jan 09 Feb 09 Income ~ 3020 • Interest Inc 500.00 3030 • Misc Income 3,500.00 -2,000.00 3060 • Student Art Auction 3060-06 • SAA T-Shirts 8~ Sale Items 2,000.00 3060 • Student Art Auction - Other 34,000.00 Total 3060 • Student Art Auction 36,000.00 3080 • Fireworks 4,500.00 2,000.00 3090 • Dinner Partners in Education 31,000.00 3200 • Grant Income 3200-10 • Misc. Grant Income 19,000.00 -5,000.00 3200-11 • City of Dublin City Grant 27,500.00 3200-12 • Palo Alto Medical Foundation 5,000.00 3200-13 • Barton Reading Program 7,000.00 Total 3200 • Grant Income 53,500.00 I 0.00 ~ 3220 • Members Recogntion Evening 2,000.00 -1,750.00 3400 • Membership Dues 3400-01 • Company/Corporate Memberships 15,300.00 3400-02 • Individual Memberships 5,000.00 3400-04 • Website Donation 8,000.00 Total 3400 • Membership Dues 28,300.00 3510 • Summer Bowling Program 20,300.00 -20,000.00 Page 1 of 6 i _I -= i i i Jul 08 Aug 08 Sep 08 Oct 08 Nov 08 Dec 08 ~ ~ Jan 09 Feb 09 Totallncome 179,600.00 0.00 -21,750.00 Expense 4012 • Members Recognition Evening 350.00 4017 • Teacher Grants 11,100.00 4018 • Winter Concert Sponsorship 1,000.00 -1,000.00 4020 • Science Fair Sponsorship 1,500.00 4021 • DHS Program Donation 4021-04 • Mentor Program 6,500.00 4021-06 • Art Scholarship 775.00 Total 4021 • DHS Program Donation 7,275.00 4023 • Elementary Program Donations 4023-01 • Fireworks Donations 2,000.00 -1,000.00 Total 4023 • Elementary Program Donations 2,000.00 -1,000.00 4026 • DUSD Leadership Training Grant 4,000.00 -4,000.00 4060 • Students Art Auction 4060-16 • SAA Easel Rental 500.00 4060 • Students Art Auction - Other 17,000.00 Total 4060 • Students Art Auction 17,500.00 4070 • Fall Golf-Tournament 4070-15 • G.T. Postage 400.00 4070 • Fall Golf-Tournament-Other 1,800.00 -1,800.00 Total 4070 • Fall Golf-Tournament 1,800.00 -1,400.00 4080 • Fireworks Expense 250.00 4090 • Dinner Partners-in-Education 11,000.00 4200 • Grant Expenses 4200-13 • Barton Reading Program 7,000.00 Total 4200 • Grant Expenses ~ 7,000.00 Page 2 of 6 i i i i ~ i ~ i i Jul OS Aug 08 Sep 08 ~ Oct 08 ~ Nov 08 ~ Dec 08 ~ Jan 09 Feb 09 4400 • Website Expenses 500.00 4510 • Bowling Event 10,000.00 25.00 -9,725.00 5210 • Office Supplies 2,500.00 5220 • Postage 4,000.00 5260 • Bank Fees 1,500.00 -500.00 5300 • Office Equipment Expense 1,000.00 -1,000.00 5450 • Outside CPA Services 1,200.00 5520 • Corporation Filing 175.00 5550 • Insurance-Liability & E8~0 3,100.00 5620 • Exec Director-Expenses 500.00 5630 • Marketing & Program Info. 5,000.00 1,000.00 5635 • Printing Expenses 5,000.00 5710 • Professional Development 1,500.00 ~ 5715 • Strategic Planning 1,000.00 -450.00 5780 • Taxes 8~ Fees 458.00 5810 • Misc Expenses 2,600.00 -1,600.00 6560 • Payroll Expenses 6560-01 • Exec. Director Payroll Expenses 40,000.00 -19,400.00 900.00 6560-02 • Admin. Srvcs. Payroll Expenses 15,600.00 -400.00 6560-03 • Worker Comp Insurance 1,100.00 6560-04 • Staff Incentive Package 5,000.00 6560-OS • Paychex Services 700.00 300.00 6560-06 • Payroll Taxes 5,500.00 6560-07 • Program Manager 10,800.00 -1,500.00 6560-08 • Event Manager 10,800.00 1,000.00 Total 6560 • Payroll Expenses 79,000.00 -15,000.00 6,400.00 Total Expense 182,208.00 -12,975.00 -13,675.00 Net Income -2,608.00 12,975.00 -8,075.00 Page 3 of 6 Dublin Partners in Education, Inc. 11:01 AM Profit 8 Loss Budget Overview 40158 July 2008 through June 2009 Cash Basis TOTAL I Mar 09 ~ Apr 09 May 09 Jun 09 Jul '08 - Jun 09 Income 3020•Interestlnc 500.00 3030 • Misc Income 1,500.00 3060 • Student Art Auction 3060-06 • SAA T-Shirts 8~ Sale Items 2,000.00 3060 • Student Art Auction - Other 34,000.00 Total 3060 • Student Art Auction 36,000.00 3080 • Fireworks 6,500.00 3090 • Dinner Partners in Education 31,000.00 3200 • Grant Income 3200-10 • Misc. Grant Income 14,000.00 3200-11 • City of Dublin City Grant 27,500.00 3200-12 • Palo Alto Medical Foundation 5,000.00 3200-13 • Barton Reading Program 7,000.00 Total 3200 • Grant Income 53,500.00 3220 • Members Recogntion Evening 250.00 3400 • Membership Dues 3400-01 • Company/Corporate Memberships 15,300.00 3400-02 • Individual IVlemberships 5,000.00 3400-04 • Website Donation -8,000.00 0.00 Total 3400 • Membership Dues -8,000.00 20,300.00 3510 • Summer Bowling Program 300.00 Page 4 of 6 I I I I TOTAL Mar 09 Apr 09 May 09 I Jun 09 Jul '08 - Jun 09 Total In ome -8,000.00 149,850.00 Expense 4012 • Members Recognition Evening 350.00 4017 • Teacher Grants -8,300.00 2,800.00 4018 • Winter Concert Sponsorship 0.00 4020 • Science Fair Sponsorship 1,500.00 4021 • DHS Program Donation 4021-04 • Mentor Program 6,500.00 4021-06 • Art Scholarship 775.00 Total 4021 • DHS Program Donation 7,275.00 4023 • Elementary Program Donations 4023-01 • Fireworks Donations 1,000.00 Total 4023 • Elementary Program Donations 1,000.00 4026 • DUSD Leadership Training Grant 4,000.00 4,000.00 4060 • Students Art Auction 4060-16 • SAA Easel Rental 500.00 4060 • Students Art Auction - Other -2,000.00 15,000.00 Tota14060 • Students Art Auction -2,000.00 15,500.00 4070 • Fall Golf-Toumament 4070-15 • G.T. Postage 400.00 4070 • Fall Golf-Tournament - Other 0.00 Total 4070 • Fall Golf-Tournament 400.00 4080 • Fireworks Expense 250.00 4090 • Dinner Partners-in-Education 11,000.00 4200 • Grant Expenses 4200-13 • Barton Reading Program 7,000.00 Total 4200 • Grant Expenses ~ 7,000.00 Page 5 of 6 I I TOTAL Mar 09 Apr 09 May 09 Jun 09 Jul '08 - Jun 09 4400 • Website Expenses 500.00 4510 • Bowling Event 300.00 5210 • Office Supplies -500.00 2,000.00 5220 • Postage -2,000.00 2,000.00 5260 • Bank Fees 1,000.00 5300 • Office Equipment Expense 0.00 5450 • Outside CPA Services 1,200.00 5520 • Corporation Filing I 175.00 5550 • Insurance-Liability & E80 3,100.00 5620 • Exec Director-Expenses 500.00 5630 • Marketing 8~ Program Info. -1,000.00 5,000.00 5635 • Printing Expenses -1,500.00 3,500.00 5710 • Professional Development 1,500.00 5715 • Strategic Planning 550.00 5780 • Taxes 8 Fees 458.00 5810 • Misc Expenses 1,000.00 6560 • Payroll Expenses 6560-01 • Exec. Director Payroll Expenses 5,500.00 27,000.00 6560-02 • Admin. Srvcs. Payroll Expenses 15,200.00 6560-03 • Worker Comp Insurance 1,100.00 6560-04 • Staff Incentive Package -3,000.00 2,000.00 6560-05 • Paychex Services 400.00 1,400.00 6560-06 • Payroll Taxes 5,500.00 6560-07 • Program Manager 9,300.00 6560-08 • Event Manager 3,000.00 14,800.00 Total 6560 • Payroll Expenses 3,400.00 ~ 2,500.00 ~ 76,300.00 Total Expense -4,900.00 -500.00 150,158.00 Net Income -3,100.00 500.00 -308.00 Page 6 of 6 ~ TAX RETURN FILING INSTRUCTIONS CALIFORNIA FORM RRF-1 FOR THE YEAR ENDING June 30, 2008 ..... .................. ........... Preparedfor Dublin Partnerships In Education P. O. Box 2307 Dublin, CA 94568 Prepared by Timpson Garcia, LLP 70 Washington Street, Suite 300 Oakland, CA 94607-3705 Mail tax return to Registry of Charitable Trusts P.O. Box 903447 Sacramento, CA 94203-4470 Return must be May 15 , 2 0 0 9 mailed on or before Special The return should be signed and dated by an authorized Instructions individual. Enclose a check for $50 made payable to Attorney General's Registry of Charitable Trusts. Include "Form RRF-1," the report year and the organization's state charity registration number and/or organization number on the remittance. 700082 04-27-07 MAI!• T0: Regi~try of CharitabVe Trusts P.O. Box 903447 Sacramento, CA 94203-4470 Telephone:(916)445-2021 WEB SITE ADDRESS: http://ag.ca.gov/charities/ ANNUAL REGISTRATION RENEWAL FEE REPORT TO ATTORNEY GENERAL OF CALIFORNIA Sections 12586 and 12587, California 6overnment Code 11 Cal. Code Regs. sections 301-307, 311 and 312 Failure to submit this report annually no later than four months and fifteen days after the end of the organization's accounting period may result in the loss of tax exemption and the assessment of a minimum tax of $800, plus interest, and/or fines or filing penalties as defined in Government Code section 12586.1. IRS extensions will be honored. State Charity Registration Number: CT 9 3 7 4 3 Check if: 0 Change of address DUBLIN PARTNERSHIPS IN EDUCATION ~ Amended report Name of Organization P. 0. BOX 2 3 0 7 Corporate or Organization No. 18 8 5 4 6 2 Address ( umber and Street) DUBLIN, CA 94568 FederalEmployerl.D.No. 94-3207780 City or Town, State and ZIP Code ANNUAL REGISTRATION RENEWAL FEE SCHEDULE (11 Cal. Code Regs. sections 301-307, 311 and 312) Make Check Payable to Attorney General's Registry of Charitable Trusis Gross Annual Revenue Fee Gross Annual Revenue Fee Gross Annual Revenue Fee Less than $25,000 0 Between $100,001 and $250,000 $50 Between $1,000,001 and $10 million $150 Between $25,000 and $100,000 $25 Between $250,001 and $1 million $75 Between $10,000,001 and $50 million $225 Greater than $50 million $300 PART A - ACTIVITIES For your most recent fu!{ accounting period (beginning 0 7/ 01 / 2 0 0 7 ending 0 6/ 3 0/ 2 0 0 8 ) list: Gross annual revenue $ 131 , 3 6 0. Total assets $ 6 4, 8 4 7. PART B- STATEMENTS REGARDING ORGANIZATION DURING THE PERIOD OF THIS REPORT Note: If you answer "yes" to any of the questions below, you must attach a separate sheet providing an explanation and details for each "yes" response. Please review RRF-1 instructions for information required. loans, leases or other financial transactions between the organization were there any contracts During this reporting period 1 Yes No , , . and any officer, director or trustee thereof either directly or with an entity in which any such officer, director or trustee had any financial interest? X 2. During this reporting period, was there any theft, embeulement, diversion or misuse of the organization's charitable property orfunds? X 3. During this reporting period, did non-program expenditures exceed 50% of gross revenues? X 4. During this reporting period, were any organization funds used to pay any penalty, fine or judgment? If you filed a Form 4720 with the Intemal Revenue Service, attach a copy. X 5. During this reporting period, were the services of a commercial fundraiser or fundraising counsel for charitable purposes used? If "yes," provide an attachment listing the name, address, and telephone number of the service provider. X 6. During this reporting period, did the organization receive any governmental funding? If so, provide an attachment listing the name of the agency, mailing address, contact person, and telephone number. X 7. During this reporting period, did the organization hold a raffle for charitable purposes? If "yes," provide an attachment indicating the number of raffles and the date(s) they occurred. X 8. Does the organization conduct a vehicle donation program? If "yes," provide an attachment indicating whether the program is operated by the charity or whether the organization contracts with a commercial fundraiser for charitable purposes. X 9. Did your organization have prepared an audited financial statement in accordance with generally accepted accounting principles for this reporting period? X Organization's area code and telephone number ( 9 2 5) 8 2 8- 2 5 51 Organization's e-mail address I declare under penaHy of perjury that I have examined this report, including accompanying doeuments, and to the best of my knowledge and belief, it is true, correct and complete. ignature o au orized o icer Printed ame Title Date ~zazai 04-27-07 , Form, 990 Department of the Treasury Internal Revenue Service Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) af the Internal Revenue Code (except black lung benefit trust or private foundation) - The organization may have to use a copy of this return to satisfy state reporting requirements. A For the 2007 calendar year, or tax year beginning ~TUL B Check if please C Name of organization applicable: ,__ and ending Address label or ~change printor UBLIN PARTNERSHIPS IN EDUCATION D~n ~9a ~see Number and street (or P.O. box if mail is not delivered to street address) ~;et`~a~ SPe~~r~~ p. 0. BOX 2 3 0 7 Termin- ~nstruc- ~ation t~o~s. Ciry or town, state or country, and ZIP + 4 ~euended UgLIN, CA 94568 ~Application • Section 501(c)(3) organizations and 4947(a)(1) nonexempt charitable trusts pending must attach a completed Schedule A(Form 990 or 990-EZ). G Website:-N/A J Organization type (cneckonryone)~ ~ 501(c) ( 3 )~ (insertno.) ~J 4947(2)(1) 0~ U K Check here - if ihe organization is not a 509(a)(3) supporting organization and its gross receipts are normally not more than $25,000. A return is not required, but if the organization chooses to file a return, be sure to file a complete return. L Gross receipts: Add lines 6b, 8b, 9b, and 10b to line 12 - 191, 014 D~.+ 1 Rpvani~p FYnPncPC_ anrl Chanaes in Net Assets or Fund B OMB No. 1545-0047 2~07 D Employer identification number 94-3207780 Room/suite E Telephone number (925)828-2551 F Accounting method: LX ~ Cash LJ Accrual s eci ~ ~Pe~~'l~ H and I are not applicable to section 527 organizations. H(a) Is this a group return for affiliates? 0 Yes ~ No H(b) If "Yes;' enter number of affiliates- N/A 527 H(c) Are all affiliates included? N/A Yes No (If "No;' attach a list.) H(d) Is this a separate return filed by an or- ganization covered by a group ruling? 0 Yes ~ No I Group Exemption Number- N/A M Check - if the organization is not required to attach Sch. B(Form 990, 990-EZ, or 990-PF). 1 Contributions, gifts, grants, and similar amounts received: -`;;~ a Contributions to donor advised funds ..... .............. ...... ... ............ ....... 1a ' Y~ b Direct public support (not included on line 1a) ...., ..... ......... 1b 17 , 6 0 6. '` c Indirect public support (not included on line 1a) .. .....,.. ...... .......... 1c 13 , 8 ~ 6. ~~ d Government contributions (grants) (not includetl on line 1a) ........................... 1d . '4 ':"~' ~ ~ e Total (add lines 1a through 1d) (cash $ 31, 412 . noncash $ )... ie 31, 412 . 2 Program service revenue including government fees and contracts (from Part VII, line 93) ............ ........................ 2 3 Membership dues and assessments ............................................................... ..................... ........................ 3 4 Interest on savings and temporary cash investments ....................................... ..................... ........................ 4 9 47 . 5 Dividends and interest from securities ............................................................ ..................... ........................ 5 6 a Gross rents ...................................................................................... 6a ~` " ~w.. b Less: rental expenses .............. ............. . .. .... . ..... .. .. .. ........ ..... .. sb ~.+ `a.~ ~, c Net rental income or (loss). Subtract line 6b from line 6a .................................... ..................... ........................ 6c e' 7 Other investment income (describe - 7 d 8 a Gross amount from sales of assets other A Securities B) Other ~ °C than inventory .., ....................... ............ . 8a ~, ~ ~ " b Less: cost or other basis and sales expenses ......... 8b .,, ,: „,,' c Gain or (loss) (attach schedule) ........................... 8c '~` d Net gain or (loss). Combine line 8c, columns (A) and (B) .................................... ..................... ........................ 8d 9 Special events and activities (attach schedule). If any amount is from gaming, check here ~ ~ `"_ 8 Gross revenue (not inc~utling $ ~• of contributions repoRetl an line 1b) ... 98 1~J 8, 6 5 5. ~ b Less:directexensesotherthanfundraismgexenses.,.._..,...._..__.._....._..,.... P P 9b 59,654. :,,=.,~~ ~ 4 c Net income or (loss) from special events. Subtract line 9b from line 9a ............ ..S EE STATEMENT. .1. . 9c 9 9, 0 01 . 10 a Gross sales of inventory, less returns and allowances ............... ...... ......... 10a ~F~ b Less: cost of goods sold ........................................................................... 106 ~ c Gross profit or (loss) from sales of inventory (attach schedule). Subtract line 10b fro m line 10a ...... ........................ 10c 11 Other revenue (from Part VII, line 103) ............................................................ ..................... ........................ 11 12 Total revenue. Add lines 1e, 2, 3, 4, 5, 6c, 7, 8d, 9c, 10c, and 11 ........................ ..................... ........................ 12 131 , 3 6 0. 13 Program services (from line 44, column (B)) ................................................... ..................... ........................ 13 116 , 4 3 0. N y 14 Management and general (from line 44, column (C)) ...................................... ..................... ........................ 14 2 4, 5 6 7. a 15 Fundraising (from line 44, column (D)) . . .. .... .. .... ... ........ .... .. .. ..... ...... .. . . 15 12 , 8 5 3. W 16 Payments to affiliates (attach schetlule) ...................................... ..................... ........................ 16 17 Total expenses. Add lines 16 and 44, column (A ............................. ............... 17 15 3 8 5 0. , 18 Excess or (deficit) for the year. Subtract line 17 from line 12 .............................. .......... i8 <2 2, 4 9 0. N ~ y 19 Net assets or fund balances at beginning of year (from line 73, column (A)) 1g 7 9, 9 4 9. ZQ 20 Other changes in net assets or fund balances (attach explanation) ... ................ .... .... .... .... . . 20 ~. 21 Netassets orfund balances at end ofyear. Combine lines 18, 19, and 20 ............... ..................... ........................ 21 57 , 459 . > iz=zi-o~ LHA For Privacy Act and Paperwark Reduction Act Notice, see the separate instructions. Form 990 (2007) 1 16260512 748525 19412 2007.07050 DUBLIN PARTNERSHIPS IN EDUC 19412_1 ~ Forrr1990 (2007) DUBL IN PARTNERSH I PS IN EDUCAT I ON 9 4- 3 2 0 7 7 8 0 Page 2 PaYt II'~", SteterTlellt Of All organizations must complete column (A). Columns (B), (C), and (D) are required for section 501(c)(3) Functional Expenses and (4) organizations and section 4947(a)(1) nonexempt charitable trusts but optional for others. Do not include amounts reported on line (p) Total (B) Program (C) Management (D) Fundraising 6b, 8b, 9b, lOb, or 16 of Part l. services and general 22a Grants paid from donor advised funds ~~'N~'~ ~*~~~~ ~° ~ K ~ ~ ~r ~ t + ~ '~" ` ~ ~ `'~ (attach schedule) ........................... ........... ~ ~ ~M1 t 4g i ~A'4.~~,M1h'~ , ~F ," " + '~' '" -0 (cash $ ~ . noncash $ ~ • 3 ~ P ~ '. ~'~M F ~"C. m P~ a , ' ~ A 4 ^. ; 4 ' J If this amount includes foreign gr8nts, check here ~ 222 aV m~ ~:;'~f ~~~+ '~ ~ ,~ ~i , a~ + ~:~ . ~ ~ 22b Other grants and allocations (attach schedule STATEMEN,T 3 a r " ~ '~_ ~ ~: ~ „ ~. a c~a5h s 5 4,161 0. • f10fIC85I1.~ d ¢ nk ~~~ ~"~~` T ~ y~ #~`',`f3=%k fl ~ ^; .. t~ Yi . „$ If this amount includes foreign grants, check here ~ 22b 5 4 , 161 . A 5'3 ,161 . ~ ~ ~ ,_~ ~ '~' ' ~' ~ ` . ' '~ ~~ ~~' ~ i L~, , , ~, 23 Specific assistance to individuals (attach .~r ~~ ,? ~;~~ .nq a ~ , ~ ~'~ schedule) ................. .... ....... 23 sr ,~ ~~~ R~~4 n, ~ ~'~ ,` ar v idl~ 24 Benefits paid to or for members (attach ~~. ~ r ~ ~ r v ~ '~` `~ ~ a " ~ ~ schedule) ................................................. 24 ~~.~U.. ~. , ~< ~~~ , ~.., ~~ ~ ~ 25a Compensation of current officers, directors, key employees, etc. listetl in Part V-A ..................... 25a 9, 9 2 3. 5, 9 5 4. 2, 9 7 7. 9 9 2. b Compensation of former officers, directors, key emp~oyees, etc. listed in Part V-B . . 25b 8, 3 4 6. 5, 0 0 8. 2, 5 0 4. 8 3 4. c Compensation and other distributions, not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(~)(3)(B) .................................... 25c 26 Salaries and wages of employees not included on lines 25a, b, and c .................. 26 3 5, 0 5 4. 21, 6 0 4. 4, 815 . 8, 6 3 5. 27 Pension plan contributions not included on lines 25a, b, and c .................................... 27 28 Employee benefits not included on lines " 25a-27 .................................................. 28 2s Payrolltaxes ............................................. 29 6,000. 3,664. 1,159. 1,177. 30 Professional fundraising fees ..................... 30 31 Accounting fees ....................................... 31 1, ~ ~ ~. 1, ~ 0 ~. 32 Legal fees ................................................ 32 33 Supplies ................................................... 33 1, 0 6 2. 1, ~ 6 2. 34 Telephone ................................................ 34 35 Postageandshipping ................................. 35 594. 594. 36 OccupancY ................................................ 36 37 Equipment rental and maintenance ......,.__., 37 38 Printing and publications ........................... 38 39 Travel ...................................................... 39 40 Conferences, conventions, and meetings .,. 40 41 Interest ...................................................... 41 42 Depreciation, depletion, etc. (attach schedule) 42 43 Other expenses not covered above (itemize): a 43a b 43b c 43c d 43d e 43e f 43f g SEE STATEMENT 2 43g 37,710. 26,039. 11,518. 153. 44 Total functional expenses. Add lines 22a through 43g. (Organizations completing columns (B)-(D), carrythesetotalstolinesl3-15) ..................... 44 153,850. 116,430. 24,567. 12,853. Joint Costs. Check ~ Q if you are following SOP 98-2. Are any joint costs from a combined educational campaign and fundraising solicitation reportetl in (B) Program services? ..................... - 0 Yes ~ No If "Yes;' enter (i) the aggregate amount of these joint costs $ N/A ;(ii) the amount allocated to Program services $ N/A - ~iii) the amount allocated to Management and general $ N/A ; and (iv) the amount allocated to Fundraising $ N/A 12_27_0~ Farm 990 (2007) 2 16260512 748525 19412 2007.07050 DUBLIN PARTNERSHIPS IN EDUC 19412 1 , Forrri 990 (2007) DUBL IN PARTNERSH I P S IN EDUCAT I ON 9 4- 3 2 0 7 7 8 0 Page 3 ~ Part~'lll: Statement of Program Service Accomplishments (see tne rnstructions.) Form 990 is available for public inspection and, for some people, serves as the primary or sole source of information about a particular organization. How the public perceives an organization in such cases may be determined by the information presented on its return. Therefore, please make sure the return is complete and accurate and fully describes, in Part III, the organization's programs and accomplishments. What is the organization's primary exempt purpose? - SEE STATEMENT All organizations must describe their exempt purpose achievements in a clear and concise manner. State the number of clients served, publications issued, etc. Discuss achievements that are not measurable. (Section 501(c)(3) and (4) organizations and 4947(a)(1) nonexempt charitable trusts must also enter the amount of grants and allocations to others.) a TEACHER GR.ANTS - TO PROVIDE ADDITIONAL FUNDING TO ENHANCE PROGRAMS THAT ARE OUTSIDE OF THE PURVIEW OF THE NORMAL SITE BUDGET. (Grants and allocations $ 5 4, 161 .) If this amount includes foreign grants, check here - lJ b STUDENT ACTIVITIES AND SCHOOL PROGR.AMS - TO PROVIDE FUNDS FOR VARIOUS ACTIVITIES INCLUDING INTERVENTION, SCIENCE FAIRES, MUSIC AND PERFORMING ARTS PROGR.AMS. (Grants and allocations $ ) If this amount includes foreign grants, check here - c SUPPORT OF PROGRAMS, ACTIVITIES, AND OTHER NONPROFIT ORGANIZATIONS. (Grants and allocations $ ) If this amount includes foreign grants, check here ~- d Program Service Expenses (Required for 501(c)(3) and (4) orgs., and 4947(a)(1) trusts; but optional for others.) 54,161. 25.390. 36,879. (Grants and allocations $ ) If this amount includes foreign grants, check here ~ 0 @ Other program services (attach schedule) (Grants and allocations $ ) If this amount includes foreign grants, check here - 0 f Total of Program Service Expenses (should equal line 44, column (B), Program services) ....................................... ~ 116 , 4 3 0. Form 990 (2007) 723021 12-27-07 3 16260512 748525 19412 2007.07050 DUBLIN PARTNERSHIPS IN EDUC 19412_1 Form 990 (2007) DUBL IN PARTNERSH I P S IN EDUCAT I ON 9 4- 3 2 0 7 7 8 0 Page 4 P~rt .iV~; BalanCe SheetS (See the instructions.) Note: Where required, attached schedules and amounts within the description column (A) (B) should be for end-of-year amounts only. Beginning of year End of year 45 Cash-non-interest-bearing ........................................................................... 92 , 529. 45 61, 520. 46 Savings and temporary cash investments ...................................................... 46 ~s . ~ ~~ n~. o. 47 a Accounts receivable 47a ...................... ............. ~}~_ b Less: allowance for doubtful accounts 47b 47c ~ _ ...~.L+ ~ ^ : y~~ )4 U ...,a...~.._cu~.lxr.~.,~ t ",'~ R.~t~. "" . ' 48 a Pledges receivable ............................... 48a .. .i~ ~:~.~- b Less: allowance for doubtful accounts ......... 48b 48c 49 Grants receivable .......................................................................................... 49 50 a Receivables from current and former officers, directors, trustees, and key employees ............................................................................................. 50a b Receivables from other disqualified persons (as defined under section y 4958(~(1)) and persons described in section 4958(c)(3)(B) .............................. 50b y 51 a Other notes and loans receivable .................. 51a ,~~ a b Less: allowance for doubtf~l accounts ................. 51b 51c 52 Inventories for sale or use .............................................................................. 52 53 Prepaid expenses and deferred charges ...................................................... 465 . 53 465 . 54 a Investments - publicly-traded securities ........ ......... - ~ Cost ~ FMV 54a b Investments • other securities - ~ Cost ~ FMV ................................ 54b 55 a Investments • land, buildings, and !,~ ~ s,~a; equipment: basis 55a .................................... .. .. ~ „~;; rn6^n h i • . I~ A ~ ,d~~i M b Less: accumulated depreciation .................. 55b 55c 56 Investments - other ....................................................................................... 56 57 a Land, buildings, and equipment: basis .... _ 57a 2 8 6 2. ~ ~'' ° _._:~ic b Less: accumulated depreciation ................ 57b 2, 862 . 57c 2, 862 . 58 Other assets, including program-related investments (describe - ) 58 59 Total assets (must equal {ine 74). Add lines 45 throu n 5s ........................... 9 5, 8 5 6. 59 6 4, 8 4 ~. 60 Accounts payable and accrued expenses ...................................................... 60 61 Grants payable ............................................................................................. 61 62 Deferred revenue ......................................................................................... 62 N r; 63 Loans from officers, directors, trustees, and key employees ........................... 63 ;n 64 a Tax•exempt bond liabilities ........................................................................... 64a ~ b Mortgages and other notes payable . . ..,, .. ........ ........ .. . .. .... 64b 65 Other liabilities (describe - SEE STATEMENT 5 ) 15 , 9 0 7. 65 7, 3 8 8. 66 Total liabilities. Add lines 60 throu n s5 ...................................................... 15 , 9 ~ 7. 66 7, 3 8 8. Organizations that follow SFAS 117, check here ~ and complete lines ~• ~' 67 through 69 and lines 73 and 74. ~r ~m ~ 67 unrestricted ................................................................................................ 7 9, 9 4 9. s7 51, 5 8 5. ~ m . 68 Temporarily restricted .................................................................................... ~. 68 5, 8 7 . m 69 Permanently restricted ................................................................................. 69 u Organizations that do not follow SFAS 117, check here ~ 0 and ~~ ~ ~ complete lines 70 through 74. ~ ~~; ,°~ 70 Capital stock, trust principal, or current funds ................................................ 70 .. y 71 Paid-in or capital surplus, or land, building, and equipment fund ..................... 71 N a 72 Retained earnings, endowment, accumulated income, or other funds .........,.. 72 Z 73 Total net assets or fund balances. Add lines 67 through 69 or lines 70 through 72. ~~: ~ (Column (A) mustequal line 19 and column (B) mustequal line 21) ........................... ~ 9, 9 4 9. ~3 5 7, 4 5 9. 74 Total liabilities and net assets/fund balances. Add lines 66 and 73 9 5, 8 5 6. 74 6 4, 8 4 ~. Form 990 (2007) 723031 12-27-07 16260512 748525 19412 2007.07050 DUBLIN PARTNERSHIPS IN EDUC 19412_1 ~ Form 990 (2007) DUBL IN PARTNERSHI PS IN EDUCAT I ON 9 4- 3 2 0 7 7 8 0 Page 5 '' art - econci iation o evenue per u ite mancia tatements it evenue per etui'll (See the instructions.) a Total revenue, gains, and other support per audited financial statements .................................................................. b Amounts included on line a but not on Part I, line 12: 1 Net unrealized gains on investments ................................................................................. b1 2 Donated services and use of facilities .............................................................................. b2 3 Recoveries of prior year grants .......................................................................................... b3 4 Other (specify): b4 Add lines bi through b4 .,._..., ........... ... ...... ............ ............... ......... ............ ............ ......... ... ... ......... ......... ......... ... c Subtract line b from line a .... ...... ......... ... ......... ......... ... ... ...... ............ ............ ............ ... ...... ... ......... ......... ... ...... d Amounts included on Part I, line 12, but not on line a: 1 Investment expenses not included on Part I, line 6b ................ ......................................... d1 ~; 2 Other (specify): d2 ,~'",`' Add lines di and d2 ........... ............... ...... ...... ...... ....... ........ ...... ...... ...... ............ ...... ......... ...... ...... ......... ...... d e Total revenue (Part I, line 12). Add lines c and d ...................... .......................................................................... ~ e art - econci iatwn o xpenses per u ite inanaa tatements it xpenses per eturn a Total expenses and losses per audited financial statements .... ................................................................................ a ~ N~A b Amounts included on line a but not on Part I, line i T. ``"" ~ 1 Donated services and use of facilities ....................... . ... ,,, . . . .. . ........ .. ....... bi '~ ~4:; 2 Prior year adjustments reported on Part I, line 20 .... ..... ......... ................ ... . b2 ~"~~ ~,r~, ti l~ 3 Losses re orted on Part I, line 20 P ................ ......................................... b3 , u ~ :w. ,~, ~; 4 Other (specify): b4 Add lines bi through b4 ....................................................... ............................................................................. b c Subtract line b from line a .... ...... ...... ... ............ ............ ....... .............. ... ............ ......... ............ ... ............... ... ......... d Amounts included on Part I, line 17, but not on line a: "'`~ 1 Investment expenses not included on Part I, line 6b .. ....... ............................ d1 ~~> 2 Other (specify): d2 ~,. ~ Add lines d1 and d2 ............ ............ ... .................. ...... ...... ...... ......... ............ ... ... ............ ... ............ ......... ......... ...... ... e Total expenses Part I, line 17 . Add lines c and d ................... .......................................................................... ~. e Part~:Y-A Current Officers, Directors, Trustees, 8nd K@y EmplOyeeS (List each person who was an o fficer, director, trustee, or kev emolovee at anv time durina the vear even if thev were not compensated.) (See the instructions.) A Name and address ( ~ (B) Title and average hours er week devoted to p position (C) Compensation If not aid, enter ( p -0-.) D)Contributions to employee benefit plans & deferred compensation plans (E) Expense account antl other allowances --------------------------------- --------------------------------- SEE STATEMENT 6 9,923. 0. 0. ------------------=-------------- --------------------------------- --------------------------------- --------------------------------- --------------------------------- --------------------------------- --------------------------------- --------------------------------- --------------------------------- --------------------------------- --------------------------------- Form 990 (2007) 7230A1 12-27-07 5 16260512 748525 19412 2007.07050 DUBLIN PARTNERSHIPS IN EDUC 19412_1 Forrr199o (2007) DUBLIN PARTNERSHIPS IN EDUCATION 94-3207780 Pa9e6 Part V-A Current Officers, Directors, Trustees, and Key Employees ~contrnued) Yes No 75 a Enter the total number of officers, directors, and trustees permitted to vote on organization business at board ~,G . „ meetings .................................................................................................................................... - 15 b. Are any officers, directors, trustees, or key employees listed in Form 990, Part V•A, or highest compensated employees listed in Schedule A, Part I, or highest compensated professional and other independent contractors listed in Schedule A, Part II-A or II-B, related to each other through family or business relationships? If "Yes," attach a statement that identifies the individuals and explains the relationship(s) ... ..... ........................ 75b X c Do any officers, directors, trustees, or key employees listed in Form 990, Part V-A, or highest compensated employees listed in Schedule A, Part I, or highest compensated professional and other independent contractors listed in Schedule A, " Part II•A or II-B, receive compensation from any other organizations, whether tax exempt or taxable, that are related to the organization? See the instructions for the definition of "related organization." 75c X If "Yes," attach a statement that includes the information described in the instructions. d Does the or anization have a written conflict of interest olic ? .......................................................................................... 75d X Part V-B Former Officers, Directors, Trustees, and Key Employees That Received Compensation or Other B@~@fltS (If any former officer, director, trustee, or key employee received compensation or other benefits (described below) during the year, list that person below and enter the amount of compensation or other benefits in the appropriate column. See the instructions.) (A) Name and address (B) Loans and Advances (C) Compensation (if not paid, e~tef -~- ~ Contributions to employee benefit Plans & deferred compensation plans (E) Expense account and other allowances DONNA MCMILLION --------------------------------- 6800 PENN DRIVE --------------------------------- DUBLIN, CA 94568 . ,346. . . --------------------------------- --------------------------------- --------------------------------- --------------------------------- --------------------------------- --------------------------------- --------------------------------- --------------------------------- --------------------------------- --------------------------------- --------------------------------- --------------------------------- --------------------------------- --------------------------------- Part VI Other Information (see rne ~r,stn,ct~ons.) Yes No 76 Did the organization make a change in its activities or methods of conducting activities? If "Yes," attach a detailed ~ ~'~~ statement of each chan9e ................................................................................................................................................ 76 X 77 Were any changes made in the organizing or governing documents but not reported to the IRS? .......................................... 77 X If "Yes," attach a conformed copy of the changes. ~ ~ 78 a Did the organization have unrelated business gross income of $1,000 or more during the year covered by this return? ,,.,..,.. 78a X b If "Yes," has it filed a tax return on Form 990-T for this year? ........................................................................ N~A 78b 79 Was there a liquidation, dissolution, termination, or substantial contraction during the year? If "Yes," attach a statement ...... 79 X 80 a Is the organization related (other than by association with a statewide or nationwide organization) through common ~ ~ membership, goveming bodies, trustees, officers, etc., to any other exempt or nonexempt organization? . ... .................. BOa X b If "Yes," enter the name of the organization~ N~A and check whether it is exempt or nonexempt 81 a Enter direct and indirect political expenditures. (See line 81 instructions.) ........................... 81a ~• . , ~ :,' _~ ;;I ~ b Did the organization file Form 1120-POL for this year? ...................................................................................................... 81b X Form 9 0 (200~) 723161/12-27-07 6 16260512 748525 19412 2007.07050 DUBLIN PARTNERSHIPS IN EDUC 19412_1 Form sso (2007) DUBL IN PARTNERSH I P S IN EDUCAT I ON 9 4- 3 2 0 7 7 8 0 Page 7 PartwVl Other Information (continued) Yes No 82 a Did the organization receive donated services or the use of materials, equipment,. or facilities at no charge or at substantially less than fair rental value? ................................................................................................................................................ 82a X b If "Yes," you may indicate the value of these items here. Do not include this ' " amount as revenue in Part I or as an expense in Part II. (See instructions in Part III.) ................................................................................................ 82b N/A ~~. .,' _.~ ~,, ~ . _:~._ 83 a Did the organization comply with the public inspection requirements for returns and exemption applications? ........................ 83a X b Did the organization comply with the disclosure requirements relating to quid pro quo contributions? .................................... 83b X 84 a Did the organization solicit any contributions or gifts that were not tax deductiblel ............................................ N~A . 84a b If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not ~~ ~ ^ tax deductible? .......................................................................................................................................... N/A......... 84b 85 a 501(c)(4), (5), or(6). Were substantially all dues nondeductible by members? ..................................................... N~A._. _. 85a b Did the organization make only in-house lobbying expenditures of $2,000 or less? ...... .... ..... _,.,, N~A. . 85b If "Yes" was answered to either 85a or 85b, do not complete 85c through 85h below unless the organization received a "` waiver for proxy tax owed for the prior year. c Dues, assessments, and similar amounts from members ...................................................... 85c N/A ; d Section 162(e) lobbying and political expenditures .. _... ....... ......... ................ 85d N/A ~ ~ e Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices . ._., 85e N/A I f Taxable amount of lobbying and political expenditures (line 85d less 85e) ..,.. .... 85f N/A ~1 ~',_i___., ~- -JUL,J g Does the organization elect to pay the section 6033(e) tax on the amount on line 85f? ...................................... N/A_ _._... 85g h If section 6033(e)(1)(A) dues notices were sent, does the organization agree to add the amount on line 85f to its reasonable estimate of dues allocable to nondeductible Iobbying and political expenditures for the following tax year? ......................................................................................................................................... N~A 85h 86 501(c)(7) organizations. Enter: a Initiation fees and capital contributions included on ~ . " line 12 86a N~A ..................... ...... ......... ............... ...... ................................................ ............ ......... '~ ` b Gross receipts, included on line 12, for public use of club facilities ....................................... 86b N/A 87 501(c)(12) organizations. Enter: a Gross income from members or shareholders .................. 87a N/A b Gross income from other sources. (Do not net amounts due or paid to other sources I against amounts due or received from them.) 87b N~A .................................................................... , , , 88 a At any time during the year, did the organization own a 50% or greater interest in a taxable corporation or partnership, or an entity disregarded as separate from the organization under Regulations sections 301.7701•2 and 301.7701-3? ~ ~.- ._-- If "Yes," complete Part IX ................................................................................................................................................... 88a b At any time during the year, did the organization, directly or indirectly, own a controlled entity within the meaning of section 512(b)(13)? If "Yes,,, complete Part XI .................................................................................................................. ~ 88b X 89 a 501(c)(3) organizations. Enter: Amount of tax imposed on the organization during the year under: ~ I section 4911- 0.; section 4912 ~ ~•; section 4955 ~ ~• I b 501(c)(3) and 501(c)(4) organizations. Did the organization engage in any section 4958 excess benefit " i transaction during the year or did it become aware of an excess benefit transaction from a prior year7 __~ T If "Yes," attach a statement explaining each transaction ...................................................................................................... X 89b , c Enter: Amount of tax imposed on the organization managers or disqualified persons during the year under .., , I sections 4912, 4955, and 4958 ............................................................................................. ~ ~. d Enter: Amount of tax on line 89c, above, reimbursed by the organization ................................. ~ ~• ~_~ ~,~,~,,I e All organizations. At any time during the tax year, was the organization a party to a prohibited tax shelter transaction? ......... 89e X f All organizations. Did the organization acquire a direct or indirect interest in any applicable insurance contract? ..................... 89f X g For supporting organizations and sponsoring organizations maintaining donor advised funds. Did the supporting organization, or a fund maintained by a sponsoring organization, have excess business holdings at any time during the year? .................. 89g X 90 a List the states with which a copy of this return is filed ~CA b Number of employees employed in the pay period that includes March 12, 2007 ....................................... 90b 3 91a Thebooksareincareof- WILLIAM E. MOY Telephoneno.- (925)8 29-1928 ~ocatedat- 6800 PENN DRIVE, DUBLIN, CA ZIP+4-94568 b At any time during the calendar year, did the organization have an interest in or a signature or other authority over Y@S NO a financial account in a foreign country (such as a bank account, securities account, or other financial account)? .................. 91b X If "Yes," enter the name of the foreign country ~ N~A See the instructions for exceptions and filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts. Form 990 (2007) 723162/12-27-07 7 16260512 748525 19412 2007.07050 DUBLIN PARTNERSHIPS IN EDUC 19412_1 Forrrr990(2007) DUBLIN PARTNERSHIPS IN EDUCATION 94-3207780 Page8 Part Vl t er n ormation ~contr~ued~ Yes No c At any time during the calendar year, did the organization maintain an office outside of the United States? 91c X If "Yes," enter the name of the foreign country - N/A 92 Seciion 4947(a)(1) nonexempt charitable trusts filing Form 990 in lieu of Form 1041- Check here ...................................................... - ~ and enter the amount of tax-exempt interest received or accrued during the tax year ........................... - 92 N/A Part VII Ana ysis of ncome- ro uClltg ACtlVltles (See the instructions.) ross amounts unless otherwise r N t : E t nre a e usiness income Exclud ed by section 512, 573, or 514 (E~ g o e n e indicated. 93 Program service revenue: (A~ B codess (B) Amount E~~~_ c tle ~~) Amount Related or exempt function income a b c d e f Medicare/Medicaid payments ........................... g Fees and contracts from government agencies .,. 94 Membership dues and assessments .................. 95 Interest on savings and temporary cash investments ... 14 9 4 7. 96 Dividends and interest from securities ............... 97 Net rental income or (loss) from real estate: ~ a debt-financed property ....................................... b not debt-financed property ................................. 98 Net rental income or (loss) from personal property 99 Other investment income . ...... ............ .............. 100 Gain or (loss) from sales of assets ........................ otherthaninventory .................. 101 Net income or (loss) from special events ,..... _..... 9 9, ~ ~ 1. 102 Gross profit or (loss) from sales of inventory ,..,._ 103 Otherrevenue: a b c d e 104 Subtotal (add columns (B), (D), and (E)) ............... ~,•:~ ~. :,. 9 4 ~. 9 9, ~ ~ 1. 105 Total (add line 104, columns (B), ~~), and ~E)) . ....... .................. ................................... ......... .................................. ~ 9 9, 9 4 8. . Note: Line 105 plus line 1 e, Part l, should equal the amo unt on line 1 2, Part l. Part VI11 Relationship of Activities to the Accomplishment of Exempt Purposes (see tne ~nstrucuo~s.) Line No. Explain how each activity for which income is reported in column (E) of Part VII contributed importantly to the accomplishment of the organization's ~ exempt purposes (other than by provitling funds for such purposes). 101 HESE ACTIVITIES ONLY INCIDENTALLY ACCOMPLISH AN EXEMPT FUNCTION. THE PRIMARY PURPOSE IS TO R.AISE FUNDS THAT ARE OTHER THAN CONTRIBUTIONS TO INANCE THE ORGANIZATION'S EXEMPT ACTIVITIES. Part IX Information Regard ing Taxable Subsidiaries and Disregarded Entities (see rne instructions.) Name, address, and EIN of corporation, partnership,or disregarded entity Percentage of ownership interest Nature of activities Total income End-of-year assets % N/A % % % Part x.. InTOrmat~on Hegaramg ~ ransrers ~-ssociaiea wizn rersonai aenerii ~.ontracts ~~ee rne ~nsrrucr~ons.~ (a) Did the organization, during the year, receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? _........... Yes No (b) Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract7 ....................................... 0 Yes 0 No Note: lf "Yes° to (b), fife Form 8870 and Form 4720 (see instructions). Farm 990 (2007) 723163 12-27-07 8 16260512 748525 19412 2007.07050 DUBLIN PARTNERSHIPS IN EDUC 19412_1 Form99o(2007) DUBLIN PAR.TNERSHIPS IN EDUCATION 94-3207780 Page9 Part Xl `~;~ Information Regarding Transfers To and From Controlled Entities. Complete only if the organization is a cnntrollino oroanization as defined in section 512(bl(13). N/ A Yes No 106 Did the reporting organization make any transfers to a controlled entity as defined in section 512(b)(13) of the Code? If "Yes," complete the schedule below for each controlled entity. (A) Name, address, of each controlled entity (B) Employer Identification Number (C) Description of transfer (D) Amount of transfer a --------------------------------- --------------------------------- b --------------------------------- --------------------------------- c --------------------------------- --------------------------------- Totals ~ ., - Yes No 107 Did the reporting organization receive any transfers from a controlled entity as defined in section 512(b)(13) of the Code? If "Yes," complete the schedule below for each controlled entity. (A) Name, address, of each controlled entity (B) Employer Identification Number (~J Description of transfer I~1 Amount of transfer a --------------------------------- --------------------------------- b --------------------------------- --------------------------------- c --------------------------------- --------------------------------- Totals '°'h Yes No 108 Did the organization have a binding written contract in effect on August 17, 2006, covering the interest, rents, royalties, and annuities described in question 107 above7_ Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, antl to the best of my knowleage ana beuet, it is true, correct, and complete. Declaration of preparer (other than offcer) is based on all information of which preparer has any knowledge. Please ' I Sign Signature of officer Date Here ' Type or print name and title Preparer~S UBTE GI78CK IT Preparer's SSN or PI IN (See Gen. Inst. X) Paid self- signature ELAINE LEE KAWASAKI 0 5/ 12 / 0 9 employed - 0 Preparer's Firm'sname(or TIMPSON GARCIA~ LLP EIN - Use Only v~~~s u self-employed), ''7 0 WASHINGTON STREET , SUITE 3 0 0 address,and ziP.4 OAKLAND, CA 94607-3705 Phone no. -( 510 ) 832-2325 Form 990 (2007) 723164/12-27-07 9 16260512 748525 19412 2007.07050 DUBLIN PARTNERSHIPS IN EDUC 19412_1 SCHEDULE A Organization Exempt Under Section 501(c)(3) (Form 990 or 990-EZ) (Except Private Foundation) and Section 501(e), 501(f), 501(k), 501(n), or 4947(a)(1) Nonexempt Charitable Trust DepartmentottheT~easury Supplementary Information-(See separate instructions.) Internal Revenue Service ~ MUST be completed by the above organizations and attached to their Form 990 or 990-EZ OMB No. 1545-0047 2007 Name of the organization Employer itlentification numDer DUBLIN PARTNERSHIPS IN EDUCATION 94:3207780 Part I Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees ISee oaae 1 of the instructions. List each one. If there are none, enter "None:') (a) Name and address of each employee paid more than $50,000 i e an average ours per week devoted to position (c) Compensation employeeUbenari plans & deferred compensation e xpense account and other allowances NONE --------------------------------- --------------------------------- --------------------------------- --------------------------------- --------------------------------- Total number of other employees paid over$50,000 ................................................................................._....- 0 ' y. : ~ `' ~ : Part II-A~ Compensation of the Five Highest Paid Independent Gontractors tor Protessionai 5ervices (See page 2 of the instructions. List each one (whether individuals or firms). If there are none, enter "None:') (a) Name and address of each independent contractor paid more than $50,000 ~ (b) Type of service ~(c) Compensation -------------------------------------------- NONE Total number of others receiving over 4~= ° ~ ' ° ~ ~ o ,M•,. : ~~ , , $50,000 for professional services .,,........_ ................................... '' ° ~ _....- ~ Part II-B Compensation of the Five Highest Paid Independent Contractors for Other Services (List each contractor who pertormed services other than professional services, whether individuals or firmt_ If there are none_ enter "None" See oaae 2 of the instructions.l (a) Name and address of each independent contractor paid more than $50,000 (b) Type of service (c) Compensation -------------------------------------------- NONE -------------------------------------------- -------------------------------------------- -------------------------------------------- -------------------------------------------- Total number of other contractors receiving over $50,000 far other services .................. . ... .. - ~ '~•.` ~ ~~~" ` ~, ' ~. '° ° `' ~ ~zaioviz-z~-o~ LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990 and Form 990-EZ. 10 16260512 748525 19412 2007.07050 DUBLIN PARTNERSHIPS Schedule A(Form 990 or 990-EZ) 2007 IN EDUC 19412_1 ~ Schedule A(Form 990 or 990-EZ) 2007 DUBL IN PARTNERSHI PS IN EDUCATION 9 4- 3 2 0 7 7 8 0 Page 2 Part;' II' Statements About Activities (See page 2 of the instructions.) Yes No 1 During the year, has the organization attempted to influence national, state, or local legislation, including any attempt to influence public opinion on a legislative matter or referendum? If "Yes," enter the total expenses paid or incurred in connection with the lobbying activities -$ $ (Must equal amounts on line 38, Part VI-A, or line i of Part VI-B.) ~ X Organizations that made an election under section 501(h) by filing Form 5768 must complete Part VI-A. Other organizations checking "Yes" must complete Part VI-B AND attach a statement giving a detailed description of the lobbying activities. 2 During the year, has the organization, either directly or indirectly, engaged in any of the following acts with any substantial contributors, trustees, directors, officers, creators, key employees, or members of their families, or with any taxable organization with which any such p ty p p y( y question is "Yes, " erson is affiliated as an officer, director, trustee, majori owner, or rinci al beneficiar 1/f the answer to an attach a detailed statement explaining the transactions.) ' " , a Sale, exchange, or leasing of proPertY? ....................................................................................................................................... 2a - X b Lending of money or other extension of credit? .............................................................................................................................. 2b X c Furnishing of goods, services, or faciiities? .................................................................................................................................... 2c X d Payment of compensation (or payment or reimbursement of expenses if more than $1,000)? .................................................................. 2d X e Transfer of any part of its income or assets? ......... ........ ... ............................................ ..... .. ......... 2e X . ........... 3 a Did the organization make grants for scholarships, fellowships, student loans, etc ~(If "Yes," attach an explanation of how the organization determines that recipients qualify to receive payments.) ............................................................................................. 3a X b Did the organization have a section 403(b) annuity plan for its employees? ,.,.... ........ ........ ............................. 3b X c Did the organization receive or hold an easement for conservation purposes, including easements to preserve open space, the environment, historic lantl areas or historic structures? If "Yes," attach a detailed statement ............................................................... 3c X d Did the organization provide credit counseling, debt management, credit repair, or debt negotiation services? .......... ......... ...,... 3d X 4 a Did the organization maintain any donor advised funds? If "Yes," complete lines 4b through 4g. If "No," complete lines 4f and 49 .... ............................................................................................................................................................................ 4a X . b Did the organization make any taxable distributions under section 4966? ............................................................................. N~A _ 4b c Did the organization make a distribution to a donor, donor advisor, or related person? ..... ..... ......... ......... ,,,,,,, N~A .. 4c d Enter the total number of donor advised funds owned at the end of the tax year . _ ...... ......... ...,,. ........ ......... - ~ e Enter the aggregate value of assets held in all donor advised funtls owned at the end of the tax year ...... ,..,.. ....... ......... - N/A f Enter the total number of separate funds or accounts owned at the end of the year (excluding donor advised funds included on line 4d) where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts ............... - ~• g Enter the aggregate value of assets in all funds or accounts included on line 4f at the end of the tax year ............................................. - 0• Schedule A(Form 990 or 990-EZ) 2007 723171 12-27-07 11 16260512 748525 19412 2007.07050 DUBLIN PARTNERSHIPS IN EDUC 19412_1 Schedule A(Form 990 or 990-EZ) 2007 DUBL IN PARTNERSH I P S IN EDUCAT I ON 9 4- 3 2 0 7 7 8 0 Page 3 Part'-IV Reason for Non-Private Foundation Status (See pages 4 through 8 of the instructions.) I certify that the organization is not a private foundation because it is: (Please check only ONE applicable box.) 5 0 A church, convention of churches, or association of churches. Section 170(b)(1)(A)(i). 6 ~ A school. Section 170(b)(1)(A)(ii). (Also complete Part V.) 7 ~ A hospital or a cooperative hospital service organization. Section 170(b)(1)(A)(iii). 8 0 A federal, state, or local government or governmental unit Section 170(b)(1)(A)(v). 9 ~ A medical research organization operated in conjunction with a hospital. Section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state - 10 ~ An organization operated for the benefit of a college or university owned or operated by a governmental unit Section 170(b)(1)(A)(iv). (Also complete the Support Schedule in Part IV-A.) 11 a 0 An organization that normally receives a substantial part of its support from a governmental unit or from the general public. Section 170(b)(1)(A)(vi). (Also complete the Support Schedule in Part IV-A.) 11b ~ A community trust Section 170(b)(1)(A)(vi). (Also complete the Support Schedule in Part IV-A.) 12 ~ An organization that normally receives: (1) mare than 33 1/3~0 of its support from contributions, membership fees, and gross receipts from activities related to its charitable, etc., functions - subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Also complete the Support Schedule in Part IV-A.) 13 ~ An organization that is not controlled by any disqualified persons (other than foundation managers) and otherwise meets the requirements of section 509(a)(3). Check the box that describes the type of supporting organization: ~ Type I ~ Type II 0 Type III-Functionally Integrated ~ Type III-Other Provide the following information aboutthe supported organizations. (See page 8 of the instructions.) (a) Name(s) of supported organization(s) (b) Employer identification number (EIN) (c) Type of organizatian (described in lines 5 through 12 above or IRC section) (d) Is the supported organization listed in the supporting organization's governing documents. (e) Amount of support Yes Na Total ................................................................................................................................................................................. - I 14 ~ An organization organized and operated to test for public safety. Section 509(a)(4). (See page 8 of the instructions.) Schedule A(Form 990 ar 990-EZ) 2007 723121 12-27-07 12 16260512 748525 19412 2007.07050 DUBLIN PARTNERSHIPS IN EDUC 19412 1 Schetlule A(Form 990 or 990-EZ) 2007 DUBL IN PARTNERSHI PS IN EDUCATION 9 4- 3 2 0 7 7 8 0 Page 4 81't. - Support Schedule (Complete only if you checked a box on line 10, 11, or 12.) Use cash method of accounting. Nntpc Vnu mav use the worksheet ~n the instructions for convertino from the accrual to the cash method of accountinp. a en aryear or isca year beginning in) .............................. - (a) 2006 (b) 2005 (c) 2004 (d) 2003 (e) Total 15 i s, grants, an contri utions received. (Do not include unusual grants.see~ine2s.) .................. 62, 932. 48, 035. 35, 564. 36, 178. 182, 709. 16 Membership fees received ......... 17 Gross receipts from atlmissions, merchandise sold or services pertormed, or furnishing of facilities in any activity that is related to the organization's charitab~e,etc.,purpose ..._.._..._. 146, 080. 182, 267. 129, 351. 105, 271. 562, 969. 18 Gross income from interest, divid- ends, amounts received from pay- ments on securities loans (section 512(a)(5~) rents, royalties, income and unrelated from similar sources , business taxable income (less section 511 taxes) from businesses acquired by the organization after ~une 30, 1975 ........................ 44O . 9 6. 5 36 . 19 Net income from unrelated business activities not included in line 18 pp ax revenues evie or e organization's benefit and either paid to it or expended on its behalf 21 The value of services or facilities furnished to the organization by a governmental unit without charge. Do not include the value of services or facilities generally furnished to the public without charge . 22 t er income. ttac a sc e u e. Do not include gain or (loss) from sale of capital assets ............... 23 Totaloflinesl5through22 ... 209,452. 230,398. 164,915. 141,449. 746,214. 2a Line23minuslinel7 ............... 63, 372. 48,131. 35, 564. 36,178. 183, 245. 2s Enter 1°~0 of line 23 .................. 2, 0 9 5. 2, 3 0 4. 1, 6 4 9. 1, 414 . I 26 Organizations described on lines 10 or 11: a Enter 2% of amount in column (e), line 24 ............................................. - 26a N/A b Prepare a list for your records to show the name of and amount contributed by each person (other than a govemmental ~"" I unit or publicly supported organization) whose total gifts for 2003 through 2006 exceeded the amount shown in line 26a. ' ,, ~~ ___ j Do not file this list with your return. Enter the total of all these excess amounts ......................................................... - 26b N/A c Total support for section 509(a)(1) test: Enter line 24, column (e) ................ .._,. ,,,.,. .... ... - 26c N/A d Add: Amounts from column (e) for lines: 18 19 ,_~ 22 26b ~ ....... 26d N/A e Public support (line 26c minus line 26d total) ....................... ~ .................................................................................. 26e N/A f Public support percentage (line 26e numerator divided by line 26c denominator .......................... - 26f N/A % 27 Organizations described on line 12: a For amounts included in lines 15, 16, and 17 that were received from a"disqualified person;' prepare a list for your records to show the name of, and total amounts received in each year from, each "disqualified person:' Do not file this list with your return. Enter the sum of such amounts for each year: ~2oos) .................................0. ~. (2oos) ....................................0. ~. (2ooa) .................................0. ~. (2oos) .................................~. ~. b For any amount included in line 17 that was received from each person (other than "disqualified persons"), prepare a list for your records to show the name of, and amount receivetl for each year, that was more than the larger of (1) the amount on line 25 for the year or (2) $5,000. (Include in the list organizations described in lines 5 through 11b, as well as individuals.) Do not file this list with your return. After computing the difference between the amount received and the larger amount described in (1) or (2), enter the sum of these differences (the excess amounts) for each year: (2006) .................................~. ~. ~2005) ....................................~. ~. ~2004) .................................Q. ~. 12003) .................................Q. ~. c Add: Amounts from column (e) for lines: 15 18 2, 7 ~ 9. 16 t~ 562,969. 20 21 - 2~c 745,678. d Add: Line 27a total ... ~. and line 27b total .................. ~. _. - 27d ~. e Public support (line 27c total minus line 27d total) ................................................................................................ - 27e 7 4 5, 6 7 8. f Total support for section 509(a)(2) test: Enter amount on line 23, column (e) .._...... - 27f 7 4 6, 214 . , ~ p Pubiic support percentage (line 27e (numerator) divided by line 27f (denominator)) ................................. ~ 27g 9 9. 9 2 8 2% h Investment income percentage line 18, column e numerator divided by line 27f denominator - 27h . ~ 718% 28 Unusual Grants: For an organization described in line 10, 11, or 12 that received any unusual grants tluring 2003 through 2006, prepare a list for your records to show, for each year, the name of the contributor, the date and amount of the grant, and a brief description of the nature of the grant. Do not file this list with your return. Do not inciude these grants in line 15. 723131 iz-z~-o~ NONE Schedule A(Form 990 or 990-EZ) 2007 13 16260512 748525 19412 2007.07050 DUBLIN PARTNERSHIPS IN EDUC 19412_1 , Schedule A(Form 990 or 990-EZ) 2007 DUBL IN PARTNERSHI PS IN EDUCATI ON 9 4- 3 2 0 7 7 8 0 Page 5 ' Part V Private School Questionnaire (See page 9 of the instructions.) N/A ITo be comoleted ONLY bv schools that checked the box on line 6 in Part I~ 29 Does the organization have a racially nondiscriminatory policy towartl students by statement in its charter, bylaws, other governing Yes No instrument, or in a resolution of its governing bodY? ..................................................................................................................... 29 30 Does the organization include a statement of its racially nondiscriminatory policy toward students in all its brochures, catalogues, ~ _~ and other written communications with the public dealing with student admissions, programs, and scholarships? .................................... 30 31 Has the organization publicized its racially nondiscriminatory policy through newspaper or broadcast metlia during the period of solicitation for students, or during the registration period if it has no solicitation program, in a way that makes the policy known to all parts of the general communiry it serves? .......................................................................................................................... ~ - - 31 ---- -~ - . If "Yes;' please describe; if "No," please explain. (If you need more space, attach a separate statement) ii' . - ~I 32 Does the organization maintain the following: a Records indicating the racial composition of the student body, faculty, and administrative staff? ............................................................ 32a ~ ~~„~ b Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory basis? ........................ 32b c Copies of all catalogues, brochures, announcements, and other written communications to the public dealing with student admissions, programs, and scholarshiPs? ................................................................................................................................. 32c d Copies of all material usetl by the organization or on its behalf to solicit contributions? ........................................................................ 32d If you answered "No" to any of the above, please explain. (If you need more space, attach a separate statement.) ~ ~ ~ , ~ ~ 33 Does the organization discriminate by race in any way with respect to: a Students' rights or privileges? ................................................................................................................................................ 33a b Admissians palicies? ............................................................................................................................................................ 33b c Employment of faculty or administrative staff? ........................................................................................................................... 33c d Scholarships or other financial assistance? ................................................................................................................................. 33d e Educational policies? ............................................................................................................................................................ 33e f Use of facilities? .................................................................................................................................................................. 33f p Athletic programs? ............................................................................................................................................................... 339 h Other extracurricular activities? ................................................................................................................................................ 33h If you answered "Yes" to any of the above, please explain. (If you need more space, attach a separate statement.) 34 a Does the organization receive any financial aid or assistance from a governmental agency? ....................................................... b Has the organization's right to such aid ever been revoked or suspended? ............................................................................ If you answered "Yes" to either 34a or b, please explain using an attached statement. 35 Does the organization certify that it has complied with the applicable requirements of sections 4.01 through 4.05 of Rev. Proc. 75-50, 1975-2 C.B.587, covering racial nondiscrimination? If "No,"attach an explanation ______________________________________________________ 723141 12-27-07 .... .. ........ ~ 35 ~ ~ Schedule A(Form 990 or 990-EZ) 2007 14 16260512 748525 19412 2007.07050 DUBLIN PARTNERSHIPS IN EDUC 19412_1 ~ Schedute A(Form 990 or 990-EZ) 2007 DUBL IN PARTNERSHI PS IN EDUCATION 9 4- 3 2 0 7 7 8 0 Page s Part VI-A Lobbying Expenditures by Electing Public Charities (See page 11 of the instructions.) N/A (To be completed ONLY by an eligible organization that filed Form 5768) Check - a if the organization belongs to an affiliated group. Check - b if you checked "a" and "limited control" provisions apply. Limits on Lobb in Ex enditures ~a) (b) Y 9 P Affiliated group To be completed for all (The term "expenditures" means amounts paid or incurred.) totals electing organizations 36 Total lobbying expenditures to influence public opinion (grassroots lobbying) ........................... 36 37 Total lobbying expenditures to influence a legislative body (direct lobbying) .............................. 37 38 Total lobbying expenditures (add lines 36 and 37) ............................................................... 38 39 Other exempt purpose expenditures ..................................................................... 40 Total exempt purpose expenditures (add lines 38 and 39) ............................................. 41 Lobbying nontaxable amount. Enter the amount from the following table - If the amount on ~ine 40 is - The lobbying nontaxable amount is - Not over $500,000 .................................... 20% of the amount on line 40 .,,, ,................. _.. Over $500,000 but not over $1,000,000 ,... $100,000 plus 15% of the excess over $500,000 Over $1,000,000 but not over $1,500,000 ......... $175,000 plus 10% of tha excess over $1,000,000 Over $1,500,000 but not over $17,000,000 $225,000 plus 5°k of the excess over $1,500,000 ...... I 39 ~,,. ,~ ~ .,.,a z Over $17,000,000 .................................... $1,000,000 ~~ `~ ......................................................... 42 Grassroots nontaxable amount (enter 25% of line 41) ......................................................... 42 43 Subtract line 42 from line 36. Enter -0- if line 42 is more than line 36 ....................................... 43 44 Subtract line 41 from line 38. Enter -0- if line 41 is more than line 38 ....................................... 44 , I N N,`t`~~ . ` .. ; ~r . ' ' ~~ ~~ Caution: If there is an amount on either line 43 or line 44, you must file Form 4720. 4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the instructions for lines 45 through 50 on page 13 of the instructions.) Lobbying Expenditures During 4-Year Averaging Period N/A Calendaryear(or (a) (b) (c) (d) (e) fiscal year beginning in) ~ 2007 2006 2005 2004 Total 45 Lobbying nontaxable amount ........................ 0. 46 Lobbying ceiling amount ° , ~ ,.,r ~ N~h~ ,,; ,- c 150% of line 45 e)) M~ ~" , ~ 47 Totallobbying expenditures .................. ~ • 48 Grassroots nontaxable amount ........................ 0. 49 Grassroots ceiling amount ;,,, , . '~ ~" ~~".~ ~ ';~' - ~~~~~'~~ erd•~ ~ ~ .. ~~ ~~ ~~ ~~ ~~ (150% of Iine 4S(e)) ......... . `~ ~ : . :: . u„' ~ ~" ~ . 50 Grassrootslobbying expenditures .................. 0 • ~ Part.,Vl-B ~ Lobbying Activity by Nonelecting Nupnc cnarities (For reporting only by organizations that did not complete Part VI-A) (See page 14 of the instructions.) N/A During the year, did the organization attempt to influence national, state or local legislation, including any attempt to Yes No Amount influence public opinion on a legislative matter or referendum, through the use of: a Volunteers ~~"_ , " ~ ~~~ , ~ ~ ~ " ~ ,, i ........................................................................................................................................ "• ~ b Paid staff or mana ement Include com ensation in ex enses re orted on lines c throu h h. ~ 9 ( P P P 9 ) ............ ...... ......... ...... ... ~ ~ w y.:_J c Media advertisements ................................................................................................................................. d Mailings to members, legislators, or the public ................................................................................................ e Publications, or published or broadcast statements .......................................................................................... f Grants to other organizations for lobbying purposes .......................................................................................... g Direct contact with legislators, their staffs, government officials, or a legislative body ................................................ h Rallies, demonstrations, seminars, conventions, speeches, lectures, or any other means .......................................... i Total lobbying expenditures (Add lines c through h.) .......................................................................................... _'„ ~• If "Yes" to any of the above, also attach a statement giving a detailed description of the lobbying activities. i2_z~_o~ Schedule A(Form 990 or 990-EZ) 2007 15 16260512 748525 19412 2007.07050 DUBLIN PARTNERSHIPS IN EDUC 19412_1 Schedule A(Form 990 or 990-EZ) 2007 DUBL IN PARTNERSHI PS IN EDUCATI ON 9 4- 3 2 0 7 7 8 0 Page 7 Part VII Information Regarding Transfers To and Transactions and Relationships With Noncharitable EXempt OI'ga111Zat10t1S (See page 14 of the instructions.) 51 Did the reporting organization directly or indirectly engage in any of the following with any other organization described in section 501(c) of the Cotle (other than section 501(c)(3) organizations) or in section 527, relating to political organizations? a Transfers from the reporting organization to a noncharitable exempt organization of: Yes No (i) Cash ...... ............ ... ............... ...... ......... ............... ............... ...... ...... ...... ... .................. ...... ............ ............... 51a(i) ... X (ii) Other assets ............................................................................................................................................................... ... al~~) X b Other transactions: (i) Sales or exchanges of assets with a noncharitable exempt organization ... .............................................................................. ... b(i) X (ii) Purchases of assets from a noncharitable exempt organization ............. ,...... ....... .,, ....... ,....... .......... ... b(ii) X (iii) Rental of facilities, equipment, or other assets ........................ .......... ........ .... ... ........ ......... .... ........... ... b(iii) X (iv) Reimbursementarrangements ....... ... ............... ............ ..................... ...... ...... ...... ...... ............ ...... ... ......... ......... ............ b(~~) ... X (v) Loans or loan guarantees ............................................................................................................................................. ... b~~) X (vi) Pertormance of services or membership or fundraising solicitations ....................................................................................... ... b~°~~ X c Sharing of facilities, equipment, mailing lists, other assets, or paid employees ,.,.,..,. ......... ................ .... ....... ... ~ X d if the answer to any of the above is "Yes;' complete the following schedule. Column (b) shoultl always show the fair market value of the goods, other assets, or services given by the reporting organization. If the organization received less than fair market value in any transaction or sharing arrangement, show in cotumn (d) the value of the goods, other assets, or services received: N/A (e) lb) (~) (d) Line no. Amount involved Name of noncharitable exempt organization Description of transfers, transactions, antl sharing arrangem ents 16 16260512 748525 19412 2007.07050 DUBLIN PARTNERSHIPS IN EDUC 19412_1 52 a Is the organization directly or indirectly affiliated with, or related to, one or more tax-exempt organizations described in section 501(c) of the Code (other than section 501(c)(3)) or in section 527? .....................................................................................................~ ~ Yes ~X No h If "Yes:' complete the fallowinp schedule: N~A Schedule B (FoYm 990, 990-EZ, or 990-PF) Department ot the Treasury Internal Revenue Service Schedule of Contributors Supplementary Information for line 1 of Form 990, 990-EZ, and 990-PF (see instructions) OMB No. 1545-0047 20~7 Name of organization ~ Employer identification number DUBLIN PARTNERSHIPS IN EDUCATION ~ 94-3207780 Organization type(check one): Filers of: Section: Form 990 or 990-EZ ~ 501(c)( 3)(enter number) organization 0 4947(a)(1) nonexempt charitable trust not treated as a private foundation 0 527 political organization Form 990-PF ~ 501(c)(3) exempt private foundation ~ 4947(a)(1) nonexempt charitable trust treated as a private foundation ~ 501(c)(3) taxable private foundation Check if your organization is covered by the General Rule or a Special Rule. (Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the Genera/ Rule and a Specia/ Ru/e-see instructions.) General Rule- OX For organizations filing Form 990, 990-EZ, or 990•PF that received, during the year, $5,000 or more (in money or property) from any one contributor. (Complete Parts I and II.) Special Rules- ~ For a section 501(c)(3) organization filing Form 990, or Form 990•EZ, that met the 33 1/3% support test of the regulations under sections 509(a)(1)/170(b)(1)(A)(vi), and received from any one contributor, during the year, a contribution of the greater of $5,000 or 2% of the amount on line 1 of these forms. (Complete Parts I and II.) 0 For a section 501(c)(7), (8), or (10) organization filing Form 990, or Form 990-EZ, that received from any one contributor, during the year, aggregate contributions or bequests of more than $1,000 for use exclusively for religious, charitable, scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. (Complete Parts I, II, and III.) 0 Caution: Organizations that are not covered by the General Rule and/or the Specia/ Rules do not file Schedule B(Form 990, 990-EZ, or 990-P~, but they must check the box in the heading of their Form 990, Form 990-EZ, or on line 2 of their Form 990-PF, to certify that they do not meet the filing requirements of Schedule 8(Form 990, 990-EZ, or 990-P~. LHA For Paperwork Reduction Act Notice, see the Instructions Schedule B(Form 990, 990-EZ, or 990-PF) (2007) for Form 990, Form 990-EZ, and Form 990-PF. 723451 12-27-07 For a section 501(c)(7), (8), or (10) organization filing Form 990, or Form 990-EZ, that received from any one contributor, during the year, some contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did not aggregate to more than $1,000. (If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the Parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more during the year.) ........................... ~$ 17 16260512 748525 19412 2007.07050 DUBLIN PARTNERSHIPS IN EDUC 19412_1 ' Schedule B(Farm 990, 990-EZ, or 990-PF) (2007) Page 1 of 1 of Part I Name of organization DUBLIN PARTNERSHIPS IN_EDUCATION Employer identification number 94-3207780 Pal't l,~ ContYlbut0l'S (See Specific Instructions.) (a) No. (b) Name, address, and ZIP + 4 (c) Aggregate contributions (d) Type of contribution 1 REALTORS GETTING REAL ABOUT SCHOOLS Person ~ 3 7 8 5 TRENERY DRI VE $ 10 , 5 0 0. Payroll ~ Noncash ~ PLEASANTON , CA 9 4 5 8 8 (Complete Part II if there is a noncash contribution.) (a) No. (b) Name, address, and ZIP + 4 (c) Aggregate contributions (d) Type of contribution Person ~ $ Payroll 0 Noncash ~ (Complete Part II if there is a noncash contribution.) (a) No. (b) Name, address, and ZIP + 4 (c) Aggregate contributions (d) Type of contribution Person Q $ Payroll ~ Noncash ~ (Complete Part II if there is a noncash contribution.) (a) No. (b) Name, address, and ZIP + 4 (c) Aggregate contributions (d) Type of contribution Person 0 $ Payroll ~ Noncash ~ (Complete Part II if there is a noncash contribution.) (a) No. (b) Name, address, and ZIP + 4 (c) Aggregate contributions (d) Type of contribution Person ~ $ Payroll ~ Noncash ~ (Complete Part II if there is a noncash contribution.J (a) No. (b) Name, address, and ZIP + 4 (c) Aggregate contributions (d) Type of contribution Person ~ $ Payroll ~ Noncash 0 (Complete Part II if there is a noncash contribution.) 723452 i2-z~-o~ Schedule B(Form 990, 990-EZ, or990-PF)(2007) 18 16260512 748525 19412 2007.07050 DUBLIN PARTNERSHIPS IN EDUC 19412_1 DUBLIN PARTNERSHIPS IN EDUCATION 94-3207780 FORM 990 SPECIAL EVENTS AND ACTIVITIES STATEMENT 1 GROSS CONTRIBUT. GROSS DIRECT NET INCOME DESCRIPTION OF EVENT RECEIPTS INCLUDED REVENUE EXPENSES OR (LOSS) GOLF TOURNAMENT 89,530. 89,530. 36,189. 53,341. STUDENT ART AUCTION 34,343. 34,343. 13,191. 21,152. FIREWORKS 4,275. 4,275. 170. 4,105. DINNER PARTNERS 30,507. 30,507. 10,104. 20,403. TO FM 990, PART I, LINE 9 158,655. FORM 990 OTHER EXPENSES STATEMENT 2 DESCRIPTION (A) TOTAL ~B) PROGRAN! SERVICES (C) MANAGEMENT AND GENERAL (D) FUNDR.AI S ING BANK FEES 1,569. INSURANCE 3,119. MARKETING AND ADVERTISING 1,704. PROFESSIONAL DEVELOPMENT 1,480. STUDENT ACTIVITIES AND SCHOOL PROGFtAMS 25,390. WORKER'S COMPENSATION INSURANCE 778. TAXES AND FEES 70. OFFICE SUPPLIES 1,498. BOARD MEETING EXPENSES 477. ADMINISTRATIVE SERVICES 290. MEMBERSHIP DUES 100. SUPPORT OF OTHER NONPROFIT ORGANIZATIONS 174. PAYROLL SERVICE 866. MISCELLANEOUS EXPENSE 195. TOTAL TO FM 990, LN 43 37,710. 1,569. 3,119. 1,704. 1,480. 158,655. 59,654. 99,001. 25,390. 475. 150. 70. 1,498. 477. 153. 290. 100. 174. 26,039. 866. 195. 11,518. 153. 19 STATEMENT(S) 1, 2 16260512 748525 19412 2007.07050 DUBLIN PARTNERSHIPS IN EDUC 19412 1 DUBLIN PARTNERSHIPS IN EDUCATION FORM 990 CASH GRANTS AND ALLOCATIONS STATEMENT 3 TO OTHERS CLASS OF ACTIVITY/DONEE'S NAME AND ADDRESS TEACHER GRANTS VARIOUS DUSD TEACHERS DUBLIN UNIFIED SCHOOL DISTRICT DUBLIN, CA 94568 TOTAL INCLUDED ON FORM 990, PART II, LINE 22B FORM 990 STATEMENT OF ORGANIZATION'S PRIMARY EXEMPT PURPOSE STATEMENT 4 PART III EXPLANATION TO FOSTER MUTUALLY BENEFICIAL BUSINESS EDUCATION PARTNERSHIPS IN ORDER TO MAXIMIZE COMMUNITY RESOURCES FOR THE STUDENTS OF THE DUBLIN UNIFIED SCHOOL DISTRICT. FORM 990 OTHER LIABILITIES STATEMENT 5 94-3207780 54,161. AMOUNT 54,161. DESCRIPTION BEGINNING OF YEAR END OF YEAR PAYROLL TAXES PAYABLE DEFERRED GOLF REVENUE CREDIT CARDS PAYABLE TOTAL TO FORM 990, PART IV, LINE 65 2,337. 13,570. 0. 0. 0. 7,388. 15,907. 7,388. 20 STATEMENT(S) 3, 4, 5 16260512 748525 19412 2007.07050 DUBLIN PARTNERSHIPS IN EDUC 19412_1 DUBLIN PARTNERSHIPS IN EDUCATION 94 -3207780 FORM 990 PART V-A - LIST OF CURRENT OFFICERS, DIRECTORS, STATEMENT 6 TRUSTEES AND KEY EMPLOYEES EMPLOYEE TITLE AND COMPEN- BEN PLAN EXPENSE NAME AND ADDRESS AVRG HRS/WK SATION CONTRIB ACCOUNT MARYBETH PHILLIPS EXECUTIVE DIRECTOR 6800 PENN DRIVE 30.00 9,923. 0. 0. DUBLIN, CA 94568 DON BIDDLE PRESIDENT 6800 PENN DRIVE 2.00 0. 0. 0. DUBLIN, CA 94568 TESS THOMAS VICE PRESIDENT 6800 PENN DRIVE 2.00 0. 0. 0. DUBLIN, CA 94568 WILLIAM MOY TREASURER 6800 PENN DRIVE 2.00 0. 0. 0. DUBLIN, CA 94568 DR. DAVE MARKEN BOARD MEMBER 6800 PENN DRIVE 2.00 0. 0. 0. DUBLIN, CA 94568 ANGELA FONTES BOARD MEMBER 6800 PENN DRIVE 2.00 0. 0. 0. DUBLIN, CA 94568 TED HOFFMAN, JR. BOARD MEMBER 6800 PENN DRIVE 2.00 0. 0. 0. DUBLIN, CA 94568 KELLEE JONES BOARD MEMBER 6800 PENN DRIVE 2.00 0. 0. 0. DUBLIN, CA 94568 ~ CHRIS BENNETT CO-SECRETARY 6800 PENN DRIVE 2.00 0. 0. 0. DUBLIN, CA 94568 KATHY DE JONG CO-SECRETARY 6800 PENN DRIVE 2.00 0. 0. 0. DUBLIN, CA 94568 BILL PRESCOTT BOARD MEMBER 6800 PENN DRIVE 2.00 0. 0. 0. DUBLIN, CA 94568 21 STATEMENT(S) 6 16260512 748525 19412 2007.07050 DUBLIN PARTNERSHIPS IN EDUC 19412_1 DUBLIN PARTNERSHIPS IN EDUCATION 94- 3207780 FAWN HOLMAN BOARD MEMBER 6800 PENN DRIVE 2.00 0. 0. 0. DUBLIN, CA 94568 ALCINA WEGRYNOWSKI BOARD MEMBER 6800 PENN DRIVE 2.00 0. 0. 0. DUBLIN, CA 94568 PAT KOHNEN LIAISON TO DUSD DOARD 6800 PENN DRIVE 2.00 0. 0. 0. DUBLIN, CA 94568 AMY FR.ANTZ STUDENT REPRESENTATIVE 6800 PENN DRIVE 2.00 0. 0. 0. DUBLIN, CA 94568 TOTALS INCLUDED ON FORM 990, PART V-A 9,923. 0. 0. 22 STATEMENT(S) 6 16260512 748525 19412 2007.07050 DUBLIN PARTNERSHIPS IN EDUC 19412_1 , ~~ dDublin ~artners In Educat9on December 16, 2009 .~ Dublin Partners in Education PO Box 2307 Dublin, CA 94568 925.828.2551 X 8024 925.803.9746 fax Email: dpieCc~dublin.kl2.ca.us website: vuvuwr.du&sBiu~.~Cg2.c~.a~s The Board of Directors of Dublin Partners in Education unanimously support the two applications for Community Grant Funding with the City of Dublin. Sincerely, ' ~-J l~ Alcina Wegrzynowski DPIE Board President DPIE is a 501 (c) ~3) Non-Profit organization All donations are tax-deductible to the extent allowable by law. Federal Tax ID 94-3207780 Dublin Partners in Education is a non-profit foundation dedicated fo foster mufually beneficial business and education parfnerships in order to maximize community resources for the students of the Dublin Unified School District. ~ _ -- ACORD CERTIFICATE OF LIABILITY INSURANCE OPID JF DATE(MMlOD/YYYY) DUBLI-1 04 02 09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO~ Nonprofit Services Ins . Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ~~nis Costa • HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR . _d43 Hopyard Rd. #169 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Pleasanton CA 94586 Phone:877-669-5101 Fax:877-669-5109 INSURED Dublin Partners In Education P.O. Box 2307 Dublin CA 94568-1599 INSURERS AFFORDING COVERAGE I NAIC # INSURER A: NIAC ~NSURER B: State Coa~ensation Ina. FUnd INSURER C: INSURER 0: - ----- ---- -- INSURER E: ~ COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDiCATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WRH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REOUCED BY PAID CLAIMS. i an --- -~6t~Y~~F~~tnr€ ~UZ~i ex~~~an - LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE M DATE MM/DD ~~M~TS GEPlERAL LIABIUTY EACH OCCURRENCE 5], ~ OOO ~ OOO A X COMMERCIAIGENERALLIABILITY 2~09-129~jQ-NpQ 03/09/09 03/09/10 PREMISES(Ea~ nce) § rJ~~~0~0 CLAIMS MADE X^ OCCUR MED EXP (My one person) S 2 ~~ ~ ~ ~ PERSONAL 8 ADV INJURY 5 1~ OOO ~ OOO X 1].Q110T 11.2L~1.11~ GENERAIAGGREGATE S 1~ OOO ~ OOO GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG 5 Z~ OOO ~ OOO POLICY ~E a LOC -- AUT OAAOB~LE LIAB(LITY COMBINEDSINGLELIMIT (Ea accident) g 1 00o O~O ~ r A ANYAUTO 2009-12954-NPO 03/09/09 03/09/10 ALL OWNED AUTOS BODIIY INJURY ` SCHEDULED AUTOS (Pef ~~) g X HIREDAUTOS BODIIY INJURY X NON-0W NED AUTOS (~ ~d~~~ 5 PROPERTY DAMAGE (Per accidenq $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S ANY AUTO EA ACC OTHER THAN ___ 5 i _- AUTO ONLY: AGG . ___ S EXCESSNbIBRELLA W-BILITY EACH OCCURRENCE S ~ ^ OCCUR ~ CLAIMS MADE AGGREGATE ---- S - ~ DEDUCTiBLE --- --------- -- -- S - RETENTION $ y - - WORKERS COMPENSAl10N AND ' ~ X TORY LIMITS ~__ ER B EMPLQYERS LIABIUTY ANY PROPRIEfOR/PARTNEWEXECUTtVE 1761723-08 . 1`2~~1~08 1`Z`~1~~9 E.L.EACHACCIDENT S 1QQQQQQ OFFICERMIEMBER EXCIUDEDT ~ -- E.L. DISEASE - EA EMPLOYE _ _~_ S ZOOOOOO If yes, tlescnbe utWer SPECIAL PROVtSIONS DelOw . v---- E.L. DISEASE -POLICY LIMIT - ----- S ZOOOOOO OTHER DESCWPTION OF OPERATIONS / LOCATIONS I VEHiCLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ~ CERTIFICATE HOLDER PROOFON Proof oP Insurance Only CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIC DATE TNEREOP, THE ISSIANG INSURER WILL ENDEAVOR TO MAIL 3O * DAYS WRITTEN NOTICE TO THE CERTffICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LWBIUTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. City of Dublin Fiscal Year 2010-2011 Application for Funds APPLICATION VERIFICATION I attest that the information contained in this FY 2010-2011 grant application is accurate and that the funds requested will not supplant any other monies secured by the organization. Attached is a resolution, letter, or other document providing evidence that the Board of Directors approved the application as submitted. Successful applicants are required to submit a summary report as soon as possible after submitting the reimbursement request, but not later than August 31, 2011. Failure to submit a report will result in ineligibility for future funding. ~a ~yP ~~ Date ~a-I~ ~9 Date SECTION 2 Page 16 of 22 ~ ~ City of Dublin Fiscal Year 2010-2011 Application for Funds COLLABORATION AGENCY AFFIDAVIT FORM o This form is to be completed by each- collaborating organization as named by the applicant agency in the proposed project/program. o Completed forms must be submitted at time of application. Collaborating Agency Name: _ Dublin Rotary Agency Division/Department: N/A Project/Program Title: . Third Grade Dictionary Give-Away Project/Program Role Description (i.e., facility space, staff support, etc.): _DPIE and Dublin Rotary pay for and distribute clictionaries to every third grade student in Dublin Unified School District Agency Project/Program Contact Person Don Biddle Title Board Member Dublin Rotary Phone 925 828-2827 _dondonnab 1 @aol.com_ I attest that the applicant agency and our organization agree to work collaboratively to implement th~roposed project/prog~am as identified in the FY 2010-2011 funding application. /a~/Y-OQ Date Email SECTION 2 Page 17 of 22 ~ ti~ /// ~ r~ ' ~ I ~ ~ ia-~ ~ ProjectlProgram Contact erson Date SECTION 2 Page 18 of 22 ~- ~:: . . - -- --- - _ _. - -'rr~~ ~~9~,;~~ ~ . ~i'` ; 9 ~. f ' . ~ ' . ~ . .. . . . . . ~ . INTERNAL REVENUE SSRVICE DISTRICT DIRECTOR 2 CUPANIA CIRCLE MONTEREY PARK, CA. 91755-7406 Date : ~OU 2 ,3 199~ , DUBLIN PARTNERSHIPS IN EDUCATION C/0 CHERYL MATTHEWS : 7471 LARKDALE AVE ' DUBLIN, CA 94568 DEPARZ~NT OF THE TREASIIRY -~,i :~,j~fk . L~ ;. ~~4 L'~ Employer ldentification Number: ~~+'sY f~1 94-3207780 ~ ,~~'. : Case Number : , ~ ~ ~ ` ° 954257003.. ~J 4 Contact Person: DANIEL Hi7MM Contact Telephone Number: (213) 725-6619 Accounting Period Ending: December 31 Foundation Status Classification: 509 (a) (2) Advance Ruling Period Begins: March 7, 1994 ~_dvance R>>li..ng P~z_od Er_d~: December 31; 1998 Addendum Applies: No Dear Applicant: Based on information you supplied, and assuming your operations will be as stated in your application for recognition of exemption, we have determined you are exempt from federal income tax under section,50~ (al- of the Internal Revenue Code as an organization described in section 501(c)(3). ~ Because you are a.newly created organization, we are not now making a final determination of your foundation status under section 509(a) of the Code. However, we have determined that you can reasonably expect to be a publicly , supported.organization described in section 509(a)(2). ~ Accordingly, during an advance ruling period you will be treated as a publicly supported organization, and not as a private foundation. This advance ruling period begins and ends on the dates shown above. ~ Within 90 days after the end of your.advance ruling period, you must send.us the information needed to determine whether you have met the require- -. ments of the applicable support test during the advance ruling period. If you establish that you have been a Fublic;ly supported ~rgan~zation, w~ will classi- fy you as a section 509(a)(1) or 509(a)(2) organization as long as you continue to meet the requirements of the applicable support test. If you do not meet the public support requirements during the. advance ruling period, we will classify you as a private foundation for future periods. Also, if we classify you as a private foundation, we will treat you as a private foundation from your beginning date for purposes of section 507(d) and 4940. Grantors and contributors may rely on our determination that you are not a private foundation until 90 days after the_end of your advance ruling period. If you send us the required information within the 90 days, grantors and contributors may continue to rely on the advance determination until we make a final determination of your foundation status. If we_publish a notice in the Internal Revenue Bulletin stating that we Letter 1045 (DO/CG) ~ -2- ` DUBLIN PARTNERSHIPS IN'EDUCATION ~ will.no longer treat you as a publicly supported organization, grantors and contributors may not rely on this determination after the date we publish the notice. In addition, if you lose your status as a publicly supported organi- zation, and a grantor or contributor was responsible for, or was aware of, the act or failure to act, that resulted in your loss of such status, that persori may not rely on this determination from the date of the act or failure to.act. Also, if a grantor or contributor.learned that we had given notice that you would be removed from classification as a publicly supported organ'ization, then that person may not re,ly on this determination as of the date he or she acquired such knowledge. If you cnange your sources of support, your.purposes, character, or method of operation, please let us know so we can consider the effect of the change on your exempt status and foundation status. If.you.amend your organizational document or bylaws, please send us a.copy of the amended document or bylaws. Also, let us know all changes in.your name or address. . As of January 1, 1984, you are liable for social securities taxes under the Federal Insurance Contributions Act on amounts of $100 or more you pay to each of your employees during a calendar year. You are not liable for the tax imposed under the Federal Unemployment Tax Act (FUTA). Organizations that are not private foundations are not subject to the pri- vate foundation excise taxes under Chapter 42 of the Internal Revenue Code. However, you are not automatically exempt from other federal excise taxes. If you have any questions about excise, employment, or other federal taxes, please , let us know. Donors may deduct contributions to.you as provided iri section 170 of the , Internal Revenue Code: Bequests, legacies, devises, transfers; or gifts to you or for your use are deductible for Federal estate and gift tax purposes if they. ~' meet the applicable provisions of sections.2055, 2106, and 2522 of the Code. Donors may deduct contributions to you only to the extent that their contributions are gifts, with no consideration received. Ticket purchases and ~ similar payments in conjunction with fundraising events may not necessarily qua3i~y as deductible cantributions, depending on the circumstances. Revenue Ruling 67-246, published in Cumulative Bulletin 1967-2, on page 104, gives guidelines regarding when taxpayers may deduct payments for admission to, or other participation in, fundraising activities for charity. , You are not required to file Form 990, Return of Organization Exempt From Income Tax, if your gross receipts each year are normally $25,000 or.less. If you receive a Form 990 package in the mail, simply attach the label.provided, check the box in the heading to indicate that your annual gross receipts are normally $25,000 or less, and sign the return. If you are required to file a return you must file it by the 15th day of the fifth month after the end of your annual accounting period.. We charge a penalty of $10 a day when a return is filed late, unless there is reasonable Letter 1045 (DO/CG) ~. -3- DUBLIN PARTNERSHIPS IN.EDUCATION. ~ cause for the delay. However, the maximum penalty we charge cannot exceed $5,000 or 5 percent of your gross receipts for the year, whichever is less.. We ,. may also charge this penalty if a return is.not complete. So, please be sure ' ' your return is complete before you file it. ~ You are not required to file federal income tax returns unless you are subject to the tax on unrelated business income under section 511.of the Code. If you are subject to this tax, you must file an income tax return on Form 990-T, Exempt Organization Business Income Tax Return. In this letter we are: not determining whether any of your present or proposed activities are unre- lated trade or business as defined in section 513 of the Code. You need an employer identification number even if you have no employees. If an employer identification number was not entered on your application, we will assign a number to you and advise you of it. Please use that number on all returns you file and in all. correspondence with the Internal Revenue Service. If we said in the heading of this letter that an addendum applies, the. addendum enclosed is an integral part of this letter. Because this letter could help us resolve any questions about your exempt status and foundation status, you should keep it in your permanent records. If you have any questions, please contact the person whose.name and telephone number are shown in the heading of this letter. Sinc y rs, / • Richard R. Orosco District Director ' Letter 1045 (DO/CG) ,. Form ~iJ ~ Z ~ C (Rev. July 1993) . pepartment of the Treasury ~ Internal Revenue Service Cansent Fixing Period of Limitation Upon Assessment of Tax Under Section 4940 of the oMB No. .,~5-~0~ . Internal Revenue Code \ To be used with Fortn 1023. Submit in dupliCate. (See instructions on ~everse side.) Under section 6501(c)(4) of the Internai Revenue Code, and as part of a request filed with Form 1023. that the . organization named below be treated as a publicly supported organization under section 170(b)(1)(A)(vi) or section . 509(a)(2) during an advance ruling period, Dublin Partnerships in Education ------------•---- •--•-••------------------------------•--------------------------------------- (Exact legaf name ol organization as shown in organizing document) ~IStfICt ~I(@CtOf Of Internal Revenue, or 7471 I:arkdale Avenue, Dublin CA 94568 and the Assistant ------------------------•--••------------------------------------------------------------------- Commissioner (Number, sUeei, city or town, state, ~o ziP ~oae~ (Employee Plans and Exempt Organizations) Consent and agree that the period for assessino tax (impese~ und~~ se~t~on 4~;~ o~ the Codej for any of the'5 tax years in the advance ruling period will extend 8 years, 4 months, and 15 days beyond the end of the first tax year. However, if a notice of deficiency in tax for any of these years is sent to the organization before the period expires, the time for making an assessmenf will be further extended by the number of days the assessment is prohibited, plus 60 days. _ December 31, 1994. _ Ending date of first tax year ___________________________________________ (Month, day, and yearJ Name of organization (as shown in organizing document) Date. Dublin Part rsh'ps i E. at' ~ I.- [g~-( O~cer or trustee aving h ri o sig Signature - Title - ~ti~ ~~1~ For IRS use only ~ -' S District Director or Assist m~ ioner (Employee Plans and Exempt Organizations) _ Date I ~~ , ~ _ _._-.~,...~~ , BY ~ ~~~ 11l1~6'~~~9 ~~.~'.. For Pape o Reduction Act Notice, see page 1 of the Form 1023 Instructions. Cat No. t69050 _ ~. , , . ' ~ ~~~ ° -vf ~ i ~-~ ~.p ~ ~ d . :~I~ z ~z~/ q ~~ ~ ~ ~ ~~`..'~ - , ~ ~~`~- ~- INTERNAL RBVENUII SfiR1TICB DEPARTMENT OF TH~ TREASURY DISTRICT DIRfiCTOR . . 2 CUPANIA CIRCL$ MONTSREY PARK, CA 91755-7466 . Employer ldsntification Number: . Date: NOY 4 ~~4 94-3207780 Case Number: 954257003 DUBLIN PARTNBRSHIPS IN EDUCATION Contact Person: C/O CHHRYL MATT'HEWS DANZEL HUMM 7471 LARImALE AVB Contact Telephone Nwnber: ' DUBLIN, CA .94568 (213} 725-6619 Response Aue Date: December 1, 1994 Dear Applicant: IIefoze we can de~ezmine whethpr your ~rganization is ~axempt from Federul income bax, we must izave enougn information to show that.you have met all legal _ requirements. You did not include the in~onnation needed to make that determination on your Forrn 1023, Application for Recognition of Exemption Under Section 501(c?(3? of the Internal Revenue Code. To help us determine whether your ozganization is exempt from Federal income tax, please send us the requested information by thP above date. We can then complete our review of your application. If we do not hear from you within that time, we will assume you do not want us to cqnsider the matter further and will.close your case. In that event, as required by Code section 6104(c), we wil,l notify the appropriaCe state officials that, based on the information we have,, we cannot recagnize you as an organization of the.kind described in Code sectian 501(c)(3). As a resu2t, the Internal Revenue Service will treat your organization.as , a taxable entiry. If we receive the information after the response due ; date, we may ask you to send us a new Form 1023. . In addition, if you do not.provide the requested information in a timely mariner, we will consider ~hat you have not taken all reasonable steps to secure ,. the determination you requested. Under Code section 7428{b)(2), your not tak- ing all reasonable steps in a timely manner to secure the determination may be . con5idered as.failure to exhaust administrative remedies available to you with- in the Service_ Therefore, you may lose your righte to a declaratory judgment under Code section 74`8. If you have any questions, please contact the person whose name and teiephone number are shawn in the heading of.this letter. Thank you for your cooperation. ' , Sin erely yours,. , ~ ~`r Exempt Orga.nizations SpeCialist , _ Letter 1312 (DO/CG) -2-` DUBLYN PARTNfiRSITYPS IN EAUCATION Please submit copies of any brochures, pamphlets, newsletters, advertise-: ments, or any ather literature regarding your organization, . Please submit proposed budgets for the years 1995 & 1996 using the assumption that you will have qualified for exemption and will therefore be applying for gxanCs and having fundraisers. As yau are requesting an advance ruling on your non-private foundation status you must subrnit two forms 872-C as stated on page 7 of the application. ~0~,8~2~C (Fiev..luly t993) nsp,anmeAt ot the TreasurY . . xnal~fleverhx Sefvice Under section 6501 {c}(4) of ihe internal Revenue Code, and as part of a request filed with Form 1023 that the . organization named below be treatec3 as a pubticly supported organization under section 170(b)(1)(A}{v) ur section 509(a}(2) during an advance ruli~g period, Dublin Partnerships in Education ..._... .....:..........................:.... . ............• _ .........._..... ..._.._._. District Director of - ' '~,~cr'~~r'~ °~ °~'~8c`°n ~ ~,°"'-" ~ °~~Z"'g °°`~'enr~ Internal Revenue, ~f 7471 Larkdale Avenue, Dublin CA 94568 and the Assistant ..... --• .............••-•-....---••--•............_..---• Commissioner ........................... _...--••-• ~Numoer. srreet, crry or rown, srare, end z-P code) {Employee Plans af~d Exempt Organizations) Consent and agree that the period tor assessing tax (impased under section 4940 of the Code) for any of the 5 ta~c years in the advance ~ling period will exte~d S years, 4 months, and 15 days beyand the end of ihe first tax year. , However, if a notECe of deficiency in tax for any of these years is sent to the organization betore the period expires, ihe tims for making an assessment wil! be further extended by the number of days the assessment is prohibited, plus 60 days. December 31, 1994 Ending date of first tax year _.--•-------------•--•--..._._............. (MOntA, day. and yea~ Name of organization {as shown in organizing document~ Dublin Pa tner ip i.E ti OK~cer or trusi havin a o o si Signature - ~~ For lRS use only Date l l--t~ ~-~~ Tide - V 4 r~G~ C~' District 17irector or Assistant Commissioner (Employee Plans and Exempt ~rganizations) i Date I 8 ~. for Papervrork ReducUon Act Notice, see page 1 of the Fortn 1023 lnstrucOorts. Cat No, t69o60 . Consent Fixing Period of Limitation upon : Assessment of Tax Under Section 494~ of the lnternal Revenue Code (See instruciions dn reverse side.} OMB No. 1545-0056 To be used with fom~ 1~21. Submft _ in duplfeate. ~alPndar Yeaz 125 Revenues t~1ro~~ed): tuncheon Fundraiser .....:........... $3,000 Donations ........................................ 504 Total :..........................................:.. $3,500 ~enses ~~roj~~ ~ ed): Printing and Mailing .................... $500 Meeting Expenses .......................... $250 Day of the Teacher Reception....... $500 Surplus Warehouse Business Supplies .................................. 2 0~0 Total : ............................................. $3,250 Balance :................................:................ $250 ('alenda Ye r 1996 . ...:.............................. $250 C~~ver ......... ..... Reveni~es tp.~.jected}: Luncheon Fundraiser ...............:..... $3,500 Donations ......................................... 1 000 Total : ................................................. $4,750 Exvens ~ (projected}: Printing and Mailing ............:............ $500 Meeting Expenses .............................. $2S0 Day of the Teacher Reception........... $500 Surplus Warehouse Business Supplies ...................................... $2,000 Mini-Grant I'rogram ..........:............ 1 250 Total :................................................ $4,500 ~ Balance :.................................................... $250 ; Dublin ParEners In Educatian (DPIE} Financial SEatement and Balance Sheet DPIE has been in operation for two years; however, its primary purpose during these two years was to build membership. Therefore, very little revenue and expenses were incurred. R~vettues Printing and Mailing ..................... $500 Meenng Expenses .......................... $250 Donations Received ....................... 300 Tatal :............................................. $1,050 Galendar Year 1994 (Current} Reven~es Printing and Mailing ....................... $500 Ivleetizg Expenses ............................. $250 Donations Received to Date .:....... 1 813 Total :................................................ $2,563 ~;xFens~g i'rinhng and Mailing ..................... $675 Meeting Expenses ......................... 00 Total :......................:...................... $1,075 Balance : ............................................... <$25> E~c;g~~..(I'rojected) Printing and Mailing ........................ $500 Meeting expenses .............................. $250 Advertising projects (promo~ionai video and brochures) .................. 1 500 Total :..................:............................. $2,25U Balance :...............................:.................... $313 . . . ~~ . . ~ ~ ~ t~' A~ J ~~ INTERNAL REVENUE SE~VICE DEPARTMENT OF TAE TREASURY DISTRICT DIRECTOR 2 CUPANIA CIRCLE MONTEREY PARK, CA 91755-7406 Date of this Notice: OCT..21, 1994 Person to Contact: ~. EO DESK OFFICER . DUBLIN PARTNERSHIPS IN EDUCATION Telephone Number: C/O CHERYL MATTHEWS (213) 725-1758 7471 LARKDALE AVE Case Number: DUBLIN, CA 94568 954257003 ~ File Folder Number: 958665431 Days to Process: 100 Application for Recognition of Exemption from Federal Income Tax _ We have received your application for recognition of exemption.from Federal income tax and have assigned it the case number listed above. You should refer to that number in any communication with us concerning your application. we will review your application and send you a reply as soon as possible: However, we must process applications in the order that we receive them. ~ You may normally expect to hear from us within the above processing time. If you do not hear from us within that period and choose to write again, please ;';_ include a copy of this letter with your correspondence. Also, please provide a telephone number and the most convenient time to call if we need to contact you. Tliank you for your cooperation. Form.5548 ~ G - ~. - 2 _ HOW TO OBTAI_N INFOt~2MATION ABOUT YOUR APPLICATION As .indicated, you should hear from us.within 100 days. If you do not, or you wish to inquire about the status of your application, you can obtai.n such information 15 days after the date of this letter, when it will be accessible on our Touch Tone System. INSTRUCTIONS 1, A touch tone telephone must be used: 2. Wait at least l5 days from the date of this letter prior~to ,, Gaiii.iay`. 3. Dial 1-800-829-0750 to access the system. 4. When requested, enter identifying numbers exactly as they appear on page one of this le tter. 5.. If your organization h as not yet received an Employer Identification Number (EIN), enter your 9 digit Case Number instead. REMINDERS * It is imnortant to have a copy of this letter available when accessinq the svstem. * Be aware that for all other purposes (except.as specified in #5 above) an EIN and Case Number are NOT interchangeable. Do not use your Case Number when filing returns. * The Employee Plans/Exempt Organizations Au~omated Info~mation System is onlv for the use of applicants and their authorized representatives. Do not share your access numbers with unauinorized persoris. INTERNAL REVENUE SERVICE LOS ANGELES KEY DISTRICT • DUBLIN UNIFIED SCHOOL DISiRICT ~ ' ' ' PAYMENT AUTHORIZATION. I certify that the attached invoice is for materials, supplies or services used for school purposes; and authorize payment. ~U'/ , ~-r3-~~ . 'Signature Date ~ ~ S -~ . . Vendor ACCOUid7 NUMBER DOLLAR AMOUNT F.UND OBJECT LOC PROGRAM LS USER 1 d ~~o ~ 0 1/ ~ o 000 ~ ~ CTL 3 FUND ,:: .:. : ACCOUNT IVUMBER , fUND OBJECT LOC PROGRAM I S IICFR rT~ -- .,.,". „ ~ ~ ~. ~ so. ~ DOLLAR AMO INT ~ DOLLAR AMOU~T $ ACCOUNT NUMBER DOLLAR AMOUNT ~UND OBJECT LOC PROGRAM LS USER CTL .~ ~ ~ ~ GRAND TOTAL $ ISD • 604= B3 ACCOUNT NUMBER OBJECT LOC PROGRAM LS t~~FR rTi , Jur~ 1:;.1~y4 08= i2A!'1 F~JM ds i , Fam ~~~ ~ ' (~. Ce~ }`~ M~ Ri :tiir sxvk~ To a~96s3z U~er Fee ~ar Exempt O~g~nix~tian Det~m[nation Letter Raquest 1- AttsCh thl~ tortrl to d4t~nnEnation F~ttor s~ppitcrtian. (form &728 Is NOT s~~lsrminntion tatter sp Ilc~tlc P.DS rer e~es tsa o~ ca~uanun,n.- ~~M p.ie u~i»,a..,« ~ n.~.. o~ ~+~ v~~-~~ -~ t°P,~=T-r-a ~t~ sr+ ~ r ~ ~s C nv G.a-r~ v-,e Z Type of nqu+st (CMtk on1~ ane box ~nd lncludo s chrk Or money order rt~ade payeLk to Int~emat Revenue Fee s.~,r~ tx n-..~,~ ~-,h~ indicatnd feer a~ Inftial flqtllbt tOr ar1 exsmpt 0[$~nix~tian determinstiDA letter (bo IJOT use tor a pension plsn detcrminet~on {ettsr~~]I sn organlatian whose annua!g~os~ rtctipts h~ not exceeded.(or are not exp~ctad to ~oc~ed) ilO,OfJR• evera~ed vrer the pretedin~ /our taxeble ysars, or new organ¢atbna wAfch entldpatv IitinWSi + gross rota+p~ srera~~ nd d+or~ thsn 510,004 durtng their first four years, if you chec~c this box rou must I ; 1~ Cotnpkte t~e Incorne oertiflcatlon belvMr . . . . . . . . . . . . . . . . . . . . . Grtlfk~ctlon I h~~ vert}fy that the snnual ~tou reoefpcs ot ~`_' bt :n ~'~"r-~v-ersh;~ :~?..~a~ct~ioR have nr,t •--(riiiin~meoia~nastlor~ --.._..._. g~~~ tp~ uo ~ ) ppp e over tho prtceding faur {or t„e flrst fou~) ysars of . ~ r _::...... ......_...~.. -•-~-• -- - T~le -----~~.!~GT~R .............. ..... b^ Lnitial ropuest ipr ar- wxempt o-gantz8tlon datermination 4etter (dtl MOT use ior e qens+on plsn dctertnfnatio+- lette~ ~tnprg~enization wM~+e annual gross reteipts Fta-~ exuetded (or are rzpected to osoee~ S10,000. a1+ef~ vYBf thb pr8~dtr~ fRtt taxaDl6 y63fs, Qr a ns~ cYgdnizetion whi~ anhcipeteb snn~al g-oss nc~~Pts S~~~ sv~~ more t~n j10.000 durin~ their flrst.iaur yesn . . . . . . . . . . . . . . . C^ Prtv=tt tOUfTdBtlOt1 which hea Con+D~t~te4 A eectaon 5O7 terminnlion ~nd whiCfi seaks a d~tormintrdtrrt lettef ~~~ tMt It 1~ r~ow a puhtlc cherity . . . . . . . . . . . . . . . . . . . . . . . . • ~ ^ G~oop reeemp4ion IsEt~rs . . . . . . : . . . . . . . . . . . . . . . . . . . . ~ 500 ~~1i~UCt~~RS be sura ttt$t yow ayplicatiat is sent to (he -~bvowrqus. A~n. ~°'~ ~^'~""^~ I~wnr a...r.r s~-voc~ ~l~o nr~on a Ilcable adOress shown below. 7»ese . ~"'''~`~ -~ou~mn wa ~~ ~ Ths DInnlOus 9tKlget ReC~nclttadon 1-Ct d a0areases superao0c the addresxs hsted ~~ ~ o paenon~ ary, ~ ~~ Tx ~~~ 1990 reqUf-as p-yment of a trsa tee, fvr !n PubNcation 557 $n4 all apptlcet;on s~h t,~ ar• ~ d~termirlatto~l klter requests submfttad !o temis. ~U,ne ~;,.,i„~,.,,,, hweal q.+.~w o.nic~ tAd intornal R.waur S~rvic~. Tho fae ~+~ ~•~8 ~+~ . ~,,,,e;,, ~. ~~co o~~ R~t atC~iilp8ny e~ch -eqaest 3UbmRte~ If saflb Is M ~r e.t.r~nat~ tn~red+lr, C~.~~ . P.O, 8R 9N !D ~ kty dEstT1G1 Off1C1. el~k IRf Dlsitita bttr ta thi. a~dd.w J~ck~a~.l+cw.omlM. NaMdb W1~ Radc Ailarwa. GI13C370 Th~ iw for eacht~. nf nqiuQSt for An ~ ~ . . Na,+ dt~.~ ~mksation tatter is t i s i dsb tb e _. soaon -o. ~ ~ .t~ r i~+d+tit t~e~,~ 5.~oa ~ ocemp o n ze n e 1f~b 1T1 1t8m ~ O~f ~!'{f5 f0I1f1. ~.hOCk'[h4 t ~} ~ ' ~ . ~ ! Q . o~^~do, ~ ~ ~ EPI~ tkvabn ~ 8 6 P• o k+cr~al~e. ~91~abeei~~ tL,1! ~~ IMwfMI RMru-~lo! ~t+~ ' 1Y7 r 0 £ N ~PE d ~UCi ~! 1 dlAC ~OC~ ~1~ y0Y af'I 3YbR1F~ilf~. ~fW ~C[~Cfl 11115 ~fifl prl Ml~n . P Ptwld~nEb 12~2 Y Brod~yn. M 1 PbrtLnd ~ ru 1~1~l, !~n t, eN IEmrn l . . . ' Iw M*rMM. CJ~ 4~Of~ia~ 1D It1E ~TOnt d( ~tn ~VIIMd ~~Ot'111 LIOt~ 9~di+~on. DMtrkt at h.l.rrul R.ren~~ Sa~ce ~ ~ Su1i1~ O~Df fDf ~11e W{~}1.~ C~t!(~t Qf fl'IO tdumEl~, Plt~~nd4 . EP/ED Division ~~~ Y~4wrnI i1NM~ ~w ~ smourrt indlcRLod. Nt1 th1- CMek or 1/KN1lMJ~ Or~f ~]I~~IP tD 2tM ~~~I rtiehmond, N.w..k. Pnt~d~tptdu. ~ P. U. 9ac 17D10 Bahimow. MD 21Z03 s.~ r..,+c:.eo E~8 Aplk~ R~1-~ op 9F Rewenw Servke, '" '~~`~'a~in-:i~ , s:~f~ a9~ios 0+6.rndn.8on btter requests rec~n+ed ~ wil1) ~0 psrmafli Or ~vkfi an InstiffiCiOM ~Jnamutl, taine4~d. I d4~~ h~t~.~.I Rev.niw serve~~ Ep/E0 a~~o~+ ~~ ~~~~~ ~ p~ ~""~° ' nt rill 6~ r~tumsd to th~ a~PAcsnt ld f 0~b n ~ Lauisr1 ~, P~rkersDUR P. 0. Bm 3359 */~wM~ mfPa. P~W S~ Loak ~l 5 2~n f. DrsOeio DPN 2o- Cl~e~l0. Il 60E0~ M. 7 0 81la f~~fSklR Of ~F1~~ I tt l Ofndn~ti. ON 4528] . . . ~'"'~1i1d e er. on dstays In rao~lrq ~ eberrnirwt ~ ~ m ~ ~ ~' < -7Z~' C_~~ ~_ ;ti.l~t-{~..~,~1 a ~:. ~'"~OIV~ .~ '~~cil'U ~?°<t~~~ ~~~ r.,} ~ 4. ~a i N s~ ~_~ ~'~ ~ Q:1 lS~ T~ ~~,~ -r~- ~ ~ ~ ~~ ~~~~f-~` ~- t ~•~ -~4 , •u.~.flPOs19f+6a26$-OOQI~00 tT ~~s. rorm 873a c~++•1o-sc4 TOTAL P.~31