C].,IENT ' S COPY

BTaIn,WESTHALL & CoCERTIFIED PUBLIC ACCOUNTANTS

4427 E.56* Sr.DAVENpoRr. tA r.5635145522 F.5635143334A DIVISIoN oF NoRTHWEST BANK & TRUST CoMPANY

AMY M.WESTFALL, CPA

November 73, 2019

NA}II GreaEer Mississippi valley1035 w Kimberly Rd #4Davenport, IA 52805

NAMI creaEer Mississippi vall-ey:

Enclosed are the original and one copy of Ehe 2018 ExemptOrganizaiion reEurn, as fo11ows. . .

2 018 Form 990

Each original should be dated,with Ehe filing instructions.for your fi1es.

Amy M Westfall

signed and fileil in accord.anceThe copy should be retained

Members American Inslitule ofCenified Public Accounlanls. Privale Companies Pracfice Secrion

Iowa Soci.ty ofCerlified Public AccounlanB

Very Eruly yours,

TAX RETURN FILING INSTRUCTIONS

FORM 990

FOR THE YEAR ENDING

December 31, 2 018

Prepared for

Prepared by

Amount dueor refund

Make checkpayable to

Mail tax returnand check (ifapplicable) to

Return mustmailed onor before

Speciallnstructions

This reE.urn hawish to have isign, date, anthen submit thpaper copy ofus by November

NAI,II Greater Mississippi Valley1035 w Kimberly Rd *4Davenport, IA 52805

B1air, Westfall & Co.100 E Kimberly RdDavenport, IA 52806

Not applicable

No! applicable

Not. applicable

Not applicable

sbETdree

een prepared for electronic filing. If youransmitted elecEronically to the TRS, pleaseeturn Form 8879-EO to our office. We willlect.ronic return to the IRS. Do not mail areEurn to the IRS. Return Form 8879-EO t.o

, 2079.the

15

800941

***** THJS IS NOT A FILEABLE COPYIRS e-file Siqnature Authorizati

for an ExEmpt Organizationon

..,.8879-EOFd calenda yd 2018, d ris@ly@ begnning 20182a

Oop4lment oi the Trss!.ynl*narFeve.ue Servce

3a Form 1120.POL check here >

> Do not send to the lRS. Keep lor your records

b Balance Due (Form 8868, line3c)

b Totalrevenue, if any (Form 990-EZ,line 9) .............................b Totaltax (Form 1120'POL, line22)

b Tar based on investment income (Form 990 PF, Part Vl, line 5)

nName ol exempt organEation Employer identificalion number

NAMI Greater Mississi i val-l-e 42 7t88963Name and title ol olficer

Terry HaruPr n

Type of Return and Return lnformation (whote Do tars onty)

Check the box for the return for which you are using this Form 8879-EO and enter the applicable amount, if any, Irom the return. lf you check the boxon line la,2a, 3a,4a, or 5a, below, and the amount on that line forthe return being filed with this form was blank, then leave line lb, 2b, 3b,4b, or 5b,whichever is applicable, blank (do not enter-0-). But, if you entered '0- on the retum, then enter {' on the applicable line below- Do not complete more

than one line in Part l.

'la Form gg0 check here >2a Form 990.E2 check here

x b Total revenue, if any (Form 990, Part Vlll, column (A), line12) L77 004.

4a Form 990-PF check here

5a Form 888 check here >

1b

2b

3bilb

5b

>E

Etr[

Under penalt,es of periury, I declare that I am an officer of the above organization and that I have examined a copy of the organization's 2018electronic return and accompanying schedules and statements and to the best of my knowledge and belief, they are true, correct, and complete. I

further deciare that the amount in Part I above as the amount shown on the copy of the organization s electronic return. I consent to allow myintermediate service provider, transmitter, or electronic return originator (ERO) to send the organization's return to the IBS and to receive from the lFiS(a) an acknowledgement of receipt or reason for rejection of the transmission, (b) the reason for any delay in processing the rcturn or refund, and (c)the date of any refund. lI applicable, I authorize the U.S. Treasury and its designated Financial Agent to initjate an electronic funds withdrawal (directdebit) entry to the financial institution account indicated in the tax preparation software for payment of the organLation's lederal taxes owed on thisreturn, and the financial institution to debit the entry to this account. To revoke a payment, I must contact the U.S. Treasury FjnancialAgent at1-888,353-4537 no later than 2 business days prior to the payment (settlement) date. I also author2e the financia, institutions involved an theprocessing of the electronic payment of taxes to receive confidentaal information necessary to answer inquiries and resolve issues related to thepayment. I have selected a personal identiflcation number (PlN) as my signature for the organization's electronic return and, if applicable, theorganization's consent to electronic funds withdrawal.

Offlcer's PIN: check one box only

ER0lirm name Enter live numbers, butdo nol enter all zeros

as my signature on the organizalion's lax year 2018 electronically filed retum. lf I have indicated within this return that a copy of the retumis being filed with a state agency(ies) regulating charities as part of the IRS Fedlstate program, I also authorize the aforementioned EBO toenter my PIN on the return's disclosure consent screen.

As an oflicer of the organization, I willenter my PIN as my signature on the organization's tax year 2018 electronically filed return. lf I have

indicated within this return that a copy of the return is being filed with a state agency(ies) regulating charities as part of the IRS Fedlstateprogram, I will enter my PIN on the return's disclosure consent screen.

Otficefs signature > ***** THIS IS NOT A FIL,EABLE COPY * * * Date >

rtif ication and AuthenticationERO's EFIN/PIN. Enter your six digit electronic filing identification

number (EFIN) followed by your five.digit self-selected PlN. 4201'7770376Do not enter all zeros

I certity that the above numeric entry is my PlN, which is my signature on the 2018 electronically ,iled retum for the organization indicated above. I

confirm that I am submitting this retum in accordance with the requirements of Pub. 4163, Modernized e.File (MeR lnformation for Authorized IRS

e-fiie Providers tor Business Returns.

ERo s siqnature > Date >

art

ERO Must Retain This Form - See lnstructionsDo Not Submit This Form to the IRS Unless Fequested To Do So

Form 8879-EO (2018)

E

E tauthorize B1air, Westfall & Co. ,oun,u..nyPtru@

LHA For Paperwork Reduction Act Notice, see inslruclions.

323051 t0-26 Ta

Extended to November 75, 2079Return of Organization Exempt From lncome Tax

Under section 50'l(c),527, or 4947lallll ol the lnternal Revenue Code (except private toundations)

> Do not enter social secu.ity numbers on this lorm as it may be made public.

toA For the m18 calendar r, or tax rb tnntn and endin

B che.k I D Employer identilication number

,"rr 990DePtlmenl ol tFe Treas!ryhternal RevenueServ'ce

2018to Public

n

42,L788953E Telephone number

2]-0 94L.

I Tax exe t status 501 C

J Website: www. nam]. .orK Form of an zation:

insert no 4947 a 0r3 501

Y.s E Ho

Yes No

527 lf 'No, attach a list. (see instructions)

H c Grou n number >oll mtcr I

ilv and

H(a) ls this a group retum

forsubordinates?.H(b) te arsuoao,nar* ncr,oear

Summ1 Briefly describe the organization's mission or most significant activities Provide support for fam

C Name of organization

NAI'{I GreaEer Mississi i Va11eDoin business as

Number and street (or P.0. box ii mail is not delivered to street address)

1035 w Kimberl Rd #4Room/suite

City or town, state or province, country, and ZIP or foreign postal code

n or IF Name and address of principal officer:Tgt: fy HafU1035 w Kimberl rA 52806orERd Daven

Corporalron Tr!st Association other > L Year of formali n: 197 9Part I

4

6

7a

7b

Prior Year

t4L ,2L8.0

IT,0

10

11

12

Contributions and grants (Part Vlll, line th)Program service revenue (Part Vlll, lane 29)

Investment income (Pan Vtll, column (A), lines 3, 4, and 7d) .. .

Other revenue (Part Vlll, column (A), lines 5, 6d, 8c, 9c, 10c, and l1e)

, line 1Total revenue add lines 8 thro al Part Vlll. columnh11 must LAL,289.0

2 ,63L,77 ,635 .

0

7L8 ,236.198,503.-57 ,2t4.

13 Grants and similar amounts paid (Part lX. column (A), lanes 1-3)

14 Beneflts paad to or for members (Part lX, column (A), line 4)

15 Salaries. other compensation. employee benefrts (Part lX. column (A). lines 5.10)

16a Professional fundraising fees (Part lX, column (A), line 11e) .

bTotalfundraisingexpenSes(Partlx,colUmn(D),line25)>17 Otherexpenses (Part lX, column (A), lines 11a-11d, 11t24e)

18 Total expenses. Add lines 13-1 7 (must equal Part lX, column (A), line 25)

Subtract line 18 from line 1219 Bevenue less ex

BeoinninI ol Current Year

720 ,775.6,1,35.

r.14,040.

n21

Total assets (Part X, line 16)

Total liabilities (Part X, line 26)

n ces. Subtract line 21 from line 20t:PjtilltEEEIL

o.5

.>

2

3

4

6

ersons with mental i1Iness.Check this box > if the organization discontinued its operations or disposed of more than 25% of its net assets

Number of voting members of the governing body (Part Vl, line 1a) .

Number of independent voting members of the governing body (Part Vl, line 1b)

Iotal number of individuals employed in calendar year 2018 {Part V, line 2a)

Total number of volunteers (estimate if necessary)

3 1 0

0

4

0

10.

tr

o,lr,i

7 a Total unrelated business revenue from Part Vlll. column (C), line 12

b Net unrelated business taxable income lrom Form 990.T, lino 38

Current Year

105 990.0.

10.7L

t7'7 004.0.

2 740.6Z aE,)

0.

7L'7 568.

0

0.556.

End oI Year

L442L 769.

2nature

llnder Denalties ol perjury, I declare that I have examined thrs return, lncluding accompanying schedules and statements, and to the best of my knowledge and belief, it is

true, correct, and com lete. Declaration ol I"o TET other than otlicer is based on allinformalion olwhich preparer has an kfow ed

5o3

q

igoature of o

Terry Haru, PresidentDateSign

HereType or pr ft name and l tle

Paid

Preparet

Use 0nly

Ma the IRS discuss this return with th hown above? see instmctrons

PTIN

010 7 315 2Firm s EIN 83-289907 4

Pnoneno.563-514-5522No

Date Cied1t

PrlntrType 0reparer s name

Amy M westfallPreparer s siqnature

Frrm's name Bl air Westfall & Co.Firm's address > 10 0 E Kimberly Rd

rA 52805Daven ort

B32oor 12 31 rs LHA For Paperwork Beduction Act Notice, s€e the sepaaate instructions

.t26.

47',

t8(

Form 990 Po18)

Forrn 990 18

Statement of Program Service AccomplishmentsCheck if Schedule O contains a response or note to any line in thls Paat lll

Briefly describe the organizatjon s mission:

To offer education and support to families and individqqls living wiEhmental i1lness.

NA.I4I r er Mis I 1 i Va11e 42_LT 63 P e2Part lll

2 Did the organization undertake any significanl program services during the year, tich were nol listed on theprior Form 990 or 990.E2?

lI "Yes,' describe these new services on Schedule O.

Did the organization cease conducting, or make signilicant changes in how it conducts, any program services?

lJ "Yes,' de$cribe these changes on Schedule O.

ves E to

ves E No

4

4a (code: _ )(Expenes$

Describe the organization's program service accomplishmenls for each of its three largest program services, as measured by expenses-

Section 501(cX3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and

revenue. if any. ,or each program servrce reporteq.

t23 100.Educa!ion sessions and oEher held lhrouqhout lhe yearincluding various consumer oriented antistigma/copi4q sessions andspeakers.

programs

,lc (code,

-

) (Expenses $

4d Other program services (Describe in Schedule O.)

(expsse S i.cludnsqranls or$

832002 r2-3r-18

123,100.Form 990 (20i8)

4€ Totalorooram service expenses >

4b {coae, _

)

rt

1 x2 x

3

4

5

6

7

8

9

10

11a x

1tb

'l lc

11d

11e x

11t

12a

12b

13

14a

't4b

15

16

17

18 x

19

20a

20b

Form 990 NAUI Greater Mi ssissi i Va11e 42-L188963Checklist of Required Schedules

1 ls the organization described in section 501(c)(3) or 4947(aX1) (other than a private foundation)?

lf "Yes, compbte Schedule A

2 ls the organization required to complete Schedule B, Schedule of ContibutorQ

3 Did the organization engage in direct or indirect political campaign aclivities on behalf of or in opposition to candidates forpublrc otfice? // 'yes, complete Schedule C, Pad I

4 Section 50 l(cx3) organizations. Did the organization engage in lobbying activities, or have a section 50'1(h) election in eftect

dunng lhe tax year? /l 'Yes, complele Schedule C. Patl ll5 ls the organization a section 501(c)(4), 501(cX5), or 501(c)(6) organization that receives membership dues, assessments, or

similar amounts as defined in Revenue Procedure 98"19? /f "yeg " compbte Schedule C, Part I . .

6 Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right toprovide advice on the distribution or investment of amounts jn such funds or accounts? /f 'Yes," camphte Schedule D, Pad I

7 Did the organizalion receive or hold a conservation easement, including easements to preserve open space,

the environment, historic land areas, or historic structures? // "fes, complete Schedule D, Pan ll . . .

8 Did the organization marntain collectaons of works of art, historical treasures, or other similar assets? /f "yes, ' complete

Schedule D. Paft lllI Did the organization report an amount in Part X, line 21, for escrow or custodial account liability, serve as a custodian for

amounts not listed in Part X; or provide credit counseling, debt management, c.edit repair, or debt negotiation services?

ll Yes. conplete Schedule D, Part lv10 Did the organization, directly or through a related organization, hold assets in temporarily reslricted endowments, permanent

endowments, or quasi.endowments? /l'yes," cofiplete Schedule D, Parl V

1l lf the organization's answer to any of the following questions is "Yes,' then complete Schedule D, Parts Vl, Vll. Vlll, lX, or X

as applicable.

a Did the organizalaon report an amount for land, buildings, and equipment in Part X, line 102 ll "Yes," conplete Schedule D,

Patl Vl

b Did the organization report an amount for investments - other securities in Part X, lane 12 that is 5% or more of ats total

assets reported rn Part X, hne'16? /l Yes,'complete Schedule D, Patl Vll

c Did the organization report an amount tor investments - program related in Part X, line 13 that is 57o or more of ils total

assets reported in Part X. line16?/f 'yes. complete Schedule D, PaftVlll

d Did the organizataon report an amount for other assets in Part X, line 15 that is 5% or more of jts totalassets reported in

Part X, lrne 16? /f 'yes, complete Schedule D, Pad lX

e Did the organization report an amount for other laabilities in Part X, ljne 25? /t "yes,' complete Schedule D, Paft X

I Did the organization's separale or consoladated financial statements for the tax year include a footnote that addresses

the organization's liability tor uncertain tax positions under FIN 48 (ASC 740)? if "yes, " complete Schedule D, Paft X

l2a Did the oroanization obtain separate, independent audited financial statements for the tax year? /l 'Yes, conpleteSchedule D, Pafts xl and xll

b Was the organization included in consolidated, independent audited financaal statements for the tax year?

ll 'Yes," and if the organization answered 'No" to line 12a, then completlng Schedule D, Pafis Xl and Xll is optional .

13 ls the organization a school described in section 170(b)(l XAXii)2 lf Yes,' complete Schedule E

l4a Did the organization maintain an office, employees, or agenls outside ofthe United States? .

b Did the organization have aggregate revenues or expenses oI more than $10,000 from grantmaking. fundraising. busrness,

investment, and program seruice activities outside the United States, or aggregate foreign investments valued at $100,000ot mote? lf Yes," complele Schedule F, Patls l and lV

15 Did the organization report on Part lX, column (A), line 3, more than $5.000 of grants or other assistance to or for any

fororgn organzatron? /l Yes,'complete Schedule F, Pafts lland lV ________.

16 Did the organization report on Part lX, column (A), line 3, more than $5,000 ol aggregate grants or other assistance toor for foreign indivrduals? /t yes,' complete Schedule F, Pafts l and lV

17 Did the organization report a total of more than $15,000 of expenses for professional fundraising servaces on Part lX,

column (A). lines 6 and 11e? ll "Yes," comphte Schedule G, Paft I

18 Did the organization report rnore than $15,000 totalof tundraising event gross income and contributions on Part Vlll, lines

1c and 8a? // "Yes, cofiplete Schedule G, Patt ll19 Did the organization report morethan $15,000 of gross income from gaming activities on Part Vlll,line9a? /l yes, "

conplele Schedule G, Pan I

20a Did the organization operate one or more hosprtal facilities? ll "Yes," complete Schedule H

b lf "Yes' to line 20a. did the organization attach a copy of its audited financial statements to this return? . .

2i Did the organization report more than $5,000 o, granls or other assistance to any domestic organization or

domestic

3

No

x

x

x

x

x

x

x

x

x

x

x

x

x

Y

xY

x

x

x

x

x

xx

832003 T2 3r-18

overnment on Part column ll.",e 1'7 ll 'c te Schedule I Patls I and llForm 990 (2018)

Part lV

24a

24b

24c24d

25a

25b

26

27

28a

28b

2Ac

29

30

33

35a

35b

36

38 x

Form 990 018 NA.I"II Greater Mississi iV 42LChecklist of Required Schedules fcont,nued)

2. Did the o(ganization report more than $5,000 of grants or other assastance to or for domestic individuals on

Part lX. column (A). line2? lf 'Yes,' complete Schedule l, Parts I and lll23 Did the organization answer "Yes' to Part Vll, Section A, lino 3, 4, or 5 about compensation ol the organization's current

and former offacers, directors, trustees, key employees, and highest compensated employeesl ff "Yes," cofiplete

Schedule J24a Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the

last day of the year, that was issued after Decenbet 31,2OO2? lf 'Yes," answer lines 24b through 24d and complete

Schedule K. ll No." go to line 25a

b Did the organization invest any proceeds of tax.exempt bonds beyond a temporary period exception?

c Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease

any tax.exempt bonds2

d Did the organization act as an 'on behalf of" issuer Ior bonds outstanding at any time during the yea1 -

25a Section 5O1(cX3), 5O1(cX4), and 5Or(cX29) organizations. Did the organization engage an an excoss benefit

transaction with a disqualified person during the year? /t "yeg' complete Schedule L, Parl I - . -

b ls the organization awa.e that it engaged in an excess benefit transaction with a disqualified person in a prior year, and

that the transaction has not been reported on any oflhe organization's prior Forms 990 ot g9o-A? lf "Yes," complete

Schedule L. Paft I

26 Did the organization report any amount on Part X, lane 5, 6, or 22 for receivables from or payables to any current or

former otflcers. directors, trustees, key employees, highest compensated employees, or disqualified persons? /f "Yes, "

complete Schedule L, Pad Il

27 Did the organization provide a grant or other assistance to an officer, director, trustoe, key employee, substantial

contributor o. employee thereof, a grant selection committee member, or to a 35% controlled entity or family member

of any of these persons? # yes. complete Schedule L, Pad lll29 Was thg organization a party to a business transaction with one of the following parlies (see Schedule L, Part lV

instructions for applicable filing thresholds, conditions, and exceptions):

a A cu(ent or former officer, director, trustee, or key employeg? /f ' yes, ' compbte Schedule L, Paft lV

b A family member of a current or former officer, director, trustee, or key employee? /f "yes, ' complete Schedule L, Part lV

c An enlity of which a cunent or former officer, director. ttustee, or key employee (or a family member thereo0 was an officer,

director, trustee, or direcl or indirect ownef ll "Yes," complete Schedub L, Pan lV

29 Did the organization receive more than $25,000 in non-cash conkibutions? /f "yes, cofiplete Schedule M . .

30 Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation

contnbutDns? // "yes, complete Schedule M

31 Did the organization liquidate, terminate, or dissolve and cease operations?

lf Yes, complete Schedule N, Paft I

32 Did the organization sell, exchange, dispose oI, or transfer more lhan 25yo of ats net assets?/f "fes," compbte

ScheduE N, Paft ll33 Did the organization own 1oelo of an entity disregarded as separate from the organization under Regulations

secrions 301 .7701 2 and 3o1.7701.3? lt "Yes," complete Schedule B. Pad I

34 Was the organization related to any tax'exempt or taxable enlity? lf 'Yes," cotnplete Schedule R, Pai ll, l1l, or lV, and

Part V, line I

A5a Did the organization have a controlled entity within the meaning of section 512(b)(13)?

b lf 'Yes ' to line 35a, did the organizataon receive any payment f rom or engage in any transaction with a controlled ontity

within the meaning of section 512(bX13)? /f "Yes," conplete Schedub R, Paft V, line 2

36 Section 501(cX3) grganizations, Did the organizatjon make any transfers to an exempt non-charitable related organization?

/l "yes, " complete Schedule R, Pai v, line 2

37 Did the o.ganization conduct more than 57o of its activrties through an entity that is not a related organization

and that is treated as a partnership for federal income tax purposes? lf 'Yes," compbte Schedule R, Pai Vl

38 Did the organization complete Schedule O and provide explanations in Schedule O for Part Vl, lines 11b and 19?

N All Form 990 file lete Schedule OStatements Begarding Filings and Tax ComplianceCheck if Schedule O contains a response or note to any line in this Part V

4

No

x

No

x

x

x

x

x

x

xx

xx

x

x

x

X

xx

x

x

lab

c

Enterthe number reported in Box 3 of Form 1096. Enter-O il not applicable

Enterthe number ol Forms W.2G included in line 1a. Enter'G if not applicable

Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming

amblr

1a 0

1b 0

1c

332004 12-3r-18

\!lnn sto rize winners?

Form 990 (2019)

I Part vl

artYes

x

3a3b

4a

5b

5c

6a

6b

7a

7b

7c

7e

7t7q

7h

I

9a

9b

10b

11b

12a

13a

13c

14a

14b

15

16

990 A.I4I reater MissisStatements Regarding Other IRS Filings and Tax mpliance @ontinued)

42-1188953 5

4

b lf at least one is reported on line 2a, did the organization file all required Iederal employment tax returns? .. . .

Note. lf the sum of lines 1a and 2a is greater than 250, you may be required to e-li/e (see instructions) .

3a Did the organization have unrelated business gross income of $1 ,000 or more during the year?

b lf 'Yes," has it filed a Form 99O-Tforthis year? ll"No to line 3b, provide an explanatton in Schedule O

4a At any time during the calendar year, did the organization have an interest in, or a signatirre or other authority over, a

financial account in a foreign country (such as a bank account, securities account, or other financial account)?

b If 'Yes,' enter the name of the foreign country: >See instructions for Iiling requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts {FBAB).

fra Was the organization a party to a prohibited tax shetter transaction at any time during the tax yea,b Did any laxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?

c lf 'Yes" to line 5a or 5b. drd the organization file Form 8886 T?

6a Does the organization have annual gross receipts that are normally grealer than $100,0O0, and did the organization solicit

any contnbrrtons thal were not tax deductible as charitable contributions?

b lf "Yes," did the organization include wilh every solicitation an express statement that such contributions or gifts

were not tax deductrble? _

? Organizations that may receive deductible conlributions under section 170(c).

a 0id the organization receive a payment in €xcess of $75 made padly as a contribution and partly for goods and seryic€s provided to the payor?

b lf 'Yes, ' did the organization notify the donor of the value of the goods or services provided?

c Did the organization sell, exchange, or otherwise disposo of tangible personal property for which it was required

to file Form 8282?

d lf "Yes," indicate the number ol Forms 8282 filed during the year

e Did the organization receive any funds, directly or indirectty, to pay premiums on a personal benefit contract?

I Did the organization, during the year, pay premiums, directly or andirectly, on a personal benefit contract?

9 lf the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?

h lf the organization receivod a contribution of cars, boats, arrplanes, or other vehicles, did the organization file a Form 1 098-C?

Sponsoring organizations maintaining donor advised Iunds. Did a donor advised fund maintained by the

sponsoring organization havo excess business holdings at any time during the year?

Sponsoring organizations maintaining donor advised funds.

a Did the sponsoring organization make any taxable distributions under section 4966?

b Didthesponsoringorganizationmakeadistributjontoadonor,donoradvisor,orrelatedperson?....t0 Section 501(cX7) organizations. Enter:

a lnitiation fees and capital contributions included on Part Vlll,line12 .

b Gross receipts, included on Form 990, Parl Vlll, line'12, for public use of club tacilities

ll Section 501(cX12) o.ganizations. Enter:

a Gross income from members or shareholders ... ... .........b Gross income trom other sources (Do not net amounts due or paid to other sources against

amounts due or received from them.)'l2a Section 4947(a)(1) non-exempt charitable trusts. ls the organization filang Form 990 in lieu of Form 1041?

2b

x

xx

x

x

x

I

10a

1la

12b

13b

b lf'Yes,"entertheamountoltax-exemptanterestreceivedoraccruedduringtheyear...........13 Section 501(cX29) qualified nonp.ofit health insurance issuers.

a ls the organization licensed to issue qualified health plans in more than one state?

Note, See the instructions for additional information the organization must report on Schedule O

b Enter the amount of reserves the organization is required to maintain by the states in which the

organization is licensed to issue qualified health plans

c Enter the amount of reserves on hand

14a Did the organization receive any payments forindoor tanning services during the tax yea(? ..

b lf "Yes," has it filed a Form 720 to report these payments? /f 'No,' ptovide an explanation in Schedule O . .

15 ls the organization sublect to the section 4960 tax on payment(s) of more than $'1,0m,000 in remuneration or

excess parachute payment(s) during the yeaf? .

lf "Yes." see instructions and lile Form 4720, Schedule N-

16 ls the organization an educational institLrtion subiect to the section 4968 excise tax on net investment income?

tf 'Ye

x

x

x

832005 12 31-18

com Fotm 4724 Schedule O

Form 99O (2018)

2a Enter the number of employees reported on Form W 3, Transmittal of Wage and Tax Statements,

filed loa the calendar year ending with or within the year covered by this return

No

Form 990 A.I{I reater Mississi i val1e 42-II88963Governance, Management, and Disclosure Fo r each "Yes" response to hnes 2 through 7b betow, and for a 'No response

to line 8a, 8b, or 10b below, descibe the circumstances, processeg or changes in Schedule O. See ,instructiors

Check if Schedule O contajns a response or note to any line in this Part Vl .. .

brt Vl

Section A. Governin Bo and Mana ement

1a

b

2

3

45

6

7a

b

8

a

b

9

Ente.thenumberofvotingmembersofthegovemingbodyattheendofthetaxyear.........lf lhere are malerial diff€rences in voling riohts among members of lhe governing body, 0r lf the governing

body delegated broad authority to an execulive committee or slmilar committee, explain in Schedule 0.

Enterthenumberolvotingmembersincludedinlinela,above,whoar€independent.. ..

Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other

officer, director, trustee, or key employee?

Did the organization delegate control over management duties customarily performed by or under the direct supervision

of officers, directors, or trustees, or key employees to a management company or other person? ... . . ..

Did the organization make any significant changes to its governing documents since the prior Form 99O was filed? .

Did the organization become aware during the year of a significant diversaon of the organization's assets? .

Did the organization have members or stockholders? .

Did the organization have members, stockholders, or other persons who had the power to elect or appoint one o.

more members ol the governrng body?

Are any govemance decisions of the organization resetued to (or subject to approval by) members, slockholders, orpersons other than the govemrng body?

Did the organization conlemporaneously document the meetings held or written actions unde(aken durin0 the year by lhe followinO:

The governrng body?

Each committee with authority to act on behalf of the governing body2 ...........-....ls there any officer, director, trustee, or key employee listed in Pan Vll, Section A, who cannot be reached at the

ion s mail address? /l "Ye the names and hedule O

Section B. Policies Section B infotmation about ies nof ned b the lntemal Revenue Code

10a Dd the organizatlon have local chapters, branches, or affiliates?

b lf 'Yes, " did the organazation have written policies and procedures goveming the activities of such chapters, affiliates,

andbranchestoensuretheiroperationsareconsistentwiththeorganization'sexemptpurposes?.........................

11a Has the organization providod a complete copy of this Form 990 to all members of its governing body belore filang the form?

b Describe in Schedule O the process, if any, used by the organization to review this Form 990.

t2a Did the organization have a written conllict of interest policy? lf "No," go to line 13 .. . .....

b Were oflicers, dtrectors, or trustees, and key employees required to disclose annually interesls that could give rise to conflicts?

c Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe

in Schedule O how thrs tvas dore ........13 Did the organization have a written whrstleblower policy?

14 Did the organization have a written document retention and destruction policy?

l5 Did the process for determining compensation of the following persons include a review and approval by independent

persons, comparability data, and contemporaneous substantiation ol the deliberation and decision?

a The organization's CEO, Executive Director ortop management official

b other offlcers or key employees of the organizatton ........ ...

lf 'Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).

16a Dad the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a

taxable entity during the yean

b lI "Yes,' did the organization follow a written policy or procedure requiring the organization to evaluate its participation

in joint venture anangements under applicable federal tax law, and take steps to safeguard the organization's

exem status with to such arran ements?

Section C. Disclosure

1a 10No

x

No

x

X

xxx

x

x

xx

x

Yes

1b 0

3

4

5

6 x

7a x

7b

8a x8b x

I

10a

10b

11a x

12a x12b x

12c'13 x14 x

't 5a

15b

16a

16b

17

1A

List the states with \rhich a copy of thas Form 990 is req u red to be fied >IASection 6104 requires an organrzation to make its Forms 1023 (1024 ot 1O24-A il applicable), 990, and 990.T (Section 501(cx3)s only) available

apply

E Other (expla/h ih S chedule O)

19 Oescribe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial

statements available to the public during the tax year.

20 State the name, address, and telephone number of the person who possesses the organization's books and records >Terry Haru 563-386 7 411

'for public inspection. lndicate how you made these available. Check all that

E own website f] Anotheas websit" [X j upon request

832006 12-31-18

imberlv Rd, DavenDorE, rA 52805Fornr 990 (20tB)

1035 w K

fft

Form 990 18 NA.I"II Greater Mi s 42 lL88 63 Pa elCompensation of Officers, Directors, Trustees, Key Employees, Highest CompensatedEmployees, and lndependent ContractorsCheck if Schedule O contains a response or note to any line in this Part Vll

Part Vll

Section A. Ofricers, Oireclors, Trustees. Kev Employees, and Hiqhest Compensated Employees

,a Complete this table for all persons required to be listed. Fleport compensation for the calendar year ending with or within the organization's tax year

a List all of the organtzatron s current ofllcers, directoas, trustees (whether individuals or organizations), regardless of amount of compensation.Enter .0 in columns (D). (O. and (D rf no compensation was paid.

a Ust ail of the organization's current key employees, f any. See instructions for definition of 'key employee-a List the organization's five current highest compensated employees (other than an officer, director, trustee, or key employee) who received report.

able compensation (Box 5 of Form W.2 and/or Box 7 of Form 1099.MlSC) ol more than $100,000 from the organization and any related organizations.. Ust all of the organization's former officers, key employees, and highest compensated employees who received more than $100,000 of

reportable compensation from the organization and any related organizalions.. List all of the organization's former directo.s or tustees that received. in the capacity as a {ormer director or trustee of the organization,

more than $10,000 of reponable compensation from the organizataon and any related organizations.

List persons in the following order: individual trustees or dkectors; institutionaltrustees; officers; key employees; highest compensated employees;and former such persons.

E Check this box if neither the nization nor an related anization com nsated an current off cer director or trustee

(F)

Estimatedamount of

othercompensation

from lheorganizationand related

organizalions

(A)

Name and Trtle

( 1) Angela callaqrherExecu

(5) Laurie Edqre

Trea

(2) Denise Beenk

President(3) John Bownan

Board uem.ber

(4) Ardrew orrego LinalsLad

Board Menber

0

0

0

0

0

0

0

0

0

0

0

(8) Tirn LohseBoard Memter(9) lrary PeterBeaBoard lletrlber

(5) Terry HaruBoard Menber

(.1-t, lorr 1 smrEn

Board Member

(7 ) Elesba Gal'nan

d L

(c)Position

(do not chel< more tha on€box, unless pgen Ls both aonid &d a dt€ror/fusr@)

(B)

Averagehours per

(list anyhours forrelated

organizationsbelowline)

(D)

Beportablecompensation

fromthe

organization(w.2/1099.MrSC)

(E)

Reportablecompensationfrom relatedorganizations

(w,2/1099.Mrsc)

30.000 0x

I. UU

x 0 01.00

x 0 01.00

0x 0

1.000 0x

1.00x 0 0

1.00x 0 0

1.000 0

1.00x 0 0

1.00x 0 0

1.00x 0 0

TIT

832007 12 31- l8 Form 990 (2018)

fl

(10) Larry PoIlard

I

Form 990 18

Section A. Offi Directors 1tMi sl-ss1 i valle

and H est Com Em s

rK

42-7 e8

No

0

(A)

Name and title

'lb Sub-totalc Total Irom continuation sheets to Part Vll, Section A

(F)

Estimatedamount of

othercompensation

from theorganizationand related

organizations

00

d Total add lines 1b and 1c

2 lotal number of individuals (including but not limited to those listed above)who receivod more than $100,000 of reportable

the anization

rendered to the o nizalio..? lf te Sch

Section B. lndependent Contractors

1 Complete thistable for your five hrghest compensated independent contractors that received more than $100,000 of compensation from

the o ization. R rt com nsation for the calendar endi with or within the ization s tax

x

x

x

(A)Name and business address NONE

2 Total number of independenl contractors {including but not limated to those listed above) who received more than

100 000 of com

(c)Compensation

art(c)

Position(do not ch6( mo.e tha onebox. unlesso<s is bothofiics d a dnedo./Vuste)

(D)

Reportablecompensation

fromthe

organization(w-2l1099-MrSC)

(E)

Reportablecompensationfrom related

organizations(!v-2l1099-M tSC)

(B)

Averagehours per

(ljst anyhours forrelated

organizatjonsb€lowline)

0 000

00

Yes

3

4

5

(B)Description of services

832003 12-31-r8

nsation from the ization 0

Form 990 (2018)

3 Did the organization list any tormer ofiicer, director, or trustee, key employee, or highest compensated employee on

l(re la? ll 'Yes," complele Schedule J for such ndtvtdual

4 For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization

and .elated organizations greater than $150,0N? ll 'Yes," complete Schedule J for such individual

5 Dad any person lasted on line 1a receive or accrue compensation from any unrelated organization or individual for services

Form 990 NStatement of RevenueCheck if Schedule O contains a re

s1 i Va11el- 42-tI889 3P e9

Reven ! d:a

se ot note to an line in this Part Vlll

from tax undersections

512 - 514

"c

"r'EEtn

Eo

oo

,9

ozE9

oa!

CE

(B)Belated or

exempt functionrevenue

(c)Unrelatedbusinessrevenue

(A)Total revenue

1a

1b 2,749.1c

1d

1e

'fi 103 241 .

105,990.

a

b

cd

I

Federated campaigns

Membership dues

Fundraising events

Related organizations

Govemment grants (contributions)

All other contributions, gifts, grants, and

similar amounts not included above _

Noncash contrLbulEns ncluded rn lnes 1a-lf:SIh Total. Add lines '1a 1f

Business Code

2ab

cd

e

I Allother program service revenue

Add lines 2a.2f

10. 10.

71,004,

lnvestment income {including dividends, interest, and

othersimilaramoUnts)'',,',,,',,.',''.,,.'.,'.,'>lncomefrominveStmentoftax-exemptbondproceeds>

Gross rents ........Less: rental expenses ... ....

Rental income or {loss)Net rental income or (loss)

Gross amount from sales of

assets other than inventory

Less: cost or other basis

and sales expenses ....

Gain or (loss)

Net gain or (loss) . ..... .....

8 a Gross income from fundraising events (not

including $ of

contributions reported on line 1c). See

Part lV, lane 18 ....................................... a

Less: direct expenses.. .. .. .. ... bNet income or (loss) from tundraising evonts

Gross income from gaming activities. See

Part lV, line 19 ....................................... a

Less: direct expenses . ..... bNet income or {loss) from gaming activilies

Grcss sales ot inventory, less retums

and allowances ............. .. a

Less: cost of goods sold . .. _ _ b

Other

l Beal

b

cd

4

0433

Personal

Net income or loss from saLes of invent

Boyalties

941 .937.

Securilies

6ab

cd

7a

b

c9a

b

c10a

b

Miscellaneous Revenue Business Code

d All other revenue

e Total.Add lines 11a 11d .

'12 Total revelue. See instructions

'tl a

b

c

L77,004. 0 10.

7t 004.

71832009 12-31-18 Form 990 (20i8)

Form 990 l- I1ona enses

Section 501(c)(3)and 501(c)(4) oeanizations must complete all columns. All other organizations fiust complete column (A).

42-1188 63 10

Check if Schedule O contains a onse or note to line in this Part lX

Do hot lhclude dmounts rcponod on lines 6b,7b.8b,9b, dnd 10b of Patl V l.

10

11

2

3

4

5

6

Grants and other assislance to domestic oroanizalions

and domestic governments. See Part lV, line 21 . .

Grants and other assistance to domestic

rndNiduals. See Part lV, line 22

Grants and other assistance to foreign

organizations, foreign governments, and foreign

individLrals. See Part lV, lines 15 and 16 . _

Benefils pad to or for members ... .. .

Compensation oI current officers, directors,

trustees. and key employees ..

Compensation not included above, to disqualilied

persoos (as deiined under section 4958(,)(1))and

persons described in section 4958(cX3)(B)

Other salaries and wages

Pension plan accruals and contributions (include

seclion 401 (k) and 403(b) employer conlributions)

Other employee benefrts .... .. ....Payroll taxes

Fees for services (non'employees):

a Management

b Legal

c Accounting

d Lobbying

e Pr0lessionalfundraisino s€rvices. See Part lV,line 17

t lnvestment management fees.. ....

g Other. (lf line 110 amount exceeds 10% of line 25,

column (A)amount, list line 110 expeflses on Sch 0.)

Advertrsing and promotion . .. . .. . .

Offce expenses...

lnformat@ntechnology .. ... ........Royahres

Occupancy

Travel

Payments of travel or entertainment expenses

for any lederal, state, o.localpublic otficialsConferences, conventions, and meetings

lnterest ..

Payments to affiliates

Deprecjation, depletion, and amortizationlnsurance

0ther expenses. llemize expenses not coveredabove. (List miscellaneous expenses in line 24e. lf line24e amOunl exceeds 100/" Ol hne 25, column (A)amounl, lisl |ne 24e expenses on Schedule 0.)

a Grant Expensesb Proqram ExDensesc General Administration

7

8

21 747.

2?O

31 126,

3

't2

13

14

15

16

17

18

19

m21

24

e Allother expenses

25 Tolal frnctionale enses. Add lnes 1 thro h24e

26 Joint cosb. Complete this line only if lhe organization

reporled in column (B)joinl costs from a combined

educationa campaigo and fundraising solicitation.

(A)Totalexpenses

(B)Proqram service

expenses

(c)Management andgeneralexpenses

2,740. 2,740.

55,494. 27,747.

6,7s8. 3,379,

6,0s0. 3,025. 2 naE

442. 442.325.

4,965. 4 ,965 .7 ,759. 7 ,759 .

12,000. 6,000. 6,000.

4,597 . 4 ,597 .

75,378. 75,378.4,505. 4, 506.\ ,546 . I ,546 .

182,560. L23,L00. 28 ,334 .

832010 12-31 18

958.720

Form 990 (20 1 B)

1

d

Part X

(A)Beginning of year

113,879. 1

2

3

4

5

6

7

a

I

o , 216. 't0c

11

13

14'15

L20 ,17 5 . '16

1 Cash . non.interest.bearing

2 Savings and temporarycash investments

3 Pledges and grants receNable, net .. .

4 Accounts receivable, net

5 Loans and other receivables lrom current and lormer offlcers, directors,

trustees, key employees, and highest compensated employees. Complete

Part ll of Schedule L

6 Loans and other receivables from other disqualified persons (as defined under

section 4958(0(1)), persons described in section 4958(CX3XB), and contributing

employers and sponsoring organizations of section 501{cxg) voluntary

employees' beneliciary organizations (see insk). Complete Part ll of Sch L .

Notes and loans receivablo, net

lnve.ltones for sale or use ... . ....Prepard expenses and deferred charges

Land, buildinOs, and equipment: cost or other

basis. Complele Part Vl ol Schedule D

Less: accumulated depreciation

lnvestments . publicly traded secur ties

lnvestments ' other securities. See Part lV, line '11

lnvestments ' program-related. See Part lV, line 1'1

lntangible assets

Other assets. See Part lV, line 1'1

Total assets. Add lines '1 throuah 15 (must equal line 34)

)) 077.10a

b

11

12

13

14

15

16

7

8

910a

17

18

4, 000. 19

N21

24

2 ,135 . 25

5.l-35.

Accounts payable and accrued expenses .. ..

Grants payable

Defe(ed revenue ..

Tax exempt bond liabrlitres

Escrow or custodial account liability. Complete Part lV of Schedule D .

Loans and other payables to cu(ent and former officers, directors, trustees,

key employees, highest compensated employees, and disqualified persons.

Complete Part ll of Schedule L

Secured mortgages and notes payable to unrelated third partjes

Unsecured notes and loans payable to unrelated third partjes .

Other liabilities (including tederai income tax, payables to related third

parties, and other liabilities not included on lines 17-24)- Complete Part X of

Schedule D

Total liabililies. Add lines 17 throuah 25

23

24

25

26

17

18

19

20

21

22

2A

N

0 30

0 31

114,040. 32

114,040.

Organizations that follow SFAS 117 (ASC 958), check here ) E and

complete lines 27 through 29, and lines A3 and 34.

Unrestricted net assetsTemporarily restricted net assets . ...Permanently restricted net assets

Organizations that do not follow SFAS l'l? (ASC 958), check h-" ) lTland complete lines 30 through 34.Capital stock or trust principal, or current funds

Paid-in or capital surplus, or land, building, or equipment fundRetained eamings, endowment, accumulated incorne, or other fu nds ... ...

Total net assets or fund ba,ances

Total liabilities and net assets/fund balances

2A

29

3031

3233

34 720 ,77 5 . g

Form 990 01 I r a er Mississi l-a nce eet

Check if Schedule O contarns a res nse or note to an line in this Part x

42-1188963 P e 11

(B)End ot year

L3'7 753.

.9z

.gJ

296.

180.

2T 769,

0.0.

t22 460.L22 460.t44

6

.E

@!

lto

z

Form 990 (20 1 8)

432011 12 31 13

1

2

3

4

5

7

8

I

10

art xl

Part Xl18 a r Mississi i Va l1e

Reconciliation of Net AssetsCheck if Schedule O contains a re onse or note to a line in this Part Xl

1 Total revenue (must equalPart Vlll, column (A), line 12)

2 Total expenses (must equal Part lX, column (A), line 25)

3 Revenuo less expenses. Subtract line 2 from line 1

4 Net assets ortund balances at beginning of year (must equal Part X, line33,column(A)).........5 Net unrealized gains (losses) on investments ... ...

6 Donated services and use oflacilitios

7 lnvestment expenses ._._..

I Prior period adjustments

I Other changes in net assets or fund balances (explain in Schedule O) . ..10 Net assets or tund balances at end ol year. Combine lines 3 through I (must equal Part X, line 33,

columnFinancial Statements and ReportingCheck if Schedule O contains a res se or note to an line in this Part Xll

't Accounting method used to prepare the Form 990: m Cash Accrual Other

lf the organization changed its method of accounting from a prior year or checked 'Other." explain in Schedule O.

2a Were the organization's financial statements compiled or reviewed by an independent accountant?

lf "Yes." check a box below to indicate whether the flnancial statements for the year were compaled or reviewed on a

separate basis, consolidated basis, or both:

E Separate basis Consolidated basis E Both consolidated and separate basis

b Were the organization's financial statements audited by an independenl accountant?

lf "Yes.' check a box below to ind icate \,vhether the financial statements lor the year were audited on a separate basis,

consolidated basis. or both:

E Separate basis E consolidated basis E Both consolidated and separate basis

c lf "Yes" to line 2a or 2b, does the organizalion have a commattee that assumes responsibility for oversight of the audit,

review, or compilation of its financial statements and selection of an independent accountant? .

lf the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.

3a As a result of a federal awa.d, was the organization required to undergo an audit or audits as set lorth in the Single Audit

Act and OMB Crrcular A.133?

b lI "Yes," did the organization undergo the required audit or audits? lI the organization did not undergo the required audit

or audits lain n ule O and describe an ste s taken to und

P e12

177 004.182 560.-5 556.

tL4 040.

13 976.0

L22 460.

No

Form 990 (2018)

x

x

x

2a

2b

3a

3b

832012 12-3r 18

E

SCHEDULE A(Form 99O o.99O-EZ)

Public Charity Status and Public SupportComplete il the organization is a section 501(c)(3) o.ganization or a section

4947(aXl) nonexempt charitable trust.> Attach to Form 9gO or Form 99O-EZ.

> Go to www.ir ormggo tor insfuctions and the latest inrormation

reater Mississi

2018

I

Open to Publiclnspection

Employer identification number

42-LL88 63

The

1

2

3

4

5

67

8

9

an

x

o

Reason for Public a tatus (All organizations must complele this part.) See insttuctions

ization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association oI churches desc.ibed in section 170(bXlXAXi).

A school described in section lTqbXlXAXii). (Attach Schedule E (Form 990 or 990 E2).)

A hospital or a cooperative hospital service organization described in seclion 170(bXlXAXiiD.

A medical research organization operated in conjunction with a hospital described in section 17qb)(lXAXiii). Enter the hosp al s name,

city, and state

An organization operated for the benefit of a college or un,versiiy owned or operated by a govemmental unit described in

section 170(bXlXAXiv). (Complete Part ll.)

A federal, state, or local government or oovernmental unit described in section lTqbxlXAXV),

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in

seclion 170{bXlXAXvi). (Complete Part ll.)

A community trust described in section lTqbIlXAXvi). (Complete Part ll.)

An agricultural rcsearch organization described in seclion lTqbxlXAX|x) operated in conjunction w,th a land-grant college

or university or a non,land-grant college oI agriculture (see instructions). Enter the name, city, and state of the college or

university

An organization that normally receives: (1) more than 33 1/3% of its support from cont.ibulions, membership fees, and gross receipts from

activities related to its exempt functions - subject to certain exceptions, and (2) no more lhan 33'l/3o/o of its support from gross investment

income and unrelated business taxable income (less section 51 'l tax) from businesses acquired by the organization afte. June 30. 1975.

See section 5O9(aX2). (Complete Part lll.)

An organizalion organazed and operated exclusively to test ,or public safety. See section soqa)(4).

An organizataon organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or

more publicly sr.rpported organizations described in section 509(aX1) or secfion soqax2). See section 509{aX3). Check the box in

lines l2athrough 12d that describes the type of supporting organization and complete lines 12e, 12f, and 129.

Type l. A supportjng organization operated, supervised, or controlled by its supported organization(s), typically by giving

the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting

organization. You must complete Part lv, Sections A and B.

Type ll. A supporting organization supervised or controlled in connection with its supported organization(s), by having

control or management ofthe supporting organization vested in the same persons that control or manage the supported

organization(s). You must complete Part lV, Sections A and C.

Type lll tunctionally integrated. A supporting organization operated in connection with, and functionally integrated with,

its supported organization(s) (see instnrctions). You must complete Part lV, Sections A, D, and E.

Type lll non-lunctionally integrated, A supporting organization operated in connection with its supported organization(s)

that is not functionally integrated. The organization genera,ly must satisfy a distribution requirement and an attentiveness

.equirement (see instructions). You must complete Part lV, Sections A and D, and Part V.

Check this box if the organization received a written determanation from the IRS lhat it is a Type I, Type Il, Type lllfunctionally integrated, or Type lll non'functionally integrated supportang organization.

I Enter the number ol supported organizations

Provide the followin information about the s rted anization

10

11

12

a

b

c

d

(i) Name ol supporled

organrzation

(vi) Anount of othersupport (see inskuclions)

T

(iD EIN (iii) Type of organEation(descnbed on lines 1 10abo!e (see instructions)) No

(v) A,l1ounl oi monetary

support (see instructions)

LHAForPaperworkReductionActNotice,seethelnsructionsfo.Formggoorggo-Ez.832021 io,11.io Schedule A (Form 990 or ggo-Ez) 2018

Depdtmenl ol the Treasuryl.lrnalRevenu€ Servrce

Name of the oaganization

schedure A (Form 990 or gsGEa 2018 NAMI Greater Mississil)Di Va11ev 42-1188963 Paoe2

(Complete only lf you checked the box on line 5. 7, or 8 of Paft I or if the organization faied to quality under Part llL. lf the organizatLon

fails to qualify under the tests listed below, please complete Part lll.)

Section A. Public SupportCalendar year (0r liscal year be0i0nin0 in)>

'I Gifts, grants, contributions, and

membgrship fees received. (Do notinclude any "unusual grants. ")

2 Tax revenues levied for the organ.

ization's benefit and either paid toor expended on its behalf . . .

3 The value of services orfacilitiesfurnished by a govemmental unit tothe organization without charge

4 Total. Add lines 1 through 3

5 The portion of total contributions

by each person (other than a

governmental unit or publacly

supported organization) included

on line '1 that exceeds 2/o of the

amount shown on line 11,

column (f)

6Pu Sublracl ine 5 trom ne

Total

Tota

Section B. Total SupportCalendar year {or liscal year beginoin0 in)>7 Amounts from line 4 .

8 Gross income from interest,

dividends, payments received on

securities loans, rents, royalties,

and income f rom similar sources ...

9 Net income from unrelated business

activities. whether or not the

business is regularly carried on

't0 Other income. Do not include gain

or loss from the sale of capital

assets (Explain in Part VL) ........ ..

'11 Total support. Add lines 7 through 10

12 Gross receipts from related activities, etc. (see instructions)

13 First live years. lf the Form 990 is for the organization s first, second, third. fourth, or flfth tax year as a section 501(cX3)

Ial2014 (b) 2015 (c) 2016 (dt 2017 (e) 2018

(c) 2016 @l2017 (e) 2018(a)2014 (b) 201s

12

nization check lhis box andon mputation of Public Support Percentage

14 Public support percentage for 2018 (line 6, column (D divided by line 1 1 , column (0)

15 Public support percentage from 2017 Schedule A, Part ll, line1416a 33 l/3/o support test - 2018. lf the organization did not check the box on line 13, and line 14 is 33 1/3oZ or more, check this box and

b 33 1/3/o support test - 2O!7. lf the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more. check this box

17a ielo -lacts-and-circumslances test - 2018. lf the organizataon did not check a box on line 13, 16a, or 16b, and line 14 is 'l Oplo or more,and if the organization meets the "facts,and.circumstances , test, check this box and stop here. Explain in part Vl how the organizationmeetsthe,facts'and-circUmstances,teSt.TheorganizationqUalifiesasapUbliclysupportedorganization>

b 1elo -tacts-and-circumstances test - 2017. lf the organization did not check a box on tine 13, 16a, 16b, or 17a, and line t5 is 1Cplo ormore, and if the organizalion meets the 'facts-and'circumstances " test, check this box and stop here. Explain in part Vl how theorganizationmeetSthe',factS.and.cjrcUmslanceS,test,Thgor9ani2ationqUalifiesasapublictysupportedorganization>

'18 Private loundation. lf the b, check this box and see instructions >fl

%

%

14

15

832022 10 1r 16

orqanization did not check a box on line 13. '16a. 16b, 17a, or 17

Schedule A (Form 990 o.990-EZ) 2018

Schedule A orrn 990 or 990-E 2018 Mi s.Lssl- i Va11e 42-LL8upport u or rganizations Described in on a

(Complete only if you checked the box on line 10 of Part I or if the organization failed to quali, under Part ll. lf the organization fails to

aualifv under the tests listed below, please comolete Part ll.)

6

Section A. Public SupportCsleodary6ar (or tiscalyear beginnin0 in)>

I Gilts, grants, contributions, and

membership fees received. (Do notinclude any unusual grants.')

2 Gross receipts from admissjons.merchandise sold or se&ic6s peaformed, or facilities turrnished inany activity that is related to theorganization's tax-exempt purpose

3 Gross receipts from actjvities that

are not an unrelated trade or bus.

iness under section 513

4 Tax revenues levied for the organ-

ization's benefit and either pajd toor expended on ils behalf . .

5 The value of services or facilities

turnished by a govemmental unit tothe organization without charge

6 Total. Add lines 1 through 5

7a Amounts included on lines 1, 2, and

3 received from disqualified persons

b amounts incrudod o. rnes2 md 3 rec€ vedfrom olher lha drsquaLLned p€rsons ihal

exceed lhe $eald or $5 000 d 1% ot the

ro-.r o- xre 13lo h€ )6a

c Add lines 7a and 7b

Public su orlSection B. Total SupportCalefldar year (or ,iscal year beginning in) >9 Amounts from line 6

1Oa Gross income from interest,djvidends, payments received onsecurities loans, rents, royalties,and income from similar sources

b L]nrelated business taxable income

(less seclion 511 taxes) 'rom bus resses

acqurred after June 30, 1975

c Add lines '10a and 10b11 Nel rncome from unrelated business

activities not included in line 10b,whether or not the business isregularly canied on

12 Other income. Do not include gainor loss from the sale of capitalassets (E:xplain in Part Vl.) .. .

'13 Tolal support. (Add Lnes e, 1oc 11 and12)

6 7 5L.

Tota

655 /51.

135.

135.

655 886.14 Firsl five years. lf the Form 990 is for the organization s first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,

check this box and stoD here >E

la\ 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018

L'72,786. 6L ,466 . 210,93L.732,957 . 78,207.

2L0 ,93t .L32,967 . 78,20L. 172,t86. 6L ,466 .

Tota

555 '75r.

655 751.

0

5

(al2O14 (b) 201s (c) 2016 ld) 2017 (e) 2018

1.32,967 . ,o anl L72,L85. 6L ,466 , 2L0,937.

54. 71. 10.

54. 10.

L32,967 . 78,20L. L72,240, 6L,537 , 2t0,94L.

15

16

Section C. Com utation ol Public Su rt Percenta15 Public support percentage for 2018 (line 8, column (0, divided by line 13, column (0) 99.98 o/"

Public su rt ercen e lrom 2017 Schedule Part lll line 15

Section D. Com utation of lnvestment lncome Perce17 lnvestment income percentage for 20'18 (lane '10c, column (r, divided by line 13, column (0)

tg lnvestment income percentage from 2017 Schedule A, Part lll,line 17

19a 33 1/!/o sr.rpport tests - 2018. lf tho organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not

more than 33 1/3%, check this box andstop here. The orqanizataon qualifies as a publrcly supported organEatron .. . .. . > Eb 3il 1/3/o support tests - 2017. ll the organization did not check a box on line '14 or line 19a, and line 16 is more than 33 1/3%, and

line 1 8 is not more than 33 1E%,checkthisboxandstophere.Theorganizationqualiflesasapubliclysupportedorganization. >E20 Private foundation 19a, or 19b, check this box and see instruclions

%

.02 %

.02 a/o

ft

17

18

832023 10 11-r8

lf the orqanization did not check a box on lane 14,

Schedule A (Form 9OO or 9SO-EZ) 2018

hedu Form 990 or 990 2018 NSupporting Organizations(Complete only if you checked a box in line 12 on Pa.t l. lf you checked 12a of Part l, complete Sections A

and B. lf you checked 12b of Part l. complete Sections A and C. lf you checked 12c o, Part l, complete

Sections A, D, and E. lf you checked 12d of Part I, complete Sections A and D, and compiete Part V.)

2

Section A. All Su rtin o nizations

b

Are all of the organization's supported organizations listed by name in the organization's governing

documents?/l"No,'describeioPadvlhowthesuppodeclorganizationsareclesignated. ll designated byclass or putpose, descibe the designation- ll hi$toric and continuing relation$hip, explain.

Did the organization have any supported organization that does not have an IRS determination of status

Lrnder section 509(aX1) o( l2l? ff "Yes,'explain in Pa.lvl how the organization deteinined that the supporled

organization was descnbed in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(cX4), 15), ot (6)? lf "Yes," answer

(b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(cxa), (5), or (6) and

satisfied the public support tests under section 509(a)(2)? ff "yes," desctibe in ParlVl wllen and how the

otganization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(CX2XB)

purposes? /f "yes, " explain in Parlvl what controls the organization put ih place to ensure such use-

Was any supported organization not organized in the United States ('foreign supported organization')? /t''Yes," and if you checked l2a or l2b in Patt l, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign

supported organization? lf "Yes,' descibe in PafiVl how the oryanization had such control and discretion

despite being contrcled or supeNised by or in connection with its suppotled organizations-

Did the organization support any foreign supported organizat,on that does not have an IBS determination

under sections 50'1(c)(3) and 509(a)(1) or (2)2 lf "Yes," explain in PartVl what contrcls the oryanization used

to ensurc that a suppott to the foreign supporled organization was used exclusively tor section 170(c)(2)(B)

purposes.

Did the organization add, substitute, or remove any supported organizations dur,ng the lax yeafi lf Yes,"

answer (A and (c) below (if applicable). Nso, provide detail in Partvl, including (i) the names and EIN

numbers of the suppoied organizations added, substituted, or rcfioved; (ii) the reasons for each such action;(iii) the authority under the organization's organizing document authotizing such action; and (iv) how the action

was accomplished (such as by amendment to the organlzing document).

Type I or Type ll only. Was any added or substituted supported organization part of a class already

designated in the organization's organizing document?

Substitutions only. Was the substitLrtion the result ol an event beyond the organization's control?

Did the organization provide support (whether an the form of grants or the provision of services or facilities) toanyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class

bonefited by one or more of its supported organizations. or (iii) other supporting organizations that also

support or benefit one or more of the filing organization's supported organizations? /, "yes," provide detail in

Part Vl.Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor

{as deflned in section 4958(C)(3XC)). a family member of a substantial contributor, or a 35% controlled entity withregard to a substantial contributor? /f "fes, " complete Part lof Schedule L (Form 990 or99O-EZ).Did the organization make a loan lo a disqualified person (as deflned in sectjon 4958) not described in line 7?ll 'Yes," compbte Part I of Schedule L (Fom 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or moredisqualified persons as defined in section 4946 (other than foundation managers and organizations describedin section 509(a)(1) or l2\J? lf 'Yes,'provide detailinpartVl.Oid one or more disqualified persons (as defined in line ga) hold a controlling interest in any entity in whichthe supporting organization had an interest? ll "Yes," ptovide detail in panVl.Did a disqualified person (as derined in lane 9a) have an ownership interest in, or derive any personal benefitfrom, assets in which the supporting organization also had an interest? /f ,yes, ptovide detail in parl.Vl.was the organization subiect to the excess business holdings rules of section 4943 because of section4943(0 (regarding certain Type ll supporting organizations, and aI Type l non-functiona y integratedsupporting organizations)? lf "Yes,^ answer 10b below.

Did the organization have any excess business holdings in the taxyear? (lJse Schedub C, Form 4120, to

c

6

10a

b

detemine whether the

No

3a

b

c

4a

b

5a

7

8

9a

b

c

1

2

3a

3b

3c

4a

4b

4c

5b

6

7

8

9a

9b

9c

10a

10b43202,1 10- r 1- r8

nlz excess busiress

Schedule A (Form ggo or 990-EZ) 2018

Schedu e A rrn 99O or 990- 2018 1 i VaI ISu rtin o anizations

l1 Has the organization accepted a gift o. contribution from any of the following persons?

a A person who directly or indirectly controls, either alone or together with persons described in (b) and (c)

below, the governing body of a supported organization?

b A family member of a person descrjbed in (a) above?

c A 35% controlled enti ofa rson described in or above? /t "Yes lo a b otc rovide detail in P rt Vl

Section B. o anizations

1 Did the directors, trustees, or membership of one or more supported organizations have the powerlo

regularly appoint or elect at least a maiority of the organization's directors or trustees at all times during the

tax year? /l "No, " describe in PaftVl how the supporTed organization(s) elfectively operated, superr'ised, or

controlled the organization's activities. ll the oqanizatioh had mote than one suppofted organization,

describe how the powers to appoinl andlor remove directors or ttustees were allocated afiong the suppofted

organizations and what conditions or rcstrictions, if any, applied to such powe6 cluing the tax year-

2 Did the organization operate for the benefit of any supported organization other than the supported

organization(s) that operated, supervised, or controlled the supporting organization? /f Yes," explain in

PartVl how providing such benefit canied out the pu9oses ol the suppofted organization(s) that operated,

SU or conlrolled the su, ization

Section C. e ll n o nizations

Were a majority of the organization's directors or trustees during the tax year also a majority of the directors

or trustees of each of the organization's supported organizaiion(s)? lf 'No," describe in ParlVl haw control

or management of the suppofting organization was vested in the sarne percons that controlled or managed

the

Section D. All lll Su rtin izations

I Did the organization provide to each of its supported organizations, by the last day of the fifth month of the

organizatjon's tax year, (i) a written notice describing the type and amount of support provided during the prior tax

year, (ii) a copy ofthe Form 990 that was most recently filed as of the date of notilication. and (iai) copies ofthe

organization s goveming documents in effect on the date of notificalion, to the enent not previously provided?

2 Were any of the organization's officers, directors, or trustees either (i) appointed or elected by the supported

organization(s) or (ii)serving on the goveming body of a supported otganizalioo? lf "No," explain in ParlVl how

the organization rkaintained a close and continuous wod<ing relationship with the suppofted oryanization(s)

3 By reason of the relationship described in (2), did the organization's supported organizations have a

significant voice in the organization's investment policies and in directing the use of the organization s

income or assets at all times during the tax yeat? ll "Yes, ' descdbe Ih Part Vl the role the organization's

SU otled fiors m lhis

1 63 p

No

No

No

No

Section E. Type lll Functionally lntegrated Supporting Organizations

rt

11a

11b

11c

Yes

1

2

1

I

2

3

1 Check the box next to the method that the organization used to satisfy the lntegral Pad Test duing the yea(see instructions).The organization satisfied the Activities Tesl. Complete line 2below.The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a govemmental entity. Descnile rh Part Vl how you st-tppofted a govemment entity (see instru

2 Activities Test. Answer (a) and (b) below.

a Did substantially all of the organization's activities during the tax year directly further the exempt purposes of

the supported organization(s) to which the organization was respon$ive? lf "Yes," then in Part Vl identify

those supported organizations and explain how these activities directly tufthered thet exempt purposes,

how the oryanization was responsive to those suppoded organizations, and how the organization detefinined

that these activities constituted substantially all ol its activities.

b Did the activities described in (a) constitute activities that, but for the organization's involvement, one or more

of the organization's supported organization(s) would have been engaged in? /f "yes, ' explain ih PartVl the

rcasons lor the organizalion! positlo, thaf its su pponed organization(s) would have engaged ln these

activities but lor the organization's involvement-

3 Parent of Supported Organizations. Answer (a) and (b) below.

a Oid the organization have the power to .egularly appoint or elect a majority of the officers, directors, or

trustees of each of the supported organizalions? Provide details inParivl.b Did the organization exercise a substantial degree of direction over the policies, programs, and activities of each

of its

a

b

cNo

2a

2b

3a

3b

832025 10 11 18

ed izal

Schedule A (Form 99O or 99O-EZ) 2018

I v""

Schedule A Form 990 or 990- 2018 NAMT reater Milll Non-Functionall lnte rated o anizations

Check here it the organization satisfied the lntegral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part Vl.) See instructions. All

olher T lll non fLrnction rated ort n nizations must com Sections A thro E

Section A - Adjusted Net lncome

1 Net short.term c ita arn

2 Recoveries of nor ar distributions

3 Other ross income see instructions

4 Add lines l throu 3

5De irtion and de letion

6 Portion oI operating expenses paid oa incured for product,on or

collection of gross income or for managemenl, conservation, ormaintenance of held for uction of income instruction

7 Other ex nses see instructions

8A sted Net lncome subtract lines 5 6 and 7 from line 4

Section B - Minimum Asset Amounl

I Aggregate faia market value of all non.exempt-Lrse assets (see

instructions for short tax ar or assets held for rt ol ear

AA e month value of securities

b Ave e month cash balances

c Fair market value of other non.exe use assets

d Total dd lines 1 1b, and 1c

e Discount claimed for blockage or other

factors in in detail in Part

2 uisition indebtedness licable to non-exem t-use assets

3 Subtract line 2 from line 1d

4 Cash deemed held for exempt use. Enter 1.1/rya ol Lne3ltor greater amount,

see nstruct ons

5 Net value of non'exem use assets subtract line 4 from line 3

6 Multi iine 5 b 035

7 Flecoveries of rior distributions

8 u add line 7 to line 6

Section C - Distributable Amount

e

(B) Current Year(optionaD

(B) Current Year(optionaI)

Current Year

'I Ad sted net income fo. eaT m Section line B Colurnn

2 Enter 85% of line 1

3 Minimum asset amount for flor Section B line 8 Column

4 Enter reater of line 2 or line 3

5 lncome tax im ed in nor

6 Distributable Amount. Subtract line 5 from line 4, unless subject tonc reduction see instructions

7 Check here if the current year is the organization's Iirct as a non-functionally integrated Type lll supporting organlzation (see

instructionsl.

(A) Prior Year

,l

2

4

5

6

7

8

(A) Prior Year

1a

1b

'!c

1d

2

3

4

5

6

7

a

1

3

4

5

6

Schedule A (Form 990 or 990-EZ) 2018

832026 10,1i-18

Schedule A rm 990 or 990 2018 NAI,II GreaEer Missrssrlll Non-Functional rated

Section D - Distributions, Amounts to su orted izations to accom ish exe

2 Amounts paid to perform activity that directly furthers exempt purposes oI supported

anizatrons. in excess of income from activit

3 Administrative ex ES to accorn ish exem U ses of sLl rted o anizations

4 Amounts to uire use assets

5 Qualified set aside amounts IRS roval uire

6 Other distributions escribe in Part Vl See instructions

7 Totalannual distribrrtions. Add lines 1 throu 6

8 Distributions to attentive supported organizations to which the organization is responsive

rovide details in Part See instructions

I Distributable amount for 2018 from Section C, line 6

10 nt divided b lne 9 a.nount

Section E - Distribution Allocations (see instructions)

1 Distributable amount for 2018 from Section C line 6

2 Underdistributions, if any, for years prior to 2018 (reason.

able cause u red. e lain in Part See instn-lctions

3 Excess distibutions c el to 2018

a From 2013

b From 2014

c From 2015

d From 2016

e Fton2o17f Total of ines 3a he

lied to underdistributions of

h lied to 2018 distribulable amount

iC er from 2013 not d e instructi

Bemainder. Subtract lines 3 3h. and 3ifrom 3f

a lied to underdist.ibutions of rior

lied to 2018 distributable amount

c Bemainder. Subtract lines 4a and 4b from 4

5 Remaining underdistributions for years prior to 2018, if

any. Subtract lines 39 and 4a from line 2. For result greater

than zero ex in in Part Vl. See lnstructions

4 Distributions for 2018 trom Section D,

lrne / $

6 Remarning underdistributions for 2018. Subtract lines 3h

and 4b from line L For result greater than zero, explain in

Part VI. See instructions.

7 Excess distibutions carryover lo 20'19. Add lines 3j

and 4c.

,11 3p e7

Currenl Year

(iiDDislributable

Amount for 2018

anizations con

b

I Breakdown of line 7

a Excess from 20T 4

b Excess from 20'15

c Excess from 2016

d Excess from 2017

e Excess from 2018

(ii)Lrnderdistributions

Pre-2018

(i)

Excess Distributions

832027 r 0.11- r8

Schedule A (Form 990 or 99O-EZ) 2018

Schedule A orm 990 or 20'18 AMT reater Missis v 42-1188963 8

Supplemental lnformation. Provide the explanations required by Part ll, line 1O; Part ll, line 17a or 17b; Part lil, line 12iPart lV, Section A, lines 1, 2, 3b, 3c, 4b,4c, 5a, 6, 9a, 9b, 9c, l1a, 11b, and '11c; Part lV, Section B, lines 1 and 2; Part lV, Section C,line 1 i Part lV, Section D, lines 2 and 3; Part lV, Section E, lines 1c, 2a, 2b, 3a. and 3b; Part V, line 1; Part V, Section B. line 1el Part V,Section D, lines 5. 6. and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information.(See instructions.)

rt Vl

832028 r 0- 11- 18 Schedule A (Form 990 or 990-EZ)2018

Schedule B(Form 99O,99O-EZ,or 9gO-PF)OepMme.l ol rrre Treasurylnls.alBeven!e Seruce

Name of the organization

Organization type (check one)

Filers of:

Form 990 or 990-EZ

Form 990 PF

Schedule of Contributors> Attach to Form 99O, Form 99O-EZ, or Form 99O-PF.

> Go to wr,vw.irs.gov/Formggo for the latest information

v I

Section

[Fl sor (c)( 3 ) (enter number) organization

4947(a)(1) nonexempt charitable trust ngt treated as a private foundataon

527 political organization

501 (cX3) exempt private foundation

4947(a)(1) ngnexempt charitable trust treated as a private foundation

501 (cX3) taxable pivate foundation

OMB No. 1545 0047

2018

I

Check if your organization is covered by the General Rule or a Special Rule.

Note: Only a section 501(cX7). (8), or (10) organization can check boxes for both the General Bule and a Special Rule. See instructions

General Rule

E For an organization filing Form 990, 99O.EZ, or 99O.PF that received, during the year, contributions totaling $5,OOO o. more (in money orproperty) from any one contributor. Complete Parts land ll. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33 1/3% support test ol the regulations under

sections 509(aX1) and 170(bxl XAXvi), that checked Schedule A (Form 990 or 990-EZ), Part ll, line 13, 16a, or 16b, and that received ,rom

any one contributor, during the year, total contributions of the greater of (1) $5,000; or (2) 2% o, the amoLint on (i) Form 990, Part Vlll, line t h;

or (ij) Form 990-EZ, line '1. Complete Parts I and ll.

For an organization described in section 501(cX7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor, during theyoar, total contributions of more than $1,000 exclusivelyfot religious, charitable, scientific, literary, or educational purposes, or for theprevention of cruelty to children or animals. Complete Parts I (entering "N/A" in column (b) instead of the contributor name and address),

ll. and lll.

For an organization described in section 501(c)(7), (8), or (10)filing Form 990 or 990-EZ that received from any one contributor, during theyear, contributions exclusive/y for religious, charitable, etc.. purposes, but no such contributions totaled more than $1,0O0. lf this boxis checked, enter here the total contributions that were received during the year for an exclusive/y religious, charitable, etc ,

purpose. Don t complete any o, the pads unless the General Rule applies to this organization because it rece,ved nonexclusivelyreligious, charitable, etc., contributions totaling $5,000 or more during the year > S

Caution: An organization that isn t covered by the General Rule and/or the Special Rules doesn't fite Schedule B (Form 990, 990-EZ. or 990-pO,but it must answer No'onPartlV, line2,of its Form gg0; or check the box on line H of its Form 990-EZ or on its Form 99O.pF, part l, line 2, tocert,fy that it doesn't meet the filing requirements of Schedule B (Form 990, 990,E2, or 990-pF).

LHA For Paperwork Reduction Aci Notice, se€ the insbuctions for Form 99O, 99O-EZ, or 99O-pF.

823451 1T-06 18

Schedule B (Form 99O,99O-EZ, or 99O-PF) (2O18)

Employer identiflcation number

Schedule B (Form 990, 990 EZ, or 990-PD (2018)

Name of organization

NAMI rea er Mi SI

2

I I 11e

Employer identification numbe.

42 Lt88 63

Part I Contributors (see instructrons). Use duplicate copies of Part I if additional space is needed

(a)

No.

(a)

No.

(a)

No.

(a)

No.

(a)

No.

(a)

No.

(d)

ol contribution

PersonPayiollNoncash

PersonPayrollNoncash

(Complete Part ll fornoncash contributions.)

T

(Complete Part ll fornoncash contributions.)

(d)

of contribution

Person EPayrollNoncash

(d)

ol contributionT

PersonPayrollNoncash

(Complete Part llfornoncash contributions.)

(d)

Type of contribution

PersonPayrollNoncash

(Complete Part llfornoncash contributions.)

(d)

Type of contribution

(Complete Part llfornoncash contributions.)

(d)

of contribution

Person EPayrollNoncash

(Complete Part ll fornoncash contributions.)

(b)

Name, address, and ZIP + 4

(c)

Total contributions

The Amy Helpenstell Family Foundatsj.onC/o CommuniEy FoundaEi

852 Middle Road #100

Bettendorf rA 52722

10 000.S

(b)

Name, address, and ZIP + 4

(c)

Total contributions

un I EyPo 1nt

Rock Island

2701 17th Sr

rL 6120t

15 100.$

(b)

Name, address, and ZIP + 4

(c)

Total contributions

Regional Development

#306IUT W ZNd STICEE

DavenporE., IA 528 01

20 000.$

(b)

Name, address, and ZIP + 4(c)

Total contributions

Community Foundation of GreaE RiverBend

852 Middle Road *100

Bettendorf rA 52722

000.$ 5

(b)

Name, address, and ZIP + 4(c)

Total contributions

Doris & Victor Day Foundation

1800 3rd Ave Ste 302

Rock I s land rL 6720t

(b)

Name, addess, and ZIP + 4(c)

Total contributions

Ea IA Mental Health Re

500 w 4rh sE.

glon

Schedule B (Form 9OO, 9€O-EZ, or 99O-pF) (2018)

1

5

EEtl

EEE

2

3

4 EEE

EEE

6

$ 10,000.

Davenport., IA 5280L

$ 21,955.

823452 11 08-13

Schedule B Form 99O, 990 E2, or 990-P 018)

Name of organization

NAMI Greater Mi vPart ll Noncash Property (see instructions). Use duplicate copies of Part ll if additionalspace is needed

3Employer identirication number

42-1188963

(a)

No.fromPart I

(d)

Oate received

(a)

No.

IromPart I

(d)

Oate received

(c)

FMV (or estimate)(See instructions.)

(b)

Description ot noncash property given

s

(c)FMV (or estimate)(See instructions.)

(b)

Oescription ol noncash property given

s

(c)

FMV (or estimate)(See instructions.)

(b)

Description of noncash property given

S

(b)

Description ot noncash property given

(c)

FMV (or estimate)(See instructions.)

s

(b)

Desc ption of noncash property given

(c)

FMV (or estimate){See instructions-)

$

{b)Description of noncash property given

(c)

FMV (or estimate)(See instructions.)

(a)

No.fromPart I

(d)

Date received

(a)

No.

tromPart I

(d)

Date received

(a)

No.lromPart I

(d)

Date received

(a)

No.

fromPart I

(d)

Date received

423453 11-08.18 Schedule B (Form 9€O,990-EZ, or99O-pF)(2O18)

$

Schedule B Form 99O, 990 EZ, or 990-PO 018) Pa 4Name of oroanization Employer identification number

I reater Mississi i Va1le 42-],L88 63rt Exclusavely religious, charitable, etc., contributions to organizations described in section 501(cX7), (8), or (1O) thaf total more than $1,Om for the year

lrom any one contsibutor. Complele columns (a) through (e) and the lollowhg line entry. FororganLalions@mpLet'n! Part lrl, e.rdthe loraror Bx. usrvory rsrgr@s, ch iable, elc , enirrbut'ons ot 3l,0oo or less ror he ys (Eill0r tris l0Jo ome ) >$Use du ate co es of Pad lll if additional ace is needed

(a) Notrom (O Description of how gift is heldP

(e) Transfer ot gift

Transleree's nam a and ZIP + 4 Relalionshi ol transreror to transferee

(a) No.fromPart I

(d) Descriplion of how gift is held

(e) Transler of gift

Ttans{eree's name address and ZIP +4 Relationshi ot transleror to transferee

(c) Use ol gift(b) Purpose ol gift

(c) Use of gift(b) Purpose ot gift

(b) Purpose of gift (c) Use ol gift

(b) Purpose of gift

(a)No.IromPart I

(d) Description oI how gift is held

(e) Transter ot gift

Transleree's name and ZIP + 4 Relationsh ol transleror to transreree

(a) NofromPart I

(O Description of how gift is held

Belationsh oI transferor to transleree

323,151 11 03 1A

Trans{eree's name a and ZIP + 4

(e) Transfer olgift

Schedule B (Form 990, 99O-EZ, or 9SO-PF)(2018)

(c) Use of gift

SCHEDULE D(Form 99O)

Supplemental Financial Statements> Complete if the organization answered "Yes" on Form 990,

Part lV, line6,7,8,9, 10, 11a, l1b, 1lc, Ild, lle, 111,I ,or1zo> Attach to Form 99O.

2018Open to Publiclnspection

OMB No 1545'0047

Yes

O€pdlment ot lhe Trdsuryrm99O for instrucli

Name of the organization Employer identitication number

rMi ].SSL i Va11e 42-LLg8 63Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. comptete if the

anization answered 'Yes" on Form 990. Pad lV. line 6(b) Funds and other accounts

1 Total number at end of year

2 Aggregate value o{ contributions to (during year)

3 Aggregate value oI grants from (during year)

4 Aggregate value at end of year

5 Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds

are the organization's property, subject to the organization's exclusive legal control?

6 Did the organization inform all grantees, donors, and donor advisors in writinq that grant funds can be used only

for charitable purposes and not for the benefit ofthe donor or donor advisor, or lor any other purpose conferring

No

Part I

(a) Donor advised fLrnds

Part lltm ssib e rivate benefit?

Conservation Easements. Complete if the organization answered Yes' on Form 990, Part lV, line 7

'I Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.9., recreation or education)

Protection of natural habitat

Preservation of open space

2 Complete lines 2a through 2d il the organization held a qualilied conservation contribution in the lorm of a

day of the tax year.

a Total number of conservation easements

b Total acreage reslricted by conservation easemenls

c Number of conservation easements on a certified historic structure included in (a)

d Number of conservation easements included in (c) acquired afte,7/25/06, and nol on a historic structure

listed rn the National Register

Preservation of a historically important land area

Preservation of a certified historic structure

4 Number of states where property subjecl to conservation easement is located >5 Does the organizalion have a wrjtten policy regarding lhe periodic monitoring, inspection, handling of

violations. and enforcement oI the conservation easements it holds2 . .

conservation easement on the last

H eld at the End ol the Tax Year

6 Staff and volunteer hours devoted to monitoring, inspecting, handling ol violations, and enforcing conservation easements during the year

7 Amount of expenses incured in monitoring, inspecting, handling ol violations, and enrorcing conservataon easements during the year

>$

ervatron easementsOrganizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.Complete if the organization answered "Yes" on Form 990, Part lV, line 8.

1a lf the organization elected, as permatted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art,

historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part X,ll,

the text of the footnote to its financial statements that describes these items-

b lf the organization elected, as permitted under SFAS 1 16 (ASC 958), to report in its revenue statement and balance sheet works of art, historical

treasures, or olher similar assels held for public exhibition, education, or research in turtherance of public service, provide the following amounts

relating to these items:

(i) Revenue included on Form 990, Partvlll, line 1 . . .. ... .......................... > $

(i0 Ass€rs included in Form 990, Part X . .... ............ > $

2 lf the organization received or held works of art, histo.ical treasures, or other similar assets for financial gain, provide

the Iollowing amounts required to be reporled under SFAS 116 (ASC 958) relating to these items:

a Bevenue included on Form 990, Part Vlll,line 1 ... ... > $b Assets included in Form 990, Part X >$

2b

2d

Part lll

832C51 10-29 1a

Schedule D (Form 990) 20'18LHA For Paperwork Reduction Act Notice, see the lnstructions for Form gg0.

3 Number of conservalion easements modified, transferred, released, extinguished, or terminated by the organization during the tax

Yea, )

-

Ev"" [_l ro

I Does each conservation easement reported on line 2(d) above satisly the requirements of section 17o(h)(4)(BXD

and sectron 170(hX4XB)(iD? . E Y." f-.] ruo

9 ln Part Xlll, describe how the organization repoats conservation easements in its revenue and expense statement, and balance sheet, and

include, if applicable, the text oI the footnote to the organization's financial statements that describes the organization s accounting for

hedule D rrn 2018 NAMI reater Missi 11e 4nizations Maintaini Collections of Historical Treasu or Other Similar Asse

3 Using the organization's acquisition, accession, and other records, check any of the following that are a significant use of its col,ection ilems

(check all that apply):

Loan or exchange programs

Other

2

a

b

4

5

Public exhibition

Scholady research

Preservation for tuture gene€tions

Provide a description of the organization s collections and explain how they furthea the organization's exempt purpose in Part Xlll

During the year, did the organization solicit or receive donations of art, historical treasures, or other similar assets

d

to odto se funds rather than to be maintained as rt of the ization s co ectron?

Escrow and Custodial Arrangements, Comptete if the o.ganization answered "Yes" on Form 990, Part lV, line 9, orreported an amount on Form 990, Part X, line 21.

flvPart lV

1a ls the organazation an agent, trustee, custodian or other intermediary for contributions or other assets not included

on Form 990. Pan X,b lf "Yes,' explain the arrangement in Part Xlll and complete the following table

c Beginning balance

d Additions during the year .

e Distributions during the year

f Ending balance

tfY ex lain the arran Xlll. Check here i, the ex nation has been TOV on Pan Xlll

Endowment Funds. Complele if the organization answered Yes on Form 990. Part lV, line 10

1a Beginning of year balance

b Contftbutions

c Net investment earnings, gains, and losses

d Grants or scholarships

e Other expenditures forfacilitiesand programs

I Administrativeexpenses

g End of year balance .......

2 Provide the estimated percentage of the current year end balance (line 19, column (a)) held as

a Board designated or quasiendowment >b Permanent endowment >c Temporarily restricted endowment > %

The percenlages on lines 2a, 2b, and 2c should equal 10Yo .

3a Are there endowment ,unds not in the possession of the organization that are held and administered for the organization

by:lil unrelated oroanizations

(ii) related organrzatrons

b lf "Yes" on line 3a(ii), are the related organizations listed as required on Schedule R?

%

Yes No

Amount

No

e Four ears back

No

'lc

1d

1e

1f

Pa]t V(d Three vears back(b) Prior year (c) Two years back(a) CLrrrent year

Yes

3a(i)

sa(ii)

3b

Part Vl4 Describe in Pad Xllt the intended uses of the o anization s endowment funds

Land, Buildings, and Equipment.Complete if the o anization answered Yes on Form 990, Part lV. line 11a. See Form 990, Part X, lane'10

Description of property

1a Land . .

b Buildings

c Leasehold improvements

d Equipment

Ad lines 1a throu

(d) Eook value

6 296.

6

(a) Cost or otherbasis (investment)

(b) Cost or otherbasis (other)

(c)Accumulateddepreciation

22,077 . 15,781.

832052 10 29 18

must al Form 990 Paft line 10c.

Schedule D (Form 9gO) 20'18

2a Did the organization include an amount on Form 990, Part X. line 21, for escrow or custodial account liability?

E

I

Schedule D Form 990 2018 NAMI Greater Misslnvestments - Other Securities.Complete if the anization answered "Yes' on Form 990, Part lV. Iine 11b- See Form 990, Part X, line 12

(a) Description olsecurity or category t.crud,ns ndeorse!.ty) (c) Method of va,uation: Cost or end'oiyear market value

(1) Financial derivatives(2) Closely.held equity interests

(3) Other

42-1188963 3

C

G

Col b iuu sl e ualForm 990 Part col B ne 12

lnvestments - Program Related.Com lete it the anization answered 'Yes' on Form 99 Part lV line 11c. See Form 990 Part line 13

(a) Description of anvestment (c) i/ethod of valuation: Cost or end.of-year market value

Tolal Col. must F 99 IX c0. line 13.

Other Assets.Com lete if the o anization answered Yes" on Form 990, Part lV, line 1 1 d. See Form 990, Part X, linel5

(a) Description (b) Book value

must al Farm 990 Patt X line 15cclOther LiabilitiesCom lete ifthe anization answered 'Yes' on Form 990, Pa.t lV, line 'l1e or 11f. See Form 99O, Part X, line 25

(a) Description of liability

Federal income taxes

Accrued ExPa ofI Liabilities Pa able

Total mLlst al Form 990 Paft x col line 25

2. Liability for uncertain tax positions- ln Part Xlll, provide the text of the foolnote to the organization's financial statements that reports theorqanization s labil eck here ifthe text of the footnote has been o rovided in Part Xlll E

1

4

1

Part Vll

(b) Book value

Part Vlll

(b) Eook va!e

Part lX

Part X

(b) Book value

7,424.t4,345.

1',1 1CO

832053 10 29 13

ity for uncenain tax pos itions under FIN 48 (ASC 740). Ch

Schedule D (Form 99O) 201g

SchedLrle D Forn,990 2a1B I reater Mississi 42-L188 63 e4Heconciliation of Revenue per Audited Financial Statements With Revenue per Return.Complete if the organization answered "Yes" on Form 990, Part lV, line 12a.

1 Total revenue, gains, and other support per audited financial statements

2 Amounls included on line 1 but not on Form 990, Part Vlll, line 12:

a Net unrealized gains (losses)on investments ....._..............b Donated services and use oI facilities

c Recovenes of prror year grants

d Other (Descnbe in Part Xlll.)

e Add lines 2a through 2d

3 Subtract hne 2e from line I ..

4 Amounls included on Form 990, Part Vlll, line 12, but not on line'1:

a lnvestment expenses not included on Form 990, Part Vlll, line 7b . .

b Other (Describe in Part Xlll.)

c Add lines 4a and 4b

4a

Total revenue. Add lines 3 and 4c. must 990 line 12

Reconciliation of Expenses per Audited Financial Statements With Expenses per Return.Complete il the o ization answered 'Yes' on Form 990. Part lV, line '12a.

I Tolalexpenses and losses per audited financial statements ...

2 Amounts included on line 1 but not on Form 990, Part lX, line 25:

a Donated services and use of facilities

b Prior year adjustments

c Other losses

d Other (Describe in Part Xlll.)

e Add lines 2a through 2d

3 Subtract line 2e from line 1 _

4 Amounts included on Form 990, Part lX, line 25, but not on line 1

a lnvestment expenses not included on Form 99O, Part Vlll, line 7b

b Other (Descnbe rn Part Xlll.)

c Add lines 4a and ,lb

2a

5T nses. Add lines and must ual Fom 990 line 18.

Supplemental lnformationProvide the descriptions required for Part ll, lines 3, 5, and 9: Part lll, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X. line 2; Part Xl,

lines 2d and 4b; and Part Xll, lines 2d and 4b. Also complete this part to provide any additional information.

4a

Part Xl

1

2b

2c2d

2e

3

4b

4c5

Part Xll

1

2b

2d

2e

3

4b

4c

Part Xlll

832054 10-29-18 Schedule D (Form 990) 2018

SCHEOULE G(Form 99O o. 99o-EZ )

Dep4im6nl ol the Trea$rylntdnarRev€.ue Swrce

Supplemental lnformation Regarding Fundraising or Gaming ActivitiesComplete il the o.ganization answered "Yes" on Form 9gO, Parl lV, line 17, 1& or 19, or if the

o.ganization entered mo.e than $1s,Om on Fo.m 990-EZ, line 6a.

> Afiach to Form 99O or Form 990-EZ.

ovlForm990 tor instuctions and the latesl inlormation.

2018

Name of the organization

er Mi.ssissi i Va11ePart I Fundraising Activities. comptete if the organization answered "Yes" on Form 990, Part lV, line 17. Form 990-EZ filers are not

required to complete this part-

Employer identifi cation number

42-1"188963

1 lndicale whether the organization raised tunds through any ol the following aclivities. Check all that apply

Mail solichations

lnternet and email solicrtations

Phone solicitationsln-person solicitations

a

b

cd

Is

Solicitation of non-government grants

Solicitation of government grants

Special tundraising events

2 a Did the organazation have a written or oral agreement with any individual (including officers, directors, trustees, or

key employees listed in Form 990, Part Vll) or entity in connection with professional tundraising services? EY"" f l Ho

b lf "Yes, ' list the 1O highest paid individuals or entjties (fundraisers) pursuant to agreements under which the tundraise. is to be

compensated at leasl $5,000 by the organizalion.

(i) Name and address of individualor entity (fundraiser)

Total

3 Lisl all states in which the organazataon is registered or licensed to solicit contributions or has been notified it is exempt from registrationor licensing.

(vi) Amount paidto (or retained by)

organization

(iv) Gross receiptsfrom activity

(v) Amount paidto {or relained by)

fundraiserlisted in col. (i)

(ii) Activity

(iii) o,o

No

832081 10 03 18

Schedule G (Form 990 or 990-EZ)2018

OMB No r545-0037

Open to Publiclnspection

LHA For Paperwork Reduction Act Notice, see the lnstuctions for Form gg0 or ggO-EZ.

ca

Lll

-

cc

ouJ

Eo

Schedule G orrn 990 or 990 er Mi ssissi i valle 63 p e2Fundraising Events. Complete il the organization answered "Yes" on Form 990, Part lV, line '18, or reported more than $15,000of tundraising event contributions and gross income on Form 990-EZ, Iines 1 and 6b. Ust events with gross receipts greater than $5,000

(d) Total evenls(add col. (a) through

col. (c))

104 94L.

104 94t.

JJ 937.33 937.

Gaming. Complete iI the organization answered "Yes' on Form 990, Part lV, line 19, or reported more than

$15,000 on Form 990-EZ, line 6a.

(d) Total gaming (add

col. (a) through col. (c))

9 Enter the state(s) in which the organjzation conducts gaming activities

a ls the organization licensed to conduct gaming activities in each of these states? Yes No

b lf ' No," explain

Part ll

(c) Other events

None(a) Event #1

AMI Walk

(b) Event #2

(event type) (event type) (totalnumber)

104.947.

3 Gross income (line 1 minus line 2)

1 Gross receipts

t04,947.

33 ,937 ,

4

5

6

7

I9

10 Direct expense summary. Add lines 4 through I in column (d)

Cash prizes

Noncash prizes

Rent/facility costs

Food and beverages

line 3 coJumnNet income summa Subtract line 10

Entertainment .. .

Other direct expenses

Part lll

(a) Blngo(b) Pulltabs/instant

bingo/progresslve b ngo(c) Other gaming

1 Gross revenue

2 Cash prizes ..

3 Noncash prizes

4 Rent/facility costs

5 Other direct expenses

Net qamino income summarv. Subtract line 7 from line '1, column (d)

Direct expense summary. Add lines 2 through 5 in column (d)

6 Volunteer labor

7

I

lOa Were any ot the organization's gaming licenses revoked, suspended, or terminated during the tax yea,b lf "Yes, ' explain:

L lve" Llruo

332032 10-03 18 Schedule G (Form 9OO or 990-EZ) 2019

2 Less: Contributions

UIe G m 990 or 990. 2018 NAIII Greater i ValleDoes the organization conduct gaming activities with nonmembers?. ..ls the organization a grantor, beneficiary ortrustee of a trust, or a member of a partnership or other entity formed

to administer charitable gaming?

lndicate the percentage oI gaming activity conducted inl

a The organizatron's facrl(y

b An outside facility

Enter the name and address of the person who prepares the organization's gaming/special evenls books and records

Name )

e

11

12f-..l vu" fl No

13

14

Address >

b lf 'Yes, " enter the amount of gaming revenue received by the organization > $ and the amount

of gaming revenue retained by the third party > $

c lf "Yes.' enter name and address of the third party

16 Gaming manager information

Gaming manager compensation > $

Description of services provided >

Director/officer fl emptoyee E lndependent contractor

17 Mandatory distributions:

a ls the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gamrng license?

b Enter the amount ol distributions required under state law to be distributed to other exempt organizations or spent in the

No

Part lVo niz aciivities durin the tax

Supplemental lnformation. Provide the explanations required by Part l, line 2b, columns (iii)and (v); and Part lll, lines 9, 9b, 10b,

15b, 15c, 16, and 17b, as app licable. Also provide any additional inlormatron. See nstructions

a32033 10 03 18 Schedule G (Form 990 or 99O-EZ) 2018

I rs" I o/o

tAT %

isa Does the organization have a contract with a third party from whom the organization receives gaming revenuel . E V"" E No

n,o-o L

n'"-^ L

-

Schedule G Mi I 1 i ValleSupplemental lnf ormation tinued)Part

83203,1 04 01 1a

Schedule G (Form 990 or 990-EZ)

Supplemental Information to Form 990 or 990-EZ2018Complete to provide info.malion for responses to specific questions on

Form 99O or 9SO-EZ or to provide any additional information.> Attach to Form 99O or 99O-EZ. Open to Public

ln

A.MI reater Mi.ssissi i Val- le

SCHEDULE O(Form 99O or gSGEZ

)

O€prlme.l ol lhe Treas!ry

Name of the organization

!'orm y y u Part VI Section A line 6

A membership fee is paid by interested individuals who parEicipate in the

orqani zation,

Form 990 ParE VI Section A l-ine 7a:

The board of direcEors are nominated and elected by the qeneral membership.

Form 990, Part VI , Section B, line 11b :

Form 990 is siven to the board during their next meeEing for revrew.

Form 990, Part VI , SecEion C, L,ine 19:

The documents are available upon request from the board.

Schedule O (Form 990 or 99O-EZ) (2018)

Employer identifi cation number

LHA For Paperwork Reduciion Act Notice, see the lnstuctions to. Form g9O or ggO-EZ.

83421r 10,10,18

rorm 8868(Bev. Jan{-rary 2019)

Application for Automatic Extension of Time To File aExempt Organization Return

> File a separate application for each return.

> Go to www.irs.gov/Form8868 for the latest information.

OMB No. 15451709

O.prlhent o, lhe Treasury.lsna Re!e.!e Ser! ce

Electronic filin9 (e-tile). You can electronically flle Form 8868 to request a 6.month automatic extension of time to file any of the

forms listed below with the exception of Form 8870, lnformataon Return for Transfers Assocaated With Certain Personal Benefit

Contracts, for which an extension request must be sent to the IBS in paper format (see instructions). For more details on the electronic

filing of this form, visit www.irs.gov/e-file-providersle-file-lor-charities-and-non'profits.

Automatic 6-Month Extension of Time. Only submlt original (no copies needed)

Allcorporations required to iile an incorne tax return other than Form 99GT (including '1'120-C filers), partnerships, REMlCs, and trusts

must use Form 7004 to request an extension of time to file income tax retums.

Enter filer's i

Employer identiflcation number (ElN) orType orprint

number

42-1L88963Social security number (SSN)

City, town or post otfice, state, and ZIP code. For a toreign address, see instructions

Daven ort rA 52806Enler the Return Code for the retum that this application is for (file a separate application for each return)

Applicationls For

Retum

Code

Form 990 or Form 990 E2

Form 990-BL

Fotm 4720 ndividual

Form 990'PF

Form 99GT or 408

al

tru

OB

0g

10

11

12Form 990'T rust other than above

Terry Haru. The books are in the care oJ ) 1035 W Kimberlv Rd - DavenporE, IA 52806

Name of exempt organization or other filer, see instructions.

NA.III Greater Mississippi Va11eyNumber, street, and room or suite no. lf a P.O. box, see instructions

1035 w Kimberly Rd *4

0 1Return

Code

ApplicationIs For

01 Form 990'T (corporation)

a2 Form 1041-A

Form 4720 (other than individual)03

a4 Fotn",5227

05 Forn,6069

06 Form 8870

Telephone uo.) 553-385-7477 Fax No. >. lf the organization does not have an ottice or place of business in the Uniled States, check this box. lf this is for a GroLrp Beturn, enter the organization's four digit Group Exemption Number (GEN) _.lf this is for the whole group, check this

box > E.ttrtistorpart of the group. check this box > E and attach a list with the names and ElNs of all members the extension is for

I I request an automatic 6-month extension of time until

the organization named above. The extension is for the organization's return lor

)E calendar year 20!8 or

) E tax year beginning , and ending

2 ll the tax year entered in line 1 is for less than 12 months, check reason

E Change in accounting period

November 15 20t9 . to file the exempt organization return for

lnltral return Frnalreturn

3a If this application as for Forms 990.8L. 99O.PF, 990-T. 4720, or 6069, enter the tentalive tax, less

an nonrefundable credits. See instructions 0.b lf this application is for Forms 99O.PF, 990-T, 4720, or 6069, enter any refundable credits and

estimated tax made. ln an nor at ove a ment allowed as a credrt

c Balance due. Subtract line 3b from line 3a. lnclude your payment with this form, if required, by

US EFTPS lectronic FederalT P ntS See instructions 0.Caution: lf you are going to make an electronic Iunds withdrawal (djrect debit) with this Form 88S, see Form 8453-EO and Form 8879'EO for payment

instructions.

LHA For Privacy Act and Paperwork Reduction Act Notice, see insttuctions.

3a

3b

3c

823841 t2-19'18

Form 8868 (Rev. 1.2019)

E