HomeMy WebLinkAbout2009Sebastian Clambake Foundation, Inc.
Compiled Financial Statements
(Unaudited)
April 30, 2009
1623 US Hwy 1, Suite B-4
Sebastian, FL 32958
To the Board of Directors,
Sebastian Clambake Foundation, Inc.
PO Box 780436
Sebastian, FL 32958
Telephone: (772) 388 -3301
Fax: (772) 388 -0810
I have compiled the accompanying statement of assets, liabilities & fund balance
— cash basis of Sebastian Clambake Foundation, Inc. (a non profit organization)
as of April 30, 2009 and 2008, and the related statements of support and
expenses — cash basis for the twelve months then ended and for each of the
twelve month periods ended April 30, 2003 through 2007 in accordance with
Statements on Standards for Accounting and Review Services issued by the
American Institute of Certified Public Accountants.
A compilation is limited to presenting in the form of financial statements
information that is the representation of management. I have not audited or
reviewed the accompanying financial statements and accordingly, do not express
an opinion or any form of assurance on them.
Management has elected to omit substantially all of the disclosures and the
statement of cash flows ordinarily included in financial statements. If the omitted
disclosures and statement were included in the financial statements, they might
influence the user's conclusions about the Sebastian Clambake Foundation's
financial position and results of operation. Accordingly, these financial
statements are not designed for those who are not informed about such matters.
I am not independent with respect to Sebastian Clambake Foundation, Inc.
June 16, 2009
The Sebastian Clambake Foundation, Inc.
Statement of Assets, Liabilities & Fund Balance - Cash Basis
As of April 30, 2009
Apr 30, 09 Apr 30, 08
ASSETS
Current Assets
Checking /Savings
Checking
Total Checking /Savings
Total Current Assets
Fixed Assets
Furniture and Equipment
Accumulated depreciation
Total Fixed Assets
TOTALASSETS
LIABILITIES & EQUITY
Equity
Unrestricted Net Assets
Net Income
Total Equity
TOTAL LIABILITIES & EQUITY
14,494.84
9,320.61
14,494.84
9,320.61
9,176.78
14,494.84
9,320.61
19,745.78
19,745.78
(10,569.00)
(7,749.00)
9,176.78
11,996.78
23,671.62
21,317.39
21,317.39
132,303.59
2,354.23
(110,986.20)
23,671.62
21,317.39
23,671.62
21,317.39
See accountant's compilation report.
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The Sebasfim-1 Clambake Foundation, Inc.
a Florida :not - for - ,profit corporation
............. ...............................
Organizers of the World Famous
SEBASTIAN CLAMBAKE LAGOON FESTIVAL
TO: Sebastian City Council Members
FROM: Nancy Veidt, Secretary
Sebastian Clambake Foundation
DATE: January 12, 2010
SUBJECT: 2009 Sebastian Clambake Foundation Financials
Attached please find a preliminary financial statement for the November 2009 Clambake
Festival. The Clambake Foundation's agreement with the City of Sebastian states that the
Clambake Foundation will provide to the City an annual financial report, prepared and certified
by a Certified Public Accountant, showing all Foundation revenue and expenses within 120 days
of the last day of the Clambake. Unfortunately the Clambake Foundation's fiscal year runs from
June 1 through May 30. Therefore, our Annual Report for 2009 will not be filed until after May
30, 2010. Since our books will not be closed until May 30, 2010, we respectfully ask for an
extension until June 30, 2010 to furnish a copy of our 2009 Annual Report and audited Financial
Statements. If you have any questions, please contact me at (772) 913 -3674 or (772) 589 -9268.
Our books are always open for your inspection by contacting Dot Judah at (772) 581 -3199 or
(772) 589 -4873. Thank you for your consideration in this matter.
PO Box 780436 13 Sebastian, Florida, 32978 -a webmaster @sebastianciambake.org
SEBASTIAN CLAMBAKE FOUNDATION
PRELIMINARY FINANCIAL STATEMENT (UNAUDITED)
January 12, 2010
Beginning Balance 6/1/09 $ 14,494.84
REVENUES
Donations / Sponsor Fees
$
5,519.00
Exhibitor /Vendor Income
$
14,345.00
Boat Show
$
1,450.00
City of Sebastian - Advertising
$
5,000.00
Ticket Sales
$
152,237.62
T -Shirt Sales
$
45.00
Kids Zone
$
200.00
Total Revenues
$
178,796.62
FESTIVAL EXPENSES
Administrative Charges
$
2,227.52
Food /Beverage
$
67,617.10
Advertising
$
8,928.85
Sales Tax
$
9,932.61
Liability Insurance
$
5,942.28
Entertainment
$
5,000.00
T- Shirts
$
1,952.30
Misc Supplies
$
6,031.09
Contest Awards
$
425.00
Total Festival Expenses
$
108,056.75
OTHER EXPENDITURES
Membership Grants
$
1,250.00
Beneficiary Payments (VFW /By the River)
$
17,750.00
TOTAL EXPENDITURES
$
127,056.75
BALANCE 1/13110
$
66,234.71
To Be Distributed:
Sharks Football
$
10,250.00
Sebastian Soccer Assn.
$
10,250.00
H.A.L.O.
$
10,250.00
Boys & Girls Club
$
10,250.00
Membership Grants
$
10,000.00
Adjusted Balance
$
15,234.71
The Sebastian Clambake Foundation Inc.
Compiled Financial Statements
(Unaudited)
April 30, 2010
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The Sebastian Clambake Foundation, Inc.
Statement of Assets, Liabilities & Fund Balance - Cash Basis
As of April 30, 2010
ASSETS
Current Assets
Checking /Savings
Checking
Total Checking /Savings
Total Current Assets
Fixed Assets
Furniture and Equipment
Accumulated depreciation
Total Fixed Assets
TOTAL ASSETS
LIABILITIES & EQUITY
Equity
Unrestricted Net Assets
Net Income
Total Equity
TOTAL LIABILITIES & EQUITY
•
Apr 30, 10 Apr 30, 09
17, 707.68
14, 494.84
17,707.68
14,494.84
17,707.68
14,494.84
20,485.66
19,745.78
(13,440.00)
(10,569.00)
7,045.66
9,176.78
24,753.34
23,671.62
23,671.62 21,317.39
1,081.72 2,354.23
24,753.34 23,671.62
24,753.34 23,671.62
See accountant's compilation report.
The Sebastian Clambake Foundation, Inc.
Statement of Support and Expenses - Cash Basis
May 2009 through April 2010
Ordinary Income /Expense
Income
Clambake Festival Income
Sponsorships
Total Income
Cost of Goods Sold
Clambake Festival Expenses
Total COGS
Gross Profit
Expense
Administrative
Advertising
Depreciation
Insurance
Penalties and interest
Professional fees
Total Expense
Net Ordinary Income
Other Income /Expense
Other Expense
Grants and allocations
Total Other Expense
Net Other Income
Net Income
May '09 - Apr 10 May '08 - Apr 09
171,002.00
9,600.00
180, 602.00
93,667.71
93,667.71
86,934.29
710.44
9,078.85
2,871.00
5,642.28
0.00
550.00
18,852.57
68,081.72
67, 000.00
67, 000.00
(67,000.00)
1,081.72
See accountant's compilation report.
163,878.76
9,000.00
172,878.76
95,425.15
95,425.15
77,453.61
1,612.02
11, 749.32
2,820.00
9,055.64
1,686.39
3,798.75
30, 722.12
46,731.49
44,377.26
44,377.26
(44,377.26)
2,354.23
CLIENT CLAMBAKE
ANTHONY M. DONINI, CPA, PA
1623 US HWY 1 SUITE B -4
SEBASTIAN, FL 32958
(772) 388 -3301
July 1, 2010
SEBASTIAN CLAMBAKE FOUNDATION, INC
PO BOX 780436
SEBASTIAN, FL 32978
Dear Client:
Your 2009 Federal Return of Organization Exempt from Income Tax will be electronically filed
with the Internal Revenue Service upon receipt of a signed Form 8879 -EO - IRS e -file Signature
Authorization. No tax is payable with the filing of this return.
Please be sure to call us if you have any questions.
Sincerely,
Anthony M. Donini, CPA
C
d T
T
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N
2009 FEDERAL EXEMPT ORGANIZATION TAX SUMMARY (EZ)
SEBASTIAN CLAMBAKE FOUNDATION, INC
PAGE 1
2009
2008
DIFF
FORM 990 -EZ REVENUE
CONTRIBUTIONS, GIFTS, AND GRANTS............
9,600
0
9,600
NET INCOME (LOSS) - SPECIAL EVENTS.........
62,612
55,363
7,249
TOTAL REVENUE .......... ...............................
72,212
55,363
16,849
EXPENSES
GRANTS AND SIMILAR AMOUNTS PAID ..............
67,000
44,377
22,623
PROFESSIONAL FEES /PYMT TO CONTRACTORS.....
550
3,799
-3,249
PRINTING, PUBLICATIONS, AND POSTAGE........
144
0
144
OTHER EXPENSES ......... ...............................
3,437
4,832
-1,395
TOTAL EXPENSES ......... ...............................
71,131
53,008
18,123
NET ASSETS OR FUND BALANCES
EXCESS OR (DEFICIT) FOR THE YEAR............
1,081
2,355
-1,274
NET ASSETS /FUND BAL. AT BEG. OF YEAR......
23,672
21,317
2,355
NET ASSETS /FUND BAL. AT END OF YEAR.......
24,753
23,672
1,081
IRS a -fi /e Signature Authorization
Form 8879-EO for an Exempt Organization
For calendar year 2009, or fiscal year beginning 501 , 2009, and ending 430 , 2010 .
Department of the Treasury
Internal Revenue Service
Name of exempt organization
Name and title of officer
Do not send to the IRS. Keep for your records.
See instructions.
ANJANI CIRILLO PRESIDENT
1PAiW Tax Return and Return Information (Whole Dollars Only)
OMB No. 1545 -1878
2009
Lion number
Check the box for the return for which you are using this Form 8879 -EO and enter the applicable amount, if any, from the return. If you check
the box on line la, 2a, 3a, 4a, or 5a, below, and the amount on that line for the return for which you are filing this form was blank, then leave
line 1 b, 2b, 3b, 4b, or 5b, whichever is applicable, blank (do not enter -0 -). But, if you entered -0- on the return, then enter -0- on the applicable
line below. Do not complete more than 1 line in Part I.
1 a Form 990 check here.... ►
❑
b Total revenue, if any (Form 990, Part VIII, column (A), line 12) .........
1 b
2a Form 990 -EZ check here.....
►
❑ b Total revenue, if any (Form 990 -EZ, line 9) ........................
2b
3a Form 1120 -POL check here......
n b Total tax (Form 1120 -POL, line 22) ............................
3b
4a Form 990 -PF check here.....
b Tax based on investment income (Form 990 -PF, Part VI, line 5) .................
4b
5a Form 8868 check here... 0
b Balance Due (Form 8868, line 3c) ...... ...............................
5b
72,212.
Declaration and Signature Authorization of Officer
Under penalties of perjury, I declare that I am an officer of the above organization and that I have examined a copy of the organization's 2009
electronic return and accompanying schedules and statements and to the best of my knowledge and belief, they are true, correct, and
complete. I further declare that the amount in Part I above is the amount shown on the copy of the organization's electronic return. I consent to
allow my intermediate service provider, transmitter, or electronic return originator (ERO) to send the organization's return to the IRS and to
receive from the IRS (a) an acknowledgement of receipt or reason for rejection of the transmission, (b) an indication of any refund offset, (c) the
reason for any delay in processing the return or refund, and (d) the date of any refund. If applicable, I authorize the U.S. Treasury and its
designated Financial Agent to initiate an electronic funds withdrawal (direct debit) entry to the financial institution account indicated in the tax
preparation software for payment of the organization's federal taxes owed on this return, and the financial institution to debit the entry to this
account. To revoke a payment, I must contact the U.S. Treasury Financial Agent at 1- 888 - 353 -4537 no later than 2 business days prior to the
payment (settlement) date. I also authorize the financial institutions involved in the processing of the electronic payment of taxes to receive
confidential information necessary to answer inquiries and resolve issues related to the payment. I have selected a personal identification
number (PIN) as my signature for the organization's electronic return and, if applicable, the organization's consent to electronic
funds withdrawal.
Officer's PIN: check one box only
XD I authorize ANTHONY M. DONINI, CPA, PA to enter my PIN as my signature
Enter five numbers, but
ERO firm name do not enter all zeros
on the organization's tax year 2009 electronically filed return. If 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 Fed /State program, I also authorize the aforementioned ERO to enter my PIN on
the return's disclosure consent screen.
As an officer of the organization, I will enter my PIN as my signature on the organization's tax year 2009 electronically filed return. If 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 Fed /State
program, I will enter my PIN on the return's disclosure consent screen.
Officer's signature 0' Date "'
P 1W I Certification and Authentication
ERO's EFIN /PIN. Enter your six -digit EFIN followed by your five -digit self - selected PIN ............................. 1
do not enter all zeros
I certify that the above numeric entry is my PIN, which is my signature on the 2009 electronically filed return for the organization indicated
above. I confirm that I am submitting this return in accordance with the requirements of Pub. 4163, Modernized e -File (MeF) Information for
Authorized IRS e -file Providers for Business Returns.
ERO's signature I- Date P'
ERO Must Retain This Form — See Instructions
Do Not Submit This Form to the IRS Unless Requested To Do So
BAA For Paperwork Reduction Act Notice, see instructions.
TEEA7401L 03/02/10
Form 8879 -EO (2009)
Form 990 -EZ
Department of the Treasury
Infernal Revenue Service
Short Form COPY
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(aX1) of the Internal Revenue Code
(except black lung benefit trust or private foundation)
► Sponsoring organizations of donor advised funds and controlling organizations as defined in section 512(b)(13) must file Form
990. All other organizations with gross receipts less than $500,000 and total assets less than $1,250,000 at the end of the year
may use this form.
► The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545 -1150
2009
A For the 2009 calendar ear, or tax year beginning 5/01 , 2009, and ending 4/30 , 2010
B Check if applicable: C D Employer identification number
Address change use IRS SEBASTIAN CLAMBAKE FOUNDATION, $NC
Name change label or PO BOX 780436
print or E Telephone number
Initial return tye pe. SEBASTIAN, FL 32978
Termination Yee 772- 388 -4733
Amended return Instruc-
tions. F Group Exemption
Application pending Number............ ►
• Section 501(c)(3) organizations and 4W(a 1) nonexempt charitab trusts G Accounting method: N Cash Accrual
must attach a completed Schedule A (Form 990 or 990-E,7). Other (specify) ►
H Check ► X if the organization is not
Website: ► WWW. SEBASTIANCLAMBAKE.ORG required to attach Schedule B (Form 990,
J Tax-exempt status check only one — IX 501 c ) ( 3 -4 insert no. 14947(a 1 or 1 1527 990 -EZ, or 990 -PF).
K Check ► L J if the organization is not a section 509(a)(3) supporting organization and its gross receipts are normally not more than
$25,000. A orm 990 -EZ or Form 990 return is not required, but if the organization chooses to file a return, be sure to file a complete return.
L Haa lines 5b, bb, and Ib, to line 9 to determine gross receipts; if $500,000 or more, file Form 990
instead of Form 99(1 -F7
Pa
. ................. ............................... Y 1 V V,
- Revenue, Expenses, and Changes in Net Assets or Fund Balances See the instructions for Part I.
R
E
E
N
e
1 Contributions, gifts, grants, and similar amounts received .............. ...............................
2 Program service revenue including government fees and contracts ..... ...............................
3 Membership dues and assessments .................................. ...............................
4 Investment income .................................................. ...............................
5a Gross amount from sale of assets other than inventory .......... .. . . 5a
b Less: cost or other basis and sales expenses ............................. L 5b
e Gain or (loss) from sale of assets other than inventor Subtract In 5b from In 5a
Y( ) ....... ...............................
6 Special events and activities (complete applicable parts of Schedule G). If any amount is from gaming, check here ...... 01
a Gross revenue (not including $ 9, 600 of contrlbutiorfs
reported on line 1) ........................................ ........I...... 6a 171, 002
b Less: direct expenses other than fundraising expenses .................... L6bj 108, 390
c Net income or (loss) from special events and activities (Subtract line 6b from line 6a) .... .. ...........................
7a Gross sales of inventory, less returns and allowances ......... L ..... 7a
b Less: cost of goods sold .................. .
c Gross profit or (loss) from sales of inventory (Subtract line 7b from line 7b
e7a) ............................
8 Other revenue (describe ► )
9 Total revenue. Add lines 1, 2, 3, 4, 5c, 6c, 7c, and 8 ................ . ..............................
1
9,600.
2
3
4
5c
6e 62,612.
7c
8
9
72,212.
E
x
P
E
N
s
E
s
10 Grants and similar amounts paid (attach schedule ) ....................... SEE . STATEMEN.T..1.....
11 Benefits paid to or for members ...................................... ...............................
12 Salaries, other compensation, and employee benefits ................. ...............................
13 Professional fees and other payments to independent contractors ...... ...............................
14 Occupancy, rent, utilities, and maintenance ........................... .............................
..
15 Printing, P ublications, postage, and shipping ......... . . ....... . . . ..... ..................... ..........
16 Other expenses (describe ► SEE STATEMENT 2 ) ....
17 Total expenses. Add lines 10 through 16 ........................... ............................... "
10
67,000.
11
12
13
550.
14
15
144.
16
3, 437.
17
71, 131.
N s
E E
T T
S
r91
18 Excess or (deficit) for the year (Subtract line 17 from line 9) ........... ...............................
19 Net assets or fund balances at beginning of year (from line 27, column (A)) (must agree with end -of -year
figure reported on prior year's return) ................................. ...............................
20 Other changes in net assets or fund balances (attach explanation) ..... ...............................
21 Net assets or fund balances at end of year. Combine lines 18 through 20 ............................ ►
1 RY. .
18
1, 081.
19
23, 672.
20
21
24,753.
• +*_= r,. - va�=a� ra.r .+r rccw. n i uidi dbbetb on line z5, column (b2 are 1> I ,GSU,000 or more, file Form 990 instead of Form 990 -EZ.
(See the instructions for Part II.) (A) Beginning of year (B) End of year
22 Cash, savings, and investments ...................... ............................... 14, 495. 22 17,707.
23 Land and buildings ...................... ...............................
24 Other assets (describe ► SEE STATEMENT 3 )........
25 Total assets ............................ ...............................
26 Total liabilities (describe m-
27 Net assets or fund balances (line 27 of column (B) must agree with line 21
BAA For Privacy Act and Paperwork Reduction Act Notice, see separate instructions.
TEEA0803L 01/30/10
9,177. 241 7,046.
23, 672. 25 24,753.
0. 26 0.
23, 672. 27 24,753.
Form 990 -EZ (2009)
Form 990 -EZ (2009) SEBASTIAN CLAMBAKE FOUNDATION, INC pan'. 9
Statement of Program Service Accomplishments See the instructions.
Expenses
(Required for section
501(c)(3) and (4)
What is the organization's primary exempt purpose? SUPPORT LOCAL CHARITIES
Describe what was achieved in carrying out the organization's exempt purposes. In a clear and concise manner,
describe the services provided, the number of persons benefited, or other relevant information for each
organizations and section
4947(a)(1) trusts; optional
program title.
for othhers.)
28 SEE STATEMENT-4
- ------------ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
0.
0.
--------------------------------------------------
(Grants $ 67, 000.) If this amount includes foreign grants, check here ................ ►
28a
67,000.
29 ---------------------------------------------------
---------------------------------------------------
SEBASTIAN, FL 32958
Grants $ ►
( ) If this amount includes foreign grants, check here.. .
29a
30 ---------------------------------------------------
T_HE_0_D_OR_A_ _HU_L_S_E_ _ _ _ - - - - -
VICE PRESIDENT
---------------------------------------------------
(Grants $ ) If this amount includes foreign grants, check here.. 0.
30 a
0.
31 Other program services (attach schedule) ................................. ......................I........
3.00
Grants $ If this amount includes foreign grants, check here ................ ►
31 a
SEBASTIAN, FL 32958
32 Total program service expenses (add lines 28a through 31 a) ............ ............................... ►
32
67,000.
___.._, -• -- -. - ...__._, _..__....,
(a) Name and address
.. --,,,, ,, ,,,,,, ,,,, , ,,,
(b) Title and average hours
per week devoted
to position
- -. LIJI GCR.II VI
(c) Compensation (If
not paid, enter -0 -.)
It: CVCII II Ilvi wrnNensdiea.
(d) Contributions to
employee benefit plans and
deferred compensation
the insirs.)
(e) Expense account
and other allowances
CIRILLO
ANJANI - ---- - - - - --
----------
PRESIDENT
0.
0.
0.
11155 ROSELAND RD
------------- -- - - - - --
3.00
SEBASTIAN, FL 32958
T_HE_0_D_OR_A_ _HU_L_S_E_ _ _ _ - - - - -
VICE PRESIDENT
0.
0.
0.
402 COPLY TERR
--------------- - - - - --
3.00
SEBASTIAN, FL 32958
NANCY VIEDT----- _ - - - - --
SECRETARY
0.
0.
0.
352 B_AN_YAN_ST_____ - - - - -_
3.00
SEBASTIAN, FL 32958
DOT JUDAH- - - - - - - - - - - - -
TREASURER
0.
0.
0.
13390N INDIAN RIVER DR -
--------------- - - - --
3.00
SEBASTIAN, FL 32958
PAT RIVIEZZO
--------------- - - - - --
DIRECTOR
0.
0.
0.
7880 92ND AVE
--------------- - - - - --
1.00
VERO BEACH, FL 32967
HOLLY BILLERO
---------------------
DIRECTOR
0.
0.
0.
PO BOX 780436
--------------- - - -
1.00
- --
SEBASTIAN, FL 32978
MARILYN WALDIS_ _ _ - - -
DIRECTOR
0.
0.
0.
816 US_H_W_Y_1 _____ - - - - --
1.00
SEBASTIAN, FL 32958
RICHARD STRINGER _
--------------- - - - --
DIRECTOR
0.
0.
0.
356 CONCHA DR.
--------- - --- - - - - - -
1.00
- -
SEBASTIAN, FL 32958
CONNELLY
BETSY - -
----- - - - - - ---------
DIRECTOR
0.
0.
0.
149 KILDARE DR
--------------- - - - -
1.00
--
SEBASTIAN, FL 32958
---------------------
---------------------
--------------- - - - - --
otita TEEA0812L 01/30/10 Form 990 -EZ (2009)
Form 990 -EZ (2009) SEBASTIAN CLAMBAKE FOUNDATION, INC Page 3
Other Information Note the statement requirements in the instrs for Part V. SEE STATEMENT 5
Yes No
33 Did the organization engage in any activity not previously reported to the IRS? If 'Yes,' attach a detailed description of
eachactivity ....................................................................... ............................... 33 X
34 Were any changes made to the organizing or governing documents? If 'Yes,' attach a conformed copy of the changes .. 34 X
5;
35 If the organization had income from business activities, such as those reported on lines 2, a, and 7a (among others), but not reported on Form 990-T,
attach a statement explaining why the organization did not report the income on Form 990 f R
a Did the organization have unrelated business gross income of $1,000 o more or was it subject to section 6033(e) notice,
reporting, and proxy tax requirements ? ............................. ...... ............................... 35a X
b If 'Yes,' has it filed a tax return on Form 990 -T for this year? .......................... ............................... 35b
36 Did the organization undergo a liquidation, dissolution, termination, or s gnificant disposition of net assets during the
year? If 'Yes,' complete applicable parts of Schedule N ............................... ............................... 36 X
37a Enter amount of political expenditures, direct or indirect, as described i the instructions. ► Val 0(3
b Did the organization file Form 1120 -POL for this year? ................. .............. ............................... 37b X
38a Did the organization borrow from, or make any loans to, any officer, dir4ctor, trustee, or key employee or were y
any such loans made in a prior year and still outstanding at the end of the period covered by this return ?.......... 38a
b If 'Yes,' complete Schedule L, Part II and enter the total -
amount involved ........ ......... 38b N/A
i
39 Section 501(c)(7) organizations. Enter:
a Initiation fees and capital contributions included on line 9.... ...... .................. 39aY N/A
b Gross receipts, included on line 9, for public use of club facilities ....................... 39b N/A ;
40a Section 501(c)(3) organizations. Enter amount of tax imposed on the or anization during the year under:
section 4911 ► 0 . ; section 4912 ► 0 . ; section 4955 ► 0 �`:'
41
b Section 501(c)(3) and 501(c)(4) organizations. Did the organization enga e in any section 4958 excess benefit
transaction during the year or is it aware that it engaged in an excess b nefit transaction with a disqualified person in a
prior year, and that the transaction has not been reported on any of the rganization's prior Forms 990 or 990 -EZ? If
'Yes,' complete Schedule L, Part I ................................................... ...............................
c Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax impo ed on organization
managers or disqualified persons during the year under sections 4912, 4 55, and 4958........ ► 0
d Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax on line 40c reimbursed _
e shelter tertransactio nt If 'Yes,' complete Form 886 -T as the organization on a
y the organization............ ...... ......... 0
organizations. Y 9 Y g party to a prohibited tax
List the states with which a copy of this return is filed ► NONE
ri
40b I I X
u �
xg OR
40e X
42a The organization's
books are in care of TREASURER -- - -_ - -- Telephoneno.► 772 - 581 -3199
------- - - - - --
Locatedat ► PO BOX 780436 SEBASTIAN FL ZIP +4 ► 32958
------------------------------------- - - - - -- ------- - - - - --
b At any time during the calendar year, did the organization have an interest in or a signature or other authority over a Yes No
financial account in a foreign country (such as a bank account, securities ccount, or other financial account)? ......... 42b X
If 'Yes,' enter the name of the foreign country:.. ► #
See the instructions for exceptions and filing requirements for Form TD F 90 22.1, Report of a Foreign Bank and Financial Accounts..,
c At any time during the calendar year, did the organization maintain an office outside of the U.S. ? ...................... 42c X
If 'Yes,' enter the name of the foreign country:.. ►
43 Section 4947(a)(1) nonexempt charitable trusts filing Form 990 -EZ in lieu of Form 1041 — Check here ....................... ► F] N/A
and enter the amount of tax - exempt interest received or accrued during the tax year ..................... ►I 43 1 N/A
Yes No
44 Did the organization maintain any donor advised funds? If 'Yes,' Form 990 must be completed instead
ofForm 990- EZ .....................................................:.............. ............................... 44 X
45 Is any related organization a controlled entity of the organization within the meaning of section 512(b)(13)? If 'Yes,'
Form 990 must be completed instead of Form 990- EZ .................... ............................... 45 X
BAA
TEEA0812L 01/30/10
Form 990 -EZ (2009)
Form 990 -EZ (2009) SEBASTIAN CLAMBAKE FOUNDATION, INC Page 4
' V(.,r, Section 501(cx3) organizations and section 4947(ax1) nonexempt charitable trusts only. All section
501(c)(3) organizations and section 4947(a)(1) nonexempt charitable trusts must answer questions
46 -49b and complete the tables for lines 50 and 51.
46 Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates Yes I No
for public office? If 'Yes,' complete Schedule C, Part I ................................ ............................... 46 X
47 Did the organization engage in lobbying activities? If 'Yes,' complete Schedule C, Part II .............................. 47 X
48 Is the organization a school as described in section 170(b)(1)(A)(ii)? If 'Yes,' complete Schedule E .................... 48 X
49a Did the organization make any transfers to an exempt non - charitable related organization ? ............................ 49a X
b If 'Yes,' was the related organization a section 527 organization? ................. ............................... I .... 49b
50 Complete this table for the organization's five highest compensated employees (other than officers, directors, trustees and key
employees) who each received more than $100.000 of comnensatinn from the nrn Ani7nfinn If fl-i is nn— o fnr 1\1n
(a) Name and address of each employee paid
more than $100,000
(b) Title and average
hours per week
devoted to position
(c) Compensation
(d) Contributions to employee
benefit plans and
deferred compensation
(e) Expense
account and
other allowances
NONE
------------------------
------------------------
------------------ - - - - --
I I otal number of orner employees palo over $ I UU,000.......
51 Complete this table for the organization's five highest compensated independent contractors who each received more than $100,000 of
compensation from the organization. If there is none, enter 'None.'
(a) Name and address of each independent contractor paid more than $100,000 (b) Type of service (c) Compensation
NONE
d Total number of other independent contractors each receiving over $100,000 ............ ►
Sign
Here
under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is
true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Signature of officer (Date
ANJANI CIRILLO PRESIDENT
Type or print name and title.
Paid Preparer's
Pre-
signature
- Vate Check if
self -
G'/ P employed ►
parer's Firm's name (or -ANTHONY M. DONINI, CPA, PA
yours if self- � 1623 US HWY 1 SUITE B -4
Use employed), EIN
Only ZIP e4 and
SEBASTIAN, FL 32958 Phone no. ► (772) 388 -3301
May the IRS discuss this return with the preparer shown above? See instructions ;n Yes n No
BAA Form 990 -EZ (2009)
Preparer's Identi ing Number
(See instructions
N/A
N/A
TEEA0812L 01/30/10
SCHEDULE A
(Form 990 or 990 -EZ)
Department of the Treasury
Internal Revenue Service
Name of the organization
OMB No. 1545 -0047
Public Charity Status and Public Support 2009
Complete if the organization is a section 501(cX3) organization or a section 4947(aX1) r
nonexempt charitable trust.
� Attach to Form 990 or Form 990 -EZ. 1, See separate instructions.
SEBASTIAN CLAMBAKE FOUNDATION, INC
Fxa�eason for Public Charity Status (All organizations
The organization is not a private foundation because it is: (For lines 1 throuc
1 A church, convention of churches or association of churches descri
2 A school described in section 170(bX1XAXii). (Attach Schedule E.'
3 A hospital or cooperative hospital service organization described in
4 A medical research organization operated in conjunction with a hos
lete this
11, check only one box.)
d in section 170(bX1XAXi).
Employer identification number
See instructions
tion 170(bX1XAXiii).
I described in section 170(bX1XAXiii). Enter the hospital's
name, city, and state: _ _ -f _ _ _ _ _ _ _ _ _
5 An organization operated for he benefit of a college or university o ned or operated by a governmental unit described in section
170(bX1XAXiv). (Complete Part II.)
6 A federal, state, or local government or governmental unit describe in section 170(bX1XAXv).
7 An organization that normally receives a substantial part of its supp rt from a governmental unit or from the general public described
in section 170(bX1XAXvi). (Complete Part 11.)
8 ❑ A community trust described in section 170(bX1XAXvi). (Complete art 11.)
9 X❑ An organization that normally receives: (1) more than 33 -1/3 % of its sup ort from contributions, membership fees, and gross receipts
from activities related to its exempt functions — subject to certain except) ns, and (2) no more than 33-1/3 % of its support from gross
investment income and unrelated business taxable income (less se ion 511 tax) from businesses acquired by the organization after
June 30, 1975. See section 509(aX2). (Complete Part III.)
10 HAn An organization organized and operated exclusively to test for publi safety. See section 509(aX4).
11 organization organized and operated exclusively for the benefit of, to perform the functions of, or carry out the purposes of one or
more publicly supported organizations described in section 509(a)(`I j or section 509(a)(2). See section 509(aX3). Check the box that
describes the type of supporting organization and complete lines 11 through 11 h.
a Type I b Type II c ❑ Type III — runctionally integrated d Type III— Other
e ❑ By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other
than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section
509(x)(2).
f If the organization received a written determination from the IRS that is a Type I, Type II or Type III supporting organization,
checkthis box .............................................................................. ............................... El
g Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
Yes No
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii) and (iii)
below, the governing body of the supported organization? ............... ...............................
(ii) a family member of a person described in (i) above? ................... ...............................
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ........ ............................... 11 (iii)
Provide the following information about the supported organizations.
(i) Name of Supported (ii) EIN (iii) Type of organization rv) Is the (v) Did you notify (vi) Is the (vii) Amount of Support
Organization (described on lines 1 -9 orc�a ization in cc l. the organization in organization in col.
above or IRC section (i) I sted in your col. (i) of (i) organized in the
(see instructions)) Governing your support? U.S.?
No I Yes I No I Yes I No
Total ;r E
BAA For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990 -EZ.
TEEA0401L 02/05/10
Schedule A (Form 990 or 990 -EZ) 2009
Schedule A (Form 990 or 990 -EZ) 2009 SEBASTIAN CLAMBAKE FOUNDATION, INC
(Complete only if you checked the box on line 5, 7, or 8 of Part I.)
Section A. Public Support
8 Gross income from interest,
dividends, payments received
on securities loans, rents,
royalties and income form
similar sources ...............
9 Net income from unrelated
business activities, whether or
not the business is regularly
carried on ....................
10 Other income. Do not include
gain or loss from the sale of
capital assets (Explain in
Part IV.) ......................
11 Total support. Add lines 7
through 10 ....................
12 Gross receipts from related activities, etc. (see instructions) ............................................. 12
13 First five years. If 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 stop here .................. ► n
Section C. Computation of Public Support Percentaae
14 Public support percentage for 2009 (line 6, column (f) divided by line 11, column (f) ........................... .
15 Public support percentage from 2008 Schedule A, Part II, line 14 ............. ............................... .
16a 33 -1/3 support test — 2009. If the organization did not check the box on line 13, and the line 14 is 33-1/3 % or more, check this box ❑
and stop here. The organization qualifies as a publicly supported organization. .................. ............................... ►
b 33 -1/3 support test — 2008. If the organization did not check a box on line 13, or 16a, and line 15 is 33 -1/3% or more, check this box ❑
and stop here. The organization qualifies as a publicly supported organization .................... ............................... ►
17a 10 %- facts - and - circumstances test — 2009 If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10%
or more, and if the organization meets the 'facts- and - circumstances' test, check this box and stop here. Explain in Part IV how ❑
the organization meets the 'facts- and - circumstances' test. The organization qualifies as a publicly supported organization......... ►
b 10 %- facts - and - circumstances test — 2008. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10%
or more, and if the organization meets the 'facts- and - circumstances' test, check this box and stop here. Explain in Part IV how the
organization meets the 'facts- and - circumstances' test. The organization qualifies as a publicly supported organization............ ►
18 Private foundation. If the organization did not check a box on line, 13, 16a, 16b, 17a, or 17b, check this box and see instructions.. ►
BAA
TEEA0402L 10/08/09
Schedule A (Form 990 or 990 -EZ) 2009
Schedule A (Form 990 or 990 -EZ) 2009 SEBASTIAN CLAMBAKE FOUNDATION, INC Page 3
Support Schedule for Organizations Described in Section 509(ax2)
(Complete only if you checked the box on line 9 of Part I.)
Section A. Public Support
Calendar year (or fiscal yr beginning in) o-
1 Gifts, grants, contributions and
membership fees received. Do
not include 'unusual grants.'...
2 Gross receipts from
admissions, merchandise sold
(a) 2005
(b) 2006
(c) 2007
(d) 2008
(e) 2009
f) Total
2,000.
9,000.
9,600.
20,600.
or services performed, or
facilities furnished in a activity
that is related to the
organization's tax - exempt
purpose ......................
3 Gross receipts from activities that are
146, 059.
177, 533.
7,183.
163, 879.
171, 002.
665, 656.
not an unrelated trade or business
under section 513 .................
0
4 Tax revenues levied for the
organization's benefit and
either paid to or expended on
its behalf .....................
0
5 The value of services or
facilities furnished by a
governmental unit to the
organization without charge....
0
146, 059.
179, 533.
7,183.
172, 879.
180, 602.
686, 256.
6 Total. Add lines 1 through 5 ...
7a Amounts included on lines 1,
2, 3 received from disqualified
persons ......................
0.
0.
0.
0.
0.
0.
b Amounts included on lines 2
and 3 received from other than
disqualified persons that
exceed the greater of 1 % of
the amount on line 13 for the
year..........................
0.
0.
0.
0.
0.
0.
0.
0.1
0.
0.
0.1
0.
c Add lines 7a and 7b...........
8 Public support (Subtract line
7c from line 6.) .
tc R
w
686, 256 .
Section t3. I otal SUDDOrt
Calendar year (or fiscal yr beginning in) m-
9 Amounts from line 6 ..........
10a Gross income from interest,
dividends, payments received
on securities loans, rents,
royalties and income form
similar sources ...............
b Unrelated business taxable
income (less section 511
taxes) from businesses
acquired after June 30, 1975.. .
c Add lines I Oa and l Ob........ .
11 Net income from unrelated business
activities not included inline lob,
whether or not the business is
regularly carried on ...............
12 Other income. Do not include
gain or loss from the sale of
capital assets (Explain in
Part IV.) ......................
13 Total support. (add ins 9, 10c, 11, and 12.)
14 First five years. If 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 stop here ................................................ ...............................
>ection C. Computation of Public Support Percentage
15 Public support percentage for 2009 (line 8, column (f) divided by line 13, column (f)) ........................... 15 100.0%
16 Public support percentage from 2008 Schedule A, Part III, line 15 .............. ............................... 16 100.0%
Section D. Computation of Investment Income Percentage
17 Investment income percentage for 2009 (line 10c, column (f) divided by line 13, column (f)) .................... 17 0.0%
18 Investment income percentage from 2008 Schedule A, Part III, line 17 .......... ............................... 18 0.0%
19a 33 -113 support tests — 2009. If the 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 and stop here. The organization qualifies as a publicly supported organization ................ I" XD
b 33 -1/3 support tests — 2008. If the organization did not check a box on line 14 or 19a, and line 16 is more than 33 -1/3 %, and line 18
is not more than 33 -1/3 %, check this box and stop here. The organization qualifies as a publicly supported organization........... ► n
20 Private foundation. If the
BAA
anization did not check a box on line 14
TEEA0403L 02/15/10
check this box and see i
........... ►
Schedule A (Form 990 or 990 -EZ) 2009
Schedule A (Form 990 or 990 -EZ) 2009 SEBASTIAN CLAMBAKE FOUNDATION, INC Page 4
Supplemental Information. Complete this part to provide the explanations required by Part II, line 10;
Part II, line 17a or 17b; and Part III, line 12. Provide any other additional information. See instructions.
BAA TEEA0404L 02/05/10 Schedule A (Form 990 or 990 -EZ) 2009
SCHEDULE G
(Form 990 or 990 -EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered'Yesj to Form 990, Part IV, lines 17, 18,
or 19, or if the organization entered more than $15,000 on Form 990 -EZ, line 6a.
Attach to Form990 or Form 990 -EZ. See separate instructions.
OMB No. 15450047
2009
°l a
'
lE
Name of the organization
SEBASTIAN CLAMBAKE FOUNDATION, INC
Employer identification number
Fundraising Activities. Complete if the organization answered 'Ye l'
Form 990EZ filers are not required to complete this part.
to Form 990, Part IV, line 17.
1 Indicate whether the organization raised funds through any of the follo
Mail solicitations
Internet and email solicitations
Phone solicitations
In- person solicitations
2a Did the organization have written or oral agreement with any individual
employees listed in Form 990, Part VII) or entity In connection with prof
b If 'Yes,' list the ten highest paid individuals or entities (fundraisers) purs
compensated at least $5,000 by the organization.
ing activities. Check all that apply.
Solicitation of non - government grants
Solicitation of government grants
Special fundraising events
including officers, directors, trustees or key
ssional fundraising services ? .................. Yes —]No
ant to agreements under which the fundraiser is to be '
(i) Name of individual
or entity (fundraiser)
(ii) Activity
(iii) Did fundraiser
have custody or control
of contributions?
v) Gross receipts
from activity
(v) Amount paid to
(or retained by)
fundraiser listed in
col.(i)
(vi) Amount paid to
(or retained by)
organization
Yes
No
Total........................... ...............................
3 List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration
or licensing.
BAA For Privacy Act and Paperwork Reduction Act Notice, see the
TEEA3701L 02/05/10
for Form 990. Schedule G (Form 990 or 990 -EZ) 2009
Schedule G (Form 990 or 990 -EZ) 2009 SEBASTIAN CLAMBAKE FOUNDATION, INC Page 2
Fundraising Events. Complete if the organization answered 'Yes' to Form 990, Part IV, line 18, or
reported more than $15,000 on Form 990 -EZ, line 6a. List events with gross receipts greater than $5,000.
(b) Pull tabs /Instant
(c) Other gaming
(a) Event #1
(b) Event #2
(c) Other Events
(d) Total Events
bingo /progressive
CLAMBAKE FESTI
E
(Add col. (a))) rough
R
E
bingo
Col. C
event t e
( yp)
(event type)
(total number)
V
N
1 Gross receipts ........................
180, 602.
1 Gross revenue ........................
180,602.
U
E
D z
2 Cash prizes ...........................
2 Less: Charitable contributions..........
9,600.
I P
9,600.
3 Gross income (line 1 minus line 2) .....
171, 002.
171,002.
C s
3 Non -cash prizes .......................
4 Cash prizes ........................... 425.
425.
5 Noncash prizes .......................
T E
D
R
6 Rent /facility costs ..................... 18,860.
18,860.
E
c
T
7 Food and beverages ................... 70,007.
70,007.
3,500.
E
P
8 Entertainment ......................... 3,500.
E
Ns
9 Other direct expenses ................. 15,598.
15,598.
E
s
10 Direct expense summary. Add lines 4- through 9 in column (d) .......... ............................... 01
108,390.
11 Net income summary. Combine lines 3, column (d) and line 10 ........... ............................... 0.
62,612.
'Old Gaming. Complete if the organization answered 'Yes' to Form 990, Part IV, line 19, or reported more than
$15,000 on Form 990 -EZ. line 6a.
R
(a) Bingo
(b) Pull tabs /Instant
(c) Other gaming
(d) Total aming
V
bingo /progressive
(Add Col. (a3 through
E
bingo
col. (c))
N
u
E
1 Gross revenue ........................
D z
2 Cash prizes ...........................
I P
R E
C s
3 Non -cash prizes .......................
T E
s
4 Rent /facility costs .....................
5 Other direct expenses .................
Yes o Yes o Yes o
HNo TNo
6 Volunteer labor ....................... No
7 Direct expense summary. Add lines 2 through 5 in column ( d) ............ ...............................
8 Net gaming income summary. Combine lines 1, column (d) and line 7 .... ...............................
YES
NO
9 Enter the state(s) in which the organization operates gaming activities:
a Is the organization licensed to operate gaming activities in each of these states? ....... ...............................
9a
b If 'No,' explain:
-
--------------------------------------------------------
-- — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — —
10a Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? ................
10a
b If 'Yes,' explain:
-- — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — —
—
—
11 Does the organization operate gaming activities with nonmembers? ................... ...............................
11
10
r 0,11
12 Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity formed to
administer charitable gaming? ...................................................... ...............................
12
DMM TEEA3702L 02/05/10 Schedule G (Form 990 or 990 -EZ) 2009
Schedule G (Form 990 or 990 -177) 2009 SP.RASTTAN CT.AMRAKP P(1TTMT)ATTnAT TN(`
Page 3
YES I NO
13 Indicate the percentage of gaming activity operated in:
a The organization's facility ................................... ............................... 13a
b An outside facility .......................................... ............................... 13b %
14 Enter the name and address of the person who prepares the organization's gaming /special events books and records:
Name: ►
--------------------------------------------------
Address: ►'
-- — — — — — — — — — — — — — — — — — — — — — — — —
— --'r— — — — — — — — — — — — — — — — — — — —
15a Does the organization have a contact with a third party from whom the rganization receives gaming revenue? ......... 15a
If 'Yes,' enter the amount of gaming revenue received by the organizati n $ and the amount
of gaming revenue retained by the third party $
c If 'Yes,' enter name and address of the third party:
Name: ►
-- — — — — — — — — — — — — — — — — — — — — — — — — — — — -- — — — — — — — — — — — — — — — — — — — —
Address: ►
16 Gaming manager information
Name: ►
Gaming manager compensation ► $
Description of services provided: ►
W�
Director /officer Employee Ind
pendent contractor
s � 8
17 Mandatory distributions
g "
a Is the organization required under state law to make charitable distributi
ns from the gaming proceeds to retain the
Ni
-
stategaming license? ................. ...............................
............. ...............................
17a
b Enter the amount of distributions required under state law to be distribut
d to other exempt organizations or spent in the
organization's own exempt activities during the tax year: ► $
BAA TEEA3703L 02/05/
JO Schedule G (Form 990 or 990 -EZ) 2009
2009 FEDERAL STATEMENTS
SEBASTIAN CLAMBAKE FOUNDATION, INC
STATEMENT 1
FORM 990 -EZ, PART I, LINE 10
GRANTS AND SIMILAR AMOUNTS PAIL
DONEE'S NAME:
DONEE'S ADDRESS:
CASH AMOUNT GIVEN:
DONEE'S NAME:
DONEE'S ADDRESS:
CASH AMOUNT GIVEN:
DONEE'S NAME:
DONEE'S ADDRESS:
CASH AMOUNT GIVEN:
DONEE'S NAME:
DONEE'S ADDRESS:
CASH AMOUNT GIVEN:
DONEE'S NAME:
DONEE'S ADDRESS:
CASH AMOUNT GIVEN:
DONEE'S NAME:
DONEE'S ADDRESS:
CASH AMOUNT GIVEN:
DONEE'S NAME:
DONEE'S ADDRESS:
CASH AMOUNT GIVEN:
DONEE'S NAME:
DONEE'S ADDRESS:
CASH AMOUNT GIVEN:
DONEE'S NAME:
DONEE'S ADDRESS:
CASH AMOUNT GIVEN:
DONEE'S NAME:
DONEE'S ADDRESS:
CASH AMOUNT GIVEN:
BY THE RIVER AFFORDABLE SENIOR HOUSING
11155 ROSELAND RD
SEBASTIAN, FL 32958
SEB SHARKS YOUTH FOOTBALL & CHEERLEADIN
1225 MAIN ST.
SEBASTIAN, FL 32958
SEBASTIAN SOCCER ASSOCIATION
PO BOX 780742
SEBASTIAN, FL 32978
KNIGHTS OF COLUMBUS
13075 US HWY 1
SEBASTIAN, FL 32958
SEBASTIAN AREA CHAMBER OF COMMERCE
700 MAIN STREET
SEBASTIAN, FL 32958
SEBASTIAN PROPERTY OWNERS ASSOCIATION
1225 MAIN ST.
SEBASTIAN, FL 32958
BOYS AND GIRLS CLUB
1415 FRIENDSHIP LANE
SEBASTIAN, FL 32958
SEBASTIAN RIVER HIGH SCHOOL ROWING CLUB
9001 90TH AVENUE
SEBASTIAN, FL 32958
VFW
815 LOUISIANA AVE.
SEBASTIAN, FL 32958
KASHI CHURCH FOUNDATION INC.
11155 ROSELAND RD #10
SEBASTIAN, FL 32958
PAGE 1
$
10,250. 1
$
10,250. 1
$
10,250. 1
$ 1,500.
$ 1,250.
$ 1,000.
$ 10,250.
$ 1,000.
$ 7,500.
$ 1,500.
2009 FEDERAL STATEMENTS
PAGE 2
SEBASTIAN CLAMBAKE FOUNDATION, INC
STATEMENT 1 (CONTINUED)
FORM 990 -EZ, PART I, LINE 10
GRANTS AND SIMILAR AMOUNTS PAID
DONEE'S NAME: PROF. ANIMAL WORLDS H.A.L.O. RESCUE
DONEE'S ADDRESS: 710 JACKSON TREET
SEBASTIAN, F 32908
CASH AMOUNT GIVEN:
$ 10,250.
DONEE'S NAME: SEBASTIAN RI ER HS WOMEN'S RUGBY TEAM
DONEE'S ADDRESS: 9001 90TH A NUE
SEBASTIAN L 32958
CASH AMOUNT GIVEN:
$ 1,000.
DONEE'S NAME: GFWC SEB. JU OR WOMAN'S CLUB
DONEE'S ADDRESS: 952 US HWY 1
SEBASTIAN, FL 32958
CASH AMOUNT GIVEN:
$ 1,000.
STATEMENT 2
FORM 990 -EZ, PART I, LINE 16
OTHER EXPENSES
BANKCHARGES .................... ...............................
.... ............................... $
5.
DEPRECIATION.......................................................
...............................
2,871.
OFFICE EXPENSE . ...............................
.....................
445.
TAXES& LICENSES .............................................:....
...............................
116.
TOTAL $
3,437.
STATEMENT 3
FORM 990 -EZ, PART II, LINE 24
OTHER ASSETS
BEGINNING
ENDING
MACHINERY AND EQUIPMENT ....................... ............................... $ 9,177.
$ 7,046.
TOTAL $ 9,177.
$ 7,046.
STATEMENT 4
FORM 990 -EZ, PART III, LINE 28
STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS
THE ANNUAL CLAMBAKE FESTIVAL, THROUGH THE EFFORTS OF VOLUNTEERS, DONATED
OVER
$83,000 FOR THE BOYS AND GIRLS CLUB'S NEW FACILITY ON MAIN STREET, HELPED FUND A
NEW AFFORDABLE SENIOR HOUSING FACILITY, CONTRIBUTED FUNDS FOR NEW SOCCER
FIELDS IN
SEBASTIAN AND FOR IMPROVED LIGHTING IN SEBASTIAN'S RIVERVIEW PARK. WE ALSO FUNDED
MAJOR IMPROVEMENTS FOR LOCAL YOUTH FOOTBALL FACILITIES, THE SEBASTIAN VFW MEETING
HALL AND THE H.A.L.O. ANIMAL RESCUE MISSION IN SEBASTIAN.
2009
FEDERAL STATEMENTS PAGE
SEBASTIAN CLAMBAKE FOUNDATION, INC
STATEMENT 5
FORM 990 -EZ, PART V
REGARDING TRANSFERS ASSOCIATED WITH PERSONAL BENEFIT CONTRACTS
(A) DID THE ORGANIZATION, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY OR
INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT ? ........................... NO
(B) DID THE ORGANIZATION, DURING THE YEAR, PAY PREMIUMS, DIRECTLY OR
INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT? .................... ............................... NO
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2009
GENERAL INFQRMATION PAGE 11
SEBASTIAN CLAMBAKE IFOUNDATION, INC
FORMS NEEDED FOR THIS RETURN
FEDERAL: 990 -EZ, SCH A, SCH G
CARRYOVERS TO 2010
NONE
i►