(Code: ) (Expenses $ including grants of $ ) (Revenue $ ) (Code: ) (Expenses $ including grants of $ ) (Revenue $ )

Transcription

1 I J Form Prt I Prt II Sign Hr Wsit: 0 Rturn of Orgniztion Exmpt From Inom Tx Unr stion 0(), 7, or 7()() of th Intrnl Rvnu Co (xpt lk lung 00 Ys H() Ys If "," tth list. (s instrutions) N/A H() Group xmption numr 00 FL Summry Brifly sri th orgniztion's mission or most signifint tivitis: OUR MISSON IS TO END THE KILLING OF DOGS AND CATS IN ANIMAL SHELTERS Chk this ox if th orgniztion isontinu its oprtions or ispos of mor thn % of its nt ssts. Numr of voting mmrs of th govrning oy (Prt VI, lin )... Numr of inpnnt voting mmrs of th govrning oy (Prt VI, lin )... Totl numr of mploys (Prt V, lin )... 6 Totl numr of voluntrs (stimt if nssry) Totl gross unrlt usinss rvnu from Prt VIII, olumn (C), lin... 7 Nt unrlt usinss txl inom from Form 0-T, lin Pi Prprr's Us Only F K Form of orgniztion: Corportion Trust Assoition Othr L Yr of formtion: M Stt of lgl omiil: A G t o i v v i r t n i n s & R v n u E x p n s s nfit trust or privt fountion) Opn to Puli Dprtmnt of th Trsury Intrnl Rvnu Srvi Th orgniztion my hv to us opy of this rturn to stisfy stt rporting rquirmnts. Insption A For th 00 lnr yr, or tx yr ginning 0-0, 00, n ning 0-0, 0 0 B Chk if pplil: Pls C Nm of orgniztion FIRST COAST NO MORE HOMELESS PETS, D Employr intifition no. Arss hng us IRS ll or Doing Businss As Nm hng print or Numr n strt (or P.O. ox if mil is not livr to strt rss) Room/suit E Tlphon numr typ. Initil rturn S 687 NORWOOD AVE (0)-000 Spifi Trmint Instru- City or town, stt or ountry, n ZIP + G Gross ripts Amn rturn tions. JACKSONVILLE, FL 08 $,, Nt Assts or Fun Bl- ns Contriutions n grnts (Prt VIII, lin h) Progrm srvi rvnu (Prt VIII, lin g) Invstmnt inom (Prt VIII, olumn (A), lins,, n 7)... Othr rvnu (Prt VIII, olumn (A), lins, 6, 8,, 0, n )... Totl rvnu - lins 8 through (must qul Prt VIII, olumn (A), lin )... Grnts n similr mounts pi (Prt I, olumn (A), lins -)... Bnfits pi to or for mmrs (Prt I, olumn (A), lin )... Slris, othr ompnstion, mploy nfits (Prt I, olumn (A), lins -0)... Profssionl funrising fs (Prt I, olumn (A), lin )... Totl funrising xpnss (Prt I, olumn (D), lin ),0 Othr xpnss (Prt I, olumn (A), lins -, f-f)... Totl xpnss. A lins -7 (must qul Prt I, olumn (A), lin )... Rvnu lss xpnss. Sutrt lin 8 from lin... My th IRS isuss this rturn with th prprr shown ov? (s instrutions) For Privy At n Pprwork Rution At ti, s th sprt instrutions. H() Prior Yr Bginning of Currnt Yr OMB Applition pning Nm n rss of prinipl offir: Is this group rturn for ffilits? Tx-xmpt sttus: 0() ( ) (insrt no.) 7()() or 7 Ar ll ffilits inlu? Unr pnltis of prjury, I lr tht I hv xmin this rturn, inluing ompnying shuls n sttmnts, n to th st of my knowlg n lif, it is tru, orrt, n omplt. Dlrtion of prprr (othr thn offir) is s on ll informtion of whih prprr hs ny knowlg. Signtur of offir Typ or print nm n titl Prprr's signtur Totl ssts (Prt, lin 6)... Totl liilitis (Prt, lin 6)... Nt ssts or fun lns. Sutrt lin from lin 0... Signtur Blok Firm's nm (or yours if slf-mploy), rss, n ZIP + Dt 0--0 Chk if slfmploy EIN Dt Currnt Yr En of Yr Prprr's intifying numr (s instrutions) Phon no Ys ,0 0,7,8,6,7,08 0 0,6,,, ,6,08,8 0,06,00,,8,77,70,7,0 (,07) 0,,8,0,,78,87,6,0,60 0,,08 Form 0 (00)

2 Form 0 (00) FIRST COAST NO MORE HOMELESS PETS, Pg Prt III Sttmnt of Progrm Srvi Aomplishmnts Brifly sri th orgniztion's mission: OUR MISSON IS TO END THE KILLING OF DOGS AND CATS IN ANIMAL SHELTERS Di th orgniztion unrtk ny signifint progrm srvis uring th yr whih wr not list on th prior Form 0 or 0-EZ?... If "Ys," sri ths nw srvis on Shul O. Di th orgniztion s onuting, or mk signifint hngs in how it onuts, ny progrm srvis?... If "Ys," sri ths hngs on Shul O. Dsri th xmpt purpos hivmnts for h of th orgniztion's thr lrgst progrm srvis y xpnss. Stion 0()() n 0()() orgniztions n stion 7()() trusts r rquir to rport th mount of grnts n llotions to othrs, th totl xpnss, n rvnu, if ny, for h progrm srvi rport. Ys Ys (Co: ) (Expnss $,8,66 inluing grnts of $ ) (Rvnu $ ) THE PROGRAMS OF FIRST COAST NO MORE HOMELESS PETS WERE ESTABLISHED TO END THE KILLING OF DDOGS AND CATS IN THE ANIMAL SHELTERS TO CONTROL THE FERAL CAT POPULATION THROUGH SPAY/NEUTER AS WELL AS PROVIDE FREE AND LOW COST SPAY & NEUTER SURGERIES FOR PETS OF LOW INCOME FAMILIES. SINCE 00, OVER 8,000 PET STERILIZATIONS HAVE BEEN PERFORMED. THE RESULTS OF THE PROGRAM HAS BEEN A SIGNIFICANT REDUCTION IN SHELTER ADMISSIONS AND EUTHANASIA. FOR THE FISCAL YEAR 007/008 MORE THAN, ANIMALS WERE STERILIZED. (Co: ) (Expnss $ inluing grnts of $ ) (Rvnu $ ) (Co: ) (Expnss $ inluing grnts of $ ) (Rvnu $ ) Othr progrm srvis. (Dsri in Shul O.) (Expnss $ inluing grnts of $ ) (Rvnu $ ) Totl progrm srvi xpnss,8,66 Form 0 (00)

3 Form 0 (00) FIRST COAST NO MORE HOMELESS PETS, Pg Prt IV Chklist of Rquir Shuls Is th orgniztion sri in stion 0()() or 7()() (othr thn privt fountion)? If "Ys," omplt Shul A... Is th orgniztion rquir to omplt Shul B, Shul of Contriutors? A Ws th orgniztion inlu in onsolit, inpnnt uit finnil sttmnts for th tx yr? Ys If "Ys," omplting Shul D, Prts I, II, n III is optionl... A Is th orgniztion shool sri in stion 70()()(A)(ii)? If "Ys," omplt Shul E... Di th orgniztion mintin n offi, mploys, or gnts outsi of th Unit Stts? Di th orgniztion ngg in irt or inirt politil mpign tivitis on hlf of or in opposition to nits for puli offi? If "Ys," omplt Shul C, Prt I... Stion 0()() orgniztions. Di th orgniztion ngg in loying tivitis? If "Ys," omplt Shul C, Prt II... Stion 0()(), 0()(), n 0()(6) orgniztions. Is th orgniztion sujt to th stion 60() noti n rporting rquirmnt n proxy tx? If "Ys," omplt Shul C, Prt III... Di th orgniztion mintin ny onor vis funs or ny similr funs or ounts whr onors hv th right to provi vi on th istriution or invstmnt of mounts in suh funs or ounts? If "Ys," omplt Shul D, Prt I... Di th orgniztion riv or hol onsrvtion smnt, inluing smnts to prsrv opn sp, th nvironmnt, histori ln rs, or histori struturs? If "Ys," omplt Shul D, Prt II... Di th orgniztion mintin olltions of works of rt, historil trsurs, or othr similr ssts? If "Ys," omplt Shul D, Prt III... Di th orgniztion rport n mount in Prt, lin ; srv s ustoin for mounts not list in Prt ; or provi rit ounsling, t mngmnt, rit rpir, or t ngotition srvis? If "Ys," omplt Shul D, Prt IV... Di th orgniztion, irtly or through rlt orgniztion, hol ssts in trm, prmnnt, or qusi-nowmnts? If "Ys," omplt Shul D, Prt V... Is th orgniztion's nswr to ny of th following qustions "Ys"? If so, omplt Shul D, Prts VI, VII, VIII, I, or s pplil... Di th orgniztion rport n mount for ln, uilings, n quipmnt in Prt, lin 0? If "Ys," omplt Shul D, Prt VI. Di th orgniztion rport n mount for invstmnts - othr suritis in Prt, lin tht is % or mor of its totl ssts rport in Prt, lin 6? If "Ys," omplt Shul D, Prt VII. Di th orgniztion rport n mount for invstmnts - progrm rlt in Prt, lin tht is % or mor of its totl ssts rport in Prt, lin 6? If "Ys," omplt Shul D, Prt VIII. Di th orgniztion rport n mount for othr ssts in Prt, lin tht is % or mor of its totl ssts rport in Prt, lin 6? If "Ys," omplt Shul D, Prt I. Di th orgniztion rport n mount for othr liilitis in Prt, lin? If "Ys," omplt Shul D, Prt. Di th orgniztion's sprt or onsolit finnil sttmnts for th tx yr inlu footnot tht rsss th orgniztion's liility for unrtin tx positions unr FIN 8? If "Ys," omplt Shul D, Prt. Di th orgniztion otin sprt, inpnnt uit finnil sttmnts for th tx yr? If "Ys," omplt Shul D, Prts I, II, n III... Di th orgniztion hv ggrgt rvnus or xpnss of mor thn $0,000 from grntmking, funrising, usinss, n progrm srvi tivitis outsi th Unit Stts? If "Ys," omplt Shul F, Prt I... Di th orgniztion rport on Prt I, olumn (A), lin, mor thn $,000 of grnts or ssistn to ny orgniztion or ntity lot outsi th Unit Stts? If "Ys," omplt Shul F, Prt II... Di th orgniztion rport on Prt I, olumn (A), lin, mor thn $,000 of ggrgt grnts or ssistn to iniviuls lot outsi th Unit Stts? If "Ys," omplt Shul F, Prt III... Di th orgniztion rport totl of mor thn $,000 of xpnss for profssionl funrising srvis on Prt I, olumn (A), lins 6 n? If "Ys," omplt Shul G, Prt I... Di th orgniztion rport mor thn $,000 totl of funrising vnt gross inom n ontriutions on Prt VIII, lins n 8? If "Ys," omplt Shul G, Prt II... Di th orgniztion rport mor thn $,000 of gross inom from gming tivitis on Prt VIII, lin? If "Ys," omplt Shul G, Prt III... 0 Di th orgniztion oprt on or mor hospitls? If "Ys," omplt Shul H Ys Form 0 (00)

4 Form 0 (00) FIRST COAST NO MORE HOMELESS PETS, Pg Prt IV Chklist of Rquir Shuls fmily mmr) ws n offir, irtor, trust, or irt or inirt ownr? If "Ys," omplt Shul L, Prt IV... 8 Di th orgniztion riv mor thn $,000 in non-sh ontriutions? If "Ys," omplt Shul M (ontinu) Di th orgniztion rport mor thn $,000 of grnts n othr ssistn to govrnmnts n orgniztions in th Unit Stts on Prt I, olumn (A), lin? If "Ys," omplt Shul I, Prts I n II... Di th orgniztion rport mor thn $,000 of grnts n othr ssistn to iniviuls in th Unit Stts on Prt I, olumn (A), lin? If "Ys," omplt Shul I, Prts I n III... Di th orgniztion nswr "Ys" to Prt VII, Stion A, lin,, or out ompnstion of th orgniztion's urrnt n formr offirs, irtors, trusts, ky mploys, n highst ompnst mploys? If "Ys," omplt Shul J... Di th orgniztion hv tx-xmpt on issu with n outstning prinipl mount of mor thn $00,000 s of th lst y of th yr, tht ws issu ftr Dmr, 00? If "Ys," nswr lins through n omplt Shul K. If "," go to lin... Di th orgniztion invst ny pros of tx-xmpt ons yon tmporry prio xption?... Di th orgniztion mintin n srow ount othr thn rfuning srow t ny tim uring th yr to fs ny tx-xmpt ons?... Di th orgniztion t s n "on hlf of" issur for ons outstning t ny tim uring th yr?... Stion 0()() n 0()() orgniztions. Di th orgniztion ngg in n xss nfit trnstion with isqulifi prson uring th yr? If "Ys," omplt Shul L, Prt I... Is th orgniztion wr tht it ngg in n xss nfit trnstion with isqulifi prson in prior yr, n tht th trnstion hs not n rport on ny of th orgniztion's prior Forms 0 or 0-EZ? If "Ys," omplt Shul L, Prt I... Ws lon to or y urrnt or formr offir, irtor, trust, ky mploy, highly ompnst mploy, or isqulifi prson outstning s of th n of th orgniztion's tx yr? If "Ys," omplt Shul L, Prt II Di th orgniztion provi grnt or othr ssistn to n offir, irtor, trust, ky mploy, sustntil ontriutor, or grnt sltion ommitt mmr, or to prson rlt to suh n iniviul? If "Ys," omplt Shul L, Prt III... Ws th orgniztion prty to usinss trnstion with on of th following prtis (s Shul L, Prt IV instrutions for pplil filing thrshols, onitions, n xptions): A urrnt or formr offir, irtor, trust, or ky mploy? If "Ys," omplt Shul L, Prt IV A fmily mmr of urrnt or formr offir, irtor, trust, or ky mploy? If "Ys," omplt Shul L, Prt IV... An ntity of whih urrnt or formr offir, irtor, trust, or ky mploy of th orgniztion (or Di th orgniztion riv ontriutions of rt, historil trsurs, or othr similr ssts, or qulifi onsrvtion ontriutions? If "Ys," omplt Shul M... Di th orgniztion liquit, trmint, or issolv n s oprtions? If "Ys," omplt Shul N, Prt I... Di th orgniztion sll, xhng, ispos of, or trnsfr mor thn % of its nt ssts? If "Ys," omplt Shul N, Prt II... Di th orgniztion own 00% of n ntity isrgr s sprt from th orgniztion unr Rgultions stions n ? If "Ys," omplt Shul R, Prt I... Ws th orgniztion rlt to ny tx-xmpt or txl ntity? If "Ys," omplt Shul R, Prts II, III, IV, n V, lin... Is ny rlt orgniztion ontroll ntity within th mning of stion ()()? If "Ys," omplt Shul R, Prt V, lin... Stion 0()() orgniztions. Di th orgniztion mk ny trnsfrs to n xmpt non-hritl rlt orgniztion? If "Ys," omplt Shul R, Prt V, lin... Di th orgniztion onut mor thn % of its tivitis through n ntity tht is not rlt orgniztion n tht is trt s prtnrship for frl inom tx purposs? If "Ys," omplt Shul R, Prt VI... Di th orgniztion omplt Shul O n provi xplntions in Shul O for Prt VI, lins n? t. All Form 0 filrs r rquir to omplt Shul O Ys Form 0 (00)

5 Form 0 (00) FIRST COAST NO MORE HOMELESS PETS, Pg Prt V 6 7 f g h Sttmnts Rgring Othr IRS Filings n Tx Complin 8 Sponsoring orgniztions mintining onor vis funs n stion 0()() supporting 0 Entr th numr rport in Box of Form 06, Annul Summry n Trnsmittl of U.S. Informtion Rturns. Entr -0- if not pplil... Entr th numr of Forms W-G inlu in lin. Entr -0- if not pplil... Di th orgniztion omply with kup withholing ruls for rportl pymnts to vnors n rportl gming (gmling) winnings to priz winnrs?... Entr th numr of mploys rport on Form W-, Trnsmittl of Wg n Tx Sttmnts, fil for th lnr yr ning with or within th yr ovr y this rturn If t lst on is rport on lin, i th orgniztion fil ll rquir frl mploymnt tx rturns? t. If th sum of lins n is grtr thn 0, you my rquir to -fil this rturn. (s instrutions) Di th orgniztion hv unrlt usinss gross inom of $,000 or mor uring th yr ovr y this rturn?... If "Ys," hs it fil Form 0-T for this yr? If "," provi n xplntion in Shul O... At ny tim uring th lnr yr, i th orgniztion hv n intrst in, or signtur or othr uthority ovr, finnil ount in forign ountry (suh s nk ount, suritis ount, or othr finnil ount)?... If "Ys," ntr th nm of th forign ountry: S th instrutions for xptions n filing rquirmnts for Form TD F 0-., Rport of Forign Bnk If "Ys," to lin or, i th orgniztion fil Form 8886-T, Dislosur y Tx-Exmpt Entity Rgring Prohiit Tx Shltr Trnstion?... Dos th orgniztion hv nnul gross ripts tht r normlly grtr thn $00,000, n i th orgniztion soliit ny ontriutions tht wr not tx util?... If "Ys," i th orgniztion inlu with vry soliittion n xprss sttmnt tht suh ontriutions or gifts wr not tx util?... Orgniztions tht my riv util ontriutions unr stion 70(). Di th orgniztion riv pymnt in xss of $7 m prtly s ontriution n prtly for goos n srvis provi to th pyor?... If "Ys," i th orgniztion notify th onor of th vlu of th goos or srvis provi?... Di th orgniztion sll, xhng, or othrwis ispos of tngil prsonl proprty for whih it ws rquir to fil Form 88?... If "Ys," init th numr of Forms 88 fil uring th yr... 7 Di th orgniztion, uring th yr, riv ny funs, irtly or inirtly, to py prmiums on prsonl nfit ontrt?... Di th orgniztion, uring th yr, py prmiums, irtly or inirtly, on prsonl nfit ontrt?... For ll ontriutions of qulifi intlltul proprty, i th orgniztion fil Form 88 s rquir?... For ontriutions of rs, ots, irplns, n othr vhils, i th orgniztion fil Form 08-C s rquir?... orgniztions. Di th supporting orgniztion, or onor vis fun mintin y sponsoring orgniztion, hv xss usinss holings t ny tim uring th yr?... Stion 0()() orgniztions. Entr: Gross inom from mmrs or shrholrs Gross inom from othr sours (Do not nt mounts u or pi to othr sours ginst mounts u or riv from thm.)... Stion 7()() non-xmpt hritl trusts. Is th orgniztion filing Form 0 in liu of Form 0?... If "Ys," ntr th mount of tx-xmpt intrst riv or ru uring th yr n Finnil Aounts. Ws th orgniztion prty to prohiit tx shltr trnstion t ny tim uring th tx yr?... Di ny txl prty notify th orgniztion tht it ws or is prty to prohiit tx shltr trnstion?... Sponsoring orgniztions mintining onor vis funs. Di th orgniztion mk ny txl istriutions unr stion 66?... Di th orgniztion mk istriution to onor, onor visor, or rlt prson?... Stion 0()(7) orgniztions. Entr: Initition fs n pitl ontriutions inlu on Prt VIII, lin... Gross ripts, inlu on Form 0, Prt VIII, lin, for puli us of lu filitis f 7g 7h 8 Ys Form 0 (00)

6 Form 0 (00) FIRST COAST NO MORE HOMELESS PETS, Pg 6 Prt VI Govrnn, Mngmnt, n Dislosur Stion A. Govrning Boy n Mngmnt Di th orgniztion lgt ontrol ovr mngmnt utis ustomrily prform y or unr th irt suprvision of offirs, irtors or trusts, or ky mploys to mngmnt ompny or othr prson?... Di th orgniztion mk ny signifint hngs to its orgniztionl oumnts sin th prior Form 0 ws fil?... Di th orgniztion om wr uring th yr of mtril ivrsion of th orgniztion's ssts?... 6 Dos th orgniztion hv mmrs or stokholrs? Stion B. Poliis 0 Dos th orgniztion rgulrly n onsistntly monitor n nfor omplin with th poliy? If "Ys," sri in Shul O how this is on... Dos th orgniztion hv writtn whistllowr poliy?... Dos th orgniztion hv writtn oumnt rtntion n strution poliy?... 6 Stion C. Dislosur For h "Ys" rspons to lins through 7 low, n for "" rspons to lin 8, 8, or 0 low, sri th irumstns, prosss, or hngs in Shul O. S instrutions. Entr th numr of voting mmrs of th govrning oy Entr th numr of voting mmrs tht r inpnnt Di ny offir, irtor, trust, or ky mploy hv fmily rltionship or usinss rltionship with ny othr offir, irtor, trust, or ky mploy?... Dos th orgniztion hv mmrs, stokholrs, or othr prsons who my lt on or mor mmrs of th govrning oy?... Ar ny isions of th govrning oy sujt to pprovl y mmrs, stokholrs, or othr prsons?... Di th orgniztion ontmpornously oumnt th mtings hl or writtn tions unrtkn uring th yr y th following: Th govrning oy?... Eh ommitt with uthority to t on hlf of th govrning oy?... Is thr ny offir, irtor, trust, or ky mploy list in Prt VII, Stion A, who nnot rh t th orgniztion's miling rss? If "Ys," provi th nms n rsss in Shul O... Rvnu Co.) (This Stion B rqusts informtion out poliis not rquir y th Intrnl Dos th orgniztion hv lol hptrs, rnhs, or ffilits? If "Ys," os th orgniztion hv writtn poliis n prours govrning th tivitis of suh hptrs, ffilits, n rnhs to nsur thir oprtions r onsistnt with thos of th orgniztion?... Hs th orgniztion provi opy of this Form 0 to ll mmrs of its govrning oy for filing th form?... Dsri in Shul O th pross, if ny, us y th orgniztion to rviw this Form 0. Dos th orgniztion hv writtn onflit of intrst poliy? If "," go to lin... Ar offirs, irtors or trusts, n ky mploys rquir to islos nnully intrsts tht oul giv ris to onflits?... Di th pross for trmining ompnstion of th following prsons inlu rviw n pprovl y inpnnt prsons, omprility t, n ontmpornous sustntition of th lirtion n ision? Th orgniztion's CEO, Exutiv Dirtor, or top mngmnt offiil... Othr offirs or ky mploys of th orgniztion... If "Ys" to lin or, sri th pross in Shul O. (S instrutions.) Di th orgniztion invst in, ontriut ssts to, or prtiipt in joint vntur or similr rrngmnt with txl ntity uring th yr?... If "Ys," hs th orgniztion opt writtn poliy or prour rquiring th orgniztion to vlut its prtiiption in joint vntur rrngmnts unr pplil frl tx lw, n tkn stps to sfgur th orgniztion's xmpt sttus with rspt to suh rrngmnts?... List th stts with whih opy of this Form 0 is rquir to fil Stion 60 rquirs n orgniztion to mk its Forms 0 (or 0 if pplil), 0, n 0-T (0()()s only) vill for puli insption. Init how you mk ths vill. Chk ll tht pply. Own wsit Anothr's wsit Upon rqust Dsri in Shul O whthr (n if so, how), th orgniztion mks its govrning oumnts, onflit of intrst poliy, n finnil sttmnts vill to th puli Stt th nm, physil rss, n tlphon numr of th prson who posssss th ooks n rors of th orgniztion: RICHARD DUCHARME (0) NORWOOD AVE JACKSONVILLE, FL Ys Ys Form 0 (00)

7 Form 0 (00) FIRST COAST NO MORE HOMELESS PETS, Pg 7 Prt VII Stion A. Compnstion of Offirs, Dirtors, Trusts, Ky Employs, Highst Compnst Employs, n Inpnnt Contrtors Offirs, Dirtors, Trusts, Ky Employs, n Highst Compnst Employs Complt this tl for ll prsons rquir to list. Rport ompnstion for th lnr yr ning with or within th orgniztion's tx yr. Us Shul J- if itionl sp is n. List ll of th orgniztion's urrnt offirs, irtors, trusts (whthr iniviuls or orgniztions), rgrlss of mount of ompnstion. Entr -0- in olumns (D), (E), n (F) if no ompnstion ws pi. List ll of th orgniztion's urrnt ky mploys. S instrutions for finition of "ky mploy." List th orgniztion's fiv urrnt highst ompnst mploys (othr thn n offir, irtor, trust, or ky mploy) who riv rportl ompnstion (Box of Form W- n/or Box 7 of Form 0-MISC) of mor thn $00,000 from th orgniztion n ny rlt orgniztions. List ll of th orgniztion's formr offirs, ky mploys, n highst ompnst mploys who riv mor thn $00,000 of rportl ompnstion from th orgniztion n ny rlt orgniztions. List ll of th orgniztion's formr irtors or trusts tht riv, in th pity s formr irtor or trust of th orgniztion, mor thn $0,000 of rportl ompnstion from th orgniztion n ny rlt orgniztions. List prsons in th following orr: iniviul trusts or irtors; institutionl trusts; offirs; ky mploys; highst ompnst mploys; n formr suh prsons. Chk this ox if th orgniztion i not ompnst ny urrnt offir, irtor, or trust. (A) (B) (C) Nm n Titl Avrg Position (hk ll tht pply) Rportl Rportl Estimt hours pr I t I t O K H F ompnstion ompnstion mount of wk n r i n r f i o m o from from rlt othr u r s u f y g m p r i s t s i h p l m th orgniztions ompnstion v t i t o orgniztion (W-/0-MISC) from th i t t m s n y r p (W-/0-MISC) orgniztion o u r t s u r t l n rlt o i o t y orgniztions l r o n l DEBBIE FIELDS PRESIDENT TOM MOILANEN TREASURER 0 LEE CONWAY DIRECTOR 0 0 PETER MARSH DIRECTOR KIM TIPPIN DIRECTOR ANASTASIA REGAS STONE DIRECTOR KELLY DELANEY DIRECTOR JOSEPH STRASSER DIRECTOR EMILY MAGEE DIRECTOR RICHARD DUCHARME EECUTIVE DIRECTOR 0 67,6 DR KELLY FERRAL MEDICAL DIRECTOR 0 (D) (E) (F) Form 0 (00)

8 Form 0 (00) FIRST COAST NO MORE HOMELESS PETS, Pg 8 Prt VII Stion A. Offirs, Dirtors, Trusts, Ky Employs, n Highst Compnst Employs (ontinu) (A) (B) (C) Nm n Titl Avrg Position (hk ll tht pply) Rportl Rportl Estimt hours pr I t I t O K H F ompnstion ompnstion mount of wk n r i n r f i o m o from from rlt othr u r s u f y g m p r i s t s i h p l m th orgniztions ompnstion v t i t o orgniztion (W-/0-MISC) from th i t t m s n y r p (W-/0-MISC) orgniztion o u r t s u r t l n rlt o i o t y orgniztions l r o n l (D) (E) (F) Totl Stion B. Inpnnt Contrtors... Totl numr of iniviuls (inluing ut not limit to thos list ov) who riv mor thn $00,000 in rportl ompnstion from th orgniztion Di th orgniztion list ny formr offir, irtor or trust, ky mploy, or highst ompnst mploy on lin? If "Ys," omplt Shul J for suh iniviul... For ny iniviul list on lin, is th sum of rportl ompnstion n othr ompnstion from th orgniztion n rlt orgniztions grtr thn $0,000? If "Ys," omplt Shul J for suh iniviul... Di ny prson list on lin riv or ru ompnstion from ny unrlt orgniztion for srvis rnr to th orgniztion? If "Ys," omplt Shul J for suh prson... Complt this tl for your fiv highst ompnst inpnnt ontrtors tht riv mor thn $00,000 of ompnstion from th orgniztion. (A) Nm n usinss rss Dsription of srvis Compnstion 67,6 0 0 (B) 0 Ys (C) Totl numr of inpnnt ontrtors (inluing ut not limit to thos list ov) who riv mor thn $00,000 in ompnstion from th orgniztion Form 0 (00)

9 Form 0 (00) FIRST COAST NO MORE HOMELESS PETS, Pg Prt VIII Contri- utions, gifts, grnts n othr similr mounts Progrm Srvi Rvnu f g h f g 6 7 Sttmnt of Rvnu Lss: ost or othr sis n sls xpnss... O t Gin or (loss)... h Nt gin or (loss)... r 8 Gross inom from funrising vnts (not inluing $ 0,7 R of ontriutions rport on lin ). v S Prt IV, lin 8... Lss: irt xpnss... n u Nt inom or (loss) from funrising vnts... Gross inom from gming tivitis. S Prt IV, lin... Lss: irt xpnss... Nt inom or (loss) from gming tivitis... 0 Gross sls of invntory, lss rturns n llowns... Lss: ost of goos sol... Nt inom or (loss) from sls of invntory... Frt mpigns... Mmrship us Funrising vnts Rlt orgniztions... Govrnmnt grnts (ontriutions).. All othr ontriutions, gifts, grnts, n similr mounts not inlu ov nsh ontriutions inlu in lins -f: $ Totl. A lins -f... All othr progrm srvi rvnu... Totl. A lins -f... Invstmnt inom (inluing ivins, intrst, n othr similr mounts)... Inom from invstmnt of tx-xmpt on pros... Royltis... (i) Rl (ii) Prsonl Gross Rnts... Lss: rntl xpnss... Rntl inom or (loss)... Nt rntl inom or (loss)... Gross mount from sls of ssts othr thn invntory Misllnous Rvnu (i) Suritis f Businss Co (ii) Othr Businss Co 0,7 All othr rvnu... Totl. A lins -... Totl rvnu. S instrutions... (A) (B) (C) (D) Totl rvnu Rlt or Unrlt Rvnu xmpt usinss xlu from tx funtion rvnu unr stions rvnu,, or 0,7 PROGRAM SERVICE FEES 000,60,6,60,6 CONTRIBUTIONS 000,8,8 GRANTS 000 0,7 0,7 OTHER 000 7,8 7,8,7,08,,,7, Form 0 (00)

10 Form 0 (00) FIRST COAST NO MORE HOMELESS PETS, Pg 0 Prt I Sttmnt of Funtionl Expnss Stion 0()() n 0()() orgniztions must omplt ll olumns. All othr orgniztions must omplt olumn (A) ut r not rquir to omplt olumns (B), (C), n (D). Do not inlu mounts rport on lins 6, 7, 8,, n 0 of Prt VIII. f g f 6 Grnts n othr ssistn to govrnmnts n orgniztions in th U.S. S Prt IV, lin... Grnts n othr ssistn to iniviuls in th U.S. S Prt IV, lin... Grnts n othr ssistn to govrnmnts, orgniztions, n iniviuls outsi th U.S. S Prt IV, lins n 6... Bnfits pi to or for mmrs... Compnstion of urrnt offirs, irtors, trusts, n ky mploys... Compnstion not inlu ov, to isqulifi prsons (s fin unr stion 8(f)()) n prsons sri in stion 8()()(B)... Othr slris n wgs... Pnsion pln ontriutions (inlu stion 0(k) n stion 0() mployr ontriutions)... Othr mploy nfits... Pyroll txs... Fs for srvis (non-mploys): Mngmnt... Lgl... Aounting... Loying... Profssionl funrising srvis. S Prt IV, lin 7. Invstmnt mngmnt fs... Othr... Avrtising n promotion... Offi xpnss... Informtion thnology... Royltis... Oupny... Trvl... Pymnts of trvl or ntrtinmnt xpnss for ny frl, stt, or lol puli offiils... Confrns, onvntions, n mtings... Intrst... Pymnts to ffilits... Dprition, pltion, n mortiztion... Insurn... Othr xpnss. Itmiz xpnss not ovr ov. (Expnss group togthr n ll misllnous my not x (A) (B) (C) (D) Totl xpnss Progrm srvi Mngmnt n Funrising xpnss gnrl xpnss xpnss, 8,, 7,778 7,706 6,800 7,7,6 0,88,678 8,70 7,67 7,8 7,,0 8,7 6,70,7 6,8,6,0,7 7,7,7,66,0, 6,0,0,7 88, 7,8 8,8,6 0,87 7,70,08,0 % of totl xpnss shown on lin low.) ANIMAL MED EP 6,70 6,70 VEHICLES 8,88 8,88 BANK SERVICE FEES 6, 6, PRINTING 6,876,6,,88 PROGRAM SUPPLIES 0,6 0,6 All othr xpnss...,0 6,8,76,0 Totl funtionl xpnss. A lins through f Joint Costs. Chk hr if following SOP 8-. Complt this lin only if th orgniztion rport in olumn (B) joint osts..,7,0,8,66,780,0 from omin utionl mpign n funrising soliittion... Form 0 (00)

11 Form 0 (00) FIRST COAST NO MORE HOMELESS PETS, Pg Prt Bln Sht Bginning of yr En of yr Csh - non-intrst-ring...,808 7,08 Svings n tmporry sh invstmnts... Plgs n grnts rivl, nt... Aounts rivl, nt...,6 6 Rivls from urrnt n formr offirs, irtors, trusts, ky mploys, n highst ompnst mploys. Complt Prt II of Shul L... Rivls from othr isqulifi prsons (s fin unr stion 8(f)()) n prsons sri in stion 8()()(B). Complt A s Prt II of Shul L... 6 s 7 ts n lons rivl, nt... 7 t 8 Invntoris for sl or us... 8 s Prpi xpnss n frr hrgs... 0 Ln, uilings, n quipmnt: ost or othr sis. Complt Prt VI of Shul D... 0,6,76 Lss: umult prition ,,, 0,,7 Invstmnts - pulily tr suritis... Invstmnts - othr suritis. S Prt IV, lin... Invstmnts - progrm-rlt. S Prt IV, lin... Intngil ssts... (,) (,) Othr ssts. S Prt IV, lin...,, 6 Totl ssts. A lins through (must qul lin )...,8,0 6,,78 7 Aounts pyl n ru xpnss...,7 7,6 8 Grnts pyl... 0,7 8 L Dfrr rvnu... i 0 Tx-xmpt on liilitis... 0 Esrow or ustoil ount liility. Complt Prt IV of Shul D... i Pyls to urrnt n formr offirs, irtors, trusts, ky l i mploys, highst ompnst mploys, n isqulifi t prsons. Complt Prt II of Shul L... 0,000 00,000 i Sur mortggs n nots pyl to unrlt thir prtis... 66,6 8,7 s Unsur nots n lons pyl to unrlt thir prtis...,,070 Othr liilitis. Complt Prt of Shul D... 6 Totl liilitis. A lins 7 through...,87,6 6,0,60 Orgniztions tht follow SFAS 7, hk hr n N F omplt lins 7 through, n lins n. u 7 Unrstrit nt ssts... 0, 7,08 t n 8 Tmporrily rstrit nt ssts... 8 A Prmnntly rstrit nt ssts... s B Orgniztions tht o not follow SFAS 7, hk hr s l n omplt lins 0 through. t 0 Cpitl stok or trust prinipl, or urrnt funs... 0 s n Pi-in or pitl surplus, or ln, uiling, or quipmnt fun... o Rtin rnings, nowmnt, umult inom, or othr funs... r s Totl nt ssts or fun lns... 0,,08 Totl liilitis n nt ssts/fun lns...,8,0,,78 (A) (B),6 Form 0 (00)

12 Form (Rv. April 00) Prt I 8868 Applition for Extnsion of Tim to Fil n Exmpt Orgniztion Rturn Dprtmnt of th Trsury Intrnl Rvnu Srvi Fil sprt pplition for h rturn. If you r filing for n Automti -Month Extnsion, omplt only Prt I n hk this ox... If you r filing for n Aitionl (t Automti) -Month Extnsion, omplt only Prt II (on pg of this form). Do not omplt Prt II unlss you hv lry n grnt n utomti -month xtnsion on prviously fil Form Automti -Month Extnsion of Tim. Only sumit originl (no opis n). A orportion rquir to fil Form 0-T n rqusting n utomti 6-month xtnsion - hk this ox n omplt Prt I only... All othr orportions (inluing 0-C filrs), prtnrships, REMICs, n trusts must us Form 700 to rqust n xtnsion of tim to fil inom tx rturns. Eltroni Filing (-fil). Gnrlly, you n ltronilly fil Form 8868 if you wnt -month utomti xtnsion of tim to fil on of th rturns not low (6 months for orportion rquir to fil Form 0-T). Howvr, you nnot fil Form 8868 ltronilly if () you wnt th itionl (not utomti) -month xtnsion or () you fil Forms 0-BL, 606, or 8870, group rturns, or omposit or onsolit Form 0-T. Inst, you must sumit th fully omplt n sign pg (Prt II) of Form For mor tils on th ltroni filing of this form, visit n lik on -fil for Chritis & nprofits. OMB. -70 Typ or print Fil y th u t for filing your rturn. S instrutions. Nm of Exmpt Orgniztion Employr intifition numr FIRST COAST NO MORE HOMELESS PETS, Numr, strt, n room or suit no. If P.O. ox, s instrutions. 687 NORWOOD AVE City, town or post offi, stt, n ZIP o. For forign rss, s instrutions. JACKSONVILLE, FL 08 Chk typ of rturn to fil (fil sprt pplition for h rturn): Form 0 Form 0-T (orportion) Form 70 Form 0-BL Form 0-T (s. 0() or 08() trust) Form 7 Form 0-EZ Form 0-T (trust othr thn ov) Form 606 Form 0-PF Form 0-A Form 8870 Th ooks r in th r of RICHARD DUCHARME 687 NORWOOD VE, FL 08 Tlphon FA. If th orgniztion os not hv n offi or pl of usinss in th Unit Stts, hk this ox... If this is for Group Rturn, ntr th orgniztion's four igit Group Exmption Numr (GEN). If this is for th whol group, hk this ox... If it is for prt of th group, hk this ox n tth list with th nms n EINs of ll mmrs th xtnsion will ovr. I rqust n utomti -month (6 months for orportion rquir to fil Form 0-T) xtnsion of tim until 0-6, 0, to fil th xmpt orgniztion rturn for th orgniztion nm ov. Th xtnsion is for th orgniztion's rturn for: lnr yr 0 or tx yr ginning 0-0, 0 0, n ning 0-0, 0 0. If this tx yr is for lss thn months, hk rson: Initil rturn Finl rturn Chng in ounting prio If this pplition is for Form 0-BL, 0-PF, 0-T, 70, or 606, ntr th tnttiv tx, lss ny nonrfunl rits. S instrutions. $ If this pplition is for Form 0-PF or 0-T, ntr ny rfunl rits n stimt tx pymnts m. Inlu ny prior yr ovrpymnt llow s rit. $ Bln Du. Sutrt lin from lin. Inlu your pymnt with this form, or, if rquir, posit with FTD oupon or, if rquir, y using EFTPS (Eltroni Frl Tx Pymnt Systm). S instrutions. $ Cution. If you r going to mk n ltroni fun withrwl with this Form 8868, s Form 8-EO n Form 887-EO for pymnt instrutions. For Privy At n Pprwork Rution At ti, s Instrutions. Form 8868 (Rv. -00)

13 SCHEDULE A (Form 0 or 0-EZ) Dprtmnt of th Trsury Intrnl Rvnu Srvi Nm of th orgniztion Prt I f g h Rson for Puli Chrity Sttus Puli Chrity Sttus n Puli Support Complt if th orgniztion is stion 0()() orgniztion or stion 7()() nonxmpt hritl trust. Atth to Form 0 or Form 0-EZ. S sprt instrutions. Typ I Typ II Typ III-Funtionlly intgrt Typ III-Othr (i) (ii) (iii) (All orgniztions must omplt this prt.) S instrutions. Th orgniztion is not privt fountion us it is: (For lins through, hk only on ox.) (i) A hurh, onvntion of hurhs, or ssoition of hurhs sri in stion 70()()(A)(i). A shool sri in stion 70()()(A)(ii). (Atth Shul E.) A hospitl or ooprtiv hospitl srvi orgniztion sri in stion 70()()(A)(iii). 00 Opn to Puli Insption A mil rsrh orgniztion oprt in onjuntion with hospitl sri in stion 70()()(A)(iii). Entr th hospitl's nm, ity, n stt: An orgniztion oprt for th nfit of ollg or univrsity own or oprt y govrnmntl unit sri in stion 70()()(A)(iv). (Complt Prt II.) A frl, stt, or lol govrnmnt or govrnmntl unit sri in stion 70()()(A)(v). An orgniztion tht normlly rivs sustntil prt of its support from govrnmntl unit or from th gnrl puli sri in stion 70()()(A)(vi). (Complt Prt II.) A ommunity trust sri in stion 70()()(A)(vi). (Complt Prt II.) An orgniztion tht normlly rivs: () mor thn /% of its support from ontriutions, mmrship fs, n gross ripts from tivitis rlt to its xmpt funtions - sujt to rtin xptions, n () no mor thn /% of its support from gross invstmnt inom n unrlt usinss txl inom (lss stion tx) from usinsss quir y th orgniztion ftr Jun 0, 7. S stion 0()(). (Complt Prt III.) An orgniztion orgniz n oprt xlusivly to tst for puli sfty. S stion 0()(). An orgniztion orgniz n oprt xlusivly for th nfit of, to prform th funtions of, or to rry out th purposs of on or mor pulily support orgniztions sri in stion 0()() or stion 0()(). S stion 0()(). Chk th ox tht sris th typ of supporting orgniztion n omplt lins through h. By hking this ox, I rtify tht th orgniztion is not ontroll irtly or inirtly y on or mor isqulifi prsons othr thn fountion mngrs n othr thn on or mor pulily support orgniztions sri in stion 0()() or stion 0()(). If th orgniztion riv writtn trmintion from th IRS tht it is Typ I, Typ II, or Typ III supporting orgniztion, hk this ox... Sin August 7, 006, hs th orgniztion pt ny gift or ontriution from ny of th following prsons? A prson who irtly or inirtly ontrols, ithr lon or togthr with prsons sri in (ii) n (iii) low, th govrning oy of th support orgniztion?... A fmily mmr of prson sri in (i) ov?... A % ontroll ntity of prson sri in (i) or (ii) ov?... Provi th following informtion out th support orgniztion(s). Employr intifition numr FIRST COAST NO MORE HOMELESS PETS, OMB Nm of support (ii) EIN (iii) Typ of orgniztion (iv) Is th orgniztion (v) Di you notify (vi) Is th (vii) Amount of orgniztion (sri on lins - in ol. (i) list in your th orgniztion in orgniztion in ol. support ov or IRC stion govrning oumnt? ol. (i) of your (i) orgniz in th (s instrutions) ) support? U.S.? Ys Ys Ys g(i) g(ii) g(iii) Ys Totl For Privy At n Pprwork Rution At ti, s th Instrutions for Form 0 or 0-EZ. Shul A (Form 0 or 0-EZ) 00

14 Shul A (Form 0 or 0-EZ) 00 FIRST COAST NO MORE HOMELESS PETS, Pg Prt II Support Shul for Orgniztions Dsri in Stions 70()()(A)(iv) n 70()()(A)(vi) (Complt only if you hk th ox on lin, 7, or 8 of Prt I.) Stion A. Puli Support Clnr yr (or fisl yr ginning in) Gifts, grnts, ontriutions, n mmrship fs riv. (Do not inlu ny "unusul grnts.")... () 00 () 006 () 007 () 008 () 00 (f) Totl 68,7 7,7 7,00,6,,,,7,8 Tx rvnus lvi for th orgniztion's nfit n ithr pi to or xpn on its hlf... 6 Th vlu of srvis or filitis furnish y govrnmntl unit to th orgniztion without hrg... Totl. A lins through... Th portion of totl ontriutions y h prson (othr thn govrnmntl unit or pulily support orgniztion) inlu on lin tht xs % of th mount shown on lin, olumn (f)... Puli support. Sutrt lin from ln Stion B. Totl Support Clnr yr (or fisl yr ginning in) 7 Amounts from lin... 8 Gross inom from intrst, ivins, pymnts riv on suritis lons, rnts, royltis n inom from similr sours... 68,7 7,7 7,00,6,,,,7,8,7,8 () 00 () 006 () 007 () 008 () 00 (f) Totl 68,7 7,7 7,00,6,,,,7,8 Nt inom from unrlt usinss tivitis, whthr or not th usinss is rgulrly rri on... 0 Othr inom. Do not inlu gin or loss from th sl of pitl ssts (Explin in Prt IV.)... Totl support. A lins 7 through 0. Gross ripts from rlt tivitis, t. (s instrutions)... Stion C. Computtion of Puli Support Prntg Puli support prntg for 00 (lin 6, olumn (f) ivi y lin, olumn (f)) % Puli support prntg from 008 Shul A, Prt II, lin... % First fiv yrs. If th Form 0 is for th orgniztion's first, son, thir, fourth, or fifth tx yr s stion 0()() orgniztion, hk this ox n stop hr... /% support tst If th orgniztion i not hk th ox on lin, n lin is /% or mor, hk this ox n stop hr. Th orgniztion qulifis s pulily support orgniztion... /% support tst If th orgniztion i not hk ox on lin or 6, n lin is /% or mor, hk this ox n stop hr. Th orgniztion qulifis s pulily support orgniztion... 0%-fts-n-irumstns tst If th orgniztion i not hk ox on lin, 6, or 6, n lin is 0% or mor, n if th orgniztion mts th "fts-n-irumstns" tst, hk this ox n stop hr. Explin in Prt IV how th orgniztion mts th "fts-n-irumstns" tst. Th orgniztion qulifis s pulily support orgniztion... 0%-fts-n-irumstns tst If th orgniztion i not hk ox on lin, 6, 6, or 7, n lin is 0% or mor, n if th orgniztion mts th "fts-n-irumstns" tst, hk this ox n stop hr. Explin in Prt IV how th orgniztion mts th "fts-n-irumstns" tst. Th orgniztion qulifis s pulily support orgniztion... Privt fountion. If th orgniztion i not hk ox on lin, 6, 6, 7, or 7, hk this ox n s instrutions...,7,8 Shul A (Form 0 or 0-EZ) 00

15 Shul A (Form 0 or 0-EZ) 00 FIRST COAST NO MORE HOMELESS PETS, Pg Prt III Support Shul for Orgniztions Dsri in Stion 0()() (Complt only if you hk th ox on lin of Prt I.) Stion A. Puli Support Clnr yr (or fisl yr ginning in) () 00 () 006 () 007 () 008 () 00 (f) Totl 6 7 Gifts, grnts, ontriutions, n mmrship fs riv. (Do not inlu ny "unusul grnts.")... Gross ripts from missions, mrhnis sol or srvis prform, or flitis furnish in ny tivity tht is rlt to th orgniztion's tx-xmpt purpos Gross ripts from tivitis tht r not n unrlt tr or us. unr s Tx rvnus lvi for th orgniztion's nfit n ithr pi to or xpn on its hlf... Th vlu of srvis or filitis furnish y govrnmntl unit to th orgniztion without hrg... Totl. A lins through... Amounts inlu on lins,, n riv from isqulifi prsons... 8 Stion B. Totl Support Stion C. Computtion of Puli Support Prntg Puli support prntg for 00 (lin 8, olumn (f) ivi y lin, olumn (f))... % 6 Puli support prntg from 008 Shul A, Prt III, lin... 6 % Stion D. Computtion of Invstmnt Inom Prntg 7 Invstmnt inom prntg for 00 (lin 0, olumn (f) ivi y lin, olumn (f))... 7 % 8 Invstmnt inom prntg from 008 Shul A, Prt III, lin % 0 Amounts inlu on lins n riv from othr thn isqulifi prsons tht x th grtr of $,000 or % of th mount on lin for th yr... A lins 7 n 7... Puli support (Sutrt lin 7 from lin 6.)... Clnr yr (or fisl yr ginning in) () 00 () 006 () 007 () 008 () 00 (f) Totl Amounts from lin Gross inom from intrst, ivins, pymnts riv on suritis lons, rnts, royltis n inom from similr sours... Unrlt usinss txl inom (lss stion txs) from usinsss quir ftr Jun 0, 7... A lins 0 n 0... Nt inom from unrlt usinss tivitis not inlu in lin 0, whthr or not th usinss is rgulrly rri on... Othr inom. Do not inlu gin or loss from th sl of pitl ssts (Explin in Prt IV.)... Totl support. (A lins, 0,, n.)... First fiv yrs. If th Form 0 is for th orgniztion's first, son, thir, fourth, or fifth tx yr s stion 0()() orgniztion, hk this ox n stop hr... /% support tsts If th orgniztion i not hk th ox on lin, n lin is mor thn /%, n lin 7 is not mor thn /%, hk this ox n stop hr. Th orgniztion qulifis s pulily support orgniztion /% support tsts If th orgniztion i not hk ox on lin or lin, n lin 6 is mor thn /%, n lin 8 is not mor thn /%, hk this ox n stop hr. Th orgniztion qulifis s pulily support orgniztion... Privt Fountion: If th orgniztion i not hk ox on lin,, or, hk this ox n s instrutions Shul A (Form 0 or 0-EZ) 00

16 Shul B (Form 0, 0-EZ, or 0-PF) Dprtmnt of th Trsury Intrnl Rvnu Srvi Nm of th orgniztion Shul of Contriutors Atth to Form 0, 0-EZ, n 0-PF. OMB Employr intifition numr FIRST COAST NO MORE HOMELESS PETS, Orgniztion typ (hk on): Filrs of: Stion: Form 0 or 0-EZ 0()( ) (ntr numr) orgniztion 7()() nonxmpt hritl trust not trt s privt fountion 7 politil orgniztion Form 0-PF 0()() xmpt privt fountion 7()() nonxmpt hritl trust trt s privt fountion 0()() txl privt fountion Chk if your orgniztion is ovr y th Gnrl Rul or Spil Rul. t. Only stion 0()(7), (8), or (0) orgniztion n hk oxs for oth th Gnrl Rul n Spil Rul. S instrutions. Gnrl Rul For n orgniztion filing Form 0, 0-EZ, or 0-PF tht riv, uring th yr, $,000 or mor (in mony or proprty) from ny on ontriutor. Complt Prts I n II. Spil Ruls For stion 0()() orgniztion filing Form 0 or Form 0-EZ tht mt th /% support tst of th rgultions unr stions 0()() n 70()()(A)(vi), n riv from ny on ontriutor, uring th yr, ontriution of th grtr of () $,000 or () % of th mount on (i) Form 0, Prt VIII, lin h or (ii) Form 0-EZ, lin. Complt Prts I n II. For stion 0()(7), (8), or (0) orgniztion filing Form 0 or 0-EZ tht riv from ny on ontriutor, uring th yr, ggrgt ontriutions of mor thn $,000 for us xlusivly for rligious, hritl, sintifi, litrry, or utionl purposs, or th prvntion of rulty to hilrn or nimls. Complt Prts I, II, n III. For stion 0()(7), (8), or (0) orgniztion filing Form 0 or 0-EZ tht riv from ny on ontriutor, uring th yr, ontriutions for us xlusivly for rligious, hritl, t., purposs, ut ths ontriutions i not ggrgt to mor thn $,000. If this ox is hk, ntr hr th totl ontriutions tht wr riv uring th yr for n xlusivly rligious, hritl, t., purpos. Do not omplt ny of th prts unlss th Gnrl Rul pplis to this orgniztion us it riv nonxlusivly rligious, hritl, t., ontriutions of $,000 or mor uring th yr... $ Cution. An orgniztion tht is not ovr y th Gnrl Rul n/or th Spil Ruls os not fil Shul B (Form 0, 0-EZ, or 0-PF), ut it must nswr "" on Prt IV, lin of its Form 0, or hk th ox on lin H of its Form 0-EZ, or on lin of its Form 0-PF, to rtify tht it os not mt th filing rquirmnts of Shul B (Form 0, 0-EZ, or 0-PF). For Privy At n Pprwork Rution At ti, s th Instrutions Shul B (Form 0, 0-EZ, or 0-PF) (00) for Form 0, 0-EZ, or 0-PF.

17 Shul B (Form 0, 0-EZ, or 0-PF) (00) Pg of of Prt I Nm of orgniztion Employr intifition numr FIRST COAST NO MORE HOMELESS PETS, Prt I Contriutors (s instrutions) () () () (). Nm, rss, n ZIP + Aggrgt ontriutions Typ of ontriution PAUL ZANDO Prson Pyroll 88 RIVER BASIN DE N $ 7,00 nsh JACKSONVILLE, FL 07 (Complt Prt II if thr is nonsh ontriution.) () () () (). Nm, rss, n ZIP + Aggrgt ontriutions Typ of ontriution HOLAND WARE CHAR FOUND Prson Pyroll MAPLE DR $,000 nsh HOGANSVILLE, GA 00 (Complt Prt II if thr is nonsh ontriution.) () () () (). Nm, rss, n ZIP + Aggrgt ontriutions Typ of ontriution CLEAR CHANNEL COMM Prson Pyroll 700 CENTRAL PKWY STE $ 6,00 nsh JACKSONVILLE, FL (Complt Prt II if thr is nonsh ontriution.) () () () (). Nm, rss, n ZIP + Aggrgt ontriutions Typ of ontriution KIM TIPPIN Prson Pyroll 8 ORTEGA BLVD $,000 nsh JACKSONVILLE, FL 0 (Complt Prt II if thr is nonsh ontriution.) () () () (). Nm, rss, n ZIP + Aggrgt ontriutions Typ of ontriution JOSEPH STRASSER Prson Pyroll 00 SAN JOSE BLVD $,80 nsh JACKSONVILLE, FL 07 (Complt Prt II if thr is nonsh ontriution.) () () () (). Nm, rss, n ZIP + Aggrgt ontriutions Typ of ontriution 6 MICHAEL MUNZ Prson Pyroll BROOKWOOD RD $ 6,000 nsh JACKSONVILLE, FL 07 (Complt Prt II if thr is nonsh ontriution.) Shul B (Form 0, 0-EZ, or 0-PF) (00)

18 Shul B (Form 0, 0-EZ, or 0-PF) (00) Pg of of Prt II Nm of orgniztion Employr intifition numr FIRST COAST NO MORE HOMELESS PETS, Prt II nsh Proprty (s instrutions) (). from Prt I IN KIND DONATION, ADVERTISING () Dsription of nonsh proprty givn () FMV (or stimt) (s instrutions) () Dt riv $ 6, (). from Prt I () Dsription of nonsh proprty givn () FMV (or stimt) (s instrutions) () Dt riv GRAPHIC DESIGN SERVICE $, (). from Prt I () Dsription of nonsh proprty givn () FMV (or stimt) (s instrutions) () Dt riv $ (). from Prt I () Dsription of nonsh proprty givn () FMV (or stimt) (s instrutions) () Dt riv $ (). from Prt I () Dsription of nonsh proprty givn () FMV (or stimt) (s instrutions) () Dt riv $ (). from Prt I () Dsription of nonsh proprty givn () FMV (or stimt) (s instrutions) () Dt riv $ Shul B (Form 0, 0-EZ, or 0-PF) (00)

19 SCHEDULE C (Form 0 or 0-EZ) Prt I-A Prt I-B Prt I-C Politil Cmpign n Loying Ativitis For Orgniztions Exmpt From Inom Tx Unr stion 0() n stion 7 Complt if th orgniztion is sri low. Dprtmnt of th Trsury Intrnl Rvnu Srvi Atth to Form 0 or Form 0-EZ. S sprt instrutions. If th orgniztion nswr "Ys," to Form 0, Prt IV, lin, or Form 0-EZ, Prt VI, lin 6 (Politil Cmpign Ativitis), thn Stion 0()() orgniztions: Complt Prts I-A n B. Do not omplt Prt I-C. Stion 0() (othr thn stion 0()()) orgniztions: Complt Prts I-A n C low. Do not omplt Prt I-B. Stion 7 orgniztions: Complt Prt I-A only. If th orgniztion nswr "Ys," to Form 0, Prt IV, lin, or Form 0-EZ, Prt VI, lin 7 (Loying Ativitis), thn Complt if th orgniztion is xmpt unr stion 0() or is stion 7 orgniztion. Complt if th orgniztion is xmpt unr stion 0()() Complt if th orgniztion is xmpt unr stion 0(), xpt stion 0()(). 00 Opn to Puli Insption Stion 0()() orgniztions tht hv fil Form 768 (ltion unr stion 0(h)): Complt Prt II-A. Do not omplt Prt II-B. Stion 0()() orgniztions tht hv NOT fil Form 768 (ltion unr stion 0(h)): Complt Prt II-B. Do not omplt Prt II-A. If th orgniztion nswr "Ys," to Form 0, Prt IV, lin (Proxy Tx), thn Stion 0()(), (), or (6) orgniztions: Complt Prt III. Nm of orgniztion If th orgniztion inurr stion tx, i it fil Form 70 for this yr? Ys Ws orrtion m? Ys Totl xmpt funtion xpniturs. A lins n. Entr hr n on Form 0-POL, lin 7... $ Di th filing orgniztion fil Form 0-POL for this yr?... Ys Provi sription of th orgniztion's irt n inirt politil mpign tivitis in Prt IV. Politil xpniturs... $ Voluntr hours... Entr th mount of ny xis tx inurr y th orgniztion unr stion $ Entr th mount of ny xis tx inurr y orgniztion mngrs unr stion $ If "Ys," sri in Prt IV. Entr th mount irtly xpn y th filing orgniztion for stion 7 xmpt funtion tivitis... $ Entr th mount of th filing orgniztion's funs ontriut to othr orgniztions for stion 7 xmpt funtion tivitis... $ Stt th nms, rsss n mployr intifition numr (EIN) of ll stion 7 politil orgniztions to whih pymnts wr m. For h orgniztion list, ntr th mount pi from th orgniztion's funs. Also ntr th mount of politil ontriutions riv tht wr promptly n irtly livr to sprt politil orgniztion, suh s sprt sgrgt fun or politil tion ommitt (PAC). If itionl sp is n, provi informtion in Prt IV. OMB Employr intifition numr FIRST COAST NO MORE HOMELESS PETS, () Nm () Arss () EIN () Amount pi from () Amount of politil filing orgniztion's ontriutions riv n funs. If non, ntr -0-. promptly n irtly livr to sprt politil orgniztion. If non, ntr -0-. For Privy At n Pprwork Rution At ti, s th Instrutions for Form 0. Shul C (Form 0 or 0-EZ) 00

20 Shul C (Form 0 or 0-EZ) 00 Prt II-A A B f g h i j Chk Chk Complt if th orgniztion is xmpt unr stion 0()() n fil Form 768 (ltion unr stion 0(h)). if th filing orgniztion longs to n ffilit group. if th filing orgniztion hk ox A n "limit ontrol" provisions pply. Limits on Loying Expniturs (Th trm "xpniturs" mns mounts pi or inurr.) Totl loying xpniturs to influn puli opinion (grss roots loying)... Totl loying xpniturs to influn lgisltiv oy (irt loying)... Totl loying xpniturs ( lins n )... Othr xmpt purpos xpniturs... Totl xmpt purpos xpniturs ( lins n )... Loying nontxl mount. Entr th mount from th following tl in oth olumns. FIRST COAST NO MORE HOMELESS PETS, If th mount on lin, olumn () or () is: Th loying nontxl mount is : t ovr $00,000 0% of th mount on lin. Ovr $00,000 ut not ovr $,000,000 $00,000 plus % of th xss ovr $00,000. Ovr $,000,000 ut not ovr $,00,000 $7,000 plus 0% of th xss ovr $,000,000. Ovr $,00,000 ut not ovr $7,000,000 $,000 plus % of th xss ovr $,00,000. Ovr $7,000,000 $,000,000. Grssroots nontxl mount (ntr % of lin f)... Sutrt lin g from lin. If zro or lss, ntr Sutrt lin f from lin. If zro or lss, ntr If thr is n mount othr thn zro on ithr lin h or lin i, i th orgniztion fil Form 70 rporting stion tx for this yr?... -Yr Avrging Prio Unr Stion 0(h) (Som orgniztions tht m stion 0(h) ltion o not hv to omplt ll of th fiv olumns low. S th instrutions for lins through f on pg.) Loying Expniturs During -Yr Avrging Prio () Filing orgniztion's totls () Ys Affilit group totls Pg Clnr yr (or fisl yr ginning in) () 006 () 007 () 008 () 00 () Totl Loying non-txl mount Loying iling mount (0% of lin, olumn ()) Totl loying xpniturs f Grssroots nontxl mount Grssroots iling mount (0% of lin, olumn ()) Grssroots loying xpniturs Shul C (Form 0 or 0-EZ) 00

21 Shul C (Form 0 or 0-EZ) 00 FIRST COAST NO MORE HOMELESS PETS, Prt II-B Complt if th orgniztion is xmpt unr stion 0()() n hs NOT fil Form 768 (ltion unr stion 0(h)). () () Pg Ys Amount f g h i j Prt III-A Prt III-B Prt IV Complt if th orgniztion is xmpt unr stion 0()(), stion 0()(), or stion 0()(6). Wr sustntilly ll (0% or mor) us riv nonutil y mmrs?... Di th orgniztion mk only in-hous loying xpniturs of $,000 or lss?... Di th orgniztion gr to rryovr loying n politil xpniturs from th prior yr?... Complt if th orgniztion is xmpt unr stion 0()(), stion 0()(), or stion 0()(6) if BOTH Prt III-A, lins n r nswr "" OR if Prt III-A, lin is nswr "Ys."... Dus, ssssmnts n similr mounts from mmrs xpnss for whih th stion 7(f) tx ws pi). Currnt yr... Crryovr from lst yr... Totl... Aggrgt mount rport in stion 60()()(A) notis of nonutil stion 6() us... During th yr, i th filing orgniztion ttmpt to influn forign, ntionl, stt or lol lgisltion, inluing ny ttmpt to influn puli opinion on lgisltiv mttr or rfrnum, through th us of: Voluntrs?... Pi stff or mngmnt (inlu ompnstion in xpnss rport on lins through i)?... Mi vrtismnts?... Milings to mmrs, lgisltors, or th puli?... Pulitions, or pulish or rost sttmnts? Grnts to othr orgniztions for loying purposs? Dirt ontt with lgisltors, thir stffs, govrnmnt offiils, or lgisltiv oy?... Rllis, monstrtions, sminrs, onvntions, sphs, lturs, or ny othr mns?... Othr tivitis? If "Ys," sri in Prt IV... Totl. A lins through i... Di th tivitis in lin us th orgniztion to not sri in stion 0()()?... If "Ys," ntr th mount of ny tx inurr unr stion... If "Ys," ntr th mount of ny tx inurr y orgniztion mngrs unr stion... If th filing orgniztion inurr stion tx, i it fil Form 70 for this yr?... Stion 6() nonutil loying n politil xpniturs (o not inlu mounts of politil If notis wr snt n th mount on lin xs th mount on lin, wht portion of th xss os th orgniztion gr to rryovr to th rsonl stimt of nonutil loying n politil xpnitur nxt yr?... Txl mount of loying n politil xpniturs (s instrutions)... Supplmntl Informtion Complt this prt to provi th sriptions rquir for Prt I-A, lin ; Prt I-B, lin ; Prt I-C, lin ; n Prt II-B, lin i. Also, omplt this prt for ny itionl informtion. Ys Shul C (Form 0 or 0-EZ) 00