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8010 02/07/2003 12:12 PM Form990 (2001 ) SUBSTANCE ABUSE COUNCIL 65 - 0202835 _ Page s Part11!11 Analysis of Income-Producin Activities See Specific Instructions on page 32. Note: Enter gross amounts unless otherwise Unrelated business income Excluded by sec. 512, 513, or 514 (E) Related or Indicated. Business code Amount xdusio Amount exempt function 93 Program service revenue: code income a OTHER 37 , 622. b GOVERNMENTAL GRANTS 418r117 c d e f Medicare/Medicaid payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . g Fees and contracts from government agencies 94 Membership dues and assessments 6 4 2 6 95 Interest on savings and temporary cash investments 96 Dividends and interest from securities . . . . . . . . . . . . . . . . . . . . . . 97 Net rental income or (loss) from real estate: a debt-financed property . .. . . . . . . . . . . . . . . . . . . . . . . . . .. . . . b not debt-financed property . . . .. . . . . . . . . . . . . . . . . . . . . 98 Net rental income or (loss) from personal property . . . . . : 99 Other investment income ' 100 Gain or (loss) from sales of assef& other than inventory 101 Net income or (loss) from special events 102 Gross profit"or. Doss) from sales of inventory 41 4r384 103 Other revenue: a . b OTHER REVENUE 1r645. d e 104 Subtotal (add columns (B), (D), and (E)) OEM 4 , 384 " 4 63 810 105 Total (add line 104, columns (B), (D), and (E)) . . . . . . . . . . . .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . .. . . . . . . . . . . . . . . . ► 468r194. Note: Une 105 plus line 1 d Part I should equal the amount on fine 12 Part 1. Relationship of Activities to the Accomplishment of Exempt Purposes see .spectric Instructions on page 32 .Line No. Explain how each activity for which income is. reported in column (E) of Part VII contributed importantly to the accomplishment • . . of the organization's exempt other than by providingfunds for such 93A PROVIDE SUBSTANCE ABUSE PREVENTION EDUCATION 94 PROVIDE SUBSTANCE ABUSE PREVENTION EDUCATION 103 PROVIDE SUBSTANCE ABUSE PREVENTION EDUCATION _ - Information Re ardin Taxable Subsidiaries and Disregarded Entitiessees tfic instructions on page 33. (A) (B) (C) (D) (E) . Name, addressi and EIN of corporation, Percentage of Nature of activities Total Income End-of-year partnership, or disregarded entity ownership Interest assets N/A 04 Information kegarding RegardingTransfers Associated with Personal Benefit Contracts See Specific Instructions on pg . 33. (a) Did the organization, during the year, receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? Yes No (b) Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? . . . . . . . . . . . . . . . . . . . . . H Yes No . . . . . . . . . . . . . . . . . . . . . . . . . Note: If "Yes" to (b), file Form 8870 and Form 4720 see instructions). Under penalties of perjury, I declare that 1 have examined this retum, including accompanying schedules and statements, and to the best of my knowledge and belief, it e, correct, and com ete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge. Please Sign Here Sin Cure of Date Type or print name a96 tftl Preparers Rol 9 20U Check if Preparees SSN or "N (See Gen. Instr. W) Paid nature em siI ► P00293972 Preparer's Firm's name (oryours 0 '- HAIP4 KNETZ NUTTALL FIELD & CO . EIN ► 59 - 1718139 Use Only if self-employed), 3111 CARDINAL DR . Phone address, and ZIP + 4 VERO BEACH FL 32963 no. ► 772 - 231 - 6902 DAA Form 990 (2001 )