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Schedule A (Form 990 or 990 -EZ ) 2001 HOMELESS ASSISTANCE CENTER INC . 59 - 3129752 Page 3
<br /> Pact IV-A Support Schedule (Complete only if you checked a box on line 101 11 , or 12 .) Use cash method of accounting .
<br /> Note: You may use the worksheet in the instructions for converting from the accrual to the cash method of accounting.
<br /> Calendar year ( or fiscal year
<br /> beginning in ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ► ( a ) 2000 ( b ) 1999 ( c ) 1998 ( d )
<br /> 1997 ( e ) Total
<br /> 15 Gifts, grants, and contributions received. 868 , 422o
<br /> (Do not include unusual grants. See
<br /> line 28.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
<br /> e. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1281284 * 385r354 * 167 145 . 187 , 639 *
<br /> 16 Membership fees received . . . . . . . . .
<br /> 17 Gross receipts from admissions,
<br /> merchandise sold or services
<br /> performed, or furnishing of
<br /> facilities in any activity that is
<br /> related to the organization ' s
<br /> charitable, etc., purpose . . . . . . . . . . . .
<br /> 18 Gross income from interest,
<br /> dividends, amounts received from
<br /> payments on securities loans (sec-
<br /> tion 512(a)( 5 )), rents, royalties, and
<br /> unrelated business taxable income
<br /> (less section 511 taxes) from
<br /> businesses acquired by the
<br /> organization after June 30, 1975 8 8 0 3 . 1 , 708 * 6 5 . 351 . 10t927 *
<br /> 19 Net income from unrelated business
<br /> activities not included in line 18
<br /> 20 Tax revenues levied for the organization ' s
<br /> benefit and either paid to it or expended
<br /> on its behalf
<br /> 21 The value of services or facilities
<br /> furnished to the organization by a
<br /> governmental unit without charge.
<br /> Do not include the value of services
<br /> or facilities generally furnished to
<br /> the public without charge . _ . . . . . . . . . .
<br /> 22 Other income. Attach a schedule. Do not SEE STATEMENT 12
<br /> include gain or (bss) from sale of capital
<br /> assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137 , 816 * 44 , 162 * 35 053 . 6 450
<br />. 223 , 481a
<br /> 23 Total of lines 15 through 22 2741903 * 431 224 . 202 263 . 194 r 440 . 1 r 102r8300
<br /> 24 Line 23 minus line 17 . . . . . . . . . . . . . . . 274r903 * 431 , 224a 202 263 . 194 , 440 * 1 , 102 ,
<br />830o
<br /> 25 Enter 1 % of line 23 . . . . . . . . . . . . . . . . . . 21749 * 4 312 . 2 , 023a , 1 r 944 e
<br /> 26 Organizations described on lines 10 or 11 : a Enter 2% of amount in column (e), line 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . .
<br />. . . . . . . . . . . . . . . . . ► 26a 22 , 057
<br /> .
<br /> b Prepare a list for your records to show the name of and amount contributed by each person (other than a governmental
<br /> unit or publicly supported organization ) whose total gifts for 1997 through 2000 exceeded the amount shown in line 26a.
<br /> Do not file this list with your return . Enter the total of all these excess amounts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
<br />. . . . . . . . . . . . . . . . . . . . . . . . . ► 26b 243 , 595
<br /> .
<br /> c Total support for section 509(a)( 1 ) test: Enter line 24 , column (e) . . . . . . . . . . . . . . . . . . . . . . . .
<br /> . . . . . . . . . . . . . . . . . . ► 26c 1 10 2 8 3 0 .
<br /> d Add: Amounts from column (e) for lines: 18 10 , 6 2 7 . 19
<br /> 22 223 , 481a 26b 243 , 595 * ► 26d 478 003 a
<br /> e Public support ( line 26c minus line 26d total) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
<br />. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ► 26e 6 2 4 8 27 .
<br /> f Public support percentage line 26e numerator divided by line 26c denominator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
<br />. . . . . . . . . . . . . . . . . . . . ► 26f 5 6 . 6 5 6 7 %
<br /> 27 Organizations described on line 12: a For amounts included in lines 15, 16, and 17 that were received from a 'disqualified person;
<br /> prepare a list for your records
<br /> to show the name of, and total amounts received in each year from , each adisqualified person.' Do not file this list with your return . Enter
<br /> the sum of such amounts
<br /> for each year: N / A
<br /> (2000) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ( 1999) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
<br />. . . . . . . . ( 1998 ) ( 1997)
<br /> b For any amount included in line 17 that was received from each peson ( other than Odisqualified persons'), prepare a list for your records
<br /> to show the name of, and
<br /> amount received for each year, that was more than the larger of ( 1 ) the amount on line 25 for the year or (2) $5,000. ( Include in the list
<br />organizations described in
<br /> lines 5 through 11 , as well as individuals. ) Do not file this list with your return . After computing the difference between the amount received
<br /> and the larger
<br /> amount described in ( 1 ) or (21 enter the sum of these differences (the excess amounts ) for each year. N / A
<br /> (2000) . . . . . . . . . . . . . . . . . . . . 4 . . . . . . . . . . . . . . . . . . ( 1999 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
<br />. . . . . . . . ( 1998 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ( 1997 )
<br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
<br /> c Add: Amounts from column (e ) for lines: 15 16
<br /> 17 20 21 ► 27c N / A
<br /> d Add: Line 27a total and line 27b total 110- 27d N / A
<br /> e Public support (line 27c total minus line 27d total) , ► 27e N A
<br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
<br />. . . . . . . . . . . . . . . . . . . . . .
<br /> f Total support for section 509 (a)(2 ) test: Enter amount on line 23, column (e ) . . . . . . . . . ► 27f N / A
<br /> g Public support percentage (line 27e (numerator) divided by line 27f (denominator)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
<br />. ► 27 N / A %
<br /> h Investment income percentage line 18 column a numerator divided by line 27f denominator ► 27h N / A %
<br /> 28 Unusual Grants: For an organization described in line 10, 11 , or 12, that received any unusual grants during 1997 through 2000, prepare
<br /> a list for your records to
<br /> show, for each year, the name of the contributor, the date and amount of the grant, and a brief description of the nature of the grant. Do
<br />not file this list with your
<br /> return . Do not include these grants in line 15.
<br /> NONE
<br /> 123121 12 -29-01 9 Schedule A ( Form 990 or 990 -EZ ) 2001
<br />
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