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6 / 1U 111TJIZUUL9: 11 AM - Schedule A (Form 990 or 990-EZ) 2001 I . R . C . HEALTHY START COALITION , INC 65 0363222 Pa e 3 Part IV A Support Schedule (Complete only if you checked a box on line 10, 11 , or 12. ) Use cash method of accounting . Note : You may use the worksheet in the instructions for converting from the accrual to the cash method of accountin . Calendar year or fiscal year beginning in ► :!9 2000 b 1999 c 1998 d 1997 a Total 15 Gifts, grants , and contributions received. (Do not include unusual rants. See line 28 . 36 242 588 720 249 , 003 226 436 2 000 401 16 Membership fees received 17 Gross receipts from admissions, merchandise sold or services performed, or fumishing of facilities in any activity that is related to the organization's charitable, etc , purpose 18 Gross inc. from int, dividends, amounts received from pymt. on securities bans (section 512(a)(5)), rents, royalties, & unrelated busn. taxable inc. (less sec. 511 taxes) from businesses acquired by the organization after June 30, 1975 . . . . . 2 142 11656 3 798 19 Net income from unrelated business activities not included in line 18 . . . . . . . 20 Tax revn. levied for the organization's ben. & either paid to it or expended on its behalf 21 The value of serv. or fad. fumished to the org. by a governmental unit without charge. Do not incl. the value of serv. or fac. gen- erally fumished to the Dublic without charge 11 , 659 41 3 8 0 53 039 22 Other income. Attach a schedule. Do not incfrom ale of cap.n or ( asets STMT 12 4r667 4 667 23 Total of lines 15through 22 . . . . . . . . . . . 938F384 590r376 265 , 329 267r816 2061 905 24 Line 23 minus line 17 . . . . . . . . . - 938 384 590r376 .265 329 267r816 2 061 905 25 Enter 1 % of line 23 . . . . . . . - 9r384 5 904 2f6531 2 678 26 Organizations described on lines 10 or 11 : a Enter 2% of amount in column (e), line 24 ► 26a 41 2 3 8 . . . . . . . . . . . . . . . . . . . . . . b Prepare a list for your records to show the name of and amount contributed by each person (other than a governmental unit or publicly supported organization ) whose total gifts for 1997 through 2000 exceeded the amount shown in line 26a. Do not file this list with your retum. Enter the total of all these excess amounts . . . . . . . . . . . 10- 26b c Total support for section 509(a)(1 ) test: Enter line 24, column (e) ► 26c 2 061 905 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d Add: Amounts from column (e) for lines: 18 3 , 798 1g 22 4 # 667 26b ► 26d 8 465 e Public support (line 26c minus line 26d total) . . . . . . . . . . . ► 26e 2 053 440 f Public support percentage line 26e numerator divided by line 26cdenominator ► 26f 9905895 % . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Organizations described on line 12: a For amounts included in lines 15, 16 , and 17 that were received from a "disqualified person ," prepare a list for your records to show the name of, and total amounts received in each year from , each "disqualified person ." Do not file this list with your return. Enter the sum of such amounts for each year: N/A 2000 . . . . . . . . . . . . . . . . . . . . . . . ( 1999) . . . . . . . . . . . . . . . 1998 b For any amount included in line 17 that was received from each person other than "disqualified persons"), ( 1997) p ( q p "), prepare a list for your records to show the name of, and 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 organizations described in lines 5 through 11 , as well as individuals .) Do not file this list with your return. After computing the difference between the amount received and the larger amount described in (1) or (2), enter the sum of these differences (the excess amounts ) for each year: N/A 2000 ) . . . . . . . . . . . . . . . . . . ( . . . ( 1999) . . . . . . . . . . . . . . . . . . . . . . . - 16 ( 1998) . . . . . . . . . . . . . . . . . . . . . . . ( 1997) . . . . . . . . . . . . . . . . . . . . . . . . c Add: Amounts from column a) for lines : 15 17 20 21 ► 27c d Add: Line 27a total ► 27d and line 27b total e Public support (line 27c total minus line 27d total) . . . . . . . . . . . . ► 27e . . . . . . . . . . . . . . . f Total support for section 509(a )(2) test: Enter amount on line 23, column (e) ► 4 1 27f g Public support percentage (line 27e (numerator) divided by line 27f (denominator)) ► 27 % Investment income Percentage line 18 column a numerator divided b line 27f denominator ► 2711 28 Unusual Grants : For an organization described in line 101 11 , or 12 that received any unusual grants during 1997 through 2000, prepare a list for your records to 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 not file this list with your return Do not include these grants in line 15 DAA Schedule A ( Form 990 or 990-EZ) 2001