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AMAC ', I Form 990 Department of the Treas Internal Revenue Service A For the 2006 cal i B Check if applicable Li Address change Li Name change Initial return 'Li Final return n Amended return Return of Organization Exempt From Income Tax OMB No 1545-0047 Under section 501(c), 527, or 4947( a)(1) of the Internal Revenue Code ( except black lung 2006 benefit trust or p rivate foundation) The organization may have to use a coov of this return to satis state reportinq requirements Op n t4 Public lmpectip Please C Name of organization D Employer Identification number use IRS AIRPORT MINORITY ADVISORY COUNCIL 62-1398266 label or print or CORP E Telephone number type. Number and street (or P 0 box if mail is not delivered to street address ) Room /suite 703-417-2622 Specefc RONALD REAGAN WASHINGTON NAT' L ARPT F Accounting method: X Cash Instruc- City or town , state or country , and ZIP +4 Li Accrual 11 Other ( specify) Application pending Section 501(c )( 3) organizations and 4947( a)(1) nonexempt charitable trusts must attach a completed Schedule A (Form 990 or 990-EZ). G Website: www.amac - org.Com - J Organization type (check only one) n 501(c) ( 6 ) 1(insert no) [1 4947(a)(1) or n 527 K Check here Li if the organization is not a 509(a)(3) supporting organization and its gross receipts are normally not more than $25,000 A return is not required, but if the organization chooses to file a return, be sure to file a complete return L Gross receipts : Add lines 6b, 8b, 9b 177,351 H and are not applicable to section 527 organizations I H(a) Is this a group return for affiliates? Li Yes No H(b) If 'Yes, ' enter number of affiliates H(c) Are all affiliates included ? Yes Li No (If'No, attach a list See instructions ) H(d) Is this a separate return filed by an I Grou p Exem p tion Numberb, M Check X if the organization is not required to attach Sch B (Form 990, 990-EZ, or 990-PF) Karl t Revenue tx enses ana t.nan es in riei assets or runs malances at:e tilt; Insuuc uuns. I Contributions, gifts, grants, and similar amounts received a Contributions to donor advised funds 1a b Direct public support (not included on line 1a) lb 2 , 500 c Indirect public support (not included on line 1a) 1c d Government contributions (grants) (not included on line 1a) 1d e Total (add lines la through 1d) (cash $ 2, 500 noncash $ ) le 2 , 500 2 Program service revenue including government fees and contracts (from Part VII, line 93) 2 3 Membership dues and assessments See Statement 1 3 127 , 587 4 Interest on savings and temporary cash investments 4 437 5 Dividends and interest from securities 5 7 , 639 6a Gross rents 6a b Less. rental expenses 6b c Net rental income or (loss). Subtract line 6b from line 6a 6c 7 Other investment income (descrlb* 7 m r- 8a Gross amount from sales of assets other ( A) Securities ( B ) Other than inventory 14 , 182 8a b Less cost or other basis and sales expenses 8b c Gain or (loss) (attach schedule) 14 , 182 8c d Net gain or (loss) Combine line 8c, columns (A) and (B) See Stmt 2 8d 14 , 182 9 Special events and activities (attach schedule) If any amount is from gaming , check herb o a Gross revenue (not including $ of C%j contributions reported on line 1b) 9a b Less direct expenses other than fundraising expenses 9b 0;^ c Net income or (loss) from special events Subtract line 9b from line 9a 9c Z- 10a Gros ales of inventory, less returns and allowances 10a LLJ :!1 b Less cost o Id 10b c Gro s profs is s ventory (attach schedule) Subtract line 10b from line 10a 10c (J 11 Ot venue n 103) 11 25 , 006 12 To ve d lines 1e, 6c, 7, 8d, 9c, 10c, and 11 12 177 , 351 13 P gr m services rom c (B)) 13 14 anaggu^ and.general (from I column (C)) 14 15 4' ,-co4um 15 CIL W I 16 Payments "a a aEl sche le) 16 17 Total ex p enses . Add liens 4, column ( A ) 17 248 , 207 18 Excess or (deficit) for the year Subtract line 17 from line 12 18 -70 , 856 Q 19 Net assets or fund balances at beginning of year (from line 73, column (A)) 19 304,287 20 Other changes in net assets or fund balances (attach explanation) See Statement 3 20 -7 , 497 Z 21 Net asse ts or fund b alances at end of year Combine lines 18, 19, and 20 21 225 , 934 t-or Privacy Act and Paperwork Keciucuon Act Notice , see mile separate Form 990 (2006) instructions. DAA
25

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Page 1: AMAC ', I 990 Return ofOrganization ExemptFromIncomeTax …990s.foundationcenter.org/990_pdf_archive/621/... · AMAC ', I Form 990 Departmentof the Treas Internal Revenue Service

AMAC ',I

Form 990Department of the TreasInternal Revenue Service

A For the 2006 cal i

B Check if applicable

Li Address change

Li Name change

Initial return

'Li Final return

n Amended return

Return of Organization Exempt From Income Tax OMB No 1545-0047

Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung 2006benefit trust or private foundation)

► The organization may have to use a coov of this return to satis state reportinq requirements Opn t4 Public lmpectip

Please C Name of organization D Employer Identification numberuse IRS AIRPORT MINORITY ADVISORY COUNCIL 62-1398266label orprint or CORP E Telephone number

type. Number and street (or P 0 box if mail is not delivered to street address ) Room/suite 703-417-2622

SpecefcRONALD REAGAN WASHINGTON NAT' L ARPT F Accounting method: X Cash

Instruc- City or town , state or country , and ZIP + 4 Li Accrual 11 Other ( specify)

Application pending • Section 501(c )( 3) organizations and 4947( a)(1) nonexempt charitable

trusts must attach a completed Schedule A (Form 990 or 990-EZ).

G Website: ► www.amac - org.Com

- J Organization type

(check only one) ► n 501(c) ( 6 ) 1(insert no) [1 4947(a)(1) or n 527

K Check here ► Li if the organization is not a 509(a)(3) supporting organization and its gross

receipts are normally not more than $25,000 A return is not required, but if the organization chooses

to file a return, be sure to file a complete return

L Gross receipts : Add lines 6b, 8b, 9b ► 177,351

H and are not applicable to section 527 organizations I

H(a) Is this a group return for affiliates? Li Yes No

H(b) If 'Yes, ' enter number of affiliates ►

H(c) Are all affiliates included ? Yes Li No

(If'No, attach a list See instructions )

H(d) Is this a separate return filed by an

I Grou p Exem ption Numberb,

M Check ► X if the organization is not required

to attach Sch B (Form 990, 990-EZ, or 990-PF)

Karl t Revenue tx enses ana t.nan es in riei assets or runs malances at:e tilt; Insuucuuns.

I Contributions, gifts, grants, and similar amounts received

a Contributions to donor advised funds 1a

b Direct public support (not included on line 1a) lb 2 , 500

c Indirect public support (not included on line 1a) 1c

d Government contributions (grants) (not included on line 1a) 1d

e Total (add lines la through 1d) (cash $ 2, 500 noncash $ ) le 2 , 500

2 Program service revenue including government fees and contracts (from Part VII, line 93) 2

3 Membership dues and assessments See Statement 1 3 127 , 587

4 Interest on savings and temporary cash investments 4 437

5 Dividends and interest from securities 5 7 , 639

6a Gross rents 6a

b Less. rental expenses 6b

c Net rental income or (loss). Subtract line 6b from line 6a 6c

7 Other investment income (descrlb* 7m

r- 8a Gross amount from sales of assets other (A) Securities ( B ) Other

than inventory 14 , 182 8a

b Less cost or other basis and sales expenses 8b

c Gain or (loss) (attach schedule) 14 , 182 8c

d Net gain or (loss) Combine line 8c, columns (A) and (B) See Stmt 2 8d 14 , 182

9 Special events and activities (attach schedule) If any amount is from gaming , check herb

o a Gross revenue (not including $ of

C%j contributions reported on line 1b) 9a

b Less direct expenses other than fundraising expenses 9b

0;^ c Net income or (loss) from special events Subtract line 9b from line 9a 9c

Z- 10a Gros ales of inventory, less returns and allowances 10aLLJ:!1 b Less cost o Id 10b

c Gro s profs is s ventory (attach schedule) Subtract line 10b from line 10a 10c

(J 11 Ot venue n 103) 11 25 , 006

12 To ve d lines 1e, 6c, 7, 8d, 9c, 10c, and 11 12 177 , 351

13 P gr m services rom c (B)) 13

14 anaggu^ and.general (from I column (C)) 14

15 4',-co4um 15CIL

W

I

16 Payments "a a aEl sche le) 16

17 Total ex penses . Addliens 4, column (A) 17 248 , 207

18 Excess or (deficit) for the year Subtract line 17 from line 12 18 -70 , 856

Q 19 Net assets or fund balances at beginning of year (from line 73, column (A)) 19 304,287

20 Other changes in net assets or fund balances (attach explanation) See Statement 3 20 -7 , 497

Z 21 Net assets or fund balances at end of year Combine lines 18, 19, and 20 21 225 , 934t-or Privacy Act and Paperwork Keciucuon Act Notice , see mile separate Form 990 (2006)instructions.DAA

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AMAC

Form99O (2006 ) AIRPORT MINORITY ADVISORY COUNCIL 62-1398266 Page2

Part It Statement of All organizations must complete column (A) Columns ( B), (C), and (D) are required for section 501(c)(3) and (4)Functional Expenses organizations and section 4947(a)(1) nonexempt chartable trusts but optional for others . ( See the instructions.)

Do not include amounts reported on line (B) Program (C) Management

6b , 8b , 9b , 10b or 16 of Part I.(A) Total services and general (D) Fundraising

22a Grants paid from donor advised funds (attach schedule)non-

(cash $ cash $ )

If this amount includes foreign grants, check here ► 22a

22b Other grants and allocations (attach schedule)

(cash $ cash $ )

If this amount includes foreign grants, check here ► 22b

23 Specific assistance to individuals (attach

schedule) 23

24 Benefits paid to or for members (attach

schedule) 24

25a Compensation of current officers, directors,

key employees, etc listed in Part V-A (attach

schedule) See Statement 4 25a 59 , 437b Compensation of former officers, directors,

key employees, etc. listed in Part V-B (attach

schedule) 25b

c Compensation and other distributions, not included above, to

disqualified persons (as defined under section 4958(f)(1)) and

persons described in section 4958(c)(3)(B) (attach schedule) 25c

26 Salanes and wages of employees not included

on lines 25a, b, and c 26

27 Pension plan contributions not included on

lines 25a, b, and c 27

28 Employee benefits not included on lines

25a - 27 28

29 Payroll taxes 29 4 , 474

30 Professional fundraising fees 30

31 Accounting fees 31 9 , 96032 Legal fees 32 33 , 23033 Supplies 33 6 , 52034 Telephone 34 1 85435 Postage and shipping 35 8 023

36 Occupancy 36 7 51937 Equipment rental and maintenance 37 6 , 93438 Pnnting and publications 38 1 85439 Travel 39 5 372

40 Conferences, conventions, and meetings 40 9 , 34841 Interest 41

42 Depreciation, depletion, etc (attach schedule) 42 758

43 Other expenses not covered above (itemize)

a See Statement 5 43a 92 , 924b 43b

c 43c

d 43d

e 43e

f 43f

g 43

44 Total functional expenses . Add lines 22a

through 43g (Organizations completing

columns (B)-(D), carry these totals to lines

13-15 ) 44 248 , 207 , 0 0 0Joint Costs. Check ► u if you are following SOP 98-2

Are any joint costs from a combined educational campaign and fundraising solicitation reported in (B) Program services? ► q Yes q No

If "Yes," enter (i) the aggregate amount of these joint cost$ , (ii) the amount allocated to Program services $

(iii) the amount allocated to Management and genera$ , and (iv) the amount allocated to Fundraising$

DAA Form 990 (2006)

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AMAC

Form 990 (2006 ) AIRPORT MINORITY ADVISORY COUNCIL 6 2-1398266 Page 3Part [II Statement of Program Service Accomplishments (See the instructions.)

Form 990 is available for public inspection and, for some people , serves as the primary or sole source of information about a

particular organization How the public perceives an organization in such cases may be determined by the information presented

on its return . Therefore , please make sure the return is complete and accurate and fully describes , in Part III , the organization's

programs and accomplishments.

What is the organization 's primary exempt purpose's

► DISPENSING INFORMATION

All organizations must describe their exempt purpose achievements in a clear and concise manner State the number

of clients served , publications issued , etc Discuss achievements that are not measurable (Section 501 ( c)(3) and (4)

organizations and 4947(a)(1) nonexempt charitable trusts must also enter the amount of grants and allocations to others

a THE COUNCIL PROMOTES THE PARTICIPATION OF MINORITY AND

WOMEN BUSINESSES AND THE EMPLOYMENT OF MINORITIES AND

WOMEN IN THE AIRPORT INDUSTRY.

(Grants and allocations $ If this amount includes foreign grants , check here ►b

(Grants and allocations $ If this amount includes foreign grants , check here ►

c

(Grants and allocations $ If this amount includes foreign grants , check here ►d

and allocations $ check here ►

Program ServiceExpenses

(Required for 501(c)(3) and(4) orgs, and 4947(a)(1)

trusts, but optional forothers I

e Other program services (attach schedule)

(Grants and allocations $ ) If this amount includes foreign grants, check here ► q

f Total of Program Service Expenses (should equal line 44, column ( B), Program services) ► 0Form 990 (2006)

DAA

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AMAC

Form990 (2006 ) AIRPORT MINORITY ADVISORY COUNCIL 62-1398266 Page4

Part IV Balance Sheets (See the instructions.)

Note : Where required , attached schedules and amounts within the description (A) (B)column should be for end -of-year amounts only. Beginning of year End of year

45 Cash-non-interest - bearing 20 9 , 147 45 55 , 957

46 Savings and temporary cash investments 38 , 302 46 41 , 693

47a Accounts receivable 47a

b Less : allowance for doubtful accounts 47b 47c

48a Pledges receivable 48a

b Less allowance for doubtful accounts 48b 48c

49 Grants receivable 49

50a Receivables from current and former officers , directors , trustees, and

key employees ( attach schedule) 50a

b Receivables from other disqualified persons (as defined under section 4958( f)(1)) and

persons described in section 4958(c)(3)(B) (att schedule) 50b

51a Other notes and loans receivable (attach

schedule) 51a

b Less allowance for doubtful accounts 51b 51cU)

52 Inventories for sale or use 52

53 Prepaid expenses and deferred charges 5354a Investments-publicly-traded

secunties See Statement 6 ► Cost FMV 138 , 930 54a 150 , 853b Investments-other securities ►

h lCost FMV 54b

(attach sc edu e)

55a Investments -land, buildings, andequipment . basis 55a

b Less accumulated depreciation (attach

schedule ) 55b 55c

56 Investments -other ( attach schedule) 56

57a Land , buildings , and equipment basis 57a 38 , 892

b Less . accumulated depreciation ( attach

schedule ) See Statement 7 57b 38 , 892 759 57c

58 Other assets, including program - related investments

(describe ► ) 58

59 Total assets ( must eq ual line 74 ) Add lines 45 throug h 58 387 , 138 59 248 , 503

60 Accounts payable and accrued expenses 60

61 Grants payable 61

62 Deferred revenue 62

U) 63 Loans from officers, directors , trustees , and key employees (attachm

schedule) 63

2 64a Tax-exempt bond liabilities ( attach schedule) 64a4

b Mortgages and other notes payable ( attach schedule) 64b

65 Other liabilities ( describe ► See Statement 8 ) 82 , 851 65 22 , 569

66 Total liabilities . Add lines 60 throug h 65 8 2 , 851 66 22 , 569

Organizations that follow SFAS 117, check here ► and complete lines

67 through 69 and lines 73 and 74

67 Unrestricted 67

r_ 68 Temporarily restricted 68

M 69 Permanently restricted 69mOrganizations that do not follow SFAS 117 , check here ► and

LL complete lines 70 through 74

0 70 Capital stock , trust principal , or current funds 70N; 71 Paid -in or capital surplus , or land , building , and equipment fund 71N

72 Retained earnings , endowment , accumulated income , or other funds 304 , 287 72 225 , 93473 Total net assets or fund balances (add lines 67 through 69 or lines

Z 70 through 72 (Column (A) must equal line 19 and column (B) must

equal line 21 ) 304 , 287 73 225 , 93474 Total liabilities and net assets/fund balances . Add lines 66 and 73 387 , 138 74 248 , 503

Form 990 (2006)

DAA

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AMAC

Form990(2006) AIRPORT MINORITY ADVISORY COUNCIL 62-1398266 Page5Part N.A Reconciliation of Revenue per Audited Financial Statements With Revenue per Return (See the

instructions.)a i otai revenue, gains, and other support per audited tinancial statements a G 3 L 14 1

b Amounts included on line a but not on Part I, line 12

1 Net unrealized gains on investments b1

2 Donated services and use of facilities b2

3 Recoveries of prior year grants b3

4 Other (specify)

b4

Add lines b1 through b4 b

c Subtract line b from line a c 232 , 14 1

d Amounts included on Part I, line 12, but not on line a:

1 Investment expenses not included on Part I, line 6b dl

2 Other (specify)

See Statement 9 d2 -54 , 790Add lines d1 and d2 d -54 , 79 0

e Total revenue (Part I, line 12) Add lines c and d ► e 17 7 , 3 51

Part tV-B Reconciliation of Expenses per Audited Financial Statements With Expenses per Returna Total expenses and losses per audited financial statements a 278 , 359b Amounts included on line a but not Part I, line 17-

1 Donated services and use of facilities b1

2 Prior year adjustments reported on Part I. line 20 b2

3 Losses reported on Part I, line 20 b3 7 , 4974 Other (specify):

b4

Add lines b1 through b4 b 7 , 497c Subtract line b from line a c 270 , 86 2

d Amounts included on Part I, line 17, but not on line a:

I Investment expenses not included on Part I, line 6b dl

2 Other (specify)

See Statement 10 d2 -22 , 655Add lines d1 and d2 d -22 , 65 5

e Total expenses (Part I, line 17) Add lines c and d ► e 248,207

Part V-A Current Officers, Directors, Trustees, and Key Employees (List each person who was an officer, director, trustee,or key employee at any time during the year even if they were not compensated ) (See the instructions )

(A) Name and address(B)

Title and aversga hours perweek devoted to position

(C) Compensation(If not paid , enter

_p_,

(D) Contributions to

deQerreddbenefit

satlon

(E) Expensecount and otherallowances

See Statement 11

Form 990 (2006)

DAA

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AMAC

Form990 2006 AIRPORT MINORITY ADVISORY COUNCIL 62- 1398266 Pa e6Part V-A Current Officers , Directors , Trustees , and Key Emp loyees (continued ) Yes No

75a Enter the total number of officers, directors, and trustees permitted to vote on organization business at board

meetings ► 20b Are any officers, directors, trustees, or key employees listed in Form 990, Part V-A, or highest compensated

employees listed in Schedule A, Part I, or highest compensated professional and other independent

contractors listed in Schedule A, Part II-A or II-B, related to each other through family or business

relationships? If "Yes," attach a statement that identifies the individuals and explains the relationship(s) 75b X

c Do any officers, directors, trustees, or key employees listed in Form 990, Part V-A, or highest

compensated employees listed in Schedule A, Part I, or highest compensated professional and other

independent contractors listed in Schedule A, Part II-A or II-B, receive compensation from any other

organizations, whether tax exempt or taxable, that are related to the organization? See the instructions for

the definition of "related organization." 75c X

If "Yes," attach a statement that includes the information described in the instructions. See Statement 12

d Does the organization have a written conflict of interest policy ? 75d X

Part V-Sr Former Officers, Directors, Trustees , and Key Employees That Received Compensation or Other Benefits

(If any former officer, director, trustee, or key employee received compensation or other benefits (described below) during the year, list that

person below and enter the amount of compensation or other benefits in the appropriate column See the instructions )

(A) Name and address ( B) Loans and Advances(C) Compensation

( if not paid,enter -0-

( D) Contributions to employbenefit plans & deferredcompensation p lans

( E) Expense

account and otherallowances

N/A

Part Vt Other Information ( See the instructions. ) Yes No76 Did the organization make a change in its activities or methods of conducting activities? If "Yes," attach a

detailed statement of each change 76 X

77 Were any changes made in the organizing or governing documents but not reported to the IRS? 77 X

78a

If "Yes," attach a conformed copy of the changes

Did the organization have unrelated business gross income of $1 , 000 or more during the year covered by

this return? 78a X

b If "Yes ," has it filed a tax return on Form 990-T for this year? 78b

79 Was there a liquidation , dissolution , termination , or substantial contraction during the year? If "Yes," attach

a statement 79 X

80a Is the organization related ( other than by association with a statewide or nationwide organization ) through

common membership , governing bodies, trustees , officers, etc , to any other exempt or nonexempt

organization? 80a X

b

81a

b

If "Yes," enter the name of the organization ► See Statement 13

and check whether it is X exempt or LI nonexempt

Enter direct and indirect political expenditures . ( See line 81 instructions) 81a

Did the organization file Form 1120-POL for this year? 1b X

Form 990 (2006)

DAA

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AMAC

AIRPORT MINORITY ADVISORY COUNCIL 62-13982

Part VI Other Information ( continued ) Yes No82a Did the organization receive donated services or the use of materials , equipment, or facilities at no charge

or at substantially less than fair rental value? 82a X

b If "Yes ," you may indicate the value of these items here Do not include this

amount as revenue in Part I or as an expense in Part II

(See instructions in Part III) 82b

83a Did the organization comply with the public inspection requirements for returns and exemption applications? 83a X

b Did the organization comply with the disclosure requirements relating to quid pro quo contributions ? N/A 83b

84a Did the organization solicit any contributions or gifts that were not tax deductible? 84a X

b If "Yes ," did the organization include with every solicitation an express statement that such contributions or

gifts were not tax deductible? N/A 84b

85 501 ( c)(4), (5), or ( 6) organizations a Were substantially all dues nondeductible by members"

,

85a X

b Did the organization make only in-house lobbying expenditures of $2,000 or less? 85b X

If "Yes" was answered to either 85a or 85b, do not complete 85c through 85h below unless the organization

received a waiver for proxy tax owed for the prior year

c Dues , assessments, and similar amounts from members 85c 127 , 857

d Section 162 ( e) lobbying and political expenditures 85d 67 , 254

e Aggregate nondeductible amount of section 6033( e)(1)(A) dues notices 85e 0

f Taxable amount of lobbying and political expenditures (line 85d less 85e ) 85f 67 254

g Does the organization elect to pay the section 6033(e) tax on the amount on line 85f? 85 X

h If section 6033 ( e)(1)(A) dues notices were sent , does the organization agree to add the amount on line 85f

to its reasonable estimate of dues allocable to nondeductible lobbying and political expenditures for the

following tax year? 85h X

86 501 ( c)(7) orgs Enter a Initiation fees and capital contributions included on line 12 86a

b Gross receipts , included on line 12 , for public use of club facilities 86b

87 501 ( c)(12) orgs Enter a Gross income from members or shareholders 87a

b Gross income from other sources ( Do not net amounts due or paid to other

sources against amounts due or received from them ) 87b

88a At any time during the year , did the organization own a 50% or greater interest in a taxable corporation or

partnership , or an entity disregarded as separate from the organization under Regulations sections

301 7701-2 and 301 7701-3" If "Yes," complete Part IX 88a X

b At any time during the year, did the organization, directly or indirectly , own a controlled entity within the

meaning of section 512(b)(13)" If " Yes," complete Part XI ► 88b X

89a 501 ( c)(3) organizations Enter Amount of tax imposed on the organization during the year under

section 4911 ► , section 4912 ► ; section 4955 ►b 501 ( c)(3) and 501 ( c)(4) orgs . Did the organization engage in any section 4958 excess benefit transaction

during the year or did it become aware of an excess benefit transaction from a prior year? If "Yes," attach

a statement explaining each transaction 89b

c Enter Amount of tax imposed on the organization managers or disqualified

persons during the year under sections 4912 , 4955 , and 4958 ►d Enter Amount of tax on line 89c , above , reimbursed by the organization . ►e All organizations At any time during the tax year , was the organization a party to a prohibited tax shelter

transaction? 89e X

f All organizations Did the organization acquire a direct or indirect interest in any applicable insurance contract? 89f X

g For supporting organizations and sponsoring organizations maintaining donor advised funds Did the

supporting organization , or a fund maintained by a sponsoring organization , have excess business holdings

at any time during the year? 89 X

90a List the states with which a copy of this return is filed ► None

b Number of employees employed in the pay period that includes March 12 , 2006 (See

instructions ) 1 90b I 2

91a The books are in care of ► SONIA SHACKLEFORD Telephone no ► 703-417-2622

Located at ► SAME AS RETURN, ZIP + 4 ► 20001

b At any time during the calendar year , did the organization have an interest in or a signature or other authority

over a financial account in a foreign country (such as a bank account, securities account , or other financial Yes No

account)? 91b 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 Foreign Bank

and Financial Accounts

DAA Form 990 (2006)

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AMAC

I AIRPORT MINORITY ADIPart VI Other Information ( continued ) Yes No

c At any time during the calendar year , did the organization maintain an office outside of the United States? 91c X

If "Yes," enter the name of the foreign country ►92 Section 4947( a)(1) nonexempt chartable trusts filing Form 990 in lieu of Form 1041 - Check here ► q

and enter the amount of tax-exempt interest received or accrued during the tax year ► 1 92

Part VII Analysis of Income-Producin g Activities ( See the instructions. )Note : Enter gross amounts unless otherwise Unrelate d business income Excluded by section 512 , 513, or 514 (E)

Indicated

93 Program service revenue

( A)Business code

(B)Amount

(C)Exclusiocode

(D )Amount

Related orexempt function

income

a

b

c

d

e

f Medicare/Medicaid payments

g Fees and contracts from government agencies

94 Membership dues and assessments 127 , 587

95 Interest on savings and temporary cash investments 14 437

96 Dividends and interest from securities 14 7 , 63997 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 assets other than inventory 14 , 182

101 Net income or ( loss) from special events

102 Gross profit or ( loss) from sales of inventory

103 Other revenue a

b CONFERENCE REGISTRATION/SPONS 21 , 050

c MISCELLANEOUS INCOME 3 , 956

d

e

104 Subtotal ( add columns (B), (D), and (E)) 0 1 1 8 , 076 1 166 , 775

105 Total (add line 104 , columns (B), (D), and (E)) ► 174 , 8 51

Note : Line 105 plus line le , Part I, should equal the amount on line 1 2, Part I

ment of Exempt Purooses (See the instructions.)Part VIII Relationship of Activities to the Accomplish

Line No .y

Explain how each activity for which income is reported in column ( E) of Part VII contributed importantly to the accomplishmentof the organization ' s exempt purposes (other than by providing funds for such purposes).

See Statement 14

Part IX Information Regardin g Taxable Subsidiaries and Disregarded Entities ( See the instructions. )(A) (B) (C) (D) (E)

Name, address, and EIN of corporation, Percentage of Nature of activities Total income End-of-yearoartnershio. or disregarded entity ownership interest assets

art X . Information Regarding Transfers Associate

(a) Did the organization, during the year, receive any funds, directly or

(b) Did the organization, during the year, pay premiums, directly or indi

Note : If "Yes" to (b), file Form 8870 and Form 4720 (see instructions)

DAA

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AMAC

Form990(2006 ) AIRPORT MINORITY ADVISORY COUNCIL 62- 1398266 Page9

Part XI Information Regarding Transfers To and From Controlled Entities . Complete only if the organizationis a cnntrnllinn nrnani7atinn as rip-fined in section 512(h)(13l_

Yes No

106 Did the reporting organization make any transfers to a controlled entity as defined in section 512(b)(13) of

the Code? If "Yes," complete the schedule below for each controlled enti ty X

(A) (B) (C)Name , address, of each Employer ID Description of

(D)

controlled entity Number transferAmount of transfer

a

b

c

Totals

Yes No

107 Did the reporting organization receive any transfers from a controlled entity as defined in section

512 b 13 of the Code? If "Yes," com plete the schedule below for each controlled enti ty . X

(A) (B) (C) (D)Name , address, of each Employer ID Description of

Amount of transfercontrolled entity Number transfer

a

b

c

Totals

Yes No

108 Did the organization have a binding written contract in effect on August 17, 2006, covering the interest,

rents, royalties, and a nnuities described in question 107 above?

Under penaltieand belief

PleaseSignHere

sag re

Type or p

s of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledgetrue, correct, and complete Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge

name

i AG

Check if Preparer ' s SSN or PTIN

/\ \ self- (See Gen Instr X)

(U / employed ► P00057083EIN ► 59-1835498Phone

no ► 407-425-4651

Paid signature R DePreparer's

irm's na SPEYUse Only F & DEXTER, P.A.(or you

if self-er^ioyed)' 72 0 RUGBY ST STE 220address, and + a ORLANDO, FL 32804-496

Form 990 (2006)

DAA

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AMAC

Form 4562 Depreciation and Amortization OMB No 1545-0172

( Including Information on Listed Property) 2006Department of the Treasury I IInternal Revenue Service Attachment

10' 67See separate instructions . 10 Attach to your tax return . Sequence No

Name ( s) shown on return AIRPORT MINORITY ADVISORY COUNCIL Identifying number

CORP 62-1398266Business or activity to which this form relates

Indirect DepreciationPart I Election To Expense Certain Property Under Section 179

Note : If you have any listed pro pe rty, com plete Part V before you complete Part I.1 Maximum amount See the instructions for a higher limit for certain businesses 1 108 , 000

2 Total cost of section 179 property placed in service (see instructions) 2

3 Threshold cost of section 179 property before reduction in limitation 3 430 , 000

4 Reduction in limitation . Subtract line 3 from line 2 If zero or less , enter -0- 4

5 Dollar limitation for tax year Subtract line 4 from line 1 If zero or less, enter -0- If married filing separatel y ,aratel , see instructions 5

( a ) Descri ption of p ro pe rty ( b ) Cost ( business use onl y)l (c ) Elected cost

6

7 Listed property. Enter the amount from line 29 7

8 Total elected cost of section 179 property Add amounts in column (c), lines 6 and 7 8 -

9 Tentative deduction Enter the smaller of line 5 or line 8 9

10 Carryover of disallowed deduction from line 13 of your 2005 Form 4562 10

11 Business income limitation Enter the smaller of business income (not less than zero) or line 5 (see instructions) 11

12 Section 179 expense deduction Add lines 9 and 10, but do not enter more than line 11 12

13 Carryover of disallowed deduction to 2007 Add lines 9 and 10, less line 12 ► 13

Note : Do not use Part II or Part III below for listed property Instead, use Part V

Part l ) Special Dep reciation Allowance and Other Depreciation ( Do not include listed prop rty. (See instructions. )

14 Special allowance for qualified New York Liberty or Gulf Opportunity Zone property (other than listed

property) placed in service during the tax year (see instructions) 14

15 Property subject to section 168(f)(1) election 15

16 Other dep reciation ( includin g ACRS 16 758

Part III MACRS Depreciation ( Do not include listed property.) (See instructions.)Section A

17 MACRS deductions for assets placed in service in tax years beginning before 2006 0

18 If you are electing to group any assets placed in service during the tax year into one or more general asset accounts, check here Poo n

17

Cnrtinn R_A¢cate Plarnrl in Rorvira Di.rinn 2nnR Tax Year tlsinn the General nanreciation System

(a) Classification of property(b) Month andyear placed in

service

(c) Basis for depreciation(business/investment use

only-see instructions

(d) Recoverypenod (e) Convention (f) Method (g) Depreciation deduction

19a 3-year p ro pe rty

b 5-year p ro pe rty

c 7-year p rope rty

d 10-ear prope rty

e 15 ear p ro pe rty

f 20 ear p ro pe rty

25 ear p rope rty 25 yrs S/L

In Residential rental 27.5 yr MM S/L

property 27 5 y rs MM S/L

i Nonresidential real 39 yrs MM S/Lproperty MM S/L

Section C_Assats Placed in Service During 2006 Tax Year Usina the Alternative Depreciation System

20a Class life S/L

b 12-year 12 yrs S/L

c 40-year 40 yrs. MM S/L

Part IV Summary ( see instructions )21 Listed property Enter amount from line 28 21

22 Total. Add amounts from line 12, lines 14 through 17, lines 19 and 20 in column (g), and line 21

Enter here and on the appropriate lines of your return. Partnerships and S corporations-see instr 22 .58

23 For assets shown above and placed in service during the current year,

enter the p ortion of the basis attributable to section 263A costs 23

For Paperwork Reduction Act Notice , see separate instructions . Form 4562 (2006)

DAA There are no amounts for Page 2

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AMAC AIRPORT MINORITY ADVISORY COUNCIL

62-1398266 Federal StatementsFYE: 12/31/2006

Statement 1 - Form 990 , Part I, Line 3 - Membership Dues and Assessments

Description Amount

MEMBERSHIP INCOME $ 127,587

Total $ 127,587

1

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AMAC AIRPORT MINORITY ADVISORY COUNCIL

62-1398266 Federal StatementsFYE: 12/31/2006

Statement 2 - Form 990 , Part I, Line 8c - Sale of Assets Other Than Inventory - Securities

Desc

How WhomRec'd Sold

Publicly Traded Securities

Total

Date Date Sale Cost & Gain/Acquired Sold Price Expense Deprec -Loss

$ 14,182 $ $ $ 14,182

$ 14,182 $ 0 $ 0 $ 14,182

2

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AMAC AIRPORT MINORITY ADVISORY COUNCIL

62-1398266FYE: 12/31/2006

Federal Statements

Statement 3 - Form 990, Line 20 - Other Changes in Net Assets or Fund Balances

Description Amount

Losses Reported on Return $ -7,497

Total $ -7,497

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AMAC AIRPORT MINORITY ADVISORY COUNCIL

62-1398266 Federal StatementsFYE: 12/31/2006

Statement 4 - Form 990, Part II, Line 25a - Compensation of Current Officers

Name

Expenses

DONNA SQUIRESCompensationBenefit Plan Contribution

SONIA SHACKLEFORDCompensationBenefit Plan Contribution

Total

Program Management &Services General

$ 0

$

33,5723,583

20,1342,148

$ 59,437

Fundraising

$

$ 0

4

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AMAC AIRPORT MINORITY ADVISORY COUNCIL

62-1398266 Federal StatementsFYE: 12/31/2006

Statement 5 - Form 990. Part II. Line 43 - Other Functional Exaenses

Total Program Mgt & Fund-Description Expenses Service General Raising

$ $ $ $Expenses

COMPUTER EXPENSES 17,012

CREDIT CARD FEES 4,496

OTHER 4,162

PROFESSIONAL FEES 67,254

Total $ 92,924 $ 0 $ 0 $ 0

5

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AMAC AIRPORT MINORITY ADVISORY COUNCIL62-1398266 Federal StatementsFYE: 12/31/2006

Statement 6 - Form 990 . Part IV. Line 54a - Publiciv Traded Securities

Beginning End of Basis ofDescription of Year Year Valuation

US and State Government $ $Corporate Stock

ALPINE GLOBAL DYN-500sh 11,500 MarketARIEL FUND-407.121sh 20,385 Market

ARIEL FU -435.455sh 22,561 MarketCALVERT SMALL CAP VALUE-977.511sh 15,112 18,143 MarketCALVERT WORLD VAL INT'L EQ-927.307sh 19,418 MarketCALVERT WRLD VAL INT'L EQ-1053.692sh 24,583 Market

MAINSTAY HIGH YIELD BOND A-1014.60sh 6,351 MarketMAINSTAY HIGH YIELD BOND A-1098.14sh 7,138 MarketMUNDER MICRO-CAP EQUITY A-500.167sh 21,622 MarketMUNDER MICRO-CAP EQUITY A-513.546sh 22,991 MarketOPPENHEIMER REAL ASSET A-2035.844sh 15,880 MarketPIMCO REAL RETURN BOND A-2298.591sh 25,468 MarketPIMCO REAL RETURN BOND A-2392.431sh 25,479 Market

THORNBURG INT'L VALUE A-626.343sh 14,694 MarketTHORNBURG INT'L VALUE A-648.112sh 18,458 Market

Corporate Bonds

Total $ 138,930 $ 150,853

Statement 7 - Form 990, Part IV, Line 57 - Land , Buildings , and Equipment

Beginning Accum End of AccumDescription of Year Deprec Year Deprec

$ 38,893 $ 38,134 $ 38,892 $ 38,892

Total $ 38,893 $ 38,134 $ 38,892 $ 38,892

Statement 8 - Form 990 , Part IV , Line 65 - Other Liabilities

Beginning End ofDescription of Year Year

DUE TO SCHOLARSHIP FUND $ 82,851 $ 22,569

Total $ 82,851 $ 22,569

6-8

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AMAC AIRPORT MINORITY ADVISORY COUNCIL

62-1398266 Federal StatementsFYE: 12/31/2006

Statement 9 - Form 990 , Part IV-A - Other Revenue Included on Return

Description Amount

ACCRUAL TO CASH BASIS RECEIVABLES $ -54,790

Total $ -54,790

Statement 10 - Form 990 , Part IV-B - Other Expenses included on Return

Description Amount

ACCRUAL TO CASH BASIS PAYABLES $ -22,655

Total $ -22,655

9-10

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AMAC AIRPORT MINORITY ADVISORY COUNCIL

62-1398266 Federal StatementsFYE: 12/31/2006

Statement 11 - Form 990 , Part V-A - List of Officers , Directors , Trustees, and KeyEmployees

Name and AverageAddress Title Hours Compensation

FARRAR-LUTEN, NEDRA CHAIR 1 0

PO BOX 20509

ATLANTA GA 30320

O'BANNON, DON 1st V CHAIR 1 0

PO BOX 619428DALLAS/FT WORTH AIRPOR TX 75261

BOCCIO, LYNN 2nd V CHAIR 1 0

3 HUNTINGTON QUAD., STE 102NMELVILLE NY 11747

ROTH, GENE TREASURER 1 0

600 CORPORATE PARK DRST LOUIS MO 63105

LINDSAY, BRENDA SECRETARY 1 0

PO BOX 280037COLUMBIA SC 29228

SWIFT, WILLIAM H PAST CHAIR 1 0

PO BOX 45896ATLANTA GA 30320

ALLEN, ROBERT DIRECTOR 1 0

121 PEARL STYPSILANTI MI 48197

BAKER, STEVEN DIRECTOR 1 0

1 AVIATION CIR, STE 156 .15WASHINGTON DC 20001

CASEY-BUFORD, SANDRA DIRECTOR 1 0ONE HARBORSIDE DR, STE 200SEAST BOSTON MA 02128

Benefits Expenses0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

11

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AMAC AIRPORT MINORITY ADVISORY COUNCIL

62-1398266 Federal StatementsFYE: 12/31/2006

Statement 11 - Form 990 , Part V-A - List of Officers, Directors, Trustees , and KeyEmployees (continued)

Name and AverageAddress Title Hours Compensation Benefits Expenses

CORRIN, MICHAEL DIRECTOR 1 0 0 0

8939 S SEPULVEDA BLVD, STE 100LOS ANGELES CA 90045

LAMAR, CASSANDRA DIRECTOR 1 0 0 0

2231 CRYSTAL DR, STE 300ARLINGTON VA 22202

MERCADO, SONIA DIRECTOR 1 0 0 0

225 BRAE BLVD

PARK RIDGE NJ 07656

MONCRIEF, DAN DIRECTOR 1 0 0 0

1069 WOODLAND AVCOLUMBUS OH 43219

PRIOLEAU, LEILA DIRECTOR 1 0 0 0

5950 FULTON INDUSTRIAL BLVD, SWATLANTA GA 30336

REEVES-HARRIS, JENNIFER DIRECTOR 1 0 0 0

AIRPORT OFFICE BLDG, ROOM 10810DENVER CO 80249

SMITH, RICKY DIRECTOR 1 0 0 0

PO BOX 81009CLEVELAND OH 44181

STEWART, APRYL DIRECTOR 1 0 0 0

6033 W CENTURY BLVD, STE 740LOS ANGELES CA 90045

THORNTON, COURTNEY DIRECTOR 1 0 0 0

701 POYDRAS ST, 45th FLOORNEW ORLEANS LA 70139

11

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AMAC AIRPORT MINORITY ADVISORY COUNCIL

62-1398266 Federal StatementsFYE: 12/31/2006

Statement 11 - Form 990 , Part V-A - List of Officers , Directors, Trustees , and KeyEmployees (continued)

Name and AverageAddress Title Hours Compensation Benefits Expenses

WADE, WILLIAM DIRECTOR 1 0 0 0

1 AIRPORT DR, BOX 45OAKLAND CA 94621

WEEDEN, KENNETH DIRECTOR 1 0 0 0

PO BOX 3113WILMINGTON NC 28406

SQUIRES, DONNA BUSINESS MGR 20 33,572 3,583 0

RONALD REAGAN WASHINGTON NAT'L AIRPWASHINGTON DC 20001

SHACKLEFORD, SONIA L ADMIN ASST 20 20,134 2,148 0

RONALD REAGAN WASHINGTON NAT'L AIRPWASHINGTON DC 20001

11

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AMAC AIRPORT MINORITY ADVISORY COUNCIL

62-1398266 Federal StatementsFYE: 12/31/2006

Statement 13 - Form 990 , Part VI , Line 80b - Name of Related Organization(s)

Name of related organization (s) Type

AIRPORT MINORITY ADVISORY COUNCIL ExemptEDUCATIONAL & SCHOLARSHIP PROGRAM

13

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Page 24: AMAC ', I 990 Return ofOrganization ExemptFromIncomeTax …990s.foundationcenter.org/990_pdf_archive/621/... · AMAC ', I Form 990 Departmentof the Treas Internal Revenue Service

AMAC

Form $868 Application for Extension of Time To File an(Rev April 2007 ) Exempt Organization Return OMB No 1545-1709

Department of the Treasury ► File a separate application for each return.Internal Revenue Service

• If you are filing for an Automatic 3-Month Extension , complete only Part I and check this box ►• If you are filing for an Additional ( not automatic ) 3-Month Extension , complete only Part II (on page 2 of this form).

Do not complete Part II unless you have already been granted an automatic 3-month extension on a previously filed Form 8868

Part I Automatic 3-Month Extension of Time . Only submit original (no copies needed).

Section 501 ( c) corporations required to file Form 990-T and requesting an automatic 6-month extension-check this box and

complete Part I only 10. U. .. .. .. ... ... .

All other corporations ( including 1120 -C filers), partnerships , REMICs , and trusts must use Form 7004 to request an extension oftime to file income tax returns.

Electronic Filing (e-file ). Generally , you can electronically file Form 8868 if you want a 3-month automatic extension of time to file

one of the returns noted below (6 months for section 501 ( c) corporations required to file Form 990-T) However , you cannot file Form

8868 electronically if (1) you want the additional ( not automatic) 3-month extension or (2) you file Forms 990-BL, 6069, or 8870, group

returns , or a composite or consolidated Form 990-T. Instead , you must submit the fully completed and signed page 2 (Part II) of Form

8868 . For more details on the electronic filing of this form , visit www irs gov/efile and click on e-file for Charities & Nonprofits.

Type or

print

File by thedue date forfiling yourreturn Seeinstructions

Name of Exempt Organization

AIRPORT MINORITY ADVISORY COUNCILCORP.

Number , street , and room or suite no . If a P 0 box , see instructions.RONALD REAGAN WASHINGTON NAT'L ARPTCity, town or post office , state, and ZIP code . For a foreign address, see instructions.WASHINGTON DC 20001

Employer identification number

62-1398266

Check type of return to be filed (file a separate application for each return).

X Form 990 Form 990-T (corporation)

Form 990-BL Form 990-T (sec. 401(a) or 408(a) trust)

Form 990-EZ Form 990-T (trust other than above)

Form 990-PF Form 1041-A

The books are in the care of ► DONNA SQUIRES

Form 4720

Form 5227

Form 6069

Form 8870

Telephone No. ► 7 0 3.- 417 - 2 6 2 2 FAXNo ►• If the organization does not have an office or place of business in the,United States , check this box ►• If this is for a Group Return , enter the organization ' s four digit Group Exemption Number (GEN) . If this is

for the whole group , check this box ► [] . If it is for part of the group, check this box attach

a list with the names and EINs of all members the extension will cover

1 I request an automatic 3-month (6 months for a section 501(c) corporation required to file Form 990-T) extension of time

until .8 /15/07 , to file the exempt organization return for the organization named above. The extension is

for the organization 's return for.

► XX calendar year 2 0 0 6 or

► tax year beginning , and ending

2 If this tax year is for less than 12 months, check reason- El Initial return El Final return El Change in accounting penod

3a If this application is for Form 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentative tax,

less any nonrefundable credits. See instructions. 3a $

b If this application is for Form 990-PF or 990-T, enter any refundable credits and estimated tax

payments made. Include any p rior year overpayment allowed as a credit. 3b $

c Balance Due . Subtract line 3b from line 3a. Include your payment with this form, or, if required,

deposit with FTD coupon or, if required, by using EFTPS (Electronic Federal Tax Payment

System ) . See instructions. 3c $

Caution. If you are going to make an electronic fund withdrawal with this Form 8868, see Form 8453-EO and Form 8879-EO

for payment instructions

For Privacy Act and Paperwork Reduction Act Notice, see Instructions . Form 8868 (Rev 4-2007)

DAA

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AMAC . , • .

Form 8868 ( Rev. 4-2007 Pa e 2

• If you are filing for an Additional ( not automatic ) 3-Month Extension , complete only Part ll and check this box ► X

Note . Only complete Part II if you have already been granted an automatic 3-month extension on a previously filed Form 8868

• If you are filing for an Automatic 3-Month Extension , complete only Part I (on page 1)

Part It Additional not automatic ) 3-Month Extension of Time . You must file on inal and one copy .Type or Name of Exempt Organization Employer identification numberprint AIRPORT MINORITY ADVISORY COUNCILFile by the CORP. 62-1398266extended Number , street , and room or suite no If a P 0 box , see instructions. For IRS use onlydue date forfiling the RONALD REAGAN WASHINGTON NAT' L ARPT

return See City, town or post office , state, and ZIP code For a foreign address , see instructionsinstructions WASHINGTON DC 20001Check tvoe of return to be filed (File a separate annhcation for each return)

X Form 990 Form 990-PF Form 1041-A Form 6069

Form 990-BL Form 990-T (sec 401 (a) or 408(a) trust ) Form 4720 Form 8870

Form 990-EZ Form 990-T ( trust other than above ) Form 5227

STOP ! Do not complete Part II if you were not already granted an automatic 3-month extension on a previously filed Form 8868.

• The books are in the care of ► DONNA SQUIRES

Telephone No. ► 703-417-2622 FAX No ►• If the organization does not have an office or place of business in the United States , check this box ►• If this is for a Group Return , enter the organization ' s four digit Group Exemption Number (GEN) If this is

for the whole group , check this box ► [] If it is for part of the group, check this box ► and attach a

list with the names and EINs of all members the extension is for

4 I request an additional 3-month extension of time until 11 / 15 / 0 7 .

5 For calendar year 2 0 0 6 , or other tax year beginning , and ending

6 If this tax year is for less than 12 months, check reason 11 Initial return Final return Change in accounting period

7 State in detail why you need the extension

Additional time is requested to gather information to prepare a completeand accurate return.

Ba

b

If this application is for Form 990-BL, 990-PF, 990-T. 4720, or 6069, enter the tentative tax,

less any nonrefundable credits See instructions

If this application is for Form 990-PF, 990-T, 4720, or 6069, enter any refundable credits and

estimated tax payments made Include any prior year overpayment allowed as a credit and any

amount paid previously with Form 8868

Er

c Balance Due. Subtract line 8b from line 8a Include your payment with this form, or, if required, deposit

with FTD coupon or , if required , by using EFTPS ( Electronic Federal Tax Payment System ) See instructions 8c $Signature and Verification

Under penalties of perjury, I declare that I have examined this form, including accompanying schedules and statements , and to the best of my knowledge and belief,it is true , correct , and complete , and that I am t onzed to prepare this form

/Jl) -O n . rt

_ _ .mow

11, ► ylNotice to Applicant . (To Be Completed by the IRS)

R We have approved this application Please attach this form to the organization ' s return

We have not approved this application . However, we have granted a 10-day grace period from the later of the date shown below or the due

date of the organization ' s return ( including any prior extensions ) This grace period is considered to be a valid extension of time for elections

otherwise required to be made on a timely return Please attach this form to the organization's return

jJ We have not approved this application After considering the reasons stated in item 7 , we cannot grant your request for an extension of time

to file We are not granting a 10-day grace period

R We cannot consider this application because it was filed after the extended due date of the return for which an extension was requested

Other

By

Alternate Mailing Address . Enter the address if you want the copy of this application for an additional 3-month extension

returned to an address different than the one entered above

Name

Type or

print

DAA

SAMPEY & DEXTER, P.A.

Title ►

Number and street ( include suite , room, or apt . no.) or a P.O. box number

720 RUGBY ST STE 220

City or town, province or state , and country (including postal or ZIP code)

ORLANDO FL 32804-4960

Form 8868 (Rev 4-2007)