Short Form OMB No. 1545-0047 rom 990-EZ Retum of Organization Exempt From Income Tax Under section 501,527, or 4947(t) ofthe intemal Revenue Code (except private foundations) > Donot enter social security numbers on this form, as it may be made public. CTEM AML aera ratte bones mntagooPeri7 wraancane atta tet oat a XK For the 2010 calendar year, or tax year beginning Tayi 278, andl ending Tone 30 1220 B cescreocanie Employer igentication number Lracnacmee [Roanoke Chowan Services for Abused Fans wth Emergencies 01677050 Crereome Taree ont (YP Bar ral Ses Set es) — [ROWS TRS ra Arse 400 Peacock Street (98273321933 Ey rmcrrwretet Syrian seo ROOF, and BPS Poe | aap oareem nostle,NC27910 Nomber > Ed “Oiher eect) 1 Ohack & Clifthe organization fo not requred to attach Scheauo BE (Form 990, 990-£7, or 990-PF) G Accounting Method: (Gash TT Accrual 1 Website: roanokechowansafe.com J Tax-exempt status check cry one) ~ Tel sov(ef@)_CI601(@)(—_) 4 feat na) C] 04749) or _L1527| K Form of organization: Corporation —L] Trust Association “Other {Aaa toss, 6 and 79 Ine 9 tere ges roses. fame oe $20 00 or ir aaa (ar colar (3) aw $500.00 or move Fom 90 nee of fom EZ, ne [EHX _Fevenue, Expenses, and Changes in Net Assets or Fund Balances G00 the istructions Tor Pa Check if the organization used Schedule O to respond to any question in this Part! . . - Oo TE] 1 Contributions, gifts, grants, and similar amounts received 1 765171.00 | 2 Program service revenue including government fees and contracts 2 ° Z| 3 Membership dues and assessments z 0 Bl 4 Investment income Ste ‘ 4 ° Sa Gross amount fom solo of asots other han ventoy | |S. La Less costo other basis and sales expenses» 3 5 Gain or oss) rom sale of assets other han inventory (ubtrac ine Sb ro ne Ba) 7 [se ° 6° Gaming and funarising overt 2 Ses nce fom gama ach Sade utr ten 3 $15,000) 3] > rose income tom untaling evens et nucng Dot contbalans | tom fundaising events reported on ine) atach Schedule G We bum of such gross income and contriutons exceeds S15000) - = | gb E © Less: rect expenses tom gaming and tunceising events... [ee E 4 Neticome re fom ging ard nan oe Gin 8 ond Ban Bae fess) a ea 0 7a. Gross sals of inventory, lees etuns and alowancoe eee zal b Less: cost of goods sold 7b c © Goer rotons om ei finan oie ott a= | 0 8 Omrerrevense(descrbein ScheddloO)s se see st ll LS 3 9 Totalrevenue.Addtnes 1,2,9,4,50,60,7o.and8 oS | ! an) ween 10 Grants and similar amounts paid (list in Schedule O) “section <5 > Section 501(6}, S01), and 601(cV2) organizations, Bid the organization engage in any section 4058 {excess benefit transaction during the year, oF ai it engage in an excess benef transaction in a prior oar that has not been rapeted onan of its prior Forms 990 or ®80-£2? I Ves," complete Schedule L, Parti [ano] |v gy Section 501(0(},801(6(, and 501(3(28) organizations. Enter amount of tax imposed Gn rvanzaton maragers mui persons an he yor nd stone 42 4965, and 4958 > Section 501(6K8), S014), and 5016/26 organizations “Enter amount of tax on ine 40e rimbursed By the organization. ae Al organizations. At any time during the tax year, was the cremation apary toa 2 reba x aor transaction? "Yes," complete Form 8866-T aoe) Lis the sites with which a copy ofthis returns flod > ‘The organization's books aren care of Tn Telephone no. > Located at > ZP +a > z At any te dui te calandr Var, dhe organalion havea ret a Vga or other authority Over” [Yes No 8 nencial account in ferign court (euch asa bank account, secures account, roterfencil ecoount? (Bm) ae If-Y6s." enter the name a the foreign country See the instructions for exceptions and ing requirements Yor FRCEN Form 174, Repor of Foroign Banana inancial Accounts (FBAR). ‘At any tie during the calendar year, dd the orgerization maintain an offce outside the United States? [azo| | wv if Yea" enter the name of the foreign curity Section 4947(at) nonexemptchartable uss fling Form 900-EZ in iou of Form 1041 Check here >o and enter the amount of tax-exempt interest received or accrued during the tx year = > Las | Yes] No Oi he ergarintion main any donor edie turds ding the year? Yon Form 999 mut bo completed insta of Form 990-62 wal |v Did the organization operate one or more hospital facies dns the year i "Yes." Fom 980 must be completed instead of Form 002. v Did te organization receive any payments for indoor tanning services curing the year? fase] [7 Yar ne t,t the area led a Fom 720 to report these pee? 1h” provide an explanation in SoneduleO ; aa) |v Did the organization havea cotroled ently within the meaning ot section S1200K15}2 a0) tw Di the organization receive any payment rom or engage in any transaction wit a controlled entity within the rang of wert S141 I ee” Form G60 and Schedule Fay non oe completed stead ot Form 990-F7. Sea nsinictons . se = las] lv Form 990-EZ gov)Fen 99082 (2019) Page Yes] No 46 Did the organization engage, directly or incirectly, in political campaign activities on behalf of or in opposition [EI to candidates for public office? “Yes,” complete Schedule G,Patl. .. - 46 v ‘Seotion 01(0){) Organizations Al section 501(c)(8) organizations must answer questions 47-49 and 52, and complete the tables for lines 50 and 51 ‘Only Check ifthe organization used Schedule O to respond to any question inthisPatVI_ ws... Ne 47 Did the organization engage in lobbying activities or have @ section 501(h) election in effect during the tax year? If*Yes," complete Schedule C, Part I ei sa i sees a7 v ‘48 isthe organization a school as described in section 170(b)1)AN(N? H*Yes,” complete Schedule E . . 8 v 49a Did the organization make any transfers to an exempt non-charitable related organization? . . | |. [aal 7 b_ If "Yes." was the related organization a section 527 organization? . 49 v Yes ‘50 Complete this table forthe organization's fve highest compensated employees (other than officers, directors, trustees, and kay employees) who each received more than $100,000 of compensation trom the organization If there is none, ener None,” 12 et eras Aeron (2 Peorase (ane at och ertoee impr Crete ome Etna anc ot cerca posten | rors Waroneans, frets adored) “ther comparetan 1 Total number of ther employees pald over $100,000 7 ‘81 Complete this table for the organization's five highest compensated independent contractors who each received more than {$100,000 of compensation from the organ ization. If there isn one, enter "None." (2) Nam are business adress of ach eseperdnt contactor By Typecteardoe (© compensaton| 4 Total number of other independent contractors each receiving over $100,000. ‘82 Did the organization complete Schedule A? Note: All ‘completed Schedule A Under penalties pein cartel have exraned ha ru, ac tee, cet and complet, Decratlon ot prepare other an oc 2 section 50%(c\3) organizations must attach a > es No ng accompanying achodlee and sateen, nd tothe bes oy knowlege end bb to onal armen of which repre has Sy knowledge. ai ae Tas Sign » ‘Signature of of Date Here Christopher Farmer, SerTreasurar BD iyps orp are anc i Paid PiVipe peoaersnane Papers aaa ome Gentle Preparer Ssteonoine Use Only |Frmsrama_> Finis oN > Fem’ ada rene. May ihe IRS ciscuss ths refum with the proparer shown above? Ses Wsinslins ee Yes ENO Fam 990-EZ ois)