Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax Form 990-EZ Department of the Treasury OMB No 1545-1150 Under section 501(c), 527, or 4947( a)(1) of the Internal Revenue Code ( except black lung benefit trust or private foundation) Spon ;onng organizations , and controlling organization as defined in section 512(bx13 ) must file Form 990 All other organizations with gross receipts less than $100, 000 and total assets less than $250, 000 at the end of the year may use this form 2006 Open to Public Inspection The orga nization rna y have to use a copy of this return to sates state rep ortin g re q uirements and ending For the 2006 calen dar year, or tax year beginning A SEP 1, AUG 31 2007 2006 Check D Employer identification number Pleese C Name of organization B 11 Address use IRS change leeel or Internal Revenue Service Odage Iai^n =Final return print or F armers' Mutual Fire & Aid Association 62-1124551 Room/suite E Telephone number see Specifi° Ins ru Number and street (or P.O. box, if mail is not delivered to street address) 158 S Co Rd 700 E City or town, state or country, and ZIP + 4 812-663-2220 F Group Exemption Number loo G Accounting method: ® Cash = Accrual Other ( s p ec ify) H Check ^ ® if the organization is not re q uired to attach Schedule B Form 990 990-EZ or 994P rAmended bons ____ a6on G reensbur g, IN 47240 • Section 501(c)(3) organizations and 4947( a)(1) nonexempt charitable trusts must attach a completed Schedule A ( Form 990 or 990-EZ). I J K Website : ^ N/A Or g anization typ e ( check only one ® 501 ( c ) 15 ( insert no. ) 0 4947 ( a )( 1 ) or 0 527 Check ^ E^l it the organization is not a section 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 Add lines 5b , 6b and 7b , to line 9 to determine g ross recei pts: if $ 100,000 or more, file Form 990 Instead of Form 990-EZ Mo. $ Revenue. Expenses . and Chances in Net Assets or Fund Balances (see Dave 47 of the instructions.) Part I I 2 3 4 cc c 4-C, 5a b c 6 a b c 7a b c 8 9 10 11 12 13 14 15 16 17 y Z 18 19 20 21 Contributions , grfts, grants , and similar amounts received Program service revenue including government fees and contracts Membership dues and assessments Investment income Gross amount from sale of assets other than inventory 5a Less: cost or other basis and sales expenses 5b Gain or ( loss) from sale of assets other than inventory ( line 5a less line 5b) (attach schedule) Special events and activities ( attach schedule ). If any amount is from gaming , check here ^ Gross revenue ( not including $ of contributions reported on line 1) 6a Less : direct expenses other than fundraising expenses 6b Net income or (loss) from special events and activities ( line 6a less line 6b) Gross sales of inventory , less returns and allowances 4 al Less: cost of goods sold Gross profit or (loss ) from sales of Inventory ( line 7a less line 7b ) 1 2 8 4 32 , 197. 27 , 278. 5c 6c .. `^ 7c 8 9 10 11 12 13 14 15 Other revenue ( describe No. Interest Income .• ^^_\ ^^^ V is ) m m K W Total revenue ( add lines 1 2 3 4 5c , 6c , 7c, and 8 ) Grants and similar amounts paid Benefits paid to or for members Salaries , other compensation, and employee benefits Professional fees and other payments to independent contractors Occupancy , rent, utilities , and maintenance Printing , publications , postage, and shipping Other expenses ( describe Ili- 4 , 919. 32 , 197 . 2 755 . 18 5 . 200 . \^,^,^ ` ®^^ \\ Q' _ See Statement 1 16 5 , 750. 8 890 . Part 22 23 24 Total exp enses ( add lines 10 throu g h 16 ) 17 Excess or (deficit ) for the year (line 9 less line 17) _ 18 Net assets or fund balances at beginning of year (from line 27, column (A)) (must agree with end -of-year figure reported on prior year 's return ) 19 Other changes in net assets or fund balances (attach explanation) 20 Net assets or fund balances at end of year ( combine lines 18 through 20 ) 21 valance Sheets - If Total assets on line 25, column (B) are $250,000 or more, file Form 990 instead of Form 990-EZ. II (See page 51 of the instructions .) ( A) Beginning of year 102 , 980. 22 23 24 23 , 307 . 102 , 980 . 126 , 287 . ( B) End of year Cash, savings , and investments Land and buildings Other assets ( 126 , 287. 126 , 287. 0. ) 25 Total assets 26 Total liabilities ( describe 10P. 27 Net assets or fund balances ( line 27 of column ( B) must agree with line 21) 123421 LHA For Privacy Act and Paperwork Reduction Act Notice , see the separate instructions . I1-19-07 1 102 , 980. 25 0. 26 102 , 980. 1 27 126 , 287. Form 990-EZ (2006) Form 990-EZ (2006) Farmers' Mutual Fire & Aid Association Part III Statement of Program Service Accomplishments ( See page 51 of the instructions.) What is the organ ization's primary exempt purpose? See Statement 2 Describe what was achieved in carrying out the organization 's exempt purposes. In a clear and concise manner, describe the services provided, the number of persons benefited , or other relevant information for each program title. 62-1124551 Page2 Expenses (Required for 53) and (4) organizations and 4947( a)(1) trusts ; optional for others.) 28 N/A (Grants $ If this amount includes forei gn g rants , check here 28a 29 (Grants $ If this amount includes forei gn g rants , check here 29a 30 Grants 31 Other program services ( attach schedule) (Grants $ If this amount includes forei gn g rants , check here If this amount includes forei g n g rants , check here 80a 31a 32 Total p rogram service exp enses ( add lines 28a through 31a) g2 - 0. Part IV List of Officers, Directors, Trustees, and Key Employees (A) Name and address (List each one even it not compensated See page 52 of the instructions) (B) Title and average hours per week devoted to position (C) Compensation (If not paid, enter -0-) (D) Contributions (E) Expense to employee account and benefit plans & deferred other allowances compensation See Statement 3 555. Part V I Other Information (Note the statement requirement in General Instruction V ) 33 Did the organization engage in any activity not previously reported to the IRS? If -Yes,- attach a detailed description of each activity 34 Were any changes made to the organizing or governing documents but not reported to the IRS? if 'Yes,' attach a conformed copy of the changes Yes No 33 34 X X If the organization had income from business activities, such as those reported on lines 2, 6, and 7 (among others), but not 35 reported on Form 990-T, attach a statement explaining your reason for not reporting the income on Form 990-T X 35a a Did the organization have unrelated business gross income of $1,000 or more or 6033(e) notice, reporting, and proxy tax requirements? 35b If Yes,' has it filed a tax return on Form 990 -T for this yeah N b 36 X 36 Was there a liquidation, dissolution, termination, or substantial contraction during the year? (If "Yes," attach a statement.) Enter amount of political expenditures, direct or indirect, as described in the instructions. ^ 37a 0. 37a 37b X b Did the organization file Form 1 120-POL for this year? Did the organization borrow from, or make any loans to, any officer, director, trustee, or key employee or were any such loans made in a prior 38a 38a X year and still unpaid at the start of the period covered by this return? 38b b If "Yes," attach the schedule specified in the line 38 instructions and enter the amount involved N/A 39 501(c)(7) organizations Enter 39a N/A a Initiation fees and capital contributions included on line 9 39b b Gross recei pts, included on line 9, for p ublic use of club facilities N/A Form 990-EZ (2006) 623431 01-19-07 2 Form 990 -EZ (2006) Farmers' Mutual Fire & Aid Association Part V Other Information (Note the statement requirement in General Instruction V.) (Continued) 62-1124551 Pagea 40a 501 (c)(3) organizations Enter amount of tax imposed on the organization during the year under: N/A N/A ; section 4955 ^ N/A ; section 4912 1p. section 4911 ^ b 501(c)(3) and (4) organizations 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 an explanation c Enter amount of tax imposed on organization managers or disqualified persons during the year under ^ sections 4912 , 4955, and 4958 . _ . ^ d Enter amount of tax on line 40c reimbursed by the organization e Al! organizations At any time during the tax year, was the organization a party to a prohibited tax shelter transaction? 41 List the states with which a copy of this return is filed. ^ None 42a The books are in care of ^ Tim Gauck Locatedat ^ 158 S Co Rd 700 E, Greensburg, At any time during the calendar year, did the organization have an interest in or Yes No 40b 0. 0. 40e X N Telephone no. ^ 812-663-2220 IN ZIP+4 ^ 47240 At any time during the calendar year, did the organization maintain an office out If "Yes," enter the name of the foreign country: ^ Section 4947(a)(1) nonexempt charitable trusts filing Form 990-EZ in It and enter the amount of tax-exempt interest received or accrued during the tax Form 990-EZ (2006) 623432 01-19-07 3 Farmers' Mutual Fire & Aid Association Form 990-EZ Other Expenses 62-1124551 Statement 1 Description Postage & Office Supplies Agent Commissions Amount Claims Total to Form 990-EZ, line 16 108. 5,112. 530. 5,750. Form 990-EZ Part III - Statement of Organization's Primary Exempt Purpose Statement 2 Explanation To provide lost cost fire and aid insurance to its members. Form 990-EZ Part IV - List of Officers, Directors, Trustees and Key Employees Statement 3 Title and Name and Address Avrg Hrs/Wk Compensation Employee Ben Plan Expense Contrib Account Charels Dieckmann 27080 Mid Rd - Batesville, Tim Gauck IN 47006 IN President 0.20 Secretary 75. 0. 0. 158 S Co Rd 700 E - Greensburg, 47240 Daniel Wilson 8.00 Director 80. 0. 0. 5425 S Co Rd 700 E - Greensburg, 47240 Clifford Meer 5843 E Co Rd 1500 N - Batesville, IN 47006 Robert Siebert 12081 N Co Rd 50 W - Batesville, 47006 Robert Krieger IN 0.20 Director 0.20 Director IN 0.20 Director 40. 0. 0. 80. 0. 0. 80. 0. 0. 13797 N Co Rd 100 W - Batesville, IN 47006 0.20 60. 0. 0. 4 Statement (s) 1, 2, 3 Farmers' Mutual Fire & Aid Association Cleo Narwold 12909 N State Rd 229 - Batesville, IN 47006 Daniel Westerfeld 3259 S Co Rd 1000 E - Batesville, IN 47006 Totals Included on Form 990-EZ, Director 0.20 Director 0.20 60. 555. 80. 62-1124551 0. 0. 0. 0. 0. 0. Part IV 5 Statement(s) 3 Farmers' Mutual Fire & Aid Association 62-1124551 FORM 990-EZ Information Regarding Transfers Associated with Personal Benefit Contracts Statement 4 A) Did the organization, during the year, receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? . . . . . . . . . . . . . . . . . . . . [ ] Yes [X] No B) Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? . . [ ] Yes [X] No 6 Statement(s) 4