Short Form OMB No. 1545-1150
Form 990-EZ Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code
(except black lung benefit trust or private foundation)
2009
G Sponsoring organizations of donor advised funds and controlling organizations as defined in section 512(b)(13) must file Form
990. All other organizations with gross receipts less than $500,000 and total assets less than $1,250,000 at the end of the year
Department of the Treasury may use this form. Open to Public
Internal Revenue Service G The organization may have to use a copy of this return to satisfy state reporting requirements. Inspection
A For the 2009 calendar year, or tax year beginning 7/01 , 2009, and ending 6/30 , 2010
B Check if applicable: C D Employer identification number
Please
Address change use IRS ROTARY INT'L LYNNWOOD ROTARY CLUB 91-6055948
Name change label or
print or PO BOX 6754 E Telephone number
Initial return type.
See
LYNNWOOD, WA 98036 425.670.1310
Termination Specific
Amended return Instruc-
tions. F Group Exemption
Application pending Number. . . . . . . . . . . . G 0573
?Section 501(c)(3) organizations and 4947(a)(1) nonexempt charitable trusts G Accounting method: Cash X Accrual
must attach a completed Schedule A (Form 990 or 990-EZ). Other (specify) G
H Check G X if the organization is not
I Website: G WWW.LYNNWOODROTARY.ORG required to attach Schedule B (Form 990,
J Tax-exempt status (check only one) ' X 501(c) ( 4 ) H (insert no.) 4947(a)(1) or 527 990-EZ, or 990-PF).
K Check G if the organization is not a section 509(a)(3) supporting organization and its gross receipts are normally not more than
$25,000. A Form 990-EZ or Form 990 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 gross receipts; if $500,000 or more, file Form 990
G$ 57,313.
instead of Form 990-EZ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Part I Revenue, Expenses, and Changes in Net Assets or Fund Balances (See the instructions for Part I.)
1 Contributions, gifts, grants, and similar amounts received. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2 Program service revenue including government fees and contracts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 39,706.
3 Membership dues and assessments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 16,580.
4 Investment income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 282.
5a Gross amount from sale of assets other than inventory . . . . . . . . . . . . . . . . . . . . 5a
b Less: cost or other basis and sales expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5b
R
E
c Gain or (loss) from sale of assets other than inventory (Subtract ln 5b from ln 5a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5c
V 6 Special events and activities (complete applicable parts of Schedule G). If any amount is from gaming, check here . . . . . . . G
E
N a Gross revenue (not including $ of contributions
U
E reported on line 1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6a
b Less: direct expenses other than fundraising expenses . . . . . . . . . . . . . . . . . . . . 6b
c Net income or (loss) from special events and activities (Subtract line 6b from line 6a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6c
7a Gross sales of inventory, less returns and allowances . . . . . . . . . . . . . . . . . . . . . 7a 65.
b Less: cost of goods sold. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7b
c Gross profit or (loss) from sales of inventory (Subtract line 7b from line 7a). . . . . . . . . . . . . . . . . . . . . . . . . . . . 7c 65.
8 Other revenue (describe G SEE STATEMENT 1 ). . 8 680.
9 Total revenue. Add lines 1, 2, 3, 4, 5c, 6c, 7c, and 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G 9 57,313.
10 Grants and similar amounts paid (attach schedule). . . . . . . . . . . . . . . . . . . . . . . .SEE . .STATEMENT . .2. . . . . .... ............. . 10 3,884.
E
11 Benefits paid to or for members. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
X
P
12 Salaries, other compensation, and employee benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 4,720.
E 13 Professional fees and other payments to independent contractors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 400.
N
S 14 Occupancy, rent, utilities, and maintenance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
E
S 15 Printing, publications, postage, and shipping. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 179.
16 Other expenses (describe G SEE STATEMENT 3 ). . . . 16 58,759.
17 Total expenses. Add lines 10 through 16. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G 17 67,942.
18 Excess or (deficit) for the year (Subtract line 17 from line 9) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 -10,629.
A
N S 19
Net assets or fund balances at beginning of year (from line 27, column (A)) (must agree with end-of-year
E S figure reported on prior year's return). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 38,818.
T E
T 20 Other changes in net assets or fund balances (attach explanation) . . . . . . . . .SEE . .STATEMENT . .4. . . . . 20 .... ............. . -610.
S
21 Net assets or fund balances at end of year. Combine lines 18 through 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . G 21 27,579.
Part II Balance Sheets. If Total assets on line 25, column (B) are $1,250,000 or more, file Form 990 instead of Form 990-EZ.
(See the instructions for Part II.) (A) Beginning of year (B) End of year
22 Cash, savings, and investments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52,331. 22 51,851.
23 Land and buildings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
24 Other assets (describe G SEE STATEMENT 5 ). . . . . . . . . . . . . . . . . . . . 28,799. 24 23,645.
25 Total assets. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81,130. 25 75,496.
26 Total liabilities (describe G SEE STATEMENT 6 ). . . . . . . . . . . . . . . . . . 42,312. 26 47,917.
27 Net assets or fund balances (line 27 of column (B) must agree with line 21) . . . . . . . . . . . 38,818. 27 27,579.
BAA For Privacy Act and Paperwork Reduction Act Notice, see separate instructions. Form 990-EZ (2009)
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2.
Form 990-EZ (2009) ROTARY INT'L LYNNWOOD ROTARY CLUB 91-6055948 Page 2
Part III Statement of Program Service Accomplishments (See the instructions.) Expenses
What is the organization's primary exempt purpose? COMMUNITY SERVICE (Required for section
501(c)(3) and (4)
Describe what was achieved in carrying out the organization's exempt purposes. In a clear and concise manner, organizations and section
describe the services provided, the number of persons benefited, or other relevant information for each 4947(a)(1) trusts; optional
program title. for others.)
28 PROVIDES A FORUM FOR COMMUNITY ISSUES AT WEEKLY LUNCHES. SERVES AS
PARENT ORGANIZATION FOR BENEFICIAL ACTIVITIES IN LOCAL COMMUNITY AS
WELL AS INTERNATIONAL.
(Grants $ 3,884. ) If this amount includes foreign grants, check here. . . . . . . . . . . . . . . . G 28 a 54,875.
29
(Grants $ ) If this amount includes foreign grants, check here . . . . . . . . . . . . . . .
. G 29 a
30
(Grants $ ) If this amount includes foreign grants, check here . . . . . . . . . . . . . . . G . 30 a
31 Other program services (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
.
(Grants $ ) If this amount includes foreign grants, check here . . . . . . . . . . . . . . . G . 31 a
32 Total program service expenses (add lines 28a through 31a). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G 32 54,875.
Part IV List of Officers, Directors, Trustees, and Key Employees. List each one even if not compensated. (See the instrs.)
(b) Title and average hours (c) Compensation (If (d) Contributions to (e) Expense account
(a) Name and address per week devoted not paid, enter -0-.) employee benefit plans and and other allowances
to position deferred compensation
STAN MCKENZIE DIRECTOR 0. 0. 0.
PO BOX 6754 3.00
LYNNWOOD, WA 98036-0754
KIM BOURKE DIRECTOR 0. 0. 0.
PO BOX 6754 2.00
LYNNWOOD, WA 98036-0754
JEFFREY GOODWIN VICE PRESIDENT 0. 0. 0.
PO BOX 6754 2.00
LYNNWOOD, WA 98036-0754
JODY WESTFALL TREASURER 0. 0. 0.
PO BOX 6754 4.00
LYNNWOOD, WA 98036-0754
ANDREW BALLARD PRESIDENT 0. 0. 0.
PO BOX 6754 5.00
LYNNWOOD, WA 98036-0754
DON ANDREWS SECRETARY 0. 0. 0.
PO BOX 6754 3.00
LYNNWOOD, WA 98036-0754
LISA GALLUCCI DIRECTOR 0. 0. 0.
PO BOX 6754 2.00
LYNNWOOD, WA 98036-0754
NICOLA SMITH DIRECTOR 0. 0. 0.
PO BOX 6754 2.00
LYNNWOOD, WA 98036-0754
TERESA POALUCCI DIRECTOR 0. 0. 0.
PO BOX 6754 2.00
LYNNWOOD, WA 98036-0754
BARBARA EARL DIRECTOR 0. 0. 0.
PO BOX 6754 2.00
LYNNWOOD, WA 98036-0754
VICKIE KOZUCK DIRECTOR 0. 0. 0.
PO BOX 6754 2.00
LYNNWOOD, WA 98036-0754
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3.
Form 990-EZ (2009) ROTARY INT'L LYNNWOOD ROTARY CLUB 91-6055948 Page 3
Part V Other Information (Note the statement requirements in the instrs for Part V.)
Yes No
33 Did the organization engage in any activity not previously reported to the IRS? If 'Yes,' attach a detailed description of
each activity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 X
34 Were any changes made to the organizing or governing documents? If 'Yes,' attach a conformed copy of the changes . . 34 X
35 If the organization had income from business activities, such as those reported on lines 2, 6a, and 7a (among others), but not reported on Form 990-T,
attach a statement explaining why the organization did not report the income on Form 990-T.
a Did the organization have unrelated business gross income of $1,000 or more or was it subject to section 6033(e) notice,
reporting, and proxy tax requirements?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 a X
b If 'Yes,' has it filed a tax return on Form 990-T for this year? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 b
36 Did the organization undergo a liquidation, dissolution, termination, or significant disposition of net assets during the
year? If 'Yes,' complete applicable parts of Schedule N. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 X
37 a Enter amount of political expenditures, direct or indirect, as described in the instructions . G 37 a 0.
b Did the organization file Form 1120-POL for this year? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 b X
38 a 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 year and still outstanding at the end of the period covered by this return? . . . . . . . . . . . . . . 38 a X
b If 'Yes,' complete Schedule L, Part II and enter the total
amount involved . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 b N/A
39 Section 501(c)(7) organizations. Enter:
a Initiation fees and capital contributions included on line 9. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 a N/A
b Gross receipts, included on line 9, for public use of club facilities . . . . . . . . . . . . . . . . . . . . . . . . . 39 b N/A
40 a Section 501(c)(3) organizations. Enter amount of tax imposed on the organization during the year under:
section 4911 G N/A ; section 4912 G N/A ; section 4955 G N/A
b Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in any section 4958 excess benefit
transaction during the year or is it aware that it engaged in an excess benefit transaction with a disqualified person in a
prior year, and that the transaction has not been reported on any of the organization's prior Forms 990 or 990-EZ? If
'Yes,' complete Schedule L, Part I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 b X
c Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax imposed on organization
managers or disqualified persons during the year under sections 4912, 4955, and 4958. . . . . . . . G 0.
d Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax on line 40c reimbursed
by the organization. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G 0.
e All organizations. At any time during the tax year, was the organization a party to a prohibited tax
shelter transaction? If 'Yes,' complete Form 8886-T . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 e X
41 List the states with which a copy of this return is filed G NONE
42 a The organization's
books are in care of G FRIENDS AND HARVEY ASSOC. INC. Telephone no. G 425-670-1310
Located at G 19721 SCRIBER LAKE RD #C, LYNNWOOD, WA LYNNWOOD WA ZIP + 4 G 98036-6119
b At any time during the calendar year, did the organization have an interest in or a signature or other authority over a Yes No
financial account in a foreign country (such as a bank account, securities account, or other financial account)? . . . . . . . . . 42 b X
If 'Yes,' enter the name of the foreign country: . . G
See the instructions for exceptions and filing requirements for Form TD F 90-22.1, Report of a Foreign Bank and Financial Accounts.
c At any time during the calendar year, did the organization maintain an office outside of the U.S.?. . . . . . . . . . . . . . . . . . . . . . 42 c X
If 'Yes,' enter the name of the foreign country: . . G
43 Section 4947(a)(1) nonexempt charitable trusts filing Form 990-EZ in lieu of Form 1041 ' Check here . . . . . . . . . . . . . . . . . . . . . . G N/A
and enter the amount of tax-exempt interest received or accrued during the tax year. . . . . . . . . . . . . . . . . . . . . G 43 N/A
Yes No
44 Did the organization maintain any donor advised funds? If 'Yes,' Form 990 must be completed instead
of Form 990-EZ. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 X
45 Is any related organization a controlled entity of the organization within the meaning of section 512(b)(13)? If 'Yes,'
Form 990 must be completed instead of Form 990-EZ. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 X
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4.
Form 990-EZ (2009) ROTARY INT'L LYNNWOOD ROTARY CLUB 91-6055948 Page 4
Part VI Section 501(c)(3) organizations and section 4947(a)(1) nonexempt charitable trusts only. All section
501(c)(3) organizations and section 4947(a)(1) nonexempt charitable trusts must answer questions
46-49b and complete the tables for lines 50 and 51.
Yes No
46 Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates
for public office? If 'Yes,' complete Schedule C, Part I. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
47 Did the organization engage in lobbying activities? If 'Yes,' complete Schedule C, Part II . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
48 Is the organization a school as described in section 170(b)(1)(A)(ii)? If 'Yes,' complete Schedule E . . . . . . . . . . . . . . . . . . . . . 48
49 a Did the organization make any transfers to an exempt non-charitable related organization?. . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 a
b If 'Yes,' was the related organization a section 527 organization? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 b
50 Complete this table for the organization's five highest compensated employees (other than officers, directors, trustees and key
employees) who each received more than $100,000 of compensation from the organization. If there is none, enter 'None.'
(b) Title and average (c) Compensation (d) Contributions to employee (e) Expense
(a) Name and address of each employee paid hours per week benefit plans and account and
more than $100,000 devoted to position deferred compensation other allowances
f Total number of other employees paid over $100,000 . . . . . . . G
.
51 Complete this table for the organization's five highest compensated independent contractors who each received more than $100,000 of
compensation from the organization. If there is none, enter 'None.'
(a) Name and address of each independent contractor paid more than $100,000 (b) Type of service (c) Compensation
d Total number of other independent contractors each receiving over $100,000 . . . . . . . . . . . . G
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is
true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign
Here G Signature of officer Date
ANDREW BALLARD PRESIDENT
G Type or print name and title.
Date Preparer's Identifying Number
Check if (See instructions)
Paid Preparer's
signature G JOHN W FRIENDS, CPA 11/08/10
self-
employed G P00166522
Pre-
parer's Firm's name (or FRIENDS AND HARVEY ASSOCIATES, INC
yours if self-
Use employed), G 19721 SCRIBER LAKE ROAD, STE C G 20-3587891
EIN
address, and
Only ZIP + 4 LYNNWOOD, WA 98036 (425) 670-1310
Phone no. G
May the IRS discuss this return with the preparer shown above? See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G X Yes
. No
BAA Form 990-EZ (2009)
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