Document dD5r6kK1y1EB7ddQMYaNgegYR

lefile GRAPHIC print - DO NOT PROCESS | As Filed Data - | DLN: 9349218800404ll Short Form OM B No 1545-1150 Form 990-EZ Department of the Treasury Internal Revenue Service Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code 2010 (except black lung benefit trust or private foundation) Sponsoring organizations of donor advised funds, organizations that operate one or more hospital facilities, and certain controlling organizations as defined in section 512(b)(13) must file Form 990 (see instructions) All other organizations with gross receipts less than $200,000 and total assets less than $500,000 at the end of the Open to Public year may use this form Inspection - The organization may have to use a copy of this return to satisfy state reporting requirements A For the 2010 calendar year, or tax year beginning 01-01-2010_________ , and ending 12-31-2010 B Check if applicable I Address change 1-- 1 Name change 1 Initial return C Name of organization ASBESTOS INFORMATION ASSOCIATIONNA Number and street (or P O box, if mail is not delivered to street address) Room/suite P O BOX 2227 1 Terminated 1 Amended return 1 Application pending City or town, state or country, and ZIP + 4 ARLINGTON, VA 222029227 D Employer identification number 13-2702826 E Telephone number (703) 560-2980 F Group Exemption Number G A ccou nting method Cash F A c c r u a l Other (specify) I W ebsite:^ N/A F )FJ Tax-Exempt status(check only one) -- 501(c)(3)^l 501(c)( ) -^(insert no 4947(a)(1) ori _ 527 H Check F ifthe organization is not required to attach Schedule B (Form 990, 9 9 0 -E Z , or 99 0 -P F ) K C h e c k H if the organization is not a s e c tio n 509(a)(3) supporting organization and its gross receipts are normally not more than $ 5 0 , 0 0 0 A Form 9 9 0 - E Z or Form 9 9 0 return is not required though Form 9 9 0 - N (e-po stc ard) may be required (see in structio n s) But if the organization c h o o s e s to file a return, be sure to file a com plete return__________________________________________________________________ L Add lines 5b, 6c, and 7b, to line 9 to determine gross receipts, If gross receipts are $200,000 or more, or if total assets (Part II, line 25, column (B) below) are $500,000 or more, file Form 990 instead of Form 990-EZ - $ 65,628 Part I Revenue, Expenses, and Changes in Net Assets or Fund Balances (See the instructions for Part i ) C h e ck if the organization used Schedule O to respond to any question in this Part I F.................................................... 1 Contributions, gifts, grants, and sim ilar amounts received .... 2 Program service revenue including government fees and contracts 2 3 M em bership dues and a s s e s s m e n t s ........................................................... 3 65,618 4 In v e s tm e n t i n c o m e ......................................................................................... 4 10 5a G ro s s amount from sale of a s s e t s other than inventory .... 5a b Less cost or other basis and sales expenses 5b c Gain or (loss) from sale of assets other than inventory (Subtract line 5b from line 5a) a> LC 6 Gaming and fundraising events a Gross income from gaming (attach Schedule G if greater than $15,000) ga 5c b Gross income from fundraising events (not including $ _of contributions from fundraising events reported on line 1) (attach Schedule G ifthe sum of such gross income and contributions exceed $ 1 5 , 0 0 0 ) ............................................ c Less direct expenses from gaming and fundraising events ... 6c d Net income or (loss) from gaming and fundraising events (Add lines 6 a and 6 b and subtract line 6 c) 6d 7a G ro s s s a le s of inventory, less returns and allowances .... 7a b L e s s c o s t of goods s o l d ................................................................... 7b c Gross profit or (loss) from sales ofinventory (Subtract line 7b from line 7a) 7c 8 O th e r revenue (d escribe in Schedule O ) .................................................... 9 Total revenue. A dd lines 1 , 2 , 3, 4, 5c, 6 d, 7c, and 8 .............................. 65,628 10 Grants and sim ilar amounts paid (list in Schedule O) 10 11 Benefits paid to or for m e m b e r s ............................................ 11 12 S alaries, other com pe nsation, and em ployee benefits 12 5 7 ,9 1 5 13 P ro fe s s io n al fees and other payments to independent con tracto rs 13 14 O c c u p a n c y , rent, utilities, and m a i n t e n a n c e .............................. 14 15 Printing, pu bli cations, postage, and shipping .... 15 16 O t h e r e x p e n s e s ( d e s c r i b e i n S c h e d u l e O ) .............................. 16 7,17 1 17 Total expenses. A dd lines 10 through 1 6 .............................. 17 6 5 , 0 8 6 18 E x c e s s o r ( d e f i c i t ) f o r t h e y e a r ( S u b t r a c t l i n e l 7 f r o m l m e 9 ) ............................................ 18 542 19 Net a s s e t s o rfu n d balance s at beginning of year (from line 27, column (A)) (must agree with en d-o f- ye ar figure reported on prior year's r e t u r n ) ........................................................... 19 2 3, 4 7 5 20 O t h e r c h a n g e s i n n e t a s s e t s o r f u n d b a l a n c e s ( e x p l a i n i n S c h e d u l e O ) .............................. 20 21 Net a s s e t s o rfu n d balance s at end of year C om bine lines 18 through 20 For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions. .... Cat No 106421 21 24,017 Form 990-EZ (2 0 1 0 ) Form 990-EZ (2010) Part II Balance Sheets C h e ck if the organization used Schedule 0 to respond to any question in this Part II Page 2 F (See the instructions for Part II ) (A) Beginning o fy e a r (B) E nd of year 22 C as h , savin gs, and i n v e s t m e n t s ................................................................... 2 5 , 1 0 0 22 24,780 23 Land and b u i l d i n g s ......................................................................................... 23 24 0 ther a s s e t s (describe in Schedule 0 ) ..................................... 1 , 0 0 0 24 1,500 25 Total a s s e t s ................................................................................................ 2 6 , 1 0 0 25 26,280 26 Total liabilities (d escribe in Schedule 0 ) .............................. 2 ,6 2 5 26 2,263 27 Net assets or fund balances (line 27 of column (B) must agree with line 21) 2 3,4 7 5 27 24,017 Part III Statement of Program Service Accomplishments C h e ck if the organization used Schedule 0 to respond to any question in this Part III F What is the organization's primary exempt p urpose7 PRO VIDIN G IN FO R M ATIO N ON ASB ES TO S -H EA LTH R ELA TIO N SH IP AND INDUSTRY EFFORTS TO ELIM INATE PO TEN TIA L PROBLEMS A S S O C IA TED WITH ASBESTOS DUST D escrib e what was achieved in carrying out the organization's exempt purposes In a cle a r and c o n c is e manner, describe the services provided, the number of persons benefited, and other relevant information for each program title Expenses (Required forsection 501 (c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts, optional for others ) 28 RE P O R T ED ON G O V E R N M E N T A C T I V I T I E S RE LA T I N G TO T H E A S B E S T O S I N D U S T R Y A P P E A R E D BEFORE G O VER N M EN TAL AGEN CIES AND PROVIDED WRITTEN COM M ENTS ON THE RULEMAKING PROCESS FOR STANDARDS AFFECTING THE INDUSTRY PRODUCED EMPLOYEE PAMPHLETS (Grants $ 0 ) If this amount includes foreign grants, check here r 28a 64,618 29 (Grants $ 30 If this amount includes foreign grants, check here r 29a (Grants $ ) If this amount includes foreign grants, check here r 30a 3 1 0 t h e r p r o g r a m s e r v i c e s ( d e s c r i b e i n S c h e d u l e O ) .................................................... (Grants $ ) If this amount includes foreign grants, check here r 31a 32 Total program service expenses (add lines 2 8 a through 3 1 a ) .............................. 32 Part IV List of Officers, Directors, Trustees, and Key Employees. List each one even if not compensated (See the instructions for Part IV ) 64,618 C h e c k if the organization used Schedule 0 to respond to any qu esti on in this Pa rt I V ............................................ (a) Name and ad dress (b) T i t 1e and average hours per week devoted to position (c) C o m p e n s a tio n (If not paid, enter -0-.) (d) C o ntr ibutio ns to em ployee benefit plans 8i deferred compensation (e) E xp en s e account and other allowances BO B J PIG G PO BOX ARLINGTO N,VA 22202 P R E S I D E N T &. TR E A S U R E R 40 00 54,000 00 G BERNARD COULOMBE PO BOX ARLINGTO N,VA 22202 D IR E C T O R 1 00 0 00 J E A N -M A R C LEBLO ND PO BOX ARLINGTO N,VA 22202 C H A I R M A N &. S E C R E T A R Y 1 00 0 00 Form 990-EZ (2 0 1 0 ) Form 990-EZ (2010) Part V Other Information (Note the statement requirements in the instructions for Part V.) C h e ck if the organization used Schedule 0 to respond to any question in this Part V .F 33 Did the organization engage in any acti vity not previously reported to the I R S 7 I f "Yes," provide a detailed de s c riptio n of ea ch ac ti vity in Schedule 0 ............................................................................... 33 34 Were any sig nifican t ch anges made to the organizing or governing d o c u m e n t s 7 If "Ye s ," atta ch a conformed copy of the amended do cu m en ts if they reflect a change to the organization's name Oth erw ise, explain the change on 34 Schedule 0 (see i n s t r u c t i o n s ) ............................................................................................................. 35 I f t h e organization had income from b u s in e s s a c tivitie s , su ch as th ose reported on lines 2, 6 a, and 7a (among others), but not reported on Form 9 9 0 - T , explain in Schedule 0 why the organization did not report the income on Form 9 9 0 - T ........................................................................................................................................... Yes Page 3 No No No a Did the organization have unrelated business gross income of $ 1 ,0 0 0 or more or was it a section 501(c)(4), 501 (c)(5), or 501(c)(6) organization subject to section 6033(e) notice, reporting, and proxy tax requirements7 35a b I f "Ye s ," has it filed a tax return on Form 990-T f o r t h is y e a r 7 (see inst r u c t i o n s ) .......................................... 35b 36 37a Did the organization undergo a liquidation, dissolution, termination, or significant disposition of net assets during the y e a r 7 I f "Yes," com plete app licab le parts o f S c h e d u le N ......................................................................... Enter amount of political expenditures, direct or indirect, as described in the instructions | 3 7 3 |_____________________ 0 36 No No b Did the organization file Form 1120-POL for this y e a r 7 ..................................................................................... 37b 38a Did the organization borrow from, or make any loans to, any officer, director, trustee, or key em ployee or we re any s u ch loans made in a p r io r y e a r and still outstanding at the end o ft h e tax y e a r c o v e r e d by this return7 38a No I f "Yes," com plete Schedule L, Part II and e n t e r t h e total amount involved 38b 39 Section 501(c)(7) organizations. Ente r a Initiation fees and capital co ntrib utions included on line 9 .............................. 39a b G ross receipts, included on line 9, for public use of club facilities . . . . 39b 40a Section 501(c)(3) organizations. Ente r amount of tax imposed on the organization during the year under section 4911 ___________________ 0_ , section 4912 ___________________ 0 , section 4955 ______________ Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in any section 4 9 5 8 e x c e s s benefit tran sactio n during the year or did it engage in an e x c e s s benefit t ra n sa ctio n in a prior year that has not been reported on any of its prior Forms 9 90 or 99 0 - E Z 7 I f "Y e s," com plete Sc hedule L, Part I . . . . 40b No Section 5 01(c)(3) and 5 0 1 ( c ) (4) organizations E n te ra m o u n t o fta x imposed on organization managers or disqualified persons during the year under sections 49 12, 4 9 5 5 , and 4 9 5 8 . . ____________________ S ec tio n 5 0 1 ( c )( 3 ) and 5 0 1 ( c ) (4) organ izations E n t e r a m o u n t o f t a x on line 4 0 c reimbursed by the o r g a n i z a t i o n ............................................................................................................. ________________ All organizations. A t any time during the tax year, was the organization a party to a prohibited tax shelter t r a n s a c t io n 7 I f "Ye s ," com plete Form 8 8 8 6 - T ........................................................................................... 40e No 41 List the states with which a copy of this return is filed ________________ 42a The organization's books are in care of STANFIELD & PHILLIPS LLC 15825 SHADY GROVE ROAD SUITE 40 Lo cate d at ROCKVILLE, MD___________________________________ Te le p h o n e no ^ (301) 5 1 9 - 3 2 8 0 Z I P + 4 P- 2 0 8 5 0 _________ b A t any time during the c a le ndar 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 a c c o u n t )7 I f " Y e s , " e n t e r t h e name o ft h e foreign country _________________________________________________________ See the instr uctio ns for e x c e ptio n s and filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts. c A t any time during the c a le ndar year, did the organization maintain an office outside o ft h e U S 7 42b Yes No No 42c No I f " Y e s , " e n t e r t h e name o ft h e foreign country _________________________________________________________ 43 S ec tio n 4 9 4 7 ( a ) ( 1 ) nonexempt charitable trusts filing Form 9 9 0 - E Z in lieu of Form 1041--C h e c k here and enter the amount of tax-exempt interest received or acc rued during the tax year . . . 43 r 44a Did the organization maintain any donor ad v ised fu n d s 7 I f "Yes ", Form 990 m u st be completed instead of Yes No Form 990-EZ. b Did the organization operate one or more hospital facilities during the year7 I f 'Yes,'Form 990 m ust be completed instead of Form990-EZ c Did the organization receive any payments for indoor tanning services during the year7 44a 44b No No 44c No d I f ' Y e s ' to line 4 4 c , has the organization filed a Form 7 2 0 to report th ese p a y m e n ts 7 I f 'No,' provide an explanation in Schedule O 44d Form 990-EZ (2 0 1 0 ) Form 99 0 -EZ (2010) Yes Page 4 No 45 Is any related organ ization a controlled entity o ft h e organization within the meaning of s e c tio n 5 1 2 ( b ) ( 1 3 ) 7 I f 'Yes,'Form 990 and Schedule R m ust be completed instead of Form990-EZ 45 No 45a Did the organization receiv e any payment from or engage in any tran s ac tio n with a controlled entity within the meaning o f s e c t i o n 5 1 2 ( b ) ( 1 3 ) 7 I f 'Yes,' Form 990 and Schedule R m u st be completed instead of Form990-EZ 45a No 46 Did the organization engage, directly or indirectly, in political campaign ac tivitie s on behalf of or in opposition to candidates for public office7 If "Yes," complete Schedule C, Part I 46 No 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 47-49b and 52. C h e c k if the organization used Schedule 0 to respond to any qu esti on in this Pa rt V I .................................................... I Yes No 47 Did the organization engage in lobbying a c t i v i t i e s 7 I f "Yes," com plete Schedule C, Pa rt II 48 Is the organ ization a s c h o o l de scribed in s e c tio n 17 0 ( b ) ( l )(A )(n)7 I f "Yes," complete Schedule E 49a Did the organization make any transfers to an exempt n on-charita ble related organ iz atio n 7 b If "Yes," was the related organization a section 527 organization7 47 48 49a 49b No No No 50 C o m plete this table fo r th e organization's five high est c o m p e n s ate d em plo yees ( o th e rt h a n officers, dire ctors, tr u stees and key em ployees) who each received more than $ 1 0 0 , 0 0 0 of com pensation from the organization If there is none, enter "None " (a) Name and addre ss o f e a c h employee paid more than $ 1 0 0 , 0 0 0 (b) T i t 1e and average hours per week devoted to position (c) C o m p e n s a tio n (d) C o ntr ibutio ns to employee benefit plans & deferred compensation (e) E xp en s e account and other allowances NONE 50(f) T o t a l n u m b e r o f o t h e r e m p l o y e e s p a i d o v e r $ 1 0 0 , 0 0 0 ......................................................................................... 51 C o m plete this table fo r th e organization's five high est c o m p e n s ate d independent co n trac to rs who ea ch received more than $ 1 0 0 , 0 0 0 of com pensation from the organization If there is none, enter "None " (a) Name and addre ss o f e a c h inde pendent c o n tra c t o r paid more than $ 1 0 0 , 0 0 0 (b) T y p e of s e rv ic e (c) C o m p e n s a tio n NONE 51(d) T o t a l n u m b e r o f o t h e r i n d e p e n d e n t c o n t r a c t o r s e a c h r e c e i v i n g o v e r $ 1 0 0 , 0 0 0 ............................................ __________________ 52 Did the organ ization com plete Schedule A 7 NOTE: A ll S ec tio n 5 0 1 ( c )( 3 ) organ izations and 4 9 4 7 ( a ) ( 1 ) nonexempt charitable trusts must atta ch a com plete d Schedule A ................................................................................................................... p" Yes | No 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 T Signature of officer L MR BOB J PIGG PRESIDENT &TREASURER W Type or print name and title Paid Preparer's L signature P ANDREW PHILLIPS CPA Preparer's Firm's name (or yours L STANFIELD & PHILLIPS LLC Use Only if self-employed), W address, and ZIP +4 ' 15825 SHADY GROVE ROAD 40 Date 2011-07-06 ROCKVILLE, MD 20850 May the IRS d iscuss this return with the preparer shown above7 See instructions 2011-07-07 Date Check if self- employed | Preparer's taxpayer identification number (See instructions) EIN Phone no (301) 519-3280 F FYes No Form 990-EZ ( 2 0 1 0 ) Ilefile GRAPHIC m n t - DO NOT PROCESS I As Filed Data - SCHEDULE A (Form 990 or990EZ) Department of the Treasury Internal Revenue Service Public Charity Status and Public Support Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust. ____ A tta ch to Form 990 or Form 990-EZ. See separate instructions.____ DLN:93492188004041 0 M B No 1545-0047 2010 Open to Public Inspection Name ofthe organization ASBESTOS INFORMATION ASSOCIATIONNA Employer identification number 13-2702826 Part I Reason for Public Charity Status (All organizations must complete this part.) See instructions_________ The organization is not a private foundation b ecause it is (For lines 1 through 11, c h e c k only one box ) 1 r A church, conventio n of churches, or a s s o c ia t io n of churches described in section 170(b)(l)(A)(i). 2 r A school described in section 170(b)(l)(A)(ii). (Attach Schedule E ) 3 r A hospital or a cooperative hospital service organization described in section 170(b)(l)(A)(iii). 4 r A medical resea rch organization operated in conjunction with a hospital d e scribed in section 170(b)( 1)(A)(iii). E n t e rt h e hospital's name, city, and state 5 r A n organization operated for the benefit of a college or university owned or operated by a governmental unit d e scribed in section 170(b)(l)(A)(iv). (Complete Part II ) 6 r A federal, state, or local government or governmental unit described in section 170(b)(l)(A)(v). 7 r An organization that normally receives a substantial part of its support from a governmental unit or from the general public de scribed in section 170(b)(l)(A)(vi) (Complete Part II ) 8 r A community trust described in section 170(b)(l)(A)(vi) (Complete Pa rt II ) 9F A n organization that normally receiv es (1) more than 33 1/3% of its s u p p o r tfr o m co ntrib utions, members hip fees, and gross receipts from a c tiv itie s related to its exempt fu n c t io n s -- su bje ct to certain ex c e p tio n s , and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 197 5 See section 509(a)(2). (Complete Part III ) r10 A n organization organized and operated e x c lu s ive ly to te st for public safety Seesection 509(a)(4). r11 A n organization organized and operated e x c lu s ive ly for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) o r s e c t i o n 509(a)(2) See section 509(a)(3). C he ck the box that describes the type of supporting organization and complete lines l i e through l l h a | Type I b | Type II c | Type III - Functionally integrated d | Type III - Other re By ch eckin g this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified pe rsons oth erth an foundation managers and o therthan one or more publicly supported organizations described in section 509(a)(1) or section 50 9 (a)(2) f I f the organization received a written determination from the IRS that it is a T y p e I, T y p e II o r T y p e III supporting organization, rc h e ck this box g Since A u g u st 17, 2 0 0 6 , has the organization accepted any gift or contribution from any ofthe following persons7 ___________ (i) a person who directly or indirectly controls, either alone or togeth er with pe rsons de scribed in (n) Yes No and (in) below, the governing body o ft h e the supported organiz ation 7 (M) a family me mber of a person de scribed in (i) a b o v e 7 (iii) a 35% controlled entity o f a person de scribed in (i) or (n ) a b o v e 7 iig() iig(ii) iig(iii) h Provide the following information about the supported orgamzation(s) () Name of s upported organization (iii) (v) Type of Is the organization organization in () (described on col (i) listed in EIN lines 1 -9 above your governing or IRC section document7 (see instructions)) Yes No (v) Did you notify the organization in col (i) of your s upport7 Yes No (vi) Is the organization in col (i) organized in the U S 7 Yes No (vii) A mount of s upport Total F o r P ap erw o rk Reduction A c t Note e, seethe In structions for Fo rm 990 C at No 11 28 5 F Sc hedule A (Form 990 o r 990-EZ) 2010 Schedule A (Form 990 or 9 9 0 - E Z ) 2 01 0 Page 2 Part II Support Schedule for Organizations Described in Sections 170(b)(l)(A)(iv) and 170(b)(1) (A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.) Section A. Public Support Calendar year (or fi scal year beginning in) 1 Gifts, grants, contributions, and membership fees received (Do not include any "unusual grants ") 2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf 3 The value ofservices orfacilities furnished by a governmental unit to the organization without charge (a) 2 0 0 6 (b) 2 0 0 7 (c) 2 0 0 8 (d) 2 0 0 9 (e) 2 0 1 0 (f) Total 4 Total. Add lines 1 through 3 5 The portion o ft o t a l co ntrib utions by each person (otherthan a governmental unit or publicly supported organization) included on line 1 that exceeds 2 % ofthe amount shown on line 1 1 , column (f) 6 Public Support. S ub tra ct line 5 from line 4 Section B. Total Support Calendar year (or fi scal year beginning in) (a) 2 0 0 6 (b) 2 0 0 7 (c) 2 0 0 8 (d) 2 0 0 9 (e) 2 0 1 0 (f) Total 7 Amounts from line 4 8 Gross income from interest, dividends, payme nts received on securities loans, rents, royalties and income from similar sources 9 Net income from unrelated business activities, whether or not the busin ess is regularly carried on 10 O th e r income Do not include gam or loss from the sale of capital assets (Explain in Part IV ) 11 Total support (Add lines 7 through 1 0 ) 12 G ro s s receipts from related activitie s, etc (See instr uctio ns ) 12 13 First Five Years If the Form 9 9 0 is fo r th e organization's first, seco n d, third, fourth, or fifth tax y e a r a s a 5 0 1 ( c )( 3 ) organization, c h e c k this box and stop here ! Section C. Computation of Public Support Percentage_________________________ i__ 14 P u b l i c S u p p o r t P e r c e n t a g e f o r 2 0 1 0 ( l i n e 6 c o l u m n ( f ) d i v i d e d b y l i n e l l c o l u m n ( f ) ) 14 15 Public Support P e rc en tage for 2 0 0 9 Schedule A, Part II, line 14 15 16a b 17a b 18 33 1/3% support test -- 2010. I f t h e organization did not c h e c k the box on line 13, and line 14 is 33 1/3% or more, c h e c k this box rand stop here. T h e organization qualifies as a publicly supported organization 33 1/3% support te s t-- 2009. I f t h e organization did not c h e c k the box on line 13 or 16a, and line 15 is 33 1/3% or more, c h e c k this rbox and stop here. Th e organization qualifies as a publicly supported organization 10%-facts-and-circumstances test -- 2010. I f t h e organization did not c h e c k a box on line 13, 16a, or 16 b and line 14 is 1 0 % or more, and if th e organ ization meets the "facts and c i r c u m s t a n c e s " test, c h e c k this box and stop here. Explain in Part IV how the organization meets the "facts and c ir c u m s t a n c e s " te st The organization qualifies as a publicly supported ro r g a n i z a t i o n 10%-facts-and-circumstances test -- 2009. I f t h e organization did not c h e c k a box on line 13, 16a, 16b, or 17a and line 15 is 10% or more, and ifth e organization meets the "facts and c i r c u m s t a n c e s " test, c h e c k this box and stop here. Explain in Part IV how the organization meets the "facts and c ir c u m s t a n c e s " te st The organization qualifies as a publicly supported organization r Private Foundation I f t h e organization did not c h e c k a box on line 13, 16a, 16b, 17a or 17b, c h e c k this box and see instructions r Schedule A (Form 990 or 990-EZ) 2010 Schedule A (Form 990 or 9 9 0 - E Z ) 2 01 0 Page 3 Part III Support Schedule for Organizations Described in Section 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)_____ Section A. Public Support Calendar year (or fi scal year beginning in) (a) 2 0 0 6 (b) 2 0 0 7 (c) 2 0 0 8 (d) 2 0 0 9 (e) 2 0 1 0 (f) Total 1 Gifts, grants, contributions, and membership fees received (Do not 81,774 82,004 70,875 75,693 75,406 385,752 include any "unusual grants ") 2 Gross receipts from admissions, merchandise sold or services performed, or fa cilitie s furnished in any activity that is related to the organization's tax-exempt purpose 3 Gross receipts from activities that are not an unrelated trade or business under section 513 4 Tax revenues levied forthe organization's benefit and either paid to or expended on its behalf 5 The value ofservices orfacilities furnished by a governmental unit to the organization without charge 6 Total. Add lines 1 through 5 81,774 82,004 70,875 75,693 75,406 385,752 7a A m o u n ts included on lines 1, 2, and 3 received from disqualified 0 persons b Am ounts included on lines 2 and 3 received from other than disqualified persons that exceed 0 the greater o f $ 5 , 000 or 1% ofthe amount on line 13 fo rth e year c Add lines 7a and 7b 0 8 Public Support (Subtract line 7c from line 6 ) 385,752 Section B. Total Support Calendar year (or fi scal year beginning in) 9 Amounts from line 6 (a) 2 0 0 6 81,774 (b) 2 0 0 7 82,004 (c) 2 0 0 8 70,875 (d) 2 0 0 9 75,693 (e) 2 0 1 0 75,406 (f) Total 385,752 10a Gross income from interest, dividends, payments received on securities loans, rents, royalties 535 480 122 15 10 1,162 and income from similar sources b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975 c Add lines 10a and 10b 535 480 122 15 10 1,162 11 Net income from unrelated business activities not included in line 1 0 b, whether or not the bu s in es s is regularly carried on 12 O th e r income Do not include gain or loss from the sale of capital a s s e t s (Explain in Part 2,267 2,267 IV ) 13 Total support (Add lines 9, 10c , 1 1 and 1 2 ) 82,309 82,484 73,264 75,708 75,416 389,181 14 First Five Years I f t h e Form 9 9 0 is fo r th e organization's first, seco n d, third, fourth, or fifth tax y e a r a s a s e c t i o n 5 0 1 ( c ) ( 3 ) organization, c h e c k this box and stop here ! Section C. Computation of Public Support Percentage 15 Public Support P e rc en tage for 2 0 1 0 (line 8 column (f) divided by line 13 column (f)) 16 Public support percentage from 2 0 0 9 Schedule A, Pa rt I I I , line 15 15 99 120 % 16 99 0 50 % Section D. Computation of Investment Income Percentage 17 In v e s tm e n t income percentage for 2010 (line 10c column (f) divided by line 13 column (f)) 17 0 3 0 0 % 18 In v e s tm e n t income percentage from 2009 Schedule A, Part III, line 17 18 0 3 9 0 % 19a b 20 33 1/3% support tests-- 2010. I f t h e organization did not c h e c k the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, c h e c k this box and stop here. T h e organ ization qualifies as a publicly supported organization F 33 1/3% support tests-- 2009. I f t h e organization did not c h e c k a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, c h e c k this box and stop here. Th e organization qualifies as a publicly supported organization r Private Foundation I f t h e organization did not c h e c k a box on line 14, 19a or 19b, c h e c k this box and see instructions r Schedule A (Form 990 or 990-EZ) 2010 Schedule A (Form 990 or 9 9 0 - E Z ) 2 01 0 Page 4 Part IV Supplemental Information. Supplemental Information. Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).________ _____________________________________________ Facts And Circumstances Test Schedule A (Form 990 or 990-EZ) 2010 lefile GRAPHIC print - DO NOT PROCESS | As Filed Data - | DLN: 9349218800404ll SCHEDULE 0 (Form 990 or990-EZ) Department of the Treasury Internal Revenue Service Supplemental Information to Form 990 or 990-EZ Complete to provide information for responses to specific questions on Form 990 or to provide any additional information. A ttach to Form 990 or 990-EZ. 0 M B No 1545-0047 2010 O pen to Public I n s p e c tio n Name of the organization ASBESTOS INFORMATION ASSOCIATIONNA Employer identification number 13-2702826 Id e n tifie r OTHER INVESTM ENT INCOME R eturn R efere n ce FO R M 9 9 0 -E Z , P A R T I, LINE 4 E x p la n a tio n INTEREST INCOME 10 Id e n tifier OTHER EXPENSES R eturn R eferen ce FORM 990-EZ, P A R T I, LINE 16 E x p la n a tio n DESCRIPTION OFFICE EXPENSES A M O U N T 3 ,5 8 5 DESCRIPTION T A X E S & LICENCES A M O U N T 651 DESCRIPTION T R A V E L A M O U N T 1,798 DESCRIPTION P A Y R O L L SERVICES A M O U N T 1,137 T O T A L TO FORM 990-EZ, LIN E 16 7,171 Id e n tifie r OTHER ASSETS R eturn R e fere n ce E x p la n a tio n FO R M 9 9 0 -E Z , P A R T II, LINE DESCRIPTIO N A C C O U N T S R E C E IV A B L E BE G O F Y E A R A M O U N T 1 ,0 0 0 END O F Y E A R 24 A M O U N T 1,500 Id e n tifie r OTHER LIABILITIES R eturn R efere n ce E x p la n a tio n FO R M 9 9 0 -E Z , P A R T II, LINE 26 DESCRIPTION P A Y R O L L T A X E S BEG O F Y E A R A M O U N T 2 ,6 2 5 END O F Y E A R A M O U N T 2 ,2 6 3 lefile GRAPHIC print - DO NOT PROCESS | As Filed Data - | TY 2010 Transfers Personal Benefits Contracts Declaration DLN:934921880040411 Name: ASBESTOS INFORMATION ASSOCIATIONNA EIN: 1 3 -2 7 0 2 8 2 6 Declaration: THE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT.