Florida Department of Agriculture & Consumer Services ADAM ... · register annually with the...

Florida Department of Agriculture & Consumer Services ADAM H. PUTNAM, Commissioner Division of Consumer Services PO Box 6700 Tallahassee FL 32314-6700

May 21, 2012

ORLANDO MUSIC CLUB C/O LISA MOORE 802 FOX VALLEY DR LONGWOOD, FL 32779-2510

SUBJECT: SOLICITATION OF CONTRIBUTIONS ANNUAL REGISTRATION Registration Number: CH14301 Expiration Date: July 25, 2012

DTN: 2385248 CH14301

Division of Consumer Services

First Floor, Mayo Building

Post Office Box 6700

Tallahassee, Florida 32314-6700

1-800-HELP-FLA

FAX 850-410-3804

Your annual state registration as a charitable organization or sponsor under the Solicitation of Contributions Act is NOW DUE AND PAY ABLE. Pursuant to Chapter 496, Florida Statutes, charitable organizations and sponsors are required to register annually with the Department of Agriculture and Consumer Services. In addition, you are required to provide financial information for the immediately preceding fiscal year by filing the Department's financial report form or a complete copy of your Internal Revenue Service Form 990 and Schedule A, or your Form 990-EZ.

Enclosed for your convenience is a pre-printed Renewal Registration Form with registration information from your last annual registration. Please note any changes by crossing out the incorrect information and entering the correct information in ink. Return it with the registration fee and financial information to the Department at P.O. Box 6700, Tallahassee, Florida 32314-6700. Your registration application MUST BE RECEIVED BEFORE your current registration expires.

PLEASE BE ADVISED that if it is determined you are operating as a charitable organization or sponsor in violation of Chapter 496, Florida Statutes, the Department will seek its available legal remedies against you. Failure to comply with this law will subject you to a cease and desist order and monetary fines up to $1,000 per violation.

If you have any questions, please contact this office at (800) 435-7352, or (850) 488-2221 if calling from outside Florida.

Enclosures

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Sincerely,

ADAM H. PUTNAM COMMISSIONER OF AGRICULTURE

12

DTN: 2385248 CH14301

July 25, 2012

DTN: 2385248 CH14301

Solicitation of Contributions DTN: 2473380Org Code: 42100625000Object Code: 001133

Solicitation of Contributions DTN: 2385248Org Code: 42100625000Object Code: 001133

For online payments, visit www.FreshFromFlorida.comMake check payable to FDACS and remit applications to:

FL Department of Agriculture & Consumer ServicesPO Box 6700Tallahassee FL 32314-6700

www.800helpfla.com1-800HELP-FLA(435-7352)(FL Only)1-850-4882221 Callin outside FLFax: 1-850-410-3804

______________________________________________________________

__________________________________

17. Does the charitable organization or sponsor employ a Professional Solicitor?

.DTN: 2385248 CH14301

D YES D NO If yes, complete Attachment A-1, and provide a copy of current contract.

18. Does the charitable or sponsor organization employ a Professional Fundraising Consultant?

D YES D NO If yes, complete Attachment A-2, and provide a copy of current contract.

19. Are you filing as a parent organization?

D YES D NO If yes, complete Attachment C.

20. If sponsor, answer the following:

a. Does the membership consist of members who are individuals of whom at least 10% or 100 members, whicheveris less, are actively employed as law enforcement officers or emergency service employees by an agency of theUnited States, this state, a municipality, or a political subdivision of this state, and who personally sign writtenmembership agreements with the organization and pay an annual membership of not less than $10 a member?

□ YES □ NO

b. Total number of sponsor's members: ________________________ _

c. Total number of members actively employed as law enforcement or emergency service employees: __ _d. Percentage of total net contributions which are dispersed in the state on behalf of its members in the

furtherance of its stated purposes or programs ( defined as the total amount of all contributions raised minusthe total cost of expenses incurred in raising contributions solicited): _________ %

21. Person Responsible for completing renewal application.

Name: _______ _______ ___________ _ please print

Daytime Phone#: ______________ _

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DTN: 2385248 CH14301

REVENUE1. Contributions, gifts grants or similar amounts received

a. Direct public support (attach list of solicitors/co-venturers & amounts, if any) 1a. 495.87 b. Indirect public support (attach list of sources and amounts) 1b. 4,600.00 c. Grants (attach list of sources and amounts) 1c.d. Total (add lines 1a, 1b, & 1c) 1d. 5,095.87 2. Inventory salesa. Gross sales (Cookboks & Tote Bags) 2a. 490.00b. Less cost of goods sold 2b. 749.96c. Gross profit (or loss) (line 2a less line 2b) 2c. -259.963. Special events and fundraising activitiesa. Gross revenue (not including contributions reported on line 1) 3a. 2,932.99 b. Less direct expenses 3b. 2,130.37 c. Net income (or loss) (line 3a less line 3b) 3c. 802.62 4. Program service revenue 4. 2,915.005. Membership dues and assessments 5. 3,395.006. Sale of assets other than inventorya. Gross sales 6a.b. Less sales expenses 6b.c. Net gain (or loss) (line 6a less line 6b) 6c. 0

7. In-Kind Contributions and Services 7.

8. Other revenue (attach list of sources and amounts) 8. 5,090.949. TOTAL REVENUE (add lines 1d, 2c, 3c, 4, 5, 6c, 7 & 8) 9. 17,039.47

EXPENSES10. Program services (including payments to affiliates) 10. 6,083.8111. Management & general 11. 837.0212. Fundraising 12.13. TOTAL EXPENSES (add lines 10,11, & 12) 13. 6,920.83

NET ASSETS14. Excess (or deficit) for the year (line 9 less line 13) 14. 10,118.6415. Net assets or fund balance at beginnng of year 15. 6,765.6916. Net assets or fund balance at end of year (add lines 14 & 15) 16. 16,884.33

Balance Sheet:(A) Beginning of

Year (B) End of Year

Cash, savings and investments $ 6,765.69 $ 12,539.03 Land and buildingOther assets (describe on separate sheet)Total assets $ 6,765.69 $ 12,539.03 Total liabilities (describe on separate sheet)Total assets or fund balance $ 6,765.69 $ 12,539.03

(Line 15) (Line 16)

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STATEMENT OF SUPPORT/REVENUE AND EXPENSES FOR THE CALENDAR YEAR 12/31/_______ OR YEAR ENDING 6 / 3 0 / 1 2

NOTE: In lieu of completing the following financial statement, you may send the IRS 990 with Schedule A or 990-EZ.

Is this a consolidated financial statement? Yes No x

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DTN: 2385248 CH14301

(A) Total (sum of B, C, D)

(B) ProgramServices

(C) Managementand General

(D) Fundraising

Grants & Allocations (cash _____ non-cash _____) (attach schedules)Assistance to individuals (attach schedule)Benefits to members (attach schedule)

Compensation to officers, etc.

Other salaries, wages, etc.

Other benefits, pensions, etc.

Payroll taxes

Professional fundraising fees

PayPalAccounting fees 48.92 48.92

Legal fees

Office Supplies 56.68 - 56.68Telephone Internet Expense 9.95 - 9.95

Postage and shipping 25.45 25.45 -Post Office BoxEquipment rental - - -Meeting room rentalOccupancy - - -

Printing 62.68 22.64 40.04

Travel - - -

Conferences and meetings 178.19 - 178.19Interest (Paypal & Bank Charges) 39.74 39.74 -Benevolences Insurance 195.00 150.00

Other (describe) Dues-FFMC & Lake 659.00 659.00Other (describe)

Honoraria & Awards 371.00 371.00Other (describe)

NFMC Festival Bulletins - - Other (describe)

Florida Registration Fee 10.00 10.00Other (describe) Scholarship Awards 3,152.00 3,152.00Other (describe) Fees for Judges, Administrators 1,799.78 1,799.78Other (describe) Recital Expense 188.04 65.80 122.24Other (describe) Lunch for Judges 169.40 169.40

Total Expenses $ 6,965.83 $ 6,083.81 $ 837.02

Statement of Functional Expenses

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DTN: 2385248 CH14301

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DTN: 2385248 CH14301 ..........

REVENUE

7. Other revenue (attach list of sources and amounts) 7. 5,090.94

Awards 4,600.00

Interest 0.94

Insignia Pins 0.00

Cookbook Sales 490.00

Albertson's Community Partners 0.00

NFMC Festival Bulletins 0.00

This image cannot currently be displayed. STATEMENT OF SUPPORT/REVENUE AND EXPENSES FOR THE CALENDAR YEAR

12/31/_______ OR YEAR ENDING 6 /3 0 /1 2

NOTE: In lieu of completing the following financial statement, you may send the IRS 990 with Schedule A or 990-EZ.

Is this a consolidated financial statement? Yes No x

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