Fo~990

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)

Department 01 the Treasury

tnt",nal Revenue ServIce ~ The organization may have to use a copy of this retum to satisfy state reporting requirements

2008

OMS No 1545-0047

Open to Public Inspection

B Check II applicable

A For the 2008 calendar year, or tax year beginning JUL 1 2008 and ending JUN 30 2009

O"'ddress change

OName change

Olnlllal return

OTermlnanon

OAmended

return City or town, state or country, and ZIP + 4

O~~~:: 1-_...J!:S::.:A~L::.:E=:M~~O::.:R~_-=9:...7.!...:3:..1:...:7 -------------I H(a) Is this a group return

F Name and address of pnncipal offlcer:RAY FALGOUT for affiliates? DYes [XJ No

4890 32ND AVE SE SALEM, OR 97317 H(b) Are all atnhates Included? DYes ONo

--------~~~~~~~~~~~~~==~7=~~~~~~~--------~

I Tax-exempt status: [XJ 501 (c) ( 3 J .... (Insert no) 0 4947(a)(1) or 0527 If "No," attach a list (see Instructions)

J Website: ~ N / A H(c) Group exem_Qtlon number ~

Domo Business As

Please C Name of organization use IRS

label Of

print or CHRISTIAN COMMUNITY

type

PLACEMENT CENTER

94-3112571

o Employer Identification number

See Number and street (or P.O. box If maills not delivered to street address) iRoom/sUite E

Specihc

Instruc- 4890 32ND AVE SE

nons

Telephone number

(503)588-5647

3 163 889.

G Gross receipts $

K Type of organization: [XJ Corporation D Trust D Assocanon D Other ~ 1 L Year of formation: 19881 M State of legal domicile: OR

1 Part II Summary

Bnefly descnbe the organization's mission or most Significant activities' PROCTOR CARE / COUNSELING YOUTH

B 1
e
co
c: 2
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Q)
:l' 3
0
<.? 4
~
III 5
Q)
:e 6
:l'
~ 7a
:J.
b
Q) 8
;:I
c: 9
Q)
:l' 10
Q)
a:
11
12 4
5
6
.. 7a
7b
Prior Year
225.
2 581 207.
68.
2 581 500. 3,163,889.

Contnbutions and grants (Part VIII, line 1 h) Program service revenue (Part VIII, line 2g)

Investment Income (Part VIII, column (A), lines 3, 4, and 7d)

Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11 e)

Total revenue- add lines 8 throuah 11 (must eaual Part VIII column (A), line 12)

Current Year

54 515.

3 109 370.

4.

13 Grants and similar amounts paid (Part IX, column (A), lines 1·3)

14 Ben _~' , column (A), line 4)

III 15 Sala ies o~ l~ I~ e benefits (Part IX, column (A), lines 5·10)

~ 16a Prof ss pnal fundralslng fees (Part lIS';) olumn (A), line 11e)

! b Tota ill dral1'.B.~xperme~~w I) ,Q urnn (D), line 25) ~ _

17 Othe~ pen"§~I(PIrt I~ column (ti)~~S 11a·11d, 11f·24t)

18 Tota ex h .... ~ squal Part IX, column (A), line 25)

19 RevE hue le~~~l\buY;It line 8 from line 12

~cn

o~

cnc::

],l-1il 20 Total assets (Part X, line 16)

~ 21 Total liabilities (Part X, line 26)

-c::

~~ 22 Net assets or fund balances Subtract line 21 from line 20

L Part II I Signature Block

1 126 318.

1 635,197.

1 489,407.

1,620 155.

2 615 725.

3 255 352.

<34 225.c> Beainnina of Year

<91 463.c> End of Year

1 203 897.

1,110,704.

1 275,821.

1 274,091.

<163_L387.>

<71 924.1>

Sign Here

Under Pn~~~1 perJury,.kleclare that I have exammed this return, IncludIng accompanymq schedules and statements, and to the best 01 my knowledge and behel, It IS true, correct, and com r( 11 eclaratloner (other than officer) IS based on all mtormanon 01 whIch preparer has any knowledge

~ s"";2";1,o:",, r ~ - I Dol, /00 jrY7

~ RAY FALGOU¥, EXECUTIVE DIRECTOR ,.. Type or pnnt name and title

Paid

Pre parer's ~ r.-v--. L ..J I Date 0 Check If 1 Preparer's IdentIfyIng number

~ .-k. /2 I'll A...t self- D (~;,s~~onJ). I,.. .., ,.-

signature ,"-~/ v y~, , '/' rTf employed _r_ut..JI..1h~ ~>

Preparer's ~F;:-"=m-;-'s-n-am-e~(~or--"""'~~-"T--C----S:::-L---------....L-r--'''__-L.....L::::..:..t:..:..::.,!..::..::,...:::___!==:!....L-I-.I£~....LI"'--<~:::..:::::..,.,,:;_ __

Use Only yours II BOLD, ARLI E & SMITH, LLC, CPA 'S EIN ~

sell-employed), ~ 480 CHURCH ST. SE

address, and

ZIP+4 SALEM OR 97301

Phone no. ~ ( 50 3) 58 5 - 7 7 51

May the IRS diSCUSS trus return wrth the preparer shown above? (see Instructions)

[XJ Yes D No

Form 990 (2008)

0-V; '\

632001 12-16·06 LHA For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions,

Form 990 (2008) CHRISTIAN COMMUNITY PLACEMENT CENTER

9 4 - 3112 5 71 Pa e 2

1 Bnefly descnbe the organization's mission

PROCTOR CARE/COUNSELING YOUTH

2 Did the organization undertake any significant program services dunng the year which were not listed on the pnor Form 990 or 990·EZ?

If "Yes", descnbe these new services on Schedule O.

3 Did the organization cease conducting, or make significant changes In how It conducts, any program services?

If "Yes", descnbe these changes on Schedule 0

4 Descnbe the exempt purpose achievements for each of the organization's three largest program services by expenses Section 501 (c)(3) and 501 (c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, If any, for each program service reported

DYes [X]No

DYes [X]No

4a (Code ) (Expenses $ 1, 0 9 4 , 3 9 9. Including grants of $ ) (Revenue $ 1, 744 , 415. )

TRAINED NEW AND CONTINUED EDUCATION FOR ADOLESCENT TREATMENT HOMES

INCLUDING GROUP HOMES FOR EMOTIONALLY DISTURBED YOUTH FROM PRIVATE AND STATE SYSTEMS. INCLUDES COUNSELING AND DAILY PHYSICAL NEEDS OF YOUTHS. PROCTOR CARE FOR YOUTHS.

4b (Code. ) (Expenses $ 662 t 597. Including grants of $ ) (Revenue $ 722 , 011. )

SERVICES TO CHILDREN AND FAMILIES COUNSELING SERVICES AND MENTORING

PROGRAMS TO YOUTH. IGO AND METRO PROGRAMS FOR CHILDREN IN NEED.

4c (Code ) (Expenses $ 204 t 028. Including grants of $ ) (Revenue $ 642 , 943. )

CLACKAMAS COUNTY JUVENILE SERVICE FOR TROUBLED YOUTH. BEHAVIOR HELP FOR OREGON YOUTH AUTHORITY TROUBLED YOUTH.

4d Other program services. (Descnbe In Schedule 0 )

(Expenses $ Including grants of $ ) (Revenue $

4e Total program service expenses ~ $ 1 « 9 61 « 0 2 4. (Must equal Part IX, Lme 25, column (B))

Form 990 (2008)

832002 12·18-08

F

990 (2008)

CHRISTIAN COMMUNITY PLACEMENT CENTER

94 3112571

P

3

orm - age
1 P.art IV I' Checklist of Required Schedules
Yes No
1 Is the organization descnbed In section 501 (c)(3) or 494 7(a)(1) (other than a pnvate foundation)?
If "Yes, " complete Schedule A 1 X
2 Is the organization required to complete Schedule B, Schedule of Contnbutors? 2 X
3 Old the organization engage In direct or Indirect political campaign activities on behalf of or In opposinon to candidates for
public office? If • Yes, " complete Schedule C, Part I 3 X
4 Section 501(c)(3) organizations. Old the organization engage In lobbYing activities? If "Yes, " complete Schedule C, Part 1/ 4 X
5 Section 50 1 (c)(4) , 501(c)(5), and 501(c)(6) organizations. Is the organization subject to the section 6033(e) notice and
reporting requirement and proxy tax? If • Yes, " complete Schedule C, Part III 5
6 Old the organization maintain any donor advised funds or any accounts where donors have the nght to provide advice
on the drstnbutron or Investment of amounts In such funds or accounts? If "Yes, " complete Schedule D, Part I 6 X
7 Old the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, hrstonc land areas, or tustonc structures? If "Yes, " complete Schedule D, Part 1/ 7 X
8 Old the organization maintain collections of works of art, rustoncal treasures, or other Similar assets? If • Yes, • complete
Schedule D, Part III 8 X
9 Did the organization report an amount In Part X, line 21, serve as a custodian for amounts not listed In Part X; or provide
credrt counseling, debt management, credit repair, or debt negotiation services? If "Yes, " complete Schedule D, Part IV 9 X
10 Did the organization hold assets In term, permanent, or quasi-endowments? If "Yes, " complete Schedule D, Part V 10 X
11 Did the organization report an amount In Part X, lines 10, 12, 13, 15, or 25?
If • Yes, " complete Schedule D, Parts VI, VI/, VI/I, IX, or X as applicable 11 X
12 Did the organization receive an audited financial statement for the year for which It IS completing trns return that was
prepared In accordance With GAAP? If "Yes," complete Schedule D, Parts XI, XII, and XIII 12 X
13 Is the organization a school as descnbed In section 170(b)(1 )(A)(II)? If "Yes, " complete Schedule E 13 X
14a Did the organization maintain an office, employees, or agents outside of the U.S.? 14a X
b Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaklng, fundrarsmq, busmess,
and program service activities outside the U S.? If "Yes, ' complete Schedule F, Part I 14b X
15 Old the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity
located outside the United States? If "Yes, " complete Schedule F, Part 1/ 15 X
16 Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to Individuals
located outside the Unrted States? If • Yes, " complete Schedule F, Part III 16 X
17 Did the organization report more than $15,000 on Part IX, column (A), line 11 e? If "Yes, " complete Schedule G, Part I 17 X
18 Old the organization report more than $15,000 total on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part 1/ 18 X
19 Did the organization report more than $15,000 on Part VIII, line 9a? If "Yes," complete Schedule G, Part III 19 X
20 Old the organization operate one or more hospitals? If "Yes, " complete Schedule H 20 X
21 Did the organization report more than $5,000 on Part IX, column (A), line 1? If • Yes, " complete Schedule I, Parts I and 1/ 21 X
22 Old the organization report more than $5,000 on Part IX, column (A), line 2? If "Yes, " complete Schedule I, Parts I and III 22 X
23 Old the organization answer "Yes" to Part VII, Section A, questions 3, 4, or 5? If • Yes, "complete Schedule J 23 X
24a Old the organization have a tax-exempt bond Issue wrth an outstanding pnncipal amount of more than $100,000 as of the
last day of the year, that was Issued after December 31, 2002? If 'Yes," answer questions 24b-24d and complete Schedule K.
If "No ", go to question 25 24a X
b Old the organization Invest any proceeds of tax-exempt bonds beyond a temporary period exception? 24b
c Did the organization maintain an escrow account other than a refunding escrow at any time dunng the year to defease
any tax-exempt bonds? 24c
d Did the organization act as an "on behalf of" Issuer for bonds outstanding at any time dunng the year? 24d
25a Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage In an excess benefit transaction wrth a
disqualified person dunng the year? If "Yes, " complete Schedule L, Part I 25a X
b Did the organization become aware that rt had engaged In an excess benefit transaction wrth a disqualified person from a
prior year? If "Yes, ' complete Schedule L, Part I 25b X
26 Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified
person outstanding as of the end of the organization's tax year? If "Yes, " complete Schedule L, Part II 26 X
27 Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, or substantial
contributor or to a oerson related to such an Individual? If 'Yes" como/ete Schedule L Part III 27 X Form 990 (2008)

832003 12-18-08

F

990 (2008)

CHRISTIAN COMMUNITY PLACEMENT CENTER

94 3112571

P

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I Part IV I'Checklist of Required Schedules (contmued)
Yes No
28 DUring the tax year, did any person who IS a current or former officer, director, trustee, or key employee
a Have a direct business relationship with the organization (other than as an officer, director, trustee, or employee), or an
indirect business relationship through ownership of more than 35% In another entity (mdivrdually or collectively with other
person(s) listed In Part VII, Section A)? If "Yes, • complete Schedule L, Part IV 28a X
b Have a family member who had a direct or Indirect business relationship with the organization?
If • Yes, • complete Schedule L, Part IV - - 28b X
c Serve as an officer, director, trustee, key employee, partner, or member of an entity (or a shareholder of a professional
corporation) domq business with the organization? If "Yes, • complete Schedule L, Part IV 28c X
29 Did the organization receive more than $25,000 In non-cash contributions? If • Yes, u complete Schedule M 29 X
30 Did the organization receive contnbutions of art, histoncal treasures, or other Similar assets, or qualified conservation
contributions? If "Yes, " complete Schedule M 30 X
31 Did the organization hquidate, terminate, or dissolve and cease operations?
If • Yes, " complete Schedule N, Part I 31 X
32 Did the organization sell, exchange, dispose of, or transfer more than 25% of rts net assets? If "Yes, " complete
Schedule N, Part /I 32 X
33 Did the organization own 100"/0 of an entity disregarded as separate from the organization under Regulations
sections 301 7701-2 and 301 7701-3? If "Yes, n complete Schedule R, Part I 33 X
34 Was the organization related to any tax-exempt or taxable entity?
If "Yes, " complete Schedule R, Parts /I, III, IV, and V, Ime 1 34 X
35 Is any related organization a controlled entrty Within the meaning of section 512(b)(13)?
If "Yes, " complete Schedule R, Part V, Ime 2 35 X
36 Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization?
If "Yes, " complete Schedule R, Part V, Ime 2 36 X
37 Did the organization conduct more than 5% of ItS activities through an entity that IS not a related organization
and that IS treated as a oartnershm for federal Income tax purposes? If "Yes" comotete Schedule R Part VI 37 X Form 990 (2008)

832004 12·18-08

990 (2008)

CHRISTIAN COMMUNITY PLACEMENT CENTER

94 3112571

5

Form - Page
,Part V'' Statements Regarding Other IRS Filings and Tax Compliance
Yes No
1a Enter the number reported In Box 3 of Form 1096, Annual Summary and Transmittal of
U.S. Information Returns Enter ·0· If not apphcable 1a 5
b Enter the number of Forms W·2G Included In hne 1 a Enter ·0· If not apphcable 1b 0
c Old the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming
(gambhng) winnings to prize winners? r. 1c X
2a Enter the number of employees reported on Form W·3, Transmittal of Wage and Tax Statements,
filed for the calendar year ending with or within the year covered by this return 70
b If at least one IS reported on hne 2a, did the organization file all required federal employment tax returns? 2b X
Note. If the sum of hnes 1 a and 2a IS greater than 250, you may be required to e-flle trus return (see Instructions)
3a Old the organization have unrelated business gross Income of $1 ,000 or more dunnq the year covered by this return? 3a X
b If "Yes," has It filed a Form 990·T for this year? If "No, " provuie an explanation In Schedule 0 3b
4a At any time dUring the calendar year, did the organization have an Interest In, or a signature or other authonty over, a
financial account In a foreign country (such as a bank account, securrties account, or other financial account)? 4a X
b If "Yes," enter the name of the foreign country: ~
See the instructions for exceptions and fihng requirements for Form TO F 90-22 1, Report of Foreign Bank and
Financial Accounts
5a Was the organization a party to a prohibited tax shelter transaction at any time dunnq the tax year? 5a X
b Old any taxable party notify the organization that It was or IS a party to a prohibited tax shelter transaction? 5b X
c If "Yes," to question 5a or 5b, did the organization file Form 8886-T, Disclosure by Tax-Exempt Entity Regarding Prohibited
Tax Shelter Transaction? 5c
6a Old the organization sohcit any contributions that were not tax deductible? 6a X
b If "Yes," did the organization Include With every sohcrtatron an express statement that such contributions or gifts
were not tax deductible? 6b
7 Organizations that may receive deductible contributions under section 170(c).
a Old the organization provide goods or services In exchange for any quid pro quo contribution of more than $75? 7a X
b If "Yes," did the organization notify the donor of the value of the goods or services provided? 7b
c Old the organization sell, exchange, or otherwise dispose of tangible personal property for which It was required
to file Form 8282? 1 7d 1 7c X
d If "Yes," Indicate the number of Forms 8282 filed dunnq the year
e Old the organization, dunnq the year, receive any funds, directly or Indirectly, to pay premiums on a personal
benefit contract? 7e X
f Old the organization, dunnq the year, pay premiums, directly or Indirectly, on a personal benefit contract? 7f X
g For all contributions of qualified Intellectual property, did the organization file Form 8899 as required? 7g X
h For contributions of cars, boats, airplanes, and other vehicles, did the organization file a Form 1098-C as required? 7h X
8 Section 501(c)(3) and other sponsoring organizations maintaining donor advised funds and section 509(a)(3)
supporting organizations. Old the supporting organization, or a fund maintained by a sponsoring organization, have
excess business holdings at any time dUring the year? 8
9 Section 501(c)(3) and other sponsoring organizations maintaining donor advised funds.
a Old the organization make any taxable distributions under section 4966? 9a
b Old the organization make a distribution to a donor, donor advisor, or related person? 9b
10 Section 501(c)(7) organizatIons. Enter N/A
a Initiation fees and capital contributions Included on Part VIII, hne 12 110a 1
b Gross receipts, Included on Form 990, Part VIII, hne 12, for pubhc use of club tacilrtres 10b
11 Section 501(c)(12) organizatIons. Enter- N / A
a Gross Income from members or shareholders 11a
b Gross Income from other sources (Do not net amounts due or paid to other sources against
amounts due or received from them) 11b
12a Section 4947(a)(1) non-exempt charitable trusts. Is the organization fihng Form 990 In heu of Form,1041, 12a
b If "Yes" enter the amount of tax-exempt Interest received or accrued dunnq the year N / A 12b Form 990 (2008)

832005 12-18-08

Form 990(2008) CHRISTIAN COMMUNITY PLACEMENT CENTER 94-3112571 Pa e6

Governance, Management, and Disclosure (Sections A, B, and C request mtormetton about pouaes not requued by the

.__.;.._---"

Internal Revenue Code)

G

dM

Section A. overrunq Body an anagement
Yes No
For each • Yes • response to Imes 2· 7b below, and for a 'No' response to Imes 8 or 9b below, descnbe the circumstances,
processes, or changes m Schedule OSee mstructions I 1a I
1a Enter the number of voting members of the governing body 7
b Enter the number of voting members that are Independent I 1b I 3
2 Old any officer, director, trustee, or key employee have a family relationship or a business relationship With any other
officer, director, trustee, or key employee? 2 X
3 Old the organization delegate control over management duties customanly performed by or under the direct supervision
of officers, directors or trustees, or key employees to a management company or other person? 3 X
4 Old the organization make any Significant changes to ItS organizational documents since the pnor Form 990 was flied? 4 X
5 Old the organization become aware dunng the year of a material diversion of the organization's assets? 5 X
6 Does the organization have members or stockholders? 6 X
7a Does the organization have members, stockholders, or other persons who may elect one or more members of the
governing body? 7a X
b Are any decisions of the governing body subject to approval by members, stockholders, or other persons? 7b X
8 Old the organization contemporaneously document the meetings held or wntten actions undertaken dunnq the year
by the followmq
a The governing body? 8a X
b Each committee wrth authorrty to act on behalf of the governing body? 8b X
9a Does the organization have local chapters, branches, or affiliates? 9a X
b If "Yes," does the organization have wntten pohcies and procedures governing the activities of such chapters, affiliates,
and branches to ensure their operations are consistent With those of the organization? 9b
10 Was a copy of the Form 990 provided to the organization's governing body before It was filed? All organizations must
describe In Schedule 0 the process, If any, the organization uses to review the Form 990 10 X
11 Is there any officer, director or trustee, or key employee listed In Part VII, Section A, who cannot be reached at the
oroamzation's rnaihnq address? If "Yes" orovuie the names and addresses tn Schedule 0 11 X Section B Policies

.
Yes No
12a Does the organization have a wntten conflict of Interest policy? If "No," go to line 13 12a X
b Are officers, directors or trustees, and key employees required to disclose annually Interests that could give rise
to conflicts? 12b X
c Does the organization regularly and consistently monitor and enforce compliance With the policy? If "Yes, " descnbe
m Schedule 0 how this IS done 12c X
13 Does the organization have a wntten whistle blower policy? 13 X
14 Does the organization have a wntten document retention and destruction policy? 14 X
15 Old the process for determining compensation of the followmq persons Include a review and approval by Independent
persons, comparability data, and contemporaneous substantiation of the deliberation and decision
a The organization's CEO, Executive Director, or top management official? 15a X
b Other officers or key employees of the organization? 15b X
Describe the process In Schedule 0 (see Instructions)
16a Old the organization Invest In, contnbute assets to, or participate In a JOint venture or Similar arrangement With a
taxable entrty dunng the year? 16a X
b If "Yes," has the organization adopted a wntten policy or procedure requmnq the organization to evaluate ItS participation
In JOint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization's
exempt status With respect to such arranaements? 16b Section C. Disclosure

17 list the states With which a copy of this Form 990 IS required to be filed ~..!:O,-,R:.=-- _

18 Section 6104 requires an organization to make rts Forms 1023 (or 1024 If applicable), 990, and 990-T (501 (c)(3)s only) available for

public mspection. Indicate how you make these available Check all that apply

o Own webSIte 0 Another's webSIte [XJ Upon request

19 Descnbe In Schedule 0 whether (and If so, how), the organization makes ItS governing documents, conflict of Interest policy, and financial statements available to the public

20 State the name, physical address, and telephone number of the person who possesses the books and records of the organization ~ _

RAY FALGOUT - 503-588-5647

4890 32ND AVE SE, SALEM, OR 97317

832008 12-18-08

Form 990 (2008)

Form 990(2008) CHRISTIAN COMMUNITY PLACEMENT CENTER 94-3112571

Part VII 'Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors

Pa e 7

Section A. Officers, Directors, Trustees, Kev Emplovees, and Highest Compensated Employees

1a Complete this table for all persons required to be listed. Use Schedule J·2 If additional space IS needed

• List all of the organization's current officers, directors, trustees (whether mdwiduals or organizations), regardless of amount of compensation, and current key employees Enter ·0· In columns (D), (E), and (F) If no compensation was paid

• List the organization's five current highest compensated employees (other than an officer, director, trustee, or key employee) who received reportable compensation (Box 5 of Form W·2 and/or Box 7 of Form 1099·MISC) of more than $100,000 from the organization and any related organizations

• List all of the organization's former officers, key employees, and highest compensated employees who received more than $100,000 of reportable compensation from the organization and any related organizations.

• List all of the organization's former directors or trustees that received, In the capacity as a former director or trustee of the organization, more than $10,000 of reportable compensation from the organization and any related organizations

List persons In the following order mdividual trustees or directors, Institutional trustees; officers, key employees, highest compensated employees, and former such persons

Dc h b dd ffi d k

heck t IS ox If the organization I not compensate anv 0 icer irector trustee, or eyemployee
(A) (8) (C) (D) (E) (F)
Name and Title Average Position Reportable Reportable Estimated
hours (check all that apply) compensation compensation amount of
per 0 from from related other
week ~ the organizations compensation
'C ~
0 ~ j organization ryv·2/1099·MISC) from the
~ "" ~ E ryv·2/1099·MISC) organization
"" I and related
~ ! 8:!
~ u; >. .... organizations
~o ~
i'4 ..c::::i5. E
~ it;' ~~ ~
<:> '"
REX ANDERSON
PRESIDENT 1.00 X X o . o. o.
KIM MAXWELL
SECR/TREAS 40.00 X X 34,066. o . 325.
KEVIN PRUETT
VICE PRESIDENT 1.00 X X o . o. o .
SANDY FERGUSON
BOARD MEMBER 1.00 X o . o. o .
JOCELYN BRINLEE
BOARD MEMBER 13.00 X 5 783. o. o .
JIM MOORE
BOARD MEMBER 1.00 X o. o . o.
LINDA MOORE
BOARD MEMBER 1. 00 X o. o. o .
RAY FALGOUT
EXECUTIVE DIR. 40.00 X 223 121. o. 7 000. 832007 12· 18·08

Form 990 (2008)

990 (2008)

CHRISTIAN COMMUNITY PLACEMENT CENTER

94 3112571

8

Form - Page
I Part VIII Section A. Officers Directors Trustees Key Employees and Highest Compensated Emplo ees (continued)
(A) (B) (C) (D) (E) (F)
Name and trtle Average Posmon Reportable Reportable Estimated
hours (check all that apply) compensation compensation amount of
per ~ from from related other
week the organizations compensation
;;; ~
Q ~ organization (W·2/1099·MISC) from the
s '" E (W-2/1099·MISC) organization
'" i ~ and related
~ 1 8~
" ~ ~~ ~ organizations
~ ~ ~ ~~ -
.= C> :i:tuof










1b Total ~ 262 970. O. 7,325. 2 Total number of Individuals (Including those In 1 a) who received more than $100,000 In reportable

cornoensation from the oroarnzanon .. 1
Yes No
3 Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on
line 1 a? If 'Yes, .. complete Schedule J for such individual 3 X
4 For any mdividual listed on line 1 a, IS the sum of reportable compensation and other compensation from the organization
and related organizations greater than $150,OOO? If "Yes, .. complete Schedule J for such individual 4 X
5 Did any person listed on line 1 a receive or accrue compensation from any unrelated organization for services rendered to
the organization? If "Yes" complete Schedule J for such_person 5 X Section B. Independent Contractors

Complete this table for your five highest compensated Independent contractors that received more than $100,000 of compensation from NONE

the oraaruzauon
(A) (B) (C)
Name and busmess address Descnpnon of services Compensation





2 Total number of Independent contractors (Including those In 1) who received more than $100,000 In compensation
from the oruarnzanon ~ 0 Form 990 (2008)

832008 12- 18-08

Form 990 (2008)

CHRISTIAN COMMUNITY PLACEMENT CENTER

94-3112571

Page 9

I Part VIII I Statement of Revenue
(A) (8) (e) (0)
Total revenue Related or Unrelated Revenue
excluded from
exempt functron business tax under
revenue revenue sections 512,
513,or514
UIUI 1 a Federated campatqns 1a 54,226.
--
e:e:
CU:::l b MembershIp dues 1b
"'0
~E c Fundrarsmp events 1c 289.
UlCU
~ ... d Related orqarnzatrons 1d
Cl~
""-·E e Government grants (contnbunons) 1e
e:.-
OUI f All other contributions, gIftS, grants, and
~;
.EJ: smular amounts not Included above 1f
._-
.b0
e:'t:I 9 Noncash contnbunons Included In hnes 1a-1f $
Oe:
OCU h Total. Add lines ta-tf ~ 54 515.
BUSIness Code
Q) 2 a ADOLESCENT TRMT. HOMES 624100 3109370. 3109370.
0
's b
... Q)
Q):::l
U)e: c
E~ d
CUQ)
6P=
0 e
...
Co f All other program service revenue
g Total. Add lines 2a·2f ~ 3109370.
3 Investment Income (Including dividends. Interest, and
other Similar amounts) ~ 4. 4.
4 Income from Investment of tax-exempt bond proceeds ~
5 Royatties ~
(I) Real (I~ Personal
6 a Gross Rents
b Less' rental expenses
c Rental Income or (1055)
d Net rental Income or (1055) ~
7 a Gross amount from sales of (I) Securities (II) Other
assets other than Inventory
b Less. cost or other baSIS
and sales expenses
c Gam or (1055)
d Net gain or (1055) ~
Q) 8 a Gross Income from fund raIsIng events (not
:::l mcludmq $
e: of
Q)
> contributions reported on line 1 c) See
Q)
a:
... Part IV, line 18 a
Q)
J: b Less direct expenses b
5
c Net Income or (1055) from fund rarsmq events ~
9 a Gross Income from gamIng activrtres See
Part IV, line 19 a
b Less. direct expenses b
c Net Income or (1055) from gaming acnvmes ~
10 a Gross sales of Inventory, less returns
and allowances a
b Less cost of goods sold b
c Net Income or (1055) from sales of Inventory ~
Miscellaneous Revenue BUSiness Code
11 a
b
c
d All other revenue
e Total. Add lines 11a·11d ~
12 Total Revenue Add hnes 1h 2g 3 4 5 6d 7d 8e se 10e and 11e ~ 3163889. 3109370. O. 4. 832009 02-02-09

Form 990 (2008)

Form 990 (2008 CHRISTIAN COMMUNITY PLACEMENT CENTER

94 - 3112 5 71 Pa e 10

00 not include amounts reported on lines 6b, (A) (8) (C) JO)
7b, 8b, 9b, and 10b of Part VIII. Total expenses Program service Management and Fun raising
expenses Qeneralexpenses expenses
1 Granls and other assistance to governments and
organizations In the U.S. See Part IV. line 21
2 Grants and other assistance to Individuals In
the U S See Part IV. line 22
3 Grants and other assistance to governments.
organizations. and Individuals outside the U S
See Part IV. lines 15 and 16
4 Benefits paid to or for members
5 Compensation of current officers, directors,
trustees, and key employees 223,121- 223 121-
6 Compensation not Included above, to disqualified
persons (as defined under section 4958(f)(1)) and
persons described In sectron 4958(c)(3)(8)
7 Other salaries and wages 1 123 842. 811 103. 312 739.
8 Pension plan contributions (Include section 401(k)
and section 403(b) employer contnbunons)
9 Other employee benefits 173 726. 104 236. 69 490.
10 Payroll taxes 114 508. 65 989. 48 519.
11 Fees for services (non-employees)
a Management
b Legal 932. 932.
c Accounting 12 155. 12 155.
d l.obbymq
e Professional tundraismj; services. See Part IV, line 17
f Investment management fees
g Other 550. 150. 400.
12 Advartrsmq and promotion 100 638. 1 925. 98 713.
13 Office expenses 38,125. 55. 38 070.
14 Information technology
15 Royalties
16 Occupancy 32 235. 4 914. 27 321-
17 Travel 61,033. 26,776. 34 257.
18 Payments of travel or entertainment expenses
for any federal, state, or local public officrals
19 Conferences, conventions, and meetings
20 Interest 94,568. 94 568.
21 Payments to affiliates
22 Depreciation, depletion, and amortization 83 489. 55,659. 27 830.
23 Insurance 45 987. 45 987.
24 Other expenses. itemize expenses not covered
above. (Expenses grouped together and labeled
miscellaneous may not exceed 5% of total
expenses shown on line 25 below.)
a PROCTOR CARE 857 917. 857 917.
b CONTRIBUTIONS 81 200. 6 000. 75 200.
c CONSULTING-BACKGROUND C 67 659. 2 900. 64,759.
d BUILDG. MAINT. & REPAIR 42 651- 42 651.
e TELEPHONE 34 485. 145. 34 340.
f All other expenses 66 531- 23 255. 43 276.
25 Total functional expenses Add lines 1 throuoh 24f 3 255 352. 1 961 024. 1 294 328. O.
26 JOint costs. Check here ~ D If following
SOP 98-2_ Complete trus line only If the orqaruzanon
reported In column (8) JOint costs from a combined
educallonal carnoaicn and fundralslng_sollcltatlon Section 501(c)(3) and 501(c)(4) organizations must complete all columns.

All other organizations must complete column (A) but are not required to complete columns (8), (C), and (0).

832010 12-18-08

Form 990 (2008)

F

990 (2008)

CHRISTIAN COMMUNITY PLACEMENT CENTER

94 3112571

11

orm - Page
I P,art X 1 Balance Sheet
(A) (8)
Beginning of year End of year
1 Cash - non-mterest-beannq <72 402. t>1 <84 023.
2 Savings and temporary cash Investments 2 875. 2 41.
3 Pledges and grants receivable, net 3
4 Accounts receivable, net -- 4
5 Receivables from current and former officers, directors, trustees, key
employees, or other related parnes. Complete Part II of Schedule L _ 5 265. 5 5 767.
6 Receivables from other disqualified persons (as defined under section
4958(f)(1)) and persons described In section 4958(c)(3)(B)_ Complete
Part II of Schedule L 6
CII 7 Notes and loans receivable, net 7
Qj
CII 8 Inventones for sale or use 8
CII
<C 9 Prepaid expenses and deferred charges 9
10a Land, bUildings, and equipment cost baSIS 10a 1 741 504.
b Less- accumulated depreciation Complete
Part VI of Schedule D 10b 552,585. 1 268 159. 10c 1 188 919.
11 Investments - publicly traded securities 11
12 Investments - other securities See Part IV, line 11 12
13 Investments - program-related See Part IV, line 11 13
14 Intangible assets 14
15 Other assets See Part IV, line 11 15
16 Total assets. Add lines 1 throuah 15 (must eaual line 34) 1 203 897. 16 1 110 704.
17 Accounts payable and accrued expenses 17
18 Grants payable 18
19 Deferred revenue 19
20 Tax-exempt bond liabilities 20
CII 21 Escrow account habilrty Complete Part IV of Schedule D 21
~ 22 Payables to current and former officers, directors, trustees, key employees,
:c highest compensated employees, and disqualified persons Complete Part II
III
::i of Schedule L 22 3 500.
23 Secured mortgages and notes payable to unrelated third parties 1,196,813. 23 1 151 674.
24 Unsecured notes and loans payable 24
25 Other liabilities Complete Part X of Schedule D 79,008. 25 118 917.
26 Total habllitres. Add lines 17 throuoh 25 1 275,821. 26 1 274 091.
Organizations that follow SF AS 117, check here ~ o and complete
CII lines 27 through 29, and lines 33 and 34_
III
o 27 Unrestricted net assets 27
t:
III
16 28 Temporarily restricted net assets 28
co
"tl 29 Permanently restricted net assets 29
t: [XJ and
:::I Organizations that do not follow SFAS 117, check here ..
u,
"- complete lines 30 through 34_
0
CII Capital stock or trust pnncipal, or current funds o. 30 o.
- 30
III
CII 31 Paid-In or capital surplus, or land, buildmq, or equipment fund o . 31 o.
CII
<C <71 924. <163 387.
Qj 32 Retained earnings, endowment, accumulated Income, or other funds >32
z 33 Total net assets or fund balances <71 924. >33 <163 387.
34 Total liabilities and net assets/fund balances 1 203,897. 34 1 110 704.
I Part XI I Financial Statements and Reporting
Yes No
1 Accounting method used to prepare the Form 990_ [XJ Cash o Accrual o Other
2a Were the organization's financial statements complied or reviewed by an Independent accountant? 2a X
b Were the organization's financial statements audited by an Independent accountant? 2b X
c If "Yes" to lines 2a or 2b, does the organization have a commrttee that assumes responsibilrty for oversight of the audrt,
review, or compilation of ItS financial statements and selection of an Independent accountant? 2c
3a As a result of a federal award, was the organization required to undergo an audrt or audits as set forth In the Single Audit
Act and OMB Circular A-133? 3a X
b If "Yes" did the oruarnzatron underao the recurred audit or audits? 3b >

> >

832011 12- 18-08

Form 990 (2008)

SCHEDULE A (Form 990 or 99O-EZ)

OMS No 1545-0047

Public Charity Status and Public Support

2008

Department of the Treasury Internal Revenue Service

To be completed by all section 501(c)(3) organizations and section 4947(a)(1) nonexempt charitable trusts.

~ Attach to Form 990 or Form 99O-EZ. ~ See separate instructions.

Open to Public Inspection

Name of the organization

Employer identification number

CHRISTIAN COMMUNITY PLACEMENT CENTER

94-3112571

Reason for Public Charity Status (All orqaruzatrons must complete thts part) (see mstrucuons)

The organization IS not a private foundation because It IS. (Please check only one organization)

1 0 A church, convention of churches, or association of churches described In section 170(b)(1)(A)(i). 2 0 A school described In section 170(b)(1)(A)(ii). (Attach Schedule E)

3 0 A hospital or a cooperative hospital service organization described In section 170(b)(1)(A)(iii). (Attach Schedule H)

4 0 A medical research orqaruzation operated In conjunction with a hospital descnbed In section 170(b)(1)(A)(iii). Enter the hospital's name,

50 60 700

City, and state _

An organization operated for the benefit of a college or university owned or operated by a governmental unrt descnbed In section 170(b)(1)(A)(iv). (Complete Part II)

A federal, state, or local government or governmental Unit descnbed In section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of rts support from a governmental Unit or from the general public descnbed In section 170(b)(1)(A)(vi). (Complete Part II)

A community trust descnbed In section 170(b){1)(A)(vi). (Complete Part II)

80 90

An organization that normally receives: (1) more than 331/3% of rts support from contnbuuons, membership fees, and gross receipts from activities related to rts exempt functions - subject to certain exceptions, and (2) no more than 33 1/3% 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, 1975 See section 509(a)(2). (Complete the Part 111.)

10 0 An organization organized and operated exclusively to test for public safety See section 509(a)(4). (see Instructions)

11 0 An organization organized and operated exclusively 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) or section 509(a)(2) See section 509(a)(3). Check the box that

describes the type of supporting organization and complete lines 11 e through 11 h

a 0 Type I b 0 Type II cD Type III - Functtonally Integrated

dO Type III - Other

e 0 By checking thrs box, I certify that the organization IS not controlled directly or Indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations descnbed In section 509(a)(1) or section 509(a)(2)

If the organization received a wntten determination from the IRS that It IS a Type I, Type II, or Type III

supporting organization, check trus box

Since August 17, 2006, has the organization accepted any gift or contribution from any of the tollowmq persons?

(i) A person who directly or Indirectly controls, erther alone or together With persons described In (II) and (III) below,

o

9

Yes No

the governing body of the supported organization? (ii) A family member of a person described In (I) above?

(iii) A 35% controlled entity of a person described In (I) or (II) above?

h Provide the tollowmq information about the organizations the organization supports

(i) Name of supported (ii) EIN (iii) Type of iv) Is the oruarnzauon (v) Did you notify the (vi) Is the (vii) Amount of
orqaruzanon n col, (i) listed In your orqanuanon In col. orcamzauon In cot
oruamzanon (descnbed on lines 1-9 (I) organized In the support
above or IRC section governing document? (i) of your support? U.S.?
(see mstructicnsj) Yes No Yes No Yes No





Total LHA For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Schedule A (Form 990 or 99O-EZ) 2008

832021 12-17-08

Form9900r990·E 2008 CHRISTIAN COMMUNITY PLACEMENT CENTER 94-3112571 Pa e2

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only If you checked the box on line 5, 7, or 8 of Part I )

Section A. Public Support

Calendar year (or fiscal year beglnmng m)~ JjJ)2004 fb) 2005 (c) 2006 (d) 2007 (e) 2008 (f) Total
1 GiftS, grants, contributions, and
membership fees received. (Do not
Include any "unusual grants ") 1 285. 7L624. 225. 54 266. 63 400.
2 Tax revenues levied for the orqan-
rzatron's benefit and either paid to
or expended on ItS behalf
3 The value of services or tacthtres
furnished by a governmental Unit to
the organization without charge
4 Total. Add lines 1 . 3 1 285. 7 624. 225. 54 266. 63 400.
5 The portion of total contributions
by each person (other than a
governmental unrt or publicly
supported organization) Included
on line 1 that exceeds 2% of the
amount shown on line 11,
column (f) 49 320.
6 Public Support. Subtract hne 5 from nne 4 14 080. Section B. Total Support

Calendar year (or fiscal year begmmng m)~ (a) 2004 (b) 2005 (c) 2006 (d) 2007 (e) 2008 If) Total
7 Amounts from line 4 1 285. 7,624. 225. 54 266. 63 400.
8 Gross Income from Interest,
divrdends, payments received on
securrties loans, rents, royalties
and Income from Similar sources 26. 85. 63. 68. 4. 246.
9 Net Income from unrelated business
actrvmes, whether or not the
busmess IS regularly earned on
10 Other Income. Do not Include gain
or loss from the sale of capital
assets (Explain In Part IV) 281. 281.
11 Total support. Add hnes 7 through 10 63 927.
12 Gross receipts from related acnvmes, etc (see Instructions) 12 I 11,264 748. 13 First five years. If the Form 990 IS for the organization's first, second, third, fourth, or fifth tax year as a section 501 (c)(3) organization, check ttus box and stop here

Section C. Computation of Public Support Percentage

14 Public support percentage for 2008 (line 6, column (f) divided by line 11, column (f) 15 Public support percentage from 2007 Schedule A, Part IV·A, line 26f

22.03

%

51. 27

%

16a 33 1/3% support test - 2008. If the organization did not check the box on line 13, and line 14 IS 331/3% or more, check trns box and

stop here. The organization qualifies as a publicly supported organization ~ D

b 33 1/3% support test - 2007. If the organization did not check a box on line 13 or 16a, and line 15 IS 33 1/3% or more, check this box

and stop here. The organization qualifies as a publicly supported organization ~ [XJ

17a 10% -facts-and-circumstances test - 2008. If the organization did not check a box on line 13, 16a, or 16b, and line 14 IS 10% or more,

and If the organization meets the "tacts-and-ctrcumstances" test, check trus box and stop here. Explain In Part IV how the organization

meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization

b 10% -facts-and-circumstances test - 2007. If the organization did not check a box on line 13, 16a, 16b, or 17a, and hne 15 IS 10% or more, and If the organization meets the "tacts-and-circumstances" test, check trus box and stop here. Explain In Part IV how the organization meets the "facts-and-circumstances" test The organization quahfies as a pubhcly supported organization

18 Private foundation. If the organization did not check a box on hne 13, 16a, 16b, 17a, or 17b, check this box and see Instructions

Schedule A (Form 990 or 99O-EZ) 2008

832022 12·17·08

---- - - ----- ------------- --- -

Pa e 3

ou checked the box on line 9 of Part I.

Calendar year (or fiscal year beginning In)~ (a) 2004 (b) 2005 (c) 2006 (d) 2007 (e) 2008 If) Total
1 GiftS, grants, contnbutrons, and
membership fees received (Do not
Include any "unusual grants ")
2 Gross receipts from adrmssrons,
merchandise sold or services per-
formed, or facilities 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 bus-
mess under section 513
4 Tax revenues levied for the organ·
tzatron's benefit and either paid to
or expended on ItS behalf
5 The value of services or facilities
furnished by a governmental Unit to
the organization wrthout charge
6 Total. Add hnes 1 ·5
7a Amounts Included on hnes 1, 2, and
3 received from drsquahned persons
b Amounts Included on lines 2 and 3 received
from other than disqualified persons that
exceed the greater of 1% of the total of lines 9,
10c, 11, and 12 for the year or $5,000
C Add hnes 7a and 7b
8 Public SUDDort (Subtract line 7c from line 61 Section B Total Support

Calendar year (or fiscal year beginning In)~ (a) 2004 (b) 2005 (c) 2006 (d) 2007 (e) 2008 (f) Total
9 Amounts from hne 6
10a Gross Income from Interest,
dividends, payments received on
secunties loans, rents, royalties
and Income from similar sources
b Unrelated busmess taxable Income
(less secnon 511 taxes) from businesses
acquired after June 30, 1975
c Add hnes 10a and 10b
11 Net Income from unrelated business
activities not Included In hne 10b,
whether or not the business IS
regularly carned on
12 Other Income Do not Include gain
or loss from the sale of capital
assets (Explain In Part IV.)
13 Total support (Add lines 9, 10c, 11, and 12) 14 First five years. If the Form 990 IS for the organization's first, second, third, fourth, or fifth tax year as a section 501 (c)(3) organization, check thrs box and stop here

Section C. Com utation of Public Su ort Percenta e

%

15 Pubhc support percentage for 2008 (hne 8, column (I) divided by line 13, column (I)) 16 Pubhc su ort ercenta e from 2007 Schedule A Part IV·A, hne 27

%

17 Investment Income percentage for 2008 (hne 1 Oc, column (I) drvided by hne 13, column (I)) 18 Investment Income percentage from 2007 Schedule A, Part IV·A, hne 27h . 19a 33 1/3% support tests - 2008. If the organization did not check the box on hne 14, and hne 15 IS more than 33 1/3%, and hne 17 IS not

%

%

more than 33 1/3%, check this box and stop here, The organization quahfies as a pubhcly supported organization

b 33 1/3% support tests - 2007. If the organization did not check a box on hne 14 or hne 19a, and hne 16 IS more than 33 1/3% , and

~D

20 Private foundation. If the organization did not check a box on hne 14, 19a. or 19b, check thiS box and see Instructions ~ D

Schedule A (Form 990 or 990-EZ) 2008

hne 18 IS not more than 33 1/3%, check trus box and stop here. The organization qualifies as a pubhcly supported organization

832023 12-17-08

Department of the Treasury Internal Revenue Service

OMS No 1545-0047

Schedule D

(Fo'rm 990)

Supplemental Financial Statements

2008

~ Attach to Form 990, To be completed by organizations that answered "Yes," to Form 990, Part IV, line 6,7,8,9, 10, 11, or 12_

Open to Public Inspection

Name of the organization Employer identification number

CHRISTIAN COMMUNITY PLACEMENT CENTER 94-3112571

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete If the organization answered "Yes" to Form 990 Part IV line 6

(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year
2 Aggregate contributions to (dUring year)
3 Aggregate grants from (dunng year)
4 Aggregate value at end of year 5 Did the organization Inform all donors and donor advisors In writing that the assets held In donor advised funds are the organization's property, subject to the organization's exclusive legal control?

6 Did the organization Inform all grantees, donors, and donor advisors In writing that grant funds may be used only

DYes

DNo

DYes

DNo

Purpose(s) of conservation easements held by the organization (check all that apply).

D Preservation of land for public use (e g , recreation or pleasure) D Preservation of an historically Important land area

D Protection of natural habitat D Preservation of certified hrstonc structure

D Preservation of open space

2 Complete lines 2a-2d If the organization held a qualified conservation contribution In the form of a conservation easement on the last day

of the tax year

a Total number of conservation easements

b Total acreage restricted by conservation easements

c Number of conservation easements on a certified histone structure Included In (a) d Number of conservation easements Included In (c) acquired after 8/17/06

3 Number of conservation easements modified, transferred, released, extmguished, or terminated by the organization dunnq the taxable

year ~ _

4 Number of states where property subject to conservation easement IS located ~

5 Does the organization have a written policy regarding the penodic monitoring, Inspection, Violations, and enforcement of the conservation easements It holds?

Held at the End of the Year
2a
2b
2c
2d DYes

DNo

6 Staff or volunteer hours devoted to rnorutonnq, Inspecting, and entorcinq easements dunnq the year ~

7 Amount of expenses Incurred In monrtonnq, Inspecting, and entorcmq easements dunnq the year ~ $ _

8 Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(~

and section 170(h)(4)(B)(I~?

DYes

DNo

9 In Part XIV, descnbe how the organization reports conservation easements In ItS revenue and expense statement, and balance sheet, and Include, If applicable, the text of the footnote to the organization's financial statements that describes the organization's accounting for conservation easements

I Part III I Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.

Complete If the organization answered "Yes" to Form 990, Part IV, line 8

1a If the organization elected, as permitted under SFAS 116, not to report In Its revenue statement and balance sheet works of art, rustoncal treasures, or other Similar assets held for public exhibition, education, or research In furtherance of public service, provide, In Part XIV, the text of the footnote to ItS fmancial statements that descnbes these Items

b If the organization elected, as permitted under SFAS 116, to report In rts revenue statement and balance sheet works of art, rustoncal treasures, or other Similar assets held for public exhibition, education, or research In furtherance of public service, provide the tollowmq amounts relating to these Items

(i) Revenues Included In Form 990, Part VIII, line 1 (ii) Assets Included In Form 990, Part X

~ $_------~ $_-------

2 If the organization received or held works of art, histoncal treasures, or other Similar assets for frnancral gain, provide the followmq amounts required to be reported under SFAS 116 relating to these Items.

a Revenues Included In Form 990, Part VIII, line 1 b Assets Included In Form 990, Part X

~$-------~$--------

LHA For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Schedule D (Form 990) 2008

832051 12-23-08

3

USing the organization's accession and other records, check any of the following that are a significant use of Its collection rtems (check all that apply).

a D Pubhc exhibition

b D Scholarly research

c D Preservation for future generations Provide a descnption of the organization's collections and explain how they further the organization's exempt purpose In Part XIV

d D Loan or exchange programs

e D Other _

4

5 DUring the year, did the organization sohcrt or receive donations of art, historical treasures, or other similar assets

to be sold to raise funds rather than to be maintained as art of the or amzation's collection? DYes 0 No

Part IV Trust, Escrow and Custodial Arrangements. Complete If organization answered "Yes" to Form 990, Part IV, hne 9, or reported an amount on Form 990, Part X, hne 21.

1a Is the organization an agent, trustee, custodian or other Intermediary for contributions or other assets not Included on Form 990, Part X?

b If "Yes," explain the arrangement In Part XIV and complete the totlowmq table

DYes

ONo

c Beginning balance

d Additions dunnq the year

e Distributions dunnq the year Ending balance

2a Old the organization Include an amount on Form 990, Part X, hne 21?

P XIV

Amount
1c
1d
1e
1f DYes

ONo

b If "Yes" sxolam the arranaement In art
I Part vi Endowment Funds. Complete If organization answered "Yes" to Form 990, Part IV, line 10.
lal Current year Ibl Prior year M Two years back lid) Three_y_ears back lel Four years back
1a Beginning of year balance
b Contributions
c Investment earnings or losses
d Grants or scholarships
e Other expenditures for tacmues
and programs
f Administrative expenses
9 End of year balance 2 Provide the estimated percentage of the year end balance held as

a Board desrqnated or quasi-endowment ~ %

b Permanent endowment ~

c Term endowment ~ %

-------_%

3a Are there endowment funds not In the possession of the organization that are held and administered for the organization by

(I) unrelated organizations (II) related organizations

b If "Yes" to 3a(II), are the related organizations hsted as required on Schedule R?

Yes No
3alil
3aljjl
3b 4 Descnbe In Part XIV the Intended uses of the oruarnzatron's endowment funds
I Part VI I Investments - Land, Buildings, and Equipment. See Form 990, Part X, hne 10
Descnption of Investment (a) Cost or other (b) Cost or other (c) Deprecration (d) Book value
baSIS (Investment) baSIS (other)
1a Land 143 000. 143.000.
b BUildings 1 266 035. 283 650. 982 385.
c Leasehold Improvements 87 756. 77,282. 10.474.
d Equipment 238 893. 186 358. 52 535.
e Other 5 820. 5 295. 525.
Total. Add hnes ta-te (Column (d) should eaual Form 990 Part X. column (8), Ime 10(c» ~ 1 188 919. Schedule 0 (Form 990) 2008

832052 12·23·08

•

S d I D(F

990)2008

CHRISTIAN COMMUNITY PLACEMENT CENTER

94 3112571 P 3

ene ue orm - alJe
I Part VIII Investments - Other Securities. See Form 990, Part X, line 12
(a) Descnption of secunty or category (b) Book value [c) Method of valuation
(Including name of securrty) Cost or end-of-year market value
Financial denvatives and other financial products
Closely·held equity Interests
Other









Total. (Col (b) should equal Form 990 Part X col (B)lme 12) ~
I Part Villi Investments - Program Related. See Form 990 Part X line 13
(a) Descnptron of Investment type (b) Book value (c) Method of valuation
Cost or end-of-year market value










Total (Col (b) should equal Form 990 Part X col (B) line 13) ~
I Part IX I Other Assets. See Form 990, Part X, line 15
(a) Descnption (b) Book value










Total. (Column (b) should equal Form 990 Part X col (B) Ime 15.) ..
I Part X I Other Liabilities. See Form 990, Part X, line 25
(a) Descnption of liability (b) Amount
Federal Income taxes
CREDIT LINES 78 537.
ACCRUED PAYROLL LIABILITIES 33 424.
CREDIT CARD PAYABLE 6 956.






Total. (Column (b) should equal Form 990 Part X col (B) Ime 25) ~ 118 917. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48

832053 12·23·08

Schedule 0 (Form 990) 2008

Schedule O(form 990) 2008 CHRISTIAN COMMUNITY PLACEMENT CENTER 94-3112571 Page 4
I Part XI I Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) 1
2 Total expenses (Form 990, Part IX, column (A), line 25) 2
3 Excess or (deficit) for the year Subtract line 2 from line 1 3
4 Net unrealized gains (losses) on Investments 4
5 Donated services and use of tacumes 5
6 Investment expenses 6
7 Prior penod adjustments 7
8 Other (Describe In Part XIV) 8
9 Total adjustments (net). Add lines 4·8 9
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 10
I Part XII I Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements 1
2 Amounts Included on line 1 but not on Form 990, Part VIII, line 12
a Net unrealized gains on Investments 2a
b Donated services and use of Iacihtres 2b
c Recoveries of prior year grants 2c
d Other (Describe In Part XIV) 2d
e Add lines 2a through 2d 2e
3 Subtract line 2e from line 1 3
4 Amounts Included on Form 990, Part VIII, line 12, but not on line 1. I 4a I
a Investment expenses not Included on Form 990, Part VIII, line 7b
b Other (Describe In Part XIV) 4b
c Add lines 4a and 4b 4c
5 Total revenue Add lines 3 and 4c. (ThIS should equal Form 990 Part I line 12) 5
I Part Xlll] Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements 1
2 Amounts Included on line 1 but not on Form 990, Part IX, line 25
a Donated services and use of facilities 2a
b Prior year adjustments 2b
c Losses reported on Form 990, Part IX, line 25 2c
d Other (Describe In Part XIV) 2d
e Add lines 2a through 2d 2e
3 Subtract line 2e from line 1 3
4 Amounts Included on Form 990, Part IX, line 25, but not on line 1 I 4a I
a Investment expenses not Included on Form 990, Part VIII, line 7b
b Other (Describe In Part XIV) 4b
c Add lines 4a and 4b 4c
5 Total exoenses Add lines 3 and 4c. (ThIS should eaual Form 990 Part I line 18) 5
I Part XlVI Supplemental Information Complete this part to provide the descnpt.ons required for Part II, lines 3, 5, and 9; Part III, lines 1 a and 4, Part IV, lines 1 band 2b, Part V, line 4, Part X, Part XI, line 8, Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b

Schedule D (Form 990) 2008

632054 12·23·06

Compensation Information

OMS No 1545-0047

SCHEDULEJ (Form 990)

2008

For certain Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees

~ Attach to Form 990. To be completed by organizations that answered "Yes" to Form 990, Part IV, line 23.

Open to Public Inspection

Department of the Treasury Internal Revenue Service

I Employer identification number

94-3112571

Name of the organization

CHRISTIAN COMMUNITY PLACEMENT CENTER

Part I I Questions Regarding Compensation

Yes No

1a Check the appropnate box(es) If the organization provided any of the following to or for a person listed In Form 990, Part VII, Section A, line 1a Complete Part III to provide any relevant Information regarding these Items.

D Fust-ctass or charter travel D HOUSing allowance or residence for personal use

D Travel for companions D Payments for business use of personal residence

D Tax indemnification and gross·up payments D Health or social club dues or Initiation fees

D Discretionary spending account D Personal services (e g , maid, chauffeur, chef)

b If line 1a IS checked, did the organization follow a wntten policy regarding payment or reimbursement or provisron of all of the expenses descnbed above? If "No," complete Part III to explain

2 Old the organization require substantiation pnor to reimoursmq or allowing expenses Incurred by all officers, directors, trustees, and the CEO/Executive Director, regarding the Items checked In line 1 a? .

1b

2

3 Indicate which, If any, of the following the organization uses to establish the compensation of the organization's CEO/ExecutIVe Director Check all that apply.

D Compensation committee D Wntten employment contract

D Independent compensation consultant D Compensation surveyor study

D Form 990 of other organizations [X] Approval by the board or compensation committee

4 Dunng the year, did any person listed In Form 990, Part VII, Section A, line 1a a Receive a severance payment or change of control payment?

b Participate In, or receive payment from, a supplemental nonquahtred retirement plan? c Participate In, or receive payment from, an equrty-based compensation arrangement?

If "Yes" to any of lines 4a·c, list the persons and provide the applicable amounts for each Item In Part III

x

4a

x

4b

x

4c

Only 501(c)(3) and 501(c)(4) organizations must complete hnes 5-8.

5 For persons listed In Form 990, Part VII, Section A, line 1 a, did the organization payor accrue any compensation contingent on the revenues of

a The organization?

b Any related organization?

If "Yes," to line 5a or 5b, descnbe In Part III

6 For persons listed In Form 990, Part VII, Section A, line 1 a, did the organization payor accrue any compensation contingent on the net earnings of

a The organization?

b Any related organization?

If "Yes" to line 6a or 6b, descnbe In Part III

7 For persons listed In Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed payments not descnbed In lines 5 and 6? If "Yes," descnbe In Part III

8 Were any amounts reported In Form 990, Part VII, paid or accrued pursuant to a contract that was subject to the Initial contract exception described In Reqs section 53 4958·4(a)(31? If "Yes" descnbe In Part III

x

5a

x

5b

x

6a

x

6b

x

7

x

8

LHA For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Schedule J (Form 990) 2008

832111 12-23·08

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•

SCHEDULE L (Form 990 or 99O-EZ)

OMB No 1545-0047

Department of the Treasury Internal Revenue Service

Transactions with Interested Persons

~ Attach to Form 990 or Form 99O-EZ.

~ To be completed by organizations that answered

"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 99O-EZ, Part V, lines 38a or 4Ob.

2008

Open To Public Inspection

Name of the organization

CHRISTIAN COMMUNITY PLACEMENT CENTER

Employer identification number

94-3112571

Excess Benefit Transactions (section 501 (c)(3) and section 501 (c)(4) organizations only) T

o be completed by orqaruzattons that answered "Yes" on Form 990 Part IV line 25a or 25b or Form 990·EZ, Part V line 40b.
1 (a) Name of disqualified person (b) Descnption of transaction Ic) Corrected?
Yes No 2 Enter the amount of tax Imposed on the organization managers or disqualified persons dunng the year under section 4958

3 Enter the amount of tax, If any, on line 2, above, reimbursed by the organization

~ $_-----~$-------

I Part II I Loans to and/or From Interested Persons.

To be completed by orqaruzations that answered "Yes" on Form 990, Part IV line 26 or Form 990·EZ Part V, line 38a
(a) Name of Interested (b) Loan to or from (c) Onqmal pnncipal (d) Balance due (e) In (f) Approved (g) Wntten
person and purpose the organization? amount default? by board or agreement?
committee?
To From Yes No Yes No Yes No
RAY FALGOUT - TEM X 3 500. 3 500. X X X
EMPLOYEE ADVANCES X o . 5 767. X X X




Total .~ $ 9.267.
I Part III I Grants or Assistance Benefiting Interested Persons. T b

db

h

d "Y" F

990P VI 2

0 e com_!)lete )y organizations t at answere es on orm art I me 7
(a) Name of Interested person (b) Relationship between Interested person and (c) Amount of grant or type
the organization of assistance






I Part IV I Business Transactions Involving Interested Persons. To be completed by orcaruzauons that answered "Yes" on Form 990, Part IV, lines 28a 28b, or 28c
(a) Name of Interested person (b) Relationship between Interested (c) Amount of (d) Descnption of (e) Shanng of
person and the organization transaction transaction organization's
revenues?
Yes No LHA For Privacy Act and Paperwork Reducnon Act NotIce, see the Instructions for Form 990.

Schedule L (Form 990 or 990-EZ) 2008

SEE SCHEDULE 0 FOR SCHEDULE L CONTINUATIONS

832131 12·17-08

Department of the Treasury Internal Revenue Service

Supplemental Information to Form 990

~ Attach to Form 990. To be completed by organizations to provide additional information for responses to specific questions for the Form 990 or to provide any additional information.

2008

•

SCHEDULE 0 (Form 990)

OMS No 1545·0047

Open to Public Inspection

Name of the organization

CHRISTIAN COMMUNITY PLACEMENT CENTER

Employer Identification number

94-3112571

FORM 990, PART III, LINE 4D, OTHER PROGRAM SERVICES:

PROGRAM DEVELOPMENT - HELPED SET UP TEEN CRISIS CENTER TO PROVIDE HELP

TO TEENS

FORM 990, PART VI, SECTION A, LINE 2: THERE ARE FAMILY MEMBERS ON THE

BOARD AND ON STAFF. NEPOTISM PRACTICES ARE IN PLACE WHICH INCLUDE THE

EXCLUSION OF FAMILY MEMBER VOTING RIGHTS IN REGARD TO DIRECT ACTION

INVOLVING FAMILY MEMBER STAFF (IE: A BOARD MEMBER WHO IS ALSO A FAMILY

MEMBER OF STAFF MAY NOT VOTE ON A PAY RAISE FOR THE EMPLOYEE.)

FORM 990, PART VI, SECTION A, LINE 10: THE FORM 990 IS PRESENTED DURING A SCHEDULED BOARD MEETING AND IS REVIEWED AND LOGGED INTO THE MINUTES FOR

APPROVAL.

FORM 990, PART VI, SECTION B, LINE 15: THE CEO'S WAGE IS DETERMINED BY THE

INDEPENDENT BOARD OFFICERS AND MEMBERS.

FORM 990, PART VI, SECTION C, LINE 19: FORM 990, FINANCIAL STATEMENTS,

GOVERNING DOCUMENTS AND POLICIES ARE AVAILABLE UPON REQUEST AND IN

ACCORDANCE WITH PUBLIC RECORDS LAW.

SCHEDULE L, PART II, LOANS TO AND FROM INTERESTED PERSONS:

(A) NAME OF PERSON: RAY FALGOUT

(A) PURPOSE OF LOAN: TEMPORARY LOAN

(A) NAME OF PERSON: EMPLOYEE ADVANCES

LHA For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. 83221'

'2·'8·08

Schedule 0 (Form 990) 2008

•

SCHEDULE 0 (j;orm 990)

Supplemental Information to Form 990

~ Attach to Form 990. To be completed by organizations to provide additional information for responses to specific questions for the Form 990 or to provide any additional information.

2008

OMS No 1545·0047

Department of the Treasury Internal Revenue Service

Open to Public Inspection

Name of the organization

CHRISTIAN COMMUNITY PLACEMENT CENTER

Employer identification number

94-3112571

(A) PURPOSE OF LOAN: TEMPORARY PAY ADVANCES

LHA For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. 832211

12·18·08

Schedule 0 (Form 990) 2008

4562

Depreciation and Amortization (Including Information on Listed Property)

2008

Attachment Seauence No 67

Form

OMB No 1545.()172

• Department of the Treasury Internal Revenue Service

(99

~ See se arate instructions. ~ Attach to our tax return.

Name(s) shown on return

CHRISTIAN COMMUNITY PLACEMENT CENTE

Identlfymg number 94-3112571

Business or activity to which this form relates All Business Activities

__ ~art~Li Election To Expense Certain Property Under Section 179

Note: If you have any listed property. complete Part V before yOU complete Part I.
1 Maximum amount See the Instructions for a higher limit for certain businesses .. . , .. .. 1 250 000
2 Total cost of section 179 property placed In service (see Instructions) .. ..... 2
3 Threshold cost of section 179 property before reduction In limitation (see instructions) .. 3 800 000
4 Reduction In limitation Subtract line 3 from line 2. If zero or less, enter -0- ... .. .. . 4
5 Dollar limitation for tax year Subtract line 4 from line 1 If zero or less, emer c- If married filing separately, see mstrucucns 5
(a) Description of property (b) Cost (business use only) (c) Elected cost .. , ,. ";: I
" '.., ,,:., " :
6 " ,
~ "
-: I, " ~, ". ~~ ,
: .J.' ~ -, - .-,.- . " '11 .j:_ l.-
I ; •• r. '.~ :" "
7 Listed property Enter the amount from line 29 7 " - , - , ,
, . .. . , , .
8 Total elected cost of section 179 property. Add amounts in column (c), lines 6 and 7 .. 8
9 Tentative deduction Enter the smaller of line 5 or line 8 ..... . .. .. .. . ... .. . . 9
10 Carryover of disallowed deduction from line 13 of your 2007 Form 4562 .... .. .. 10
11 Business Income limitation. Enter the smaller of business income (not less than zero) or line 5 (see instructions) 11
12 Section 179 expense deduction. Add lines 9 and 10, but do not enter more than line 11 .. 12
13 Carryover of disallowed deduction to 2009. Add lines 9 and 10, less line 12 . ~I 13 { Ij -~' ,};"-.-<" ' .' ;
'.r. ' Note' Do not use Part II or Part III below for listed property Instead use Part V

I
,'-;Raiit:;U ! Special Depreciation Allowance and Other Depreciation_{_Do not include listed QrO erty.) (See mstructions.)
14 Special depreciation allowance for qualified property (other than listed property) placed In service durmq
the tax year (see instructions) 14 2.203
15 Property subject to section 168(1)(1) etection . .. .. . . .. .. ... 15
16 Other depreciation (mcludmo ACRS) 16
" MACRS Depreciation (Do not Include listed property.) (See instructrons.)

Section A

17 MACRS deductions for assets placed In service In tax years beginning before 2008

18 ear Into one or more eneral asset accounts, check here

ection -Assets Pace In ervice unng 0 ax Year Using the General Depreciation System
(b) Month and (c) BaSIS for depreciation (d) Recovery
(a) ClaSSification of property year placed In (buslnesslinvestmenl use period (e) Convention (f) Method (g) Depreciation deduction
service only-see Instructlons)-
19a 3-year property
b s-vear property 2_._068 5.0 HY 200DB 413
7 -year property . 134 7 0 20_QDB 19
c HY
d 10-y_ear_propeli\l_ ,
e 15-year property
f 20-year property
_g zs-vear propeli\l_ 25 yrs. S/L
h ReSidential rental 27,S vrs, MM S/l
property 27.5 vrs. MM S/l
i Nonresidential real 39 '{rs. MM S/l
property MM S!L
Section C-Assets Placed in Service During 2008 Tax Year Using the Alternative Depreciation System
20a Class life ,~~,:' ;; ~r~)~:~:\;- -,':? S/l
b 12-year 12 yrs. S/l
c 40-y_ear 40 vrs MM S/l
"'Par.tJVc.i Summary (see Instructions)
21 listed property. Enter amount from line 28 21
..
22 Total. Add amounts from line 12, lines 14 through 17, lines 19 and 20 In column (g), and line 21
Enter here and on the appropriate lines of your return. Partnerships and S corporations-see mstr 22 83.489
23 For assets shown above and placed In service dunnq the current year, 231 - . , .v-. t
--.- '-_,:. " .:~~
\'l~ c ,
enter the portion of the baSIS attributable to section 263A costs "'(_'l. ", "
" ~ ,\ S

B

d' S

D . 2 08 T

For Paperwork Reduction Act Notice, see separate instructions. DAA

Form 4562 (2008)

CHRISTIAN COMMUNITY .. Form 4562 (200B)

PLACEMENT CENTE

94-3112571

Page 2

Part',V '

• I • ..J

Listed Property (Include automobiles, certain other vehicles, cellular telephones, certain computers, and property used for entertainment, recreation, or amusement.)

Note: For any vehicle for which you are usmq the standard mileage rate or deducting lease expense, complete only 24a, 24bl columns (a) through (c) of Sectton A, all of Section B, and Section C If applicable

•

Section A-Depreciation and Other Information (Caution: See the Instructions for limits for ~ assenqer automobiles)
24a Do you have evidence to support the busmesszinvestment use claimed? Yes No 24b If 'Yes,' IS the evidence wntten? Yes No
(a) (b) (c) (d) (e) (f) (g) (h) (I)
Type of propsrf Date placed In Business! Cast or other Basis for depreciation Recovery Methodl Depreciancn Elected
Investment
(hst vehicles service use basis (busmess/lnvestrnent penod Convention deduction section 179
first) oercentace use only) cost
25 Special depreciation allowance for qualified listed property placed In service durmq the tax I
year and used more than 50% In a qualified business use (see Instructions) 25
26 Properf used more than 50% in a qualified business use'
VEHICLE
1/05LOO 100.00°;' 1.500 1._500 5.0 200DBHY
0;'
27 Properf used 50% or less in a qualified business use'
" - ,
. " ~ ; "i
% SIL· '.
" ' ,~ , t..;)
,- ,",
, ~I' 1 J.'l' .. -:
':i-..:,.
% S/L· c - ' ';~, '
1 ' ~ , .: :
28 Add amounts In column (h), lines 25 through 27. Enter here and on line 21, page 1 28 ,- . " , ','
"
29 Add amounts In column (I). line 26. Enter here and on line 7. oaoe 1 . " J 29 Section B-Information on Use of Vehicles

Complete this section for vehicles used by a sole proprietor, partner, or other 'more than 5% owner," or related person

If you provided vehicles to your employees, first answer the questions In Section C to see If you meet an exception to completing this section for those vehicles

30 Total busmess/mvestrnent miles driven (a) (b) (c) (d) (e) (f)
dunng the year (do not Include commuting Vehicle 1 Vehicle 2 Vehicle 3 Vehicle 4 Vehicle 5 Vehicle 6
miles) " " " "
31 Total commuting miles driven dunnq the year
32 Total other personal (noncornrnutmq) miles driven
33 Total miles driven dunnq the year. Add
lines 30 through 32 .... .. "
34 Was the vehicle available for personal Yes No Yes No Yes No Yes No Yes No Yes No
use dUring off-duty hours? .,' ..
35 Was the vehicle used primarily by a
more than 5% owner or related person?
36 Is another vehicle available for jJersonal use? Section C-Questlons for Employers Who Provide Vehicles for Use by Their Employees Answer these questions to determine If you meet an exception to completing Section B for vehicles used by employees who are

not more than 5% owners or related persons (see Instructions)
Yes No
37 Do you maintain a written policy statement that prohibits all personal use of vehicles, including commuting, by your employees? . ,
38 Do you maintain a written policy statement that prohibits personal use of vehicles, except commuting, by your employees?
See the Instructions for vehicles used by corporate officers, directors, or 1 % or more owners ..
39 Do you treat all use of vehicles by employees as personal use? .... . . " . .. . .
40 Do you provide more than five vehicles to your employees, obtain Information from your employees about
the use of the vehicles, and retain the Information received? , ... ... . . " .
41 Do you meet the requirements concerning qualified automobile demonstration use? (See mstrucnons.)
Note: If your answer to 37 38 39 40 or 41 IS 'Yes • do not com!>lete Section B for the covered vehicles. , ,:1': ... .J
-" ~.
" Amortization

, ,
(c) (d) (e) (f)
(b) Amortization
(a) Date amortization Amortizable Code penod or Amortization for
Dascnptron of costs begins amount section percentage this year 42 Amortization of costs that baqms durmq your 2008 tax year_(_see Instructions).

I I

I

I

157

43 Amortization of costs that began before your 2008 tax year

44 Total. Add amounts In column if) See the Instructions for where to reoort

1 43

157

144

Form 4562 (2ooB)

OM

Christian Community Placement Center 94-3112571

06/30/09

Page 10, Part IX, Line 24-0ther Expense

Vehicle Expense Amortization Bank Charges

Dues & subscriptions Gratuities-Promotions Licenses & permits Training

Program funds Miscellaneous

Line 24 f

Contributions Counseling/Consultations BUilding maintenance Proctor Care

Telephone

Total

8,150

157 3,279 1,103 3,379

21,262 10,964 18,191

47

66,531

81,200 67,659 42,651

857,917 34,485

Program Services

o o 1,196 35 5,677 16,259 28

23,255

6,000 2,900 o 857,917 145

1,150,443

890,218

60

Management and General 8,089

157 3,279 1,103 2,183

21,227 5,287 1,932 19

43,275

75,200 64,759 42,651

o 34,340

260,225

Fundralslng

o

,
..
CCPC
Debt
June 30, 2009
June 30, New Pnncipal Adjustments Other June 30,
2008 Loans Pa~ments to AlP Adjustments 2009
US Bank Loan #67 263,37688 13,881 36 1,68774 1,64372 252,82698 0-2
US Bank Loan #26 235,43843 10,26764 1,62705 (18226) 226,61558 0-3
Sub-total for mortgage loans 498,81531 000 24,14900 3,314 79 1,461 46 479,44256
Daimler Chrysler Loan 13,50342 4,44304 1,23207 10,29245 0-5
Chrysler Financial - Caravan 5,09553 3,817 88 42641 1,70406 0-6
Chrysler Financial - PT Cruiser 4,73338 3,61955 12565 21365 1,45313 0-4
Sub-total for loans 522,14764 000 36,02947 3,44044 3,33359 492,89220
US Bank - Credit Line #91 674,66563 20,04980 2,97721 1,18919 658,78223 0-1 1
1,196,81327 000 56,07927 6,417 65 4,52278 1,151,67443 ( PFt-e...T X wNE:;:l..5) SCHEbIJLE ;;;J....

Form aaq8 (Rev' Apnl 2009)

Application for Extension of Time To File an Exempt Organization Return

Oepartment of the Treasury Internal Revenue Service

~ File a separate application for each return.

OMS No 1545·1709

•

• If you are filing for an Automatic 3-Month Extension, complete only Part I and check this box

• If you are filing for an Additional (Not Automatic) 3-Month Extension, complete only Part II (on page 2 of this form)

Do not complete Part II unless you have already been granted an automatic 3·month extension on a previously filed Form 8868

I Part I I

Automatic 3-Month Extension of Time. Only submit onqmal (no copies needed)

A corporation required to file Form 990·T and requesting an automatic 6·month extension- check this box and complete Part I only

All other corporations (mcludmg 1120-C fliers), partnerships, REMICs, and trusts must use Form 7004 to request an extension of time to file mcome tax returns.

Electronic Filing (e-file). Generally, you can electronically ftle Form 8868 If you want a 3·month automatic extension of time to ftle one of the returns noted below (6 months for a corporation required to file Form 990·1) However, you cannot file Form 8868 electronically If (1) you want the additional (not automatic) 3·month extension or (2) you file Forms 990·SL, 6069, or 8870, group returns, or a composite or consolidated Form 990·T Instead, you must submit the fully completed and Signed page 2 (Part II) of Form 8868 For more details on the electronic filing of thrs form, VISit

www Irs.gov/eftle and click on e-fIIe for Chanties & Nonprotns

Type or Name of Exempt Organization Employer identification number

print

CHRISTIAN COMMUNITY PLACEMENT CENTER

94-3112571

File by the

due date for Number, street, and room or surte no If a P O. box, see Instructions.

filing your BOLDT CARLISLE & SMITH, LLC 480 CHURCH ST. SE

return See

instructions City, town or post office, state, and ZIP code For a foreign address, see Instructions

SALEM OR 97301

Check type of return to be filed(flle a separate application for each return)

00 Form 990 D Form 990·T (corporation)

o Form 990·BL D Form 990·T (sec 401 (a) or 408(a) trust)

o Form 990·EZ D Form 990·T (trust other than above)

o Form 990·PF 0 Form 1041·A

D Form 4720 D Form 5227 D Form 6069 o Form 8870

RAY FALGOUT

• The books are m the care of ~ 4890 32ND AVE SE - SALEM, OR 97317

Telephone No. ~ 503 - 5 8 8 - 5 647 FAX No ~

• If the organization does not have an office or place of busmess In the United States, check thrs box ~ D

• If trus IS for a Group Return, enter the organization's four digit Group Exemptton Number (GEN) If this IS for the whole group, check thrs

box ~ D If It IS for part of the group, check this box ~ D and attach a list With the names and EINs of all members the extension Will cover.

1 I request an automatic 3·month (6·months for a corporation required to file Form 990·T) extension of time untd

FEBRUARY 15, 2010 , to file the exempt organization return for the organization named above. The extension IS for the organization's return for

~ D calendar year or

~ [XJ tax year beginning JUL 1, 2 0 0 8

, and ending JUN 30, 2009

2 If this tax year IS for less than 12 months, check reason D Initial return

D Final return

o Change In accounting penod

3a If this application IS for Form 990·SL, 990·PF, 990·T, 4720, or 6069, enter the tentative tax, less any
nonrefundable credits See Instructions 3a $
b If trus application IS for Form 990·PF or 990·T, enter any refundable credits and estimated
tax payments made Include any_QTlor year overpayment allowed as a credit 3b $
c Balance Due. Subtract line 3b from line 3a Include your payment With this form, or, If required,
deposrt With FTD coupon or, If required, by usmq EFTPS (ElectrOnic Federal Tax Payment System) -
See Instructions 3c $ N/A Caution. If you are gOing to make an electroruc fund Withdrawal with this Form 8868, see Form 8453·EO and Form 8879·EO for payment Instructions

LHA For Privacy Act and Paperwork Reduction Act Notice, see Instructions.

Form 8868 (Rev. 4-2009)

823831 05·26·09