Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If 'Yes,' complete
Schedule A
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1
2
Is the organization required to complete Schedule B, Schedule of Contributors? (see instructions)
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2
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates
for public office? If 'Yes,' complete Schedule C, Part I
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3
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election
in effect during the tax year? If 'Yes,' complete Schedule C, Part II
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4
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues,
assessments, or similar amounts as defined in Revenue Procedure 98-19? If 'Yes,' complete Schedule C, Part III
. . . . . . . . .
5
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to
provide advice on the distribution or investment of amounts in such funds or accounts? If 'Yes,' complete Schedule D,
Part I
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6
7
Did the organization receive or hold a conservation easement, including easements to preserve open space, the
environment, historic land areas or historic structures? If 'Yes,' complete Schedule D, Part II
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7
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If 'Yes,'
complete Schedule D, Part III
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8
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 credit counseling, debt management, credit repair, or debt negotiation services? If 'Yes,' complete
Schedule D, Part IV
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9
Yes
No
BAA
TEEA0103 12/21/10
Form 990 (2010)
12 a Did the organization obtain separate, independent audited financial statements for the tax year? If 'Yes,' complete
Schedule D, Parts XI, XII, and XIII
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12a
b Was the organization included in consolidated, independent audited financial statements for the tax year? If 'Yes,' and
if the organization answered 'No' to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional
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12 b
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If 'Yes,' complete Schedule E
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13
14 a Did the organization maintain an office, employees, or agents outside of the United States?
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14a
b Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising,
business, and program service activities outside the United States? If 'Yes,' complete Schedule F, Parts I and IV
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14b
15
Did 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, Parts II and IV
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15
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 United States? If 'Yes,' complete Schedule F, Parts III and IV
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16
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX,
column (A), lines 6 and 11e? If 'Yes,' complete Schedule G, Part I (see instructions)
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17
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII,
lines 1c and 8a? If 'Yes,' complete Schedule G, Part II
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18
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If 'Yes,'
complete Schedule G, Part III
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19
20 a Did the organization operate one or more hospitals? If 'Yes,' complete Schedule H
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20
b If 'Yes' to line 20a, did the organization attach its audited financial statements to this return? Note. Some Form 990
filers that operate one or more hospitals must attach audited financial statements (see instructions)
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20 b
10
Did the organization, directly or through a related organization, hold assets in term, permanent, or quasi-endowments? If
'Yes,' complete Schedule D, Part V
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10
11
If the organization's answer to any of the following questions is 'Yes', then complete Schedule D, Parts VI, VII, VIII, IX,
or X as applicable.
a Did the organization report an amount for land, buildings and equipment in Part X, line 10? If 'Yes,' complete Schedule
D, Part VI
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11 a
b Did the organization report an amount for investments' other securities in Part X, line 12 that is 5% or more of its total
assets reported in Part X, line 16? If 'Yes,' complete Schedule D, Part VII
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11 b
c Did the organization report an amount for investments' program related in Part X, line 13 that is 5% or more of its total
assets reported in Part X, line 16? If 'Yes,' complete Schedule D, Part VIII
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11 c
d Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported
in Part X, line 16? If 'Yes,' complete Schedule D, Part IX
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11 d
e Did the organization report an amount for other liabilities in Part X, line 25? If 'Yes,' complete Schedule D, Part X
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11 e
f Did the organization's separate or consolidated financial statements for the tax year include a footnote that addresses
the organization's liability for uncertain tax positions under FIN 48 (ASC 740)? If 'Yes,' complete Schedule D, Part X
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11 f
MEDICAL TOURISM ASSOCIATION, INC
26-0753785
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