What is the organization's primary exempt purpose? REHABILITATION AND REFERRAL

Size: px
Start display at page:

Download "What is the organization's primary exempt purpose? REHABILITATION AND REFERRAL"

Transcription

1 Form 990 (2006) REFERRAL SERVICES, INC Page3 Part III Statement of Program Service Accomplishments (See the instructions.) Form 990 is availale for pulic inspection and, for some people, serves as the primary or sole source of information aout a particular organization How the pulic perceives an organization in such cases may e determined y the information presented on its return return is complete and accurate and fully descries, in Part III, the organization's programs and accomplishments Therefore, please make sure the What is the organization's primary exempt purpose? REHABILITATION AND REFERRAL SERVICES All organizations must descrie their exempt purpose achievements in a clear and concise manner. State the numer of clients served, pulications issued, etc Discuss achievements that are not measurale (Section 501(c)(3) and (4) organizations and 4947(a)(1) nonexempt charitale trusts must also enter the amount of grants and allocations to others) a PROVIDES REHAB, VOCATIONAL, & RESIDENTIAL SERVICES FOR INDIVIDUALS WITH BRAIN INJURIES;REFERRAL INFORMATION FROM THE COUNTY IS PROVIDED TO INDIVIDUALS AND THEIR FAMILIES. Program Service Expenses (Required for 501(c)(3) and (4) orgs., and 4947(a)(1) trusts; ut optional for others.) (Grants and allocations $ If this amount includes foreig n g rants, check here 0 2, 826, 607. C (Grants and allocations $ If this amount includes foreig n g rants, check here Q d (Grants and allocations $ If this amount includes foreig n g rants, check here (Grants and allocations $ If this amount includes foreig n g rants, check here Q e Other program services (attach schedule) (Grants and allocations $ If this amount incl udes foreig n g rants, check here 0 f Total of Program Service Expenses (should equal line 44, column (B), Program services) 2,826,607. Form 990 (2006)

2 Form 990 (2006) REFERRAL SERVICES, INC Page 4 Part IV Balance Sheets (See the instructions) Note : Where required, attached schedules and amounts within the descnption column (A) (B) should e for end -of-year amounts only Beginning of year End of year 45 Cash - non-interest - earing Savings and temporary cash investments 1, 290, , 709, a Accounts receivale 47a 472, 556. Less - allowance for doutful accounts 47 79, , c 392, a Pledges receivale 48a Less. allowance for doutful accounts 48 48c 49 Grants receivale a Receivales from current and former officers, directors, trustees, and key employees 50a Receivales from other disqualified persons (as defined under section 4958 (0(1)) and persons descried in section 4958 (c)(3 (B) a Other notes and loans receivale 51a a Less: allowance for doutful accounts Inventories for sale or use Prepaid expenses and deferred charges a Investments - pulicly -traded securities 0 Cost 0 FMV 54a Investments - other securities STMT LI Cost FMV 811, , a Investments - land, uildings, and equipment asis 55a Less. accumulated depreciation 55 55c 56 Investments - other a Land, uildings, and equipment. asis 57a 1, 439, 278. Less. accumulated depreciation STMT , , c 1, 111, Other assets, including program-related investments ( descrie SEE STATEMENT 5 ) 53, , Total assets must eq ual line 74 Add lines 45 throu g h , , 168, Accounts payale and accrued expenses - 288, , Grants payale Deferred revenue 62 ' 63 Loans from officers, directors, trustees, and key employees a Tax-exempt ond liailities 64a Mortgages and other notes payale 564, , Other liailities ( descrie SEE STATEMENT 6 ) , Total liailities. Add lines 60 throu gh , , 220, 384. Organizations that follow SFAS 117, check here and complete lines 67 through 69 and lines 73 and Unrestricted 3, 046, , 948, 123. m 68 Temporanly restricted 68 m 69 Permanently restricted 69 Organizations that do not follow SFAS 117, check here E 1 and LL complete lines 70 through Capital stock, trust principal, or current funds Paid - in or capital surplus, or land, uilding, and equipment fund 71 a 72 Retained earnings, endowment, accumulated income, or other funds 72 Z 73 Total net assets or fund alances. Add lines 67 through 69 or lines 70 through 72. ( Column ( A) must equal line 19 and column (B) must equal line 21) 3, 046, , 948, Total liailities and net assets /fund alances. Add lines 66 and 73 3, 899, , 168, 507. Form 990 (2006)

3 HEAD INJURY REHAB & REF SERVICES Form 990(2006 REFERRAL SERVICES, INC Page 5 Part IV-A Reconciliation of Revenue per Audited Financial Statements With Revenue per Return (See the instructions) a Total revenue, gains, and other support per audited financial statements a 3, 394, 081. Amounts included on line a ut not on Part I, line 12-1 Net unrealized gains on investments i 2 Donated services and use of facilities _ 2 3 Recoveries of prior year grants 3 4 Other(specify). UNREALIZED GAIN ON INVESTMENTS 4 24, 223. Add lines 1 through 4 24, 223. c Sutract line from line a c 3, 369, 858. d Amounts included on Part I, line 12, ut not on line a: 1 Investment expenses not included on Part I, line 6 dl 2 Other (specify): d2 Add lines d1 and d2 d 0. e Total revenue Part 1 line 12 ). Add lines c and d Part IV- B Reconciliation of Expenses per Audited Financial Statements With Expenses per Return a Total expenses and losses per audited financial statements Amounts included on line a ut not on Part I, line 17. c 1 Donated services and use of facilities _ 2 Prior year adjustments reported on Part I, line 20 3 Losses reported on Part I, line 20 _ 4 Other (specify): Add lines 1 through 4 Sutract line from line a d Amounts included on Part I, line 17, ut not on line a: 1 Investment expenses not included on Part I, line 6 2 Other (specify) Add lines d1 and d2 _ dl e 3, 369, 858. I c 1 3,288,162. Part V-A Current Officers, Directors, Trustees, and Key Employees (List each person who was an officer, director, trustee, or kev emolovee at any time dunna the year even if they were not compensated ) (See the instructions) (B) Title and average hours (C) Compensation (D)Contriutions to (E) Expense (A) Name and address employee enefit per week devoted to If not aid, enter account and ( p plans& deferred p osition compensation plans other allowances JOSEPH AMBROSE BOARD MEMBER ONE CHURCH-STREET ROCKVILLE, MD, ONE CHURCH-STREET ROCKVILLE, MD, SUZY MORRIS BOARD MEMBER ONE-CHURCH-STREET ROCKVILLE, MD, MINA SCHWARTZ BOARD MEMBER ONE CHURCH-STREET ROCKVILLE, MD, CHARLES WASHINGTON CHAIRMAN ONE CHURCH-STREET ROCKVILLE MD, ROZ ZEIDMAN TREASURER ONE CHURCH-STREET ROCKVILLE, MD, MICHAEL STRAND SECRETARY ONE CHURCH-STREET ROCKVILLE, MD FRANK DUGGAN VICE CHAIR ONE-CHURCH-STREET ROCKVILLE MD, Form 990 (2006)

4 Form 990 (2006) REFERRAL SERVICES. INC Page6 Part V-A Current Officers, Directors, Trustees, and Key Employees (continued) Yes No 75 a Enter the total numer of officers, directors, and trustees permitted to vote on organization usiness at oard meetings 7 Are any officers, directors, trustees, or key employees listed in Form 990, Part V-A, or highest compensated employees listed in Schedule A, Part I, or highest compensated professional and other independent contractors listed in Schedule A, Part II-A or II-B, related to each other through family or usiness relationships? If "Yes," attach a statement that identifies the individuals and explains the relationship(s) 75 X c Do any officers, directors, trustees, or key employees listed in Form 990, Part V-A, or highest compensated employees listed in Schedule A, Part I, or highest compensated professional and other independent contractors listed in Schedule A, Part II-A or II-B, receive compensation from any other organizations, whether tax exempt or taxale, that are related to the organization? See the instructions for the definition of "related organization." 75c X If "Yes," attach a statement that includes the information descried in the instructions d Does the organization have a written conflict of interest policy'? 75d X Part V-B Former Officers Directors Trustees and Key Employees That Received Compensation or Other Benefits (If any former officer, director, trustee, or key employee received compensation or other enefits (descried elow) during the year, list that person elow and enter the amount of compensation or other enefits in the appropriate column See the instructions ) (A) Name and address NONE ( B) Loans and Advances (C) Compensation ( if not paid, enter -0-) ( D) Contriutions to employee enefit plans & deferred com p ensation pans (E) Expense account and other allowances Part VI Other Information (See the instructions) Yes No 76 Did the organization make a change in its activities or methods of conducting activities? If "Yes," attach a detailed statement of each change X 77 Were any changes made in the organizing or governing documents ut not reported to the IRS? 77 X If "Yes," attach a conformed copy of the changes 78 a Did the organization have unrelated usiness gross income of $1,000 or more during the year covered y this return? - 78a X If "Yes," has it filed a tax return on Form 990 -T for this year? N/A Was there a liquidation, dissolution, termination, or sustantial contraction during the year? If "Yes," attach a statement 79 X 80 a Is the organization related (other than y association with a statewide or nationwide organization ) through common memership, governing odies, trustees, officers, etc, to any other exempt or nonexempt organization? 80a X If "Yes," enter the name of the organization' N/A and check whether it is exempt or nonexempt 81 a Enter direct or indirect political expenditures (See line 81 instructions) 81a 0. Did the org anization file Form POL for this year? 1 X Form 990 (2006) /

5 Form 990 (2006) REFERRAL SERVICES, INC Page 7 Part VI Other Information (continued) Yes No 82 a Did the organization receive donated services or the use of materials, equipment, or facilities at no charge or at sustantially less than fair rental value? 82a X If "Yes," you may indicate the value of these items here. Do not include this amount as revenue in Part I or as an expense in Part II (See instructions in Part III). 82 N / A 83 a Did the organization comply with the pulic inspection requirements for returns and exemption applications? 83a X Did the organization comply with the disclosure requirements relating to quid pro quo contriutions? 83 X 84 a Did the organization solicit any contriutions or gifts that were not tax deductile? 84a X If "Yes," did the organization include with every solicitation an express statement that such contriutions or gifts were not tax deductile? N/A (c)(4), (5), or(6) organizations. a Were sustantially all dues nondeductile y memers? N/A 85a Did the organization make only in-house loying expenditures of $2,000 or less? N/A 85 If "Yes" was answered to either 85a or 85, do not complete 85c through 85h elow unless the organization received a waiver for proxy tax owed for the prior year c Dues, assessments, and similar amounts from memers 85c N / A d Section 162(e) loying and political expenditures 85d N / A e Aggregate nondeductile amount of section 6033(e)(1)(A) dues notices 85e N / A f Taxale amount of loying and political expenditures (line 85d less 85e) 85f N / A g Does the organization elect to pay the section 6033(e) tax on the amount on line 85f' N/A 85 h If section 6033(e)(1)(A) dues notices were sent, does the organization agree to add the amount on line 85f to its reasonale estimate of dues allocale to nondeductile loying and political expenditures for the following tax year? N/A 85h (c)(7) organizations. Enter a Initiation fees and capital contriutions included on line 12 86a N / A Gross receipts, included on line 12, for pulic use of clu facilities 86 N / A (c)(12) organizations. Enter. a Gross income from memers or shareholders 87a N / A Gross income from other sources. (Do not net amounts due or paid to other sources against amounts due or received from them) 87 N / A 88 a At any time during the year, did the organization own a 50% or greater interest in a taxale corporation or partnership, or an entity disregarded as separate from the organization under Regulations sections and ? If "Yes," complete Part IX 88a X At any time during the year, did the organization, directly or indirectly, own a controlled entity within the meaning of section 512()(13)? If "Yes," complete Part XI 88 X 89 a 501(c)(3) organizations. Enter Amount of tax imposed on the organization during the year under section P. 0. ; section ; section (c)(3) and 501(c)(4) organizations. Did the organization engage in any section 4958 excess enefit transaction during the year or did it ecome aware of an excess enefit transaction from a prior year? If "Yes," attach a statement explaining each transaction 89 X c Enter Amount of tax imposed on the organization managers or disqualified persons during the year under sections 4912, 4955, and d Enter Amount of tax on line 89c, aove, reimursed y the organization 0. e All organizations. At any time during the tax year, was the organization a party to a prohiited tax shelter transaction? 89e X f Al! organizations. Did the organization acquire a direct or indirect interest in any applicale insurance contract? 89f X g For supporting organizations and sponsoring organizations maintaining donor advised funds. Did the supporting organization, or a fund maintained y a sponsoring organization, have excess usiness holdings at any time during the year? 89 X 90 a List the states with which a copy of this return is filed POP. MD Numer of employees employed in the pay period that includes March 12, a The ooks are in care of THE ORGANIZATION Telephone no Located at 1 CHURCH STREET, ROCKV I LLE, MD, ROCKV I LLE, MD ZIP At any time during the calendar year, did the organization have an interest in or a signature or other authority over Yes No a financial account in a foreign country (such as a ank account, securities account, or other financial account)? 91 X If "Yes," enter the name of the foreign country N/A See the instructions for exceptions and filing requirements for Form TD F , Report of Foreign Bank Form 990 (2006) /

6 Form 990 (2006) REFERRAL SERVICES. INC. 8 c At any time during the calendar year, did the organization maintain an office outside of the United States? 1 91c I I X If "Yes," enter the name of the foreign country N/A 92 Section 4947(a)(1) nonexempt chartale trusts filing Form 990 in lieu of Form Check here Q and enter the amount of tax -exem pt interest received or accrued durin g the tax year 92 N / A Part VII Analysis of Income - Producing Activities (See the instructions.) Note Enter ross amounts unless otherwise Unrelat ed usiness income Exclu ded y section 512, 513. or 514 (E) g Indicated. 93 a c d e f 9 94 Medicare/Medicaid payments Fees and contracts from government agencies Memership dues and assessments 2, 629, nterest on savings and temporary cash investments , Dividends and interest from secunties a d et-financed property c d e (A) (B) E(C) _ (D) Related or exempt Business Amount s,on Amount Program service revenue code code function income PATIENT FEES Net rental income or (loss) from real estate n ot det-financed property Net rental income or (loss) from personal property Other investment income Gain or (loss) from sales of assets other than inventory Net income or (loss) from special events Gross profit or (loss) from sales of inventory Other revenue. 34, 820. a MISC INCOME - ADMIN 749. S utotal (add columns (B), (D), and (E)) , , 194, ,354, Total (add line 104, columns (B), (D), and (F)) Note : Line 105 plus line le, Part 1, should equal the amount on line 12, Part 1. Part VI II Relationship of Activities to the Accomplishment of Exempt Purposes (See the instructions) Line No. V Explain how each activity for which income is reported in column (E) of Part VII contriuted importantly to the accomplishment of the organization's exempt purposes (other than y providing funds for such purposes). SEE STATEMENT 8 Part IX Information Regarding Taxale Susidiaries and Disregarded Entities (See the ins tructions) ( A ) Name, address, and EIN of corporation, partnership, or disregardedpenti ty (B Percentage of ownership interest (C) Nature of activities (D) Total Income ( E) End-of-year assets N / A % Part X Information Reaardi na Transfers Associated with Personal Benefit Contracts (See the instructions.) (a) Did the organization, during the year, receive any funds, directly or indirectly, to pay premiums on a personal enefit contract? Yes No () Did the organization, during the year, pay premiums, directly or indirectly, on a personal enefit contract? ED Yes No Note : If "Yes' to (), file Form 8870 and Form 4720 (see instructions) Form 990 (2006)

7 Form REFERRAL SERVICES, INC Page 9 Part XI Information Regarding Transfers To and From Controlled Entities. Complete only if the organization is a controlling organization as defined in section 512()(13) N/A Yes No 106 Did the reporting organization make any transfers to a controlled entity as defined in section 512()(13) of the Code? If "Yes," com plete the schedule elow for each controlled entity (A) (B) (C) (D) Name, address, of each Employer Description of Amount of Identification controlled entity Numer transfer transfer a c Totals 107 Did the reporting organization receive any transfers from a controlled entity as defined in section 512()(13) of the Code? If "Yes," com p lete the schedule elow for each controlled entity. (A) (B) (C) (D) Name, address, of each Employer Description of Amount of Identification controlled entity Numer transfer transfer Yes No a c Totals 108 Did the organization have a inding written contract in effect on August 17, 2006, covering the interest, rents, royalties, and annuities descried in q uestion 107 aove? Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the est of my knowledge and elief, it is true, correct, and complete Declaration of preparer (other than officer ) is ased on all information of which preparer has any knowledge Please ; I t- -A- Sign Signature of officer 1 Here ' Type or print name and title 1 C-A IC.6^ A U NT L /t T7^^7 OV 1- I 6 Zo c Preparers Dat Check If Preparer's SSN or PTIN (See Gen Inst X) Paid signature *7 ooo 17 1 selfemployed Preparer ' s Firm's name (or MULLEN, BERG, WIMBISH & ATONE, PA EIN Use Only ours If y s elf-employed), '2553 HOUR EY ROAD, SUITE 200 address, and zip+4 ANNAPOLIS MD Phoneno. ( 410 ) Form 990 (2006) Date Yes No /

8 SCHEDULE A Organization Exempt Under Section 501 (c)(3) 0MB No (Form 990 or 990-EZ ) (Except Private Foundation) and Section 501(e), 501(f), 501(k), 501(n ), or 4947 (a)(1) Nonexempt Charitale Trust 2006 Supplementary Information-(See separate instructions.) Department of the Treasury Internal Revenue Service MUST e completed y the aove organizations and attached to their Form 990 or 990-EZ Name of the organization HEAD INJURY REHAB & REF SERVICES Employer identification numer REFERRAL SERVICES, INC Part I Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees (See nave 2 of the instrur.tions_ List each one. If there are none. enter 'None!) ( a ) Name and address of each employee paid () Title and average hours ( d) Contriutions to (e) Expense () per week devoted to (c) Compensation p pls yy eaenc account and other more than $50,000 position compensation allowances BEVERLY WHITLOCK PRES ONE CHURCH STREET #102, ROCKVILLE, RICARDO HUNTER ICE PRES ONE CHURCH STREET #102, ROCKVILLE, , 000. TONI_OLAND DIR. ADMIN ONE CHURCH STREET #102, ROCKVILLE, M , 000. ROBERT_COUSLAND DIR. SPCH PT ONE CHRUCH STREET #102, ROCKVILLE, , 000. MARGARET HUNTER ONE CHURCH STREET #102, ROCKVILLE, , 600. Total numer of other employees paid over $50,000 0 Part II-A I Compensation of the Five Highest Paid Independent Contractors for Professional Services (See page 2 of the instructions. List each one (whether individuals or firms). If there are none, enter 'None') (a) Name and address of each independent contractor paid more than $50,000 1 () Type of service I (c) Compensation Total numer of others receiving over $50,000 for professional services 0 Part II-B Compensation of the Five Highest Paid Independent Contractors for Other Services (List each contractor who performed services other than professional services, whether individuals or firms. If there are none, enter "None.' See page 2 of the instructions.) (a) Name and address of each independent contractor paid more than $50,000 () Type of service I (c) Compensation Total numer of other contractors receiving over I 0 $50,000 for other services / LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990 and Form 990-EZ Schedule A (Form 990 or 990-EZ)

9 Schedule A (Form 990 or 990-EZ) 2006 Part III Statements Aout Activities (See page 2 of the instructions.) Yes No During the year, has the organization attempted to influence national, state, or local legislation, including any attempt to influence pulic opinion on a legislative matter or referendum? If 'Yes,' enter the total expenses paid or incurred in connection with the loying activities $ $ (Must equal amounts on line 38, Part VI-A, or line i of Part VI-B.) Organizations that made an election under section 501(h) y filing Form 5768 must complete Part VI-A. Other organizations checking'yes' must complete Part VI-13 AND attach a statement giving a detailed description of the loying activities. During the year, has the organization, either directly or indirectly, engaged in any of the following acts with any sustantial contriutors, trustees, directors, officers, creators, key employees, or memers of their families, or with any taxale organization with which any such person is affiliated as an officer, director, trustee, majority owner, or principal eneficiary? (If the answer to any question is "Yes, " attach a detailed statement explaining the transactions) a Sale, exchange, or leasing of property Lending of money or other extension of credit9 c Furnishing of goods, services, or facilities? d Payment of compensation (or payment or reimursement of expenses if more than $1,000)? SEE PART V-A. FORM 990 Transfer of any part of its income or assets9 3 a Did the organization make grants for scholarships, fellowships, student loans, etc? (If 'Yes; attach an explanation of how the organization determines that recipients qualify to receive payments.) Dd the organization have a section 403() annuity plan for its employees? c Did the organization receive or hold an easement for conservation purposes, including easements to preserve open space, the environment, historic land areas or historic structures? If 'Yes, attach a detailed statement d Did the organization provide credit counseling, det management, credit repair, or det negotiation services 4 a Did the organization maintain any donor advised funds2 If 'Yes,' complete lines 4 through 4g. If 'No,' complete lines 4f and 4g 4a X Did the organization make any taxale distriutions under section 4966? N/A 4 c Did the organization make a distriution to a donor, donor advisor, or related person? N/A 4c d Enter the total numer of donor advised funds owned at the end of the tax year N/A e Enter the aggregate value of assets held in all donor advised funds owned at the end of the tax year N/A f Enter the total numer of separate funds or accounts owned at the end of the year (excluding donor advised funds included on line 4d) where donors have the right to provide advice on the distriution or investment of amounts in such funds or accounts 0 g Enter the aggregate value of assets in all funds or accounts included on line 4f at the end of the tax year 0 X Schedule A (Form 990 or 990-EZ)

10 Schedule A (Form 990 or 990-EZ) 2006 REFERRAL SERVICES, INC Page 3 Part IV Reason for Non - Private Foundation Status (See pages 4 through 7 of the instructions.) I certify that the organization is not a private foundation ecause it is: (Please check only ONE applicale ox.) 5 0 A church, convention of churches, or association of churches. Section 170 ( )(1)(A)(i). 6 0 A school. Section 170 ( )(1)(A)(n). (Also complete Part V.) 7 0 A hospital or a cooperative hospital service organization. Section 170 ( )(1)(A)(iii). 8 A federal, state, or local government or governmental unit. Section 170()(1)(A)(v). 9 A medical research organization operated in conjunction with a hospital. Section 170 ()(1)(A)(iii). Enter the hospital 's name, city, and state 10 An organization operated for the enefit of a college or university owned or operated y a governmental unit. Section 170()(1)(A)(iv). (Also complete the Support Schedule in Part IV-A.) 11a An organization that normally receives a sustantial part of its support from a governmental unit or from the general pulic. Section 170()(1)(A)( w). (Also complete the Support Schedule in Part IV-A.) 11 A community trust Section 170()(1)(A )(vi). (Also complete the Support Schedule in Part IV-A.) 12 An organization that normally receives: ( 1) more than 33 1/3% of its support from contriutions, memership fees, and gross receipts from activities related to its charitale, etc., functions - suject to certain exceptions, and (2 ) no more than 33 1/3% of its support from gross investment income and unrelated usiness taxale income ( less section 511 tax) from usinesses acquired y the organization after June 30, See section 509 ( a)(2). (Also complete the Support Schedule in Part IV-A.) 13 0 An organization that is not controlled y any disqualified persons (other than foundation managers) and otherwise meets the requirements of section 509(a )( 3). Check the ox that descries the type of supporting organization: 0 Type I 0 Type II 0 Type III -Functionally Integrated Type III-Other Provide the following information aout the supported organizations. (See page 7 of the instructions.) (a) Name ( s) of supported organization ( s) () Employer identification numer ( EIN) (c) Type of organization ( descried in lines 5 through 12 aove or IRC section ) (d) Is the supported organization listed in the supporting organization's governing documents? (e) Amount of support Yes No 14 Q An organization organized and operated to test for pulic safety. Section 509(a )( 4). (See page 7 of the instructions.) Schedule A (Form 990 or EZ)

11 Schedule A (Form 990 or 990-EZ) 2006 REFERRAL SERVICES, INC Page 4 Part IV- A Support Schedule (Complete only if you checked a ox on line 10, 11, or 12) Use cash method of accounting. Note : You may use the worksheet in the instructions for converting from the accrual to the cash method of accounting Calendar year ( or fiscal year eginning in) (a ) 2005 ( ) 2004 c 2003 ( d ) 2002 (e) Total 15 er d ( Do not includeuunusual ceive grants. See line , , , , Memership fees received 17 Gross receipts from admissions, merchandise sold or services performed, or furnishing of facilities in any activity that is related to the organization's charitale, etc., purpose 3, 115, , 848, ,312,545. 2, 224, , 501, Gross income from interest, dividends, amounts received from payments on securities loans (section 512(a)(5)), rents, royalties, and unrelated usiness taxale income (less section 511 taxes) from usinesses acquired y the organization after June 30, , , , , , Net income from unrelated usiness activities not included in line Tax revenues levied for the organization's enefit and either paid to it or expended on its ehalf 1 21 The value of services or facilities furnished to the organization y a governmental unit without charge. Do not include the value of services or facilities generally furnished to _ the pulic without charge 22 Other Income. Attach a schedule. SEE STATEME NT 9 Do not (loss) from s talassetsor 66, , , , , 442. of capi 23 Total of lines 15 through 22 3, 320, , 399, , 302, Line 23 minus line , , , , Enterl%ofline23 33, , Organizations descried on lines 10 or 11: a Enter 2% of amount in column (e), line 24 26a N / A Prepare a list for your records to show the name of and amount contriuted y each person (other than a governmental unit or pulicly supported organization) whose total gifts for 2002 through 2005 exceeded the amount shown in line 26a. Do not file this list with your return. Enter the total of all these excess amounts 26 N / A c Total support for section 509(a)(1) test Enter line 24, column (e) 26c N / A d Add: Amounts from column (e) for lines: d N / A e Pulic support (line 26c minus line 26d total) 26e N / A f Pu lic support percentage ( line 26e (numerator ) divided y line 26c (denominator 26f N / A % 27 Organizations descried on line 12 : a For amounts included in lines 15, 16, and 17 that were received from a'disqualified person, prepare a list for your records to show the name of, and total amounts received in each year from, each 'disqualified person' Do not file this list with your return. Enter the sum of such amounts for each year: (2005) 0. (2004) 0. (2003) 0. (2002) 0. For any amount included in line 17 that was received from each person (other than 'disqualified persons'), prepare a list for your records to show the name of, and amount received for each year, that was more than the larger of (1) the amount on line 25 for the year or (2) $5,000. (Include in the list organizations descried in lines 5 through 11, as well as individuals.) Do not file this list with your return. After computing the difference etween the amount received and the larger amount descried in (1) or (2), enter the sum of these differences (the excess amounts) for each year: (2005) 0. (2004) 0. (2003) 0. (2002) c Add: Amounts from column (e) for lines: , ,501, c d Add: Line 27a total 0. and line 27 total 0. 27d e Pulic support (line 27c total minus line 27d total) 27e f Total support for section 509(a)(2) test Enter amount on line 23, column (e) 27f 10, 953, 731. g Pulic support percentage ( line 27e ( numerator ) divided y line 27f (denominator)) 27 h Investment income nercentaae ( line 18. column ( e) (numerator) divided y line 27f (denominator)) 27h 185% 28 Unusual Grants : For an organization descried in line 10, 11, or 12 that received any unusual grants during 2002 through 2005, prepare a list for your records to show, for each year, the name of the contriutor, the date and amount of the grant, and a rief description of the nature of the grant Do not file this list with your return. Do not include these grants in line NONE Schedule A (Form 990 or 990-EZ)

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax Form 990-EZ PUBLIC DISCLOSURE COPY ** PUBLIC DISCLOSURE COPY ** Short Form Return of Organization Exempt From Income Tax Under section 501, 527, or 4947(1) of the Internal Revenue Code (except private

More information

Return of Organization Exempt From Income Tax

Return of Organization Exempt From Income Tax Form Part I Activities & Governance Revenue Expenses Part II Sign Here 990 1 Paid Preparer Use Only Return of Organization Exempt From Income Tax 2013 10 NORTH ST (609)977-0228 City or town, state or province,

More information

Return of Organization Exempt From Income Tax

Return of Organization Exempt From Income Tax Return of Organization Exempt From Income Tax OMB No. 1545-0047 Form Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except lack lung enefit trust or private foundation) Open to

More information

D/w, Form 990-EZ (2009)

D/w, Form 990-EZ (2009) ,20865 09/29/2010 5 04 PM Form 990-EZ. of A For the 2009 ca' B Check if applicale Address change Name change Initial return Termination Amended return Short Form Return of Organization Exempt From Income

More information

145SchP" N IFt. Form 99Q 1 Return of Organization Exempt From Income Tax V-4 LLJ Z U V) No 1545

145SchP N IFt. Form 99Q 1 Return of Organization Exempt From Income Tax V-4 LLJ Z U V) No 1545 V-4 C, O LLJ Z U V) No 1545 Form 99Q 1 Return of Organization Exempt From Income Tax r Under section 501(c ), 527, or 4947( a)(1) of the Internal Revenue Code (except lack 2006 lung enefit trust or private

More information

Return of Organization Exempt From Income Tax

Return of Organization Exempt From Income Tax Form 990 Department of the Treasury Internal Revenue Service A For the 2006 calendar year, or tax year beginning, 2006, and ending, B Check if applicable: C D Employer Identification Number Please use

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax Form 99-EZ Department of the Treasury Internal Revenue Service Short Form Return of Organization Exempt From Income Tax Under section 51(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax Form 990-EZ Short Form Return of Organization Exempt From Income Tax Under section 501 (c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) OMB No. 1545-1150 2013 r*p LL Department

More information

FREEDOM PARTNERS CHAMBER OF COMMERCE, INC. 45-3732750

FREEDOM PARTNERS CHAMBER OF COMMERCE, INC. 45-3732750 FREEDOM PARTNERS CHAMBER OF COMMERCE, INC. 45-373275 Form 99 (214) Page 2 Part III Statement of Program Service Accomplishments Check if Schedule O contains a response or note to any line in this Part

More information

Return of Organization Exempt From Income Tax

Return of Organization Exempt From Income Tax s ci SWEESLE Form 990 Department of the 'rreasury A For the 2006 cal B Check if applicale n Address change El rx] Name change Initial return Final return Amended return Return of Organization Exempt From

More information

Part t ROVOn.IA Fvnan a and Chnnnoc in Nat Accafc nr Frrnrt Rninnr /Coa nnno37 of tha inctn,rtinnc 1

Part t ROVOn.IA Fvnan a and Chnnnoc in Nat Accafc nr Frrnrt Rninnr /Coa nnno37 of tha inctn,rtinnc 1 ASSOCIATION 07/24/2006 3:29 PM Form A 9190-EZ of 0 For the 2004 cal B Check if applicale Address change Name change Initial return Final return Short Form OMB No 1545-11; Return of Organization Exempt

More information

Form 990 Return of Organization Exempt From Income Tax

Form 990 Return of Organization Exempt From Income Tax OMB No. 1545-0047 Form 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 2011 benefit trust or private foundation)

More information

A For the 2011 calendar year, or tax year beginning 10/01 B Check if applicable:

A For the 2011 calendar year, or tax year beginning 10/01 B Check if applicable: Form 99-EZ Department of the Treasury Internal Revenue Service Short Form Return of Organization Exempt From Income Tax Under section 51(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black

More information

Return of Organization Exempt From Income Tax

Return of Organization Exempt From Income Tax Form 990 Return of Organization Exempt From Income Tax OMB No. 1545-0047 Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung 2010 benefit trust or private foundation)

More information

Form 990-EZ and supplemental forms and schedules. Sign and date: An officer must sign and date Form 990-EZ on page 4.

Form 990-EZ and supplemental forms and schedules. Sign and date: An officer must sign and date Form 990-EZ on page 4. Federal Filing Instructions 2014 Name(s) as shown on return Your Social Security Number Date to file by: 08-17-2015 Form to be filed: Form 990-EZ and supplemental forms and schedules Sign and date: An

More information

1 Briefly describe the organization's mission: SEE STATEMENT 1

1 Briefly describe the organization's mission: SEE STATEMENT 1 Form 990 (2008) 26-0850638 Page 2 Part III Statement of Program Service Accomplishments (see instructions) 1 Briefly descrie the organization's mission: SEE STATEMENT 1 2 Did the organization undertake

More information

Return of Organization Exempt From Income Tax

Return of Organization Exempt From Income Tax Form Part I 1 22 Part II Sign Here 990 Department of the Treasury Internal Revenue Service Paid Preparer Use Only Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1)

More information

Form 990 Return of Organization Exempt From Income Tax

Form 990 Return of Organization Exempt From Income Tax OMB No. 1545-0047 Form 990 Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) 2014 Do not enter social security

More information

359,843 4,352 32,364 49,373 51,701

359,843 4,352 32,364 49,373 51,701 Forms 99 / 99-EZ Return Summary For calendar year 21, or tax year eginning Denton Assistance Center Inc, and ending 7-29612 Net Asset / Fund Balance at Beginning of Year 11,89 Revenue Contriutions Program

More information

WEISERMAZARS LLP 135 WEST 50TH STREET NEW YORK, NY 10020 PRO BONO NET, INC. 151 WEST 30TH STREET NEW YORK, NY 10001 !100018!

WEISERMAZARS LLP 135 WEST 50TH STREET NEW YORK, NY 10020 PRO BONO NET, INC. 151 WEST 30TH STREET NEW YORK, NY 10001 !100018! WEISERMAZARS LLP 135 WEST 50TH STREET NEW YORK, NY 10020 PRO BONO NET, INC. 151 WEST 30TH STREET NEW YORK, NY 10001!100018! 926340 04-24-09 Caution: Forms printed from within Adoe Acroat products may not

More information

U.S. Income Tax Return for an S Corporation

U.S. Income Tax Return for an S Corporation Form 1120S U.S. Income Tax Return for an S Corporation Do not file this form unless the corporation has filed or is attaching Form 2553 to elect to be an S corporation. Information about Form 1120S and

More information

Briefly describe the organization's mission or most significant activities: SEE MISSION STATEMENT ON SCHEDULE 0

Briefly describe the organization's mission or most significant activities: SEE MISSION STATEMENT ON SCHEDULE 0 Form 990 Department of the Treasury internal Revenue Service ETENSION GRANTED TO 08/15/13 Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue

More information

Instructions for Schedule A (Form 990 or 990-EZ) Public Charity Status and Public Support

Instructions for Schedule A (Form 990 or 990-EZ) Public Charity Status and Public Support 2009 Instructions for Schedule A (Form 990 or 990-EZ) Public Charity Status and Public Support Department of the Treasury Internal Revenue Service Section references are to the Internal Revenue Code unless

More information

TAX RETURN FILING INSTRUCTIONS

TAX RETURN FILING INSTRUCTIONS TA RETURN FILING INSTRUCTIONS FORM 990 FOR THE YEAR ENDING ~~~~~~~~~~~~~~~~~ JUNE 30, 2014 Prepared for Prepared y Amount due or refund Make check payale to Mail tax return and check (if applicale) to

More information

Instructions for Schedule A (Form 990 or 990-EZ)

Instructions for Schedule A (Form 990 or 990-EZ) 2011 Instructions for Schedule A (Form 990 or 990-EZ) Public Charity Status and Public Support Department of the Treasury Internal Revenue Service Section references are to the Internal Revenue Code unless

More information

Number, street, and room or suite no. If a P.O. box, see the instructions. City or town, state or province, country, and ZIP or foreign postal code

Number, street, and room or suite no. If a P.O. box, see the instructions. City or town, state or province, country, and ZIP or foreign postal code Form 1065 Department of the Treasury Internal Revenue Service A Principal business activity U.S. Return of Partnership Income For calendar year 2015, or tax year beginning, 2015, ending, 20. Information

More information

Instructions for Schedule A (Form 990 or 990-EZ)

Instructions for Schedule A (Form 990 or 990-EZ) 2010 Instructions for Schedule A (Form 990 or 990-EZ) Public Charity Status and Public Support Department of the Treasury Internal Revenue Service Section references are to the Internal Revenue Code unless

More information

Instructions for Schedule A (Form 990 or 990-EZ)

Instructions for Schedule A (Form 990 or 990-EZ) 2012 Instructions for Schedule A (Form 990 or 990-EZ) Public Charity Status and Public Support Department of the Treasury Internal Revenue Service Section references are to the Internal Revenue Code unless

More information

0 BOX 1920 212-840-51 35 OAmended Lions return. or ASSOCIATION print or MONITORING EAU,& /O DGA SECURITY SYSTEMS, INC. 20-8098207

0 BOX 1920 212-840-51 35 OAmended Lions return. or ASSOCIATION print or MONITORING EAU,& /O DGA SECURITY SYSTEMS, INC. 20-8098207 i Form r 990-EZ ^D Return ojb^jw^n a1onxempt 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) Sponsoring organizations

More information

l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93492179004143

l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93492179004143 l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93492179004143 Form 990-EZ IN Department of the Treasury Internal Revenue Service Short Form OMB 1545-1150 Return of Organization Exempt From

More information

IRS Form 990 Information Return Highlights

IRS Form 990 Information Return Highlights IRS Form 99 Information Return Highlights Arizona State University (ASU or University) is the largest pulic university in the United States under a single administration. It has the critical mass and quality

More information

Open to Public Inspection A For the 2011 calendar year, or tax year beginning B Check if applicable: C Name of organization

Open to Public Inspection A For the 2011 calendar year, or tax year beginning B Check if applicable: C Name of organization Form 990 Department of the Treasury Internal Revenue Service Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit

More information

Instructions for Schedule A (Form 990 or 990-EZ)

Instructions for Schedule A (Form 990 or 990-EZ) 2014 Instructions for Schedule A (Form 990 or 990-EZ) Public Charity Status and Public Support Department of the Treasury Internal Revenue Service Section references are to the Internal Revenue Code unless

More information

Instructions for Schedule D (Form 990)

Instructions for Schedule D (Form 990) 2015 Instructions for Schedule D (Form 990) Supplemental Financial Statements Department of the Treasury Internal Revenue Service Section references are to the Internal Revenue Code unless otherwise noted.

More information

Instructions for Schedule D (Form 990) Supplemental Financial Statements

Instructions for Schedule D (Form 990) Supplemental Financial Statements 2009 Instructions for Schedule D (Form 990) Supplemental Financial Statements Department of the Treasury Internal Revenue Service Section references are to the Internal 1. That is separately identified

More information

THE MUSICAL CORPORATION 40-0006011

THE MUSICAL CORPORATION 40-0006011 A Sign Here 112 Form Department of the Treasury Internal Revenue Service Check if: Paid Preparer Use Only U.S. Corporation Income Tax Return 215 1a Consolidated return TYPE Numer, street, and room or suite

More information

1. The organization mission or most significant activities that you wish to highlight this year:

1. The organization mission or most significant activities that you wish to highlight this year: Form 990 Questionnaire For All Organizations Core Form Heading & Pt I Summary 1. The organization mission or most significant activities that you wish to highlight this year: 2. Total number of volunteers

More information

2008 Schedule D (Form 990) Instructions - Draft April 7, 2008. Schedule D contains a compilation of various financial statement attachments.

2008 Schedule D (Form 990) Instructions - Draft April 7, 2008. Schedule D contains a compilation of various financial statement attachments. Highlights Schedule D contains a compilation of various financial statement attachments. Part I requires information regarding donor advised funds and other similar funds or accounts. This information

More information

U.S. Corporation Income Tax Return For calendar year 2015 or tax year beginning, 2015, ending, 20

U.S. Corporation Income Tax Return For calendar year 2015 or tax year beginning, 2015, ending, 20 Form 1120 Department of the Treasury Internal Revenue Service A Check if: 1a Consolidated return (attach Form 851). b Life/nonlife consolidated return... 2 Personal holding co. (attach Sch. PH).. 3 Personal

More information

Return of Organization Exempt From Income Tax

Return of Organization Exempt From Income Tax Form 990 Department of the Treasury Internal Revenue Service For the 2011 calendar year, or tax year beginning, 2011, and ending, B Check if applicable: C D Employer Identification Number ddress change

More information

01^ 1k 990-EZ. ated 12-11 43RD AVENUE 718-361-0145 1 13141020 759639 PMT77017.04 2009.04050 UNITED UNION OF ROOFERS - L PMT77011.

01^ 1k 990-EZ. ated 12-11 43RD AVENUE 718-361-0145 1 13141020 759639 PMT77017.04 2009.04050 UNITED UNION OF ROOFERS - L PMT77011. i m O Form 990-EZ Department of the Treasury Internal Revenue Service Short Form Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code ( except

More information

Short Form. Return of Organization Exempt From Income Tax

Short Form. Return of Organization Exempt From Income Tax I Form 990-EZ Department of the Treasury Internal Revenue Service Short Form Return of Organization Exempt From Income Tax Under section 501(c ), 527, or 4947( a)(1) of the Internal Revenue Code (except

More information

Short Form OMB No 1545-1150 Return of Organization Exempt From Income Tax 2011. and endina 06-30-2012

Short Form OMB No 1545-1150 Return of Organization Exempt From Income Tax 2011. and endina 06-30-2012 l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93492286001092 990.EZ Short Form OMB 1545-1150 Return of Organization Exempt From Income Tax 2011 Form Under section 501 (c), 527, or 4947 (

More information

4 a (Code: ) (Expenses $ 184,481 including grants of $ ) (Revenue $ 5,645 ) 4 c (Code: ) (Expenses $ 24,587 including grants of $ ) (Revenue $ 0 )

4 a (Code: ) (Expenses $ 184,481 including grants of $ ) (Revenue $ 5,645 ) 4 c (Code: ) (Expenses $ 24,587 including grants of $ ) (Revenue $ 0 ) Form 990 (2013) Page 2 Part III Statement of Program Service Accomplishments Check if Schedule O contains a response or note to any line in this Part III............. 1 Briefly describe the organization

More information

33182 25 37604 26 Total liabilities (describe ) - 26 - - 27 Net assets or fund balances ine 27 of column (B) must ag ree with line 21 ) 33182 27

33182 25 37604 26 Total liabilities (describe ) - 26 - - 27 Net assets or fund balances ine 27 of column (B) must ag ree with line 21 ) 33182 27 assets_ TU CIQ 6Sa Z Form 990^EZ Short Form 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

More information

U.S. Property and Casualty Insurance Company Income Tax Return. For calendar year 2014, or tax year beginning, 2014, and ending, 20.

U.S. Property and Casualty Insurance Company Income Tax Return. For calendar year 2014, or tax year beginning, 2014, and ending, 20. Form 1120-PC Department of the Treasury Internal Revenue Service A Check if: 1 Consolidated return (attach Form 851). 2 Life-nonlife consolidated return.. 3 Schedule M-3 (Form 1120-PC) attached... U.S.

More information

Your social security number FRED ADAMS 678-09-0752. If a joint return, spouse's first name and initial SANDY ADAMS 679-09-0752 ... 7 8a ...

Your social security number FRED ADAMS 678-09-0752. If a joint return, spouse's first name and initial SANDY ADAMS 679-09-0752 ... 7 8a ... Department of the Treasury - Internal Revenue Service (99) 00 U.S. Individual Income Tax Return 0 OMB. -00 For the year Jan. -Dec., 0, or other tax year eginning,0, ending,0 Form Your first name and initial

More information

OMB No 1545-004. 2008 D Employer identification number. 05h o Q. o-- v

OMB No 1545-004. 2008 D Employer identification number. 05h o Q. o-- v 05h o Q o-- v LL Foan Ua0 Department of the Treasury Internal Revenue Service A For the 2007 calendar year, or tax year beginni Return of Organization Exempt From Income Tax Under section 501(c), 527,

More information

c Net income or (loss) from special events and activities (Subtract line 6b from line 6a) 70,712 6c

c Net income or (loss) from special events and activities (Subtract line 6b from line 6a) 70,712 6c l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93492074007020 Form 990-EZ IN Department of the Treasury Internal Revenue Service Short Form OMB No 1545-1150 Return of Organization Exempt

More information

990-PF Return of Private Foundation

990-PF Return of Private Foundation I.. Z Form 990-PF Return of Private Foundation OMB NO 1545-0052 Department of the Treasury Internal Revenje Service (77) or Section 4947(a)(1) Nonexempt Charitale Trust 2007 Treated as a Private Foundation

More information

24465 22 22553 23 Land and buildings... 23 24 Other assets (describe INSTRUMENTS MUSIC UNIFORMS TRAILER ) 8000 24 9605

24465 22 22553 23 Land and buildings... 23 24 Other assets (describe INSTRUMENTS MUSIC UNIFORMS TRAILER ) 8000 24 9605 all) 0 0N -44 Short Form Return of Organization Exempt From Income Tax 990^F1 Form Under section 501 (c), 527, or 4947( a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

More information

OMB No. 1545-0047 Form 990. Return of Organization Exempt From Income Tax. Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code

OMB No. 1545-0047 Form 990. Return of Organization Exempt From Income Tax. Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code OMB. 1545-0047 Form 990 Return of Organization Exempt From Income Tax 2012 Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code Department of the Treasury Internal Revenue Service (except

More information

Other (specify), H Check III-, if the organization is not I Website :

Other (specify), H Check III-, if the organization is not I Website : L c w 0 For, 990-EZ Department of the Treasury Internal Revenue Service Short Form Return of Organization Exempt From Income Tax Under section 501(c ), 527, or 4947( a)(1) of the Internal Revenue Code

More information

13 Professional fees and other payments to independent contractors... 13 7,000... 14 20,358

13 Professional fees and other payments to independent contractors... 13 7,000... 14 20,358 CU c%j Fom, 990 ^EZ Short Form 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)

More information

5c w 6 Special events and activities (attach schedule). If any amount is from gaming, check here ~~ a Gross revenue (not including $

5c w 6 Special events and activities (attach schedule). If any amount is from gaming, check here ~~ a Gross revenue (not including $ L~.I Form b90' EZ Department of the Treasury Internal Revenue Service ~ The A For the 2003 calendar eai B Check if applicable C Short Form Return of Organization Exempt From Income Tax Under section 501(c),

More information

lefile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93492221000650 1 Contributions, gifts, grants, and similar amounts received 1

lefile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93492221000650 1 Contributions, gifts, grants, and similar amounts received 1 lefile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93492221000650 Form 990-EZ IN Department of the Treasury Internal Revenue Service Short Form OMB No 1545-1150 Return of Organization Exempt From

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax Form 990-EZ Department of the Treasury Internal Revenue Service A B 1 I I 1 1 Short Form Return of Organization Exempt From Income Tax Under section 501(c), 627, or 4947(1) of the Internal Revenue Code

More information

Note: Page 1 of 6 Instructions for Form CHAR500 (rev. 2010)

Note: Page 1 of 6 Instructions for Form CHAR500 (rev. 2010) New York State Department of Law (Office of the Attorney General) Charities Bureau - Registration Section Instructions for Form CHAR500 Annual Filing for Charitable Organizations www.charitiesnys.com Contents:

More information

NUVASIVE SPINE FOUNDATION

NUVASIVE SPINE FOUNDATION NUVASIVE SPINE FOUNDATION KPMG LLP 355 S. Grand Avenue, Suite 2000 Los Angeles, CA 90071 Telephone 213-972-4000 Fax 213-630-2279 Private The Nuvasive Spine Foundation 7475 LUSK BOULEVARD Enclosed are the

More information

Instructions for Schedule A (Form 990 or 990-EZ)

Instructions for Schedule A (Form 990 or 990-EZ) 2004 Instructions for Schedule A (Form 990 or 990-EZ) Section references are to the Internal Revenue Code unless otherwise noted. Department of the Treasury Internal Revenue Service Contents Page 501(k),

More information

SEE SCHEDULE O SEE SCHEDULE O 1,321,367.

SEE SCHEDULE O SEE SCHEDULE O 1,321,367. Form 990 (2011) ERCES SOCIETY, INC. 51-0175253 Page 2 Part III Statement of Program Service Accomplishments Check if Schedule O contains a response to any question in this Part III....................................................

More information

Return of Organization Exempt From Income Tax

Return of Organization Exempt From Income Tax Form 99 Return of Organization Exempt From Income Tax OMB No. 1545-47 Under section 51(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung 21 benefit trust or private foundation) Open

More information

Sample 1023, Application for Recognition of Exemption FILING INSTRUCTIONS

Sample 1023, Application for Recognition of Exemption FILING INSTRUCTIONS Sample 1023, Application for Recognition of Exemption FILING INSTRUCTIONS Remember, on all attachments to have a heading with your PTA s corporation name and EIN (Employer ID Number). Form 1023 (Rev. 12-2011)

More information

2 Department of the Treasury -The organization may have to use a copy of this return to satisfy state reporting requirements Internal Revenue Service

2 Department of the Treasury -The organization may have to use a copy of this return to satisfy state reporting requirements Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions. Cat No 11282Y Form 990 (2007) l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93490219001049 Form 990 Return

More information

990-EZ. Short Form Return of Organization Exempt From Income Tax Form 75-0832625 (972) 403-7018

990-EZ. Short Form Return of Organization Exempt From Income Tax Form 75-0832625 (972) 403-7018 990-EZ Short Form Return of Organization Exempt From Income Tax Form Under section 501 (c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation) Sponsoring

More information

Return of Organization Exempt From Income Tax

Return of Organization Exempt From Income Tax Form 990 Department of the Treasury Internal Revenue Service G The organization may have to use a copy of this return to satisfy state reporting requirements. A For the 2011 calendar year, or tax year

More information

... 1 2 Program service revenue including government fees and contracts 2 3 Membership dues and assessments..

... 1 2 Program service revenue including government fees and contracts 2 3 Membership dues and assessments.. 990 -^Z Short Form Return of Organization Exempt From Income Tax Form Under section 501(c ), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation) Sponsoring

More information

2013 Exempt Organization Business Tax Return prepared for: THE ARC OF COLORADO 1580 LOGAN STREET, #730 DENVER, CO 80203-1942

2013 Exempt Organization Business Tax Return prepared for: THE ARC OF COLORADO 1580 LOGAN STREET, #730 DENVER, CO 80203-1942 201 Exempt Organization Business Tax Return prepared for: THE ARC OF COLORADO 1580 LOAN STREET, #70 DENVER, CO 8020-1942 BENZ SEYFERT & COMPANY, INC. 1620 WASHINTON AVE OLDEN, CO 80401 Form 990 Department

More information

2 00 7_ Department of the

2 00 7_ Department of the For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions. Cat No 11282Y Form 990 (2007) lefile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93490135008019 OMB No 1545-0047

More information

1SIONATTAC. 12 15, 574, 550. 13 Program services (from line 44, column ())

1SIONATTAC. 12 15, 574, 550. 13 Program services (from line 44, column ()) . Cad a) cv r. 0 L'1J Form 9 9 0 Return of Organization Exempt From Income Tax Under section 501 (c), 527, or 4947( a)(1) of the Internal Revenue Code ( except black lung Department of the Treasury benefit

More information

Return of Organization Exempt From Income Tax

Return of Organization Exempt From Income Tax Form 990 Department of the Treasury Internal Revenue Service A For the 2011 calendar year, or tax year beginning, 2011, and ending, B Check if applicable: C D Employer Identification Number Address change

More information

Instructions for Schedule L (Form 990 or 990-EZ)

Instructions for Schedule L (Form 990 or 990-EZ) 2010 Instructions for Schedule L (Form 990 or 990-EZ) Transactions With Interested Persons Department of the Treasury Internal Revenue Service State whether the transaction has been Section references

More information

990^EZ. Short Form Return of Organization Exempt From Income Tax 'ADAMS POOL CORPORATION 3DG R (781) 863-5319 101415.97 25 119284.

990^EZ. Short Form Return of Organization Exempt From Income Tax 'ADAMS POOL CORPORATION 3DG R (781) 863-5319 101415.97 25 119284. 990^EZ Short Form Return of Organization Exempt From Income Tax OMB No 1545-1150 20005 Form Under section 501 (c), 527, or 4947 (a)(1) of the Internal Revenue Code (except black lung benefit trust or private

More information

Government Copy. Community Culinary School of Charlotte, Inc. 2401-A Distribution Street Charlotte, NC 28203 704.375.4500

Government Copy. Community Culinary School of Charlotte, Inc. 2401-A Distribution Street Charlotte, NC 28203 704.375.4500 2013 TA RETURN Government Copy Client: Prepared for: 6250 Community Culinary School of Charlotte, Inc. 2401-A Distribution Street Charlotte, NC 28203 704.375.4500 Prepared by: Terry W. Lancaster C. DeWitt

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax c " C%% c^1 h Z Form 990-EZ Short Form Return of Organization Exempt From Income Tax Under section 501(c) 527, or 4947ta )( 1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

More information

HUEY & ASSOCIATES, P.C. NON-PROFIT TAX ORGANIZER - 990

HUEY & ASSOCIATES, P.C. NON-PROFIT TAX ORGANIZER - 990 HUEY & ASSOCIATES, P.C. NON-PROFIT TAX ORGANIZER - 990 ORG1 Please fill out the information below unless it is not applicable to your organization. Organization Information: Organization Name: Address:

More information

Application for Extension of Time To File an Exempt Organization Return

Application for Extension of Time To File an Exempt Organization Return Form 8868 (Rev. January 2014) Department of the Treasury Internal Revenue Service for Extension of Time To File an Exempt Organization File a separate application for each return. Information about Form

More information

Instructions for Schedule L (Form 990 or 990-EZ)

Instructions for Schedule L (Form 990 or 990-EZ) 2011 Instructions for Schedule L (Form 990 or 990-EZ) Transactions With Interested Persons Department of the Treasury Internal Revenue Service Section references are to the Internal do so, it must file

More information

U.S. Life Insurance Company Income Tax Return For calendar year 2014 or tax year beginning, 2014, ending, 20

U.S. Life Insurance Company Income Tax Return For calendar year 2014 or tax year beginning, 2014, ending, 20 Form 1120-L Department of the Treasury Internal Revenue Service A Check if: 1 Consolidated return (attach Form 851). 2 Life-nonlife consolidated return.. 3 Schedule M-3 (Form 1120-L) attached... U.S. Life

More information

OMB No 1545-0047 (502)368-1683 61-06551 87

OMB No 1545-0047 (502)368-1683 61-06551 87 . 1 " Return of Organization Exempt From Income Tax OMB No 1545-0047 Form 990 Under section 501 (c), 527, or 4947( a)(1) of the Internal Revenue Code ( except black lung 2005 benefit trust or private foundation

More information

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax I I C (r. or, c_ - Ct Form 990_EZ Short Form Return of Organization Exempt From Income Tax OMB No. 1545-1150 Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code 2009 (except black lung

More information

Small Business Services 112 Krog Street, Ste# 17 Atlanta, GA 30307 (404) 873-0470 info@smallbizservices.com

Small Business Services 112 Krog Street, Ste# 17 Atlanta, GA 30307 (404) 873-0470 info@smallbizservices.com Small Business Services 112 Krog Street, Ste# 17 Atlanta, GA 30307 (404) 873-0470 info@smallbizservices.com May 16, 2011 Global Soap Project Inc. P.O. Box 94021 Atlanta, GA 30318 Dear John E. Parkerson,

More information

A For the 2011 calendar year, or tax year beginning, 2011, and ending, D Employer identification number. 27-4205517 Name change

A For the 2011 calendar year, or tax year beginning, 2011, and ending, D Employer identification number. 27-4205517 Name change Form 990-EZ Department of the Treasury Internal Revenue Service A For the 2011 calendar year, or tax year beginning, 2011, and ending, B Check if applicable: C Name of organization D Employer identification

More information

THE SOUTH FLORIDA CHURCH OF CHRIST, INC.

THE SOUTH FLORIDA CHURCH OF CHRIST, INC. THE SOUTH FLORIDA CHURCH OF CHRIST, INC. FINANCIAL STATEMENTS THE SOUTH FLORIDA CHURCH OF CHRIST, INC. FINANCIAL STATEMENTS TABLE OF CONTENTS PAGES Independent Auditor s Report 1 Statement of Financial

More information

Short Form OMB No. 1545-1150. 2003 For organizations with gross receipts less than $100,000 and total assets less... ---

Short Form OMB No. 1545-1150. 2003 For organizations with gross receipts less than $100,000 and total assets less... --- Form 990-EZ Short Form OMB No 1545-1150 Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(axl) of the Internal Revenue Code (except black lung benefit trust or private foundation)

More information

^"J. Pnndinare. c Government contributions (grants),, _,,,, 1 c

^J. Pnndinare. c Government contributions (grants),, _,,,, 1 c Form 9 9 0 Return of Organization Exempt From Income Tax Under section 501 (c), 527, or 4947( a)(1) of the Internal Revenue Code ( except black lung Department of the Treasury benefit trust or private

More information

Notice 97-34, 1997-1 CB 422, 6/02/1997, IRC Sec(s). 6048

Notice 97-34, 1997-1 CB 422, 6/02/1997, IRC Sec(s). 6048 Notice 97-34, 1997-1 CB 422, 6/02/1997, IRC Sec(s). 6048 Returns of foreign trusts foreign gift reporting requirements tax This notice provides guidance regarding the new foreign trust and foreign gift

More information

Instructions for Form 990-EZ

Instructions for Form 990-EZ 2013 Instructions for Form 990-EZ Department of the Treasury Internal Revenue Service Short Form Return of Organization Exempt From Income Tax Under Section 501(c), 527, or 4947(a)(1) of the Internal Revenue

More information

F Group Exemption Appdlication ttons. OAKLAND, CA 94621-1 4 60

F Group Exemption Appdlication ttons. OAKLAND, CA 94621-1 4 60 , 990 -EZ Short Form OMB No 1545-1150 Return of Organization Exempt From Income Tax Form Under section 501(c ), 527, or 4947( a)(1) of the Internal Revenue Code ^oo Q (except black lung benefit trust or

More information

Charitable Activities Section Oregon Department of Justice

Charitable Activities Section Oregon Department of Justice Form CT-12 For Oregon Charities Section I. General Information 1. THE KYRON HORMAN FOUNDATION 1338 SW VIOLET CT BEAVERTON, OR 978-514 RECEDED Charitable Activities Section Oregon Department of Justice

More information

Short Form. F G rou Exem ption Ap plication pending lions. P

Short Form. F G rou Exem ption Ap plication pending lions. P N W cn a w if Form 99-EZ Short Form Return of Organization Exempt From Income Tax Under section 51 (c), 527, or 4947(aXl) of the Internal Revenue Code (except black lung benefit trust or private foundation)

More information

MEDICAL MINISTRY USA dba MEDICAL MINISTRY INTERNATIONAL

MEDICAL MINISTRY USA dba MEDICAL MINISTRY INTERNATIONAL Financial Statements Together with Independent Auditors Report For the Year Ended SWALM & ASSOCIATES, P.C. Certified Public Accountants FINANCIAL STATEMENTS Table of Contents Page Independent Auditors

More information

Franchise Tax Board 4905BE Booklet Offer In Compromise for Business Entities

Franchise Tax Board 4905BE Booklet Offer In Compromise for Business Entities State of California Franchise Tax Board 4905BE Booklet Offer In Compromise for Business Entities What you should know before preparing an Offer in Compromise Are you an OIC Candidate? If your business

More information

Compliance Guide for 501(c)(3) Public Charities

Compliance Guide for 501(c)(3) Public Charities Internal Revenue Service Tax Exempt and Government Entities Exempt Organizations Compliance Guide for 501(c)(3) Public Charities Covers: Activities that may jeopardize a charity's exempt status Federal

More information

Financial Statements. August 31, 2013 and 2012. (With Independent Auditors Report Thereon)

Financial Statements. August 31, 2013 and 2012. (With Independent Auditors Report Thereon) Financial Statements (With Independent Auditors Report Thereon) Table of Contents Page Independent Auditors Report 1 Statements of Financial Position 2 Statement of Activities Year ended August 31, 2013

More information

Source data is a custom data export provided by the IRS Exempt Organizations Projects Department.

Source data is a custom data export provided by the IRS Exempt Organizations Projects Department. About the Data The reports in this presentation contain aggregate financial information from the Form 990 (or the long form 990) that organizations reported to the Internal Revenue Service (IRS) for their

More information

Instructions for Form 990-PF

Instructions for Form 990-PF 2003 Instructions for Form 990-PF Return of Private Foundation or Section 4947(a)(1) Nonexempt Charitable Trust Treated as a Private Foundation Section references are to the Internal Revenue Code unless

More information

Short Form. OMB No 1545-1150 Return of Organization Exempt From Income Tax Under section 501 (c), 527, or 4947(aXl) of the Internal Revenue Code

Short Form. OMB No 1545-1150 Return of Organization Exempt From Income Tax Under section 501 (c), 527, or 4947(aXl) of the Internal Revenue Code cc r clk 0 LU Z Z V Form 990 -EZ Short Form OMB No 1545-1150 Return of Organization Exempt From Income Tax Under section 501 (c), 527, or 4947(aXl) of the Internal Revenue Code 2005 (except black lung

More information

UMC NO. 1545-UU4/ 7-oa

UMC NO. 1545-UU4/ 7-oa VV 0 o Return of Organization Exempt From Income Tax Form ~ Under section 501(c), 527, or 4947(a)(1 ) of the Internal Revenue Code (except lack loop enefit trust or private foundation) Department of the

More information

Caution: DRAFT NOT FOR FILING

Caution: DRAFT NOT FOR FILING Caution: DRAFT NOT FOR FILING This is an early release draft of an IRS tax form, instructions, or publication, which the IRS is providing for your information as a courtesy. Do not file draft forms. Also,

More information