Short Form Return of Organization Exempt From Income Tax

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Short Form Return of Organization Exempt From Income Tax"

Transcription

1 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 r*p LL Department of the Treasury Internal Revenue Service Do not enter Social Security numers on this form as it may e made pulic. Information aout Form 990-EZ and its instructions is at Inspection A For the 2013 calendar year, or tax year eginning January 1, 2013, and ending Decemer 31, B Check if applicale C Name of organization D Employer identification numer q Address change Gonstead Clinical Studies Society, Inc q Name change Numer and street (or P 0 ox, if mail is not delivered to street address) Room /suite E Telephone numer q Initial return th Avenue Ste q Terminated City or town, state or province, country, and ZIP or foreign postal code F Group Exemption q Amended return Application pending Santa Cruz CA Numer G Accounting Method : q Cash q Accrual Other (specify) H Check q if the organization is not I Wesite : required to attach Schedule B J Tax -exempt status (check only one) (c)(21) q 501 (c) ( ) 4 (insert no. ) q 4947 (a)( 1 ) or 0527 (Form 990, 990-EZ, or 990-PF). K Form of organization : q Corporation q Trust q Association q Other L Add lines 5, 6c, and 7, to line 9 to determine gross receipts. If gross receipts are $200, 000 or more, or if total assets (Part II, column (B) elow ) are $500,000 or more, file Form 990 instead of Form 990-EZ $ Ealy Revenue, Expenses, and Changes in Net Assets or Fund Balances (see the instructions for Part I) Char. k if the nrnani7atinn used Schedule () to respond to any auestinn in this Part I I71 1 Contriutions, gifts, grants, and similar amounts received ,367 2 Program service revenue including government fees and contracts Memership dues and assessments ,857 4 Investment income a Gross amount from sale of assets other than inventory.... 5a -0- Less : cost or other asis and sales expenses c Gain or ( loss) from sale of assets other than inventory (Sutract line 5 from line 5a).... 5c -0-6 Gaming and fundraising events a Gross income from gaming (attach Schedule G if greater than $15,000 ) a -0- Gross income from fundraising events (not including $ - 0- of contriutions from fundraising events reported on line 1 ) (attach Schedule G if the sum of such gross income and contriutions exceeds $ 15,000) c Less : direct expenses from gaming and fundraising events... 6c -0- d Net income or (loss ) from gaming and fundraising events (add lines 6a and 6 and sutract line 6c ) d -0-7a Gross sales of inventory, less returns and allowances a -0- Less : cost of goods sold c Gross profit or (loss) from sales of inventory (Sutract line 7 from line 7a) c -0-8 Other revenue (descrie in Schedule 0 ) Total revenue. Add lines 1, 2, 3, 4, 5c, 6d, 7c, and , Grants and similar amounts paid ( list in Schedule 0). 10\jE Benefits paid to or for memers ^^^ Salaries, other compensation, and employee enefits p Professional fees and other payments to independent con W ors rc J) , Occupancy, rent, utilities, and maintenance , Printing, pulications, postage, and shipping. 15 3, Other expenses (descrie in Schedule 0) , Total expenses. Add lines 10 throug h ,677 y 18 Excess or (deficit ) for the year (Sutract line 17 from line 9) , Net assets or fund alances at eginning of year (from line 27, column (A)) (must agree with end-of-year figure reported on prior year ' s return) , Other changes in net assets or fund alances (explain in Schedule 0) Z 21 Net assets or fund alances at end of year. Comine lines 18 throug h For Paperwork Reduction Act Notice, see the separate instructions. Cat No Form 88U-tL (2013) \\ U

2 Form 990 -EZ (2013) Page 2 IUCM Balance Sheets (see the instructions for Part II) Check if the organization used Schedule 0 to respond to any question in this Part II.. q (A) Beginning of year (B) End of year 22 Cash, savings, and investments , , Land and uildings o Other assets (descrie in Schedule 0) o Total assets , , Total liailities (descrie in Schedule 0 ) Net assets or fund alances (line 27 of column ( B) must ag ree with line 21 ) 81, ,233 Statement of Program Service Accomplishments (see the instructions for Part III) Expenses Check if the organization used Schedule 0 to respond to any question in this Part III - q (Required for section What is the organization's primary exempt purpose? Chiropractic Research and Education 501(c)(3) and 501(c)(4) organizations and section Descrie the organization's program service accomplishments for each of its three largest program services, 4947(a)(1) trusts; optional as measured y expenses. In a clear and concise manner, descrie the services provided, the numer of for others.) persons enefited, and other relevant information for each program title. 28 Pulished & presented " History or Science. The Controversy over Chiropractic - Spinograohy" in Chiropractic History Journal and at Assoc. for History of Chiropractic in Greeley, CO & the_ Annual semianr of the Grant_ Adams-Chiro.-Societ-y, Moses Lake, WA:_also presented tofaculty at Palmer Chiro_Colleoe_ DavenpoL IA (Grants $ -0-) If this amount includes foreign grants, check here. q 28a 16, Article on x-raypro1ection errors relating to retrolisthesis continues Chir to - e - presented : rejected y Canadian Chic Assoc. Re-writes were unsuccessful. Now in process at the Journal of Chiropractic Medicine Grants $ -0-) If this amount includes forei g n grants, check here. q 29a 16, Meeting of the Minds Annual Research Conference held in Daveport, Iowa Gonstead Extravaganza Gonstead Technique Seminar held in Mt. Hore, WI pulications of The Scope and 4 pulications of "The G Note " plus one Memership-Directorypulished (Grants $ -o-) If this amount includes foreign grants, check here. q 30a 13, Other program services (descrie in Schedule 0) (Grants $ -0-) If this amount includes forei gn g rants, check here. q 31a Total program service expenses (add lines 28a through 31 a) , 734 IMM List of Officers. Directors. Trustees. and Kev Emolovees (list each one even if not compensated-see the instructions for Part IV) Check if the organization used Schedule 0 to respond to an question in this Part IV. q () Average (c) Reportale (d) Health enefits, (a) Name and title hos per week devoted to position compensation contriutions to employee (e) Estimated amount of (Forms W- 2/1099 -MISC) enefit plans, and other compensation (d not paid, enter -0 -) deferred compensation Jeanne Taylor, Roger Coleman, DC Director of Research , C ---- Executi e -- irector , Michele Hohmann, Exeuctive Secretary 35 19, Steven T Tanaka,- DC Director of Pulications , Patrick Ryan, DC President Rocco Perugini, DC V. P Perrx Chinn,_ DC Sec 'UTreas Peter DeLoe, DC Past President _yaia_ De_v_er,_DC Michael Tomasello, DC Dennis O'Hara, DC David Gea ry, DC Randall Johnson, DC Trac Gaert, DC William Pollock, - DC Roger Heschong, DC Steven Rindal, DC Da I Chapman, DC Gerttan Van_ Koert, - DC Form 990-EZ (2013)

3 Form 990-EZ (2013) Page 3 Other Information (Note the Schedule A and personal enefit contract statement requirements in the instructions for Part V) Check if the organization used Schedule 0 to respond to any Question in this Part V q Yes No 33 Did the organization engage in any significant activity not previously reported to the IRS? If "Yes," provide a detailed description of each activity in Schedule Were any significant changes made to the organizing or governing documents? If "Yes," attach a conformed copy of the amended documents if they reflect a change to the organization's name. Otherwise, explain the change on Schedule 0 (see instructions) a 36 c 37a 38a 39 a 40a c d e 41 42a 43 c 44a c d 45a 45 Did the organization have unrelated usiness gross income of $1,000 or more during the year from usiness activities (such as those reported on lines 2, 6a, and 7a, among others)? a If "Yes," to line 35a, has the organization filed a Form 990-T for the year? If "No," provide an explanation in Schedule Was the organization a section 501 (c)(4), 501 (c)(5), or 501 (c)(6) organization suject to section 6033(e) notice, reporting, and proxy tax requirements during the year? If "Yes," complete Schedule C, Part III c Did the organization undergo a liquidation, dissolution, termination, or significant disposition of net assets during the year? If "Yes," complete applicale parts of Schedule N Enter amount of political expenditures, direct or indirect, as descried in the instructions 37a -0- Did the organization file Form 1120-POL for this year? Did the organization orrow from, or make any loans to, any officer, director, trustee, or key employee or were any such loans made in a prior year and still outstanding at the end of the tax year covered y this return?. 3 If "Yes," complete Schedule L, Part II and enter the total amount involved Section 501(c)(7) organizations. Enter: Initiation fees and capital contriutions included on line a.0- Gross receipts, included on line 9, for pulic use of clu facilities Section 501 (c)(3) organizations. Enter amount of tax imposed on the organization during the year under: section ; section ; section Section 501 (c)(3) and 501 (c)(4) organizations. Did the organization engage in any section 4958 excess enefit transaction during the year, or did it engage in an excess enefit transaction in a prior year that has not een reported on any of its prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax imposed on organization managers or disqualified persons during the year under sections 4912, 4955, and Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax on line 40c reimursed y the organization All organizations. At any time during the tax year, was the organization a party to a prohiited tax shelter transaction? If "Yes," complete Form 8886-T e List the states with which a copy of this return is filed CA, WI The organization's ooks are in care of Jeanne Taylor, DC Telephone no Located at th Ave., Ste. 101, Santa Cruz, CA 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)? 42 If "Yes," enter the name of the foreign country: See the instructions for exceptions and filing requirements for Form TD F , Report of Foreign Bank and Financial Accounts. At any time during the calendar year, did the organization maintain an office outside the U.S.? c 3 If "Yes," enter the name of the foreign country: Section 4947(a)(1) nonexempt charitale trusts filing Form 990-EZ in lieu of Form Check here... q and enter the amount of tax-exempt interest received or accrued during the tax year Yes No Did the organization maintain any donor advised funds during the year? If "Yes," Form 990 must e completed instead of Form EZ a 3 Did the organization operate one or more hospital facilities during the year? If "Yes," Form 990 must e completed instead of Form 990-EZ Did the organization receive any payments for indoor tanning services during the year? If "Yes" to line 44c, has the organization filed a Form 720 to report these payments? If "No," provide an explanation in Schedule c 3 Did the organization have a controlled entity within the meaning of section 512()(13) Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512 ()(13)? If "Yes," Form 990 and Schedule R may need to e completed instead of Form 990-EZ (see instructions ) Form 990-EZ (2013) 44d

4 Form 990 -EZ (2013) Page 4 'I No 46 Did the organization engage, directly or indirectly, in political campaign activities on ehalf of or in opposition ' to candidates for pulic office? If "Yes," complete Schedule C, Part I q6 3 GCMW Section 501 (c)(3) organizations only All section 501 (c)(3) organizations must answer questions and 52, and complete the tales for lines 50 and 51. Check if the organization used Schedule 0 to respond to an y q uestion in this Part VI. q Yes No 47 Did the organization engage in loying activities or have a section 501(h) election in effect dunng the tax year? If "Yes," complete Schedule C, Part II Is the organization a school as descried in section 170 ()(1)(A)(ii)? If "Yes," complete Schedule E a Did the organization make any transfers to an exempt non-charitale related organization? a 3 If "Yes," was the related organization a section 527 organization? Complete this tale for the organization ' s five highest compensated employees (other than officers, directors, trustees and key employees ) who each received more than $ 100,000 of compensation from the organization. If there is none, enter "None." (a) Name and title of each employee NONE () Average hours per week devoted to position (c) Reportale compensation (Forms W-2/1099-MISc) (d) Health enefits, contriutions to employee enefit plans, and deferred compensation (e) Estimated amount of other compensation f Total numer of other employees paid over $100, Complete this tale for the organization's five highest compensated independent contractors who each received more than $100,000 of compensation from the organization. If there is none, enter "None." (a) Name and usiness address of each independent contractor I () Type of service I (c) Compensation NONE d Total numer of other independent contractors each 52 Did the organization complete Schedule A? Note. All nonexempt charitale trusts must attach a completes Under penalties of penury, I declare that I have examined this return, including accorr true, correct, and complete Decl Lion of preparer (other than officer) is ased on all Sign Sig ture of officer Here Paid Preparer Use Only t Patrick Ryan, DC President Type or print name and title Pnnt/Type preparer's name Firm's name Preparer's signature Firm's address May the IRS discuss this return with the preparer shown aove? Si

5 SCHEDULE A (Form 990 or 990-EZ) Pulic Charity Status and Pulic Support Complete if the organization is a section 501 (c )(3) organization or a section 4947(a)(1) nonexempt charitale trust. OMB No Department of the Treasury Do- Attach to Form 990 or Form 990-FZ. " Internal Revenue Service Information aout Schedule A (Form 990 or 990-EZ) and Its instructions is at Name of the organization Employer identification numer Reason for Pulic Charity Status (All organizations must complete this part.) See instructions. The organization is not a private foundation ecause it is: (For lines 1 through 11, check only one ox.) 1 q A church, convention of churches, or association of churches descried in section 170 ()(1)(A)(). 2 q A school descried in section 170 ()(1)(A)(i). (Attach Schedule E.) 3 q A hospital or a cooperative hospital service organization descried in section 170()(1)(A)(iii). 4 q A medical research organization operated in conjunction with a hospital descried in section 170 ()(1)(A)(iii). Enter the hospital's name, city, and state: own------ed --- or------operated E] An organization operated for the acoll ege----- g----ōv---ernm ent-al-----un- ȳ ā it --- enefit of or univers---i--ty ---o- de--s---c---ried insection 170()(1)(A)(v). (Complete Part II.) 6 q A federal, state, or local government or governmental unit descried in section 170 ()(1)(A)(v). 7 q An organization that normally receives a sustantial part of its support from a governmental unit or from the general pulic descried in section 170( )(1)(A)(vi). (Complete Part II.) 8 q A community trust descried In section 170 ()(1)(A)(vi). (Complete Part II.) 9 q An organization that normally receives: (1) more than 33'/3% of its support from contriutions, memership fees, and gross receipts from activities related to its exempt functions-suject to certain exceptions, and (2) no more than 331/3% 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). (Complete Part III.) 10 q An organization organized and operated exclusively to test for pulic safety. See section 509(a)(4). 11 q An organization organized and operated exclusively for the enefit of, to perform the functions of, or to carry out the purposes of one or more pulicly supported organizations descried in section 509(a)(1) or section 509(a)(2). See section 509(a )(3). Check the ox that descries the type of supporting organization and complete lines 11 a through 11 h. (A) (B) (C) (D) (E) a q Type I q Type II c q Type III-Functionally integrated d q Type III-Non-functionally integrated e q By checking this ox, I certify that the organization is not controlled directly or indirectly y one or more disqualified persons other than foundation managers and other than one or more pulicly supported organizations descried in section 509(a)(1) or section 509(a)(2). f If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, check this ox q Since August 17, 2006, has the organization accepted any gift or contriution from any of the following persons? (i) A person who directly or indirectly controls, either alone or together with persons descried in (ii) and Yes No (iii) elow, the governing ody of the supported organization? (1) (ii) A family memer of a person descried in (I) aove? itg(i) (iii) A 35% controlled entity of a person descried in (I) or (II) aove? lgfii) Provide the following information aout the supported organization(s). () Name of supported organization (ii) EIN (ii) Type of organization (descned on lines 1-9 aove or IRC section (see instructions)) (rv) Is the organization in col (1) listed in your governing document? (v) Did you notify the organization in col () of your support? (vi) Is the organization in col (1) organized in the US? Yes No Yes No Yes No (vi) Amount of monetary support Total For Paperwork Reduction Act Notice, see the Instructions for Cat No 11285F Schedule A (Form 990 or 990 -EZ 2013 Form 990 or 990-E1.

6 Schedule A (Form 990 or 990-Q ) 2013 Page 2 jjm Support Schedule for Organizations Descried in Sections 170()( 1)(A)(iv) and 170()(1)(A)(vi) (Complete only if you checked the ox on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part Ill. If the organization fails to qualify under the tests listed elow, please complete Part III.) Section A. Pulic Support Calendar year (or fiscal year eginning in ) (a) 2009 () 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total 1 Gifts, grants, contriutions, and memership fees received. (Do not include any 'unusual grants.")... 2 Tax revenues levied for the organization's enefit and either paid to or expended on its ehalf... 3 The value of services or facilities furnished y a governmental unit to the organization without charge Total. Add lines 1 through The portion of total contriutions y each person (other than a governmental unit or pulicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. 6 Pulic support. Sutract line 5 from line 4. Section B. Total Support Calendar year (or fiscal year eginning in) (a) 2009 () 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total 7 Amounts from line Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources Net income from unrelated usiness activities, whether or not the usiness is regularly carried on Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) Total support. Add lines 7 through Gross receipts from related activities, etc. (see instructions) 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 this ox and stop here D Section C. Computation of Pulic Support Percentage 14 Pulic support percentage for 2013 (line 6, column (f) divided y line 11, column (f)) % - 15 Pulic support percentage from 2012 Schedule A, Part II, line % 16a 33 1,3% support test If the organization did not check the ox on line 13, and line 14 is 331,3% or more, check this ox and stop here. The organization qualifies as a pulicly supported organization El 33',3% support test If the organization did not check a ox on line 13 or 16a, and line 15 is 331,3% or more, check this ox and stop here. The organization qualifies as a pulicly supported organization D 17a 10%-facts -and-circumstances test If the organization did not check a ox on line 13, 16a, or 16, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this ox and stop here. Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a pulicly supported organization %-facts -and-circumstances test If the organization did not check a ox on line 13, 16a, 16, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this ox and stop here. Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a pulicly supported organization El 18 Private foundation. If the organization did not check a ox on line 13, 16a, 16, 17a, or 17, check this ox and see instructions q Schedule A (Form 990 or 990-EA 2013

7 Schedule A (Form 990 or 990-EZ) 2013 Page 3 Support Schedule for Organizations Descried in Section 509(a)(2) (Complete only if you checked the ox on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed elow, please complete Part II.) Section A. Pulic Support Calendar year (or fiscal year eginning in) (a) 2009 () 2010 (c) 2011 (d) 2012 (e) 2013 Total I Gifts, grants, contriutions, and memership fees received. (Do not include any "unusual grants.") 97, , , , , ,423 2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose Gross receipts from activities that are not an unrelated trade or usiness under section Tax revenues levied for the organization's enefit and either paid to or expended on its ehalf o The value of services or facilities furnished y a governmental unit to the organization without charge o Total. Add lines 1 through , , , , , ,423 7a Amounts included on lines 1, 2, and 3 received from disqualified persons Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1 % of the amount on line 13 for the year 97, ,481 99, , , ,423 c Add lines 7a and Pulic support (Sutract line 7c from line 6.) ,423 Section B. Total Support Calendar year (or fiscal year eginning in) (a) 2009 () 2010 (c) 2011 (d) 2012 (e) 2013 (t) Total 9 Amounts from line , , , , , ,423 10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources Unrelated usiness taxale income (less section 511 taxes) from usinesses acquired after June 30, c Add lines 10a and Net income from unrelated usiness activities not included in line 1 O, whether or not the usiness is regularly carried on Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) I Total support. (Add lines 9, 10c, 11, and 12.) , , , , , , 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 this ox and stop here Section C. Computation of Pulic Support Percentage 15 Pulic support percentage for 2013 (line 8, column (f) divided y line 13, column (f)) % 16 Pulic support percentage from 2012 Schedule A, Part III, line % Section D. Computation of Investment Income Percentage 17 Investment income percentage for 2013 (line 10c, column (f) divided y line 13, column (f)) 17 0% 18 Investment income percentage from 2012 Schedule A, Part III, line % 19a 331x,% support tests If the organization did not check the ox on line 14, and line 15 is more than 331,3%, and line 17 is not more than 331,3%, check this ox and stop here. The organization qualifies as a pulicly supported organization. 331,3% support tests If the organization did not check a ox on line 14 or line 19a, and line 16 is more than 331,3%, and line 18 is not more than 331,3%, check this ox and stop here. The organization qualifies as a pulicly supported organization 20 Private foundation. If the organization did not check a ox on line 14, 19a, or 19, check this ox and see instructions Schedule A (Form 990 or 990-EZ) 2013

8 Schedule A (Form 990 or 990-EZ ) 2013 Page 4 Supplemental Information. Provide the explanations required y Part II, line 10; Part II, line 17a or 17; and Part III, line 12. Also complete this part for any additional information. (See instructions). Schedule A (Form 990 or 990-EZ) 2013

9 SCHEDULE 0 (Form 990 or 990-EZ) Department of the Treasury Internal Revenue Service Name of the organization Supplemental Information to Form 990 or 990-EZ Complete to provide information for responses to specific questions on Form 990 or 990-EZ or to provide any additional information. Attach to Form 990 or 990-FZ. Information aout Schedule 0 (Form 990 or 990-EZ) and its instructions is at OMB No Employer identification numer Banking $2.204 Continuin Education 1,430 Entertainment 2, Gifts for Speakers Memerships Office Supplies - 2, Reimursements Taxes 92 Travel 1, TOTAL $10,789 For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Cat. No 51056K Schedule 0 (Form 990 or 990-EZ) (2013)

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

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

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

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

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

Client Copy KOPERNIK KOPERNIK SOLUTIONS 125 COURT STREET STE 10DS BROOKLYN, NY 11201 917-975-6352

Client Copy KOPERNIK KOPERNIK SOLUTIONS 125 COURT STREET STE 10DS BROOKLYN, NY 11201 917-975-6352 2009 TA RETURN Client Copy Client: Prepared for: KOPERNIK KOPERNIK SOLUTIONS 125 COURT STREET STE 10DS BROOKLYN, NY 11201 917-975-6352 Prepared by: Chunyee W. Miot CPA PC CHUNYEE W MIOT CPA PC 626 RECORP

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

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

Short Form Return of Organization Exempt From Income Tax 990-EZ 2009

Short Form Return of Organization Exempt From Income Tax 990-EZ 2009 OMB 1545-1150 Form Under section 501, 527, or 4947(1) of the Internal Revenue Code (except lack lung enefit trust or private foundation) Sponsoring organizations of donor advised funds and controlling

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

Short Form Return of Organization Exempt From Income Tax

Short Form Return of Organization Exempt From Income Tax Short Form Return of Organization Exempt From Income Tax OMB No. 1545-1150 Form Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except lack lung enefit trust or 990-EZ private foundation)

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

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

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

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 (2014) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Form 990 (2014) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Form 990 (014) FRACTURED ATLAS, INC. 11-3451703 Part III Statement of Program Service Accomplishments 1 3 4 4a Check if Schedule O contains a response or note to any line in this Part III Briefly descrie

More information

ALLENTOWN, PA Phone no May the IRS discuss this return with the preparer shown above? (see instructions)...

ALLENTOWN, PA Phone no May the IRS discuss this return with the preparer shown above? (see instructions)... Form Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) Department of the Treasury Do not enter social security numers on this form as it may e made pulic.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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 Checklist

Form 990-EZ Checklist Pickens Snodgrass Koch LLP Form 990-EZ Checklist Please also complete Form 990-EZ Supplemental Schedules Checklist Revised 11/24/2008 1. Name of Organization 2. Organization exempt status (please circle)

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

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

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) 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

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

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

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

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

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

What is the organization's primary exempt purpose? REHABILITATION AND REFERRAL Form 990 (2006) REFERRAL SERVICES, INC. 52-1732096 Page3 Part III Statement of Program Service Accomplishments (See the instructions.) Form 990 is availale for pulic inspection and, for some people, serves

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

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

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

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

Short Form ... 23 24 Other assets (describe ) 24 25 Total assets

Short Form ... 23 24 Other assets (describe ) 24 25 Total assets W It C CC C. C 990 Short Form OMB No 15451150 Return of Organization Exempt From Income Tax Form EZ Under section 501(c ), 527, or 4947 (a)(1) of the Internal Revenue Code R008 (except black lung benefit

More information

990^EZ. H Check 3q if the organization I Website : 10- wwf Lakesherwoodacres. com

990^EZ. H Check 3q if the organization I Website : 10- wwf Lakesherwoodacres. com 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

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

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

COUNTY ROAD BEN LOMOND GUN CLUB, INC LIZABETH CO Number lop,

COUNTY ROAD BEN LOMOND GUN CLUB, INC LIZABETH CO Number lop, Form 4 990-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) Sponsoring

More information

Forms 990 and 990-PF for Tax Exempt Organizations Arkansas Federal Tax Institute December 5, 2014. By Michelle C. Mann, CPA JPMS Cox, PLLC

Forms 990 and 990-PF for Tax Exempt Organizations Arkansas Federal Tax Institute December 5, 2014. By Michelle C. Mann, CPA JPMS Cox, PLLC Forms 990 and 990-PF for Tax Exempt Organizations Arkansas Federal Tax Institute December 5, 2014 By Michelle C. Mann, CPA JPMS Cox, PLLC Tax Exempt Entity Forms Form 990 (expanded for 2008 forward) Form

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

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

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

F Group Exemption Application p endin g

F Group Exemption Application p endin g C-J er) lu z 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)

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

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

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

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

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

Open to Public Inspection A For the 2014 calendar year, or tax year beginning, 2014, and ending,

Open to Public Inspection A For the 2014 calendar year, or tax year beginning, 2014, and ending, Form990 Department of the Treasury Internal Revenue Service OMB. 545-0047 Return of Organization Exempt From Income Tax 204 Under section 50(c), 527, or 4947(a)() of the Internal Revenue Code (except private

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

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

D Employer identificationpnumber q Address change

D Employer identificationpnumber q Address change l Form WOu-CL Department of the Treasury I n te rnal R evenu e Se rvi ce Short Form Return of Organization Exempt From Income Tax Under section 51(c ), 527, or 4947( a)(1) of the Internal Revenue Code

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

NATIONAL PUBLIC RADIO, INC. 2013 FORM 990 RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX PUBLIC INSPECTION COPY FISCAL YEAR ENDED 09/30/2014

NATIONAL PUBLIC RADIO, INC. 2013 FORM 990 RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX PUBLIC INSPECTION COPY FISCAL YEAR ENDED 09/30/2014 NATONAL PUBLC RADO, NC. 213 FORM 99 RETURN OF ORGANZATON EEMPT FROM NCOME TA PUBLC NSPECTON COPY FSCAL YEAR ENDED 9/3/214 Return of Organization Exempt From ncome Tax OMB No. 1545-47 Form Under section

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

Do not enter Social Security numbers on this form as it may be made public. Open to Public Internal Revenue Service

Do not enter Social Security numbers on this form as it may be made public. Open to Public Internal Revenue Service OMB No. 1545-0047 Return of Organization Exempt From Income Tax Form 990 Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) 2013 Department of the Treasury

More information

Instructions for IRS Form 990-EZ

Instructions for IRS Form 990-EZ Overview These instructions are intended to help clarify and supplement the Instructions for Form 990-EZ as published by the IRS. They are not intended to replace those instructions. Both the form and

More information

For the 2014 calendar year, or tax year beginning

For the 2014 calendar year, or tax year beginning Form 99 OMB. - Department of the Treasury Internal Revenue Service A B For the calendar year, or tax year beginning C Check if applicable: Address change Name change Initial return Return of Organization

More information

TO IMPROVE THE HEALTH OF CHILDREN BY PROVIDING THEM THE MOTIVATION, TOOLS AND SUPPORT TO LIVE HAPPIER AND HEALTHIER LIFESTYLES.

TO IMPROVE THE HEALTH OF CHILDREN BY PROVIDING THEM THE MOTIVATION, TOOLS AND SUPPORT TO LIVE HAPPIER AND HEALTHIER LIFESTYLES. Form 990 (2014) Marathon Kids, Inc. 06-1722171 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

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

RESCUED AND ADOPTED OUT DOGS AND CATS; AIDED IN THE SPAYING AND NEUTERING OF THE ANIMALS WHEN APPROPRIATE TO LOW-INCOME FAMILIES

RESCUED AND ADOPTED OUT DOGS AND CATS; AIDED IN THE SPAYING AND NEUTERING OF THE ANIMALS WHEN APPROPRIATE TO LOW-INCOME FAMILIES Form 990 (2013) H A L O 86-0832160 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..................................................

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

Form 990 Return of Organization Exempt From Income Tax

Form 990 Return of Organization Exempt From Income Tax OMB No. 1545-47 Form 99 Return of Organization Exempt From Income Tax Under section 51(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) 215 Do not enter social security

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

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

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

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

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

PRIVATE FOUNDATION CAUTION: The purposes of this memorandum are to assist you, the directors of your private foundation, and your accountant in:

PRIVATE FOUNDATION CAUTION: The purposes of this memorandum are to assist you, the directors of your private foundation, and your accountant in: CHERRY CREEK CORPORATE CENTER 4500 CHERRY CREEK DRIVE SOUTH #600 DENVER, CO 80246-1500 303.322.8943 WWW.WADEASH.COM DISCLAIMER Material presented on the Wade Ash Woods Hill & Farley, P.C., website is intended

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

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

Form 990 Return of Organization Exempt From Income Tax

Form 990 Return of Organization Exempt From Income Tax OMB No. 1545-47 Form 99 Return of Organization Exempt From Income Tax Under section 51(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) 214 Do not enter social security

More information

Return of Organization Exempt From Income Tax

Return of Organization Exempt From Income Tax Form 990 Termination Please use IRS label or print or type. See specific Instructions. Return of Organization Exempt From Income Tax Amended return G Gross receipts $ 591,316. Application pending F Name

More information

Short Form OMB NO 1545-1150

Short Form OMB NO 1545-1150 Short Form OMB NO 1545-1150 Return of Organization Exempt From Income Tax Form 990-EZ Under section 501(c), 527, or 4947(a)(1) of the internal Revenue Code (except black lung benefit trust or 2003 Department

More information

2015 EXEMPT ORGANIZATION INCOME TAX RETURN CHECKLIST (FORM 990)

2015 EXEMPT ORGANIZATION INCOME TAX RETURN CHECKLIST (FORM 990) 2015 EXEMPT ORGANIZATION INCOME TAX Client Name and Number: Prepared by: Date: Reviewed by: Date: 100) GENERAL INFORMATION DONE N/A 101) Determine if the organization is exempt from filing an exempt organization

More information

The Public Support Test What a Grant Seeker Should Know

The Public Support Test What a Grant Seeker Should Know I. Overview: Why Public Support is Important The Public Support Test What a Grant Seeker Should Know Organizations that seek grants from foundations are usually principally interested in obtaining the

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

Form 990 and Tax Update Olivia A. Hutton, CPA

Form 990 and Tax Update Olivia A. Hutton, CPA Form 990 and Tax Update Olivia A. Hutton, CPA Certified Public Accountants and Consultants Connecting depth and insight with community values. Your 990 should prove that you are: Organized and operated

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

I Information about Form 990 and its instructions is at Inspection

I Information about Form 990 and its instructions is at  Inspection Return of Organization Exempt From ncome Tax OMB No. 1545-47 Form Under section 51(c), 527, or 4947(a)(1) of the nternal Revenue Code (except private foundations) 99 À¾µ Do not enter Social Security numers

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

(c) Compensation. (b) Title and average hours per week devoted to position. Type or print name and title tp sel^ck if Pre arer s Identdy mg.

(c) Compensation. (b) Title and average hours per week devoted to position. Type or print name and title tp sel^ck if Pre arer s Identdy mg. Form 990-EZ (2008) Page 4 Part VI Section 501 (c)(3) organizations only. All section 501(c)(3) organizations must answer questions 46-49 and complete the tables for lines 50 and 51., 46 Did the organization

More information

Form 1023-EZ Streamlined Application for Reinstatement of Tax-Exempt Status For Organizations within 15 months of Revocation

Form 1023-EZ Streamlined Application for Reinstatement of Tax-Exempt Status For Organizations within 15 months of Revocation Form 1023-EZ Streamlined Application for Reinstatement of Tax-Exempt Status For Organizations within 15 months of Revocation Dear PTA Leader: The IRS has released their new Form 1023-EZ to facilitate the

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