AMERICAN CANCER SOCIETY INC, NEW ENGLAND DIVISION INC. FORM 990 TAX YEAR 2009

Size: px
Start display at page:

Download "AMERICAN CANCER SOCIETY INC, NEW ENGLAND DIVISION INC. FORM 990 TAX YEAR 2009"

Transcription

1 AMERCAN CANCER SOCETY NC, NEW ENGLAND DVSON NC. FORM 990 TA YEAR 2009

2 For ½½ Return of Organization Exept Fro ncoe Tax Under section 501(c), 527, or 4947(a)(1) of the nternal Revenue Code (except lack lung enefit trust or private foundation) OMB No À¾ ½ Open to Pulic Departent of the Treasury nternal Revenue Service The organization ay have to use a copy of this return to satisfy state reporting requireents. nspection A For the 2009 calendar year, or tax year eginning 09/01, 2009, and ending 08/31, B Check if applicale: C Nae of organization AMERCAN CANCER SOCETY NC, NEW ENGLAND D Eployer identification nuer Address change Doing Business As Nuer and street (or P.O. ox if ail is not delivered to street address) Roo/suite E Telephone nuer J Nae change nitial return Please use RS lael or print or type. See Specific Terinated nstructions. City or town, state or country, and ZP + 4 Aended return Application pending FRAMNGHAM, MA G Gross receipts $ 101,227,279. F Nae and address of principal officer: DONALD GUDATS H(a) s this a group return for affiliates? Yes No H() Are all affiliates included? Yes No J Tax-exept status: 501(c) ( ) (insert no.) 4947(a)(1) or 527 f "No," attach a list. (see instructions) Wesite: H(c) Group exeption nuer 0580 K For of organization: Corporation Trust Association Other L Year of foration: M State of legal doicile: Suary Part Activities & Governance Revenue Expenses Net Assets or Fund Balances 1 Briefly descrie the organization's ission or ost significant activities: a a Part Sign Here Check this ox if the organization discontinued its operations or disposed of ore than 25% of its net assets. Nuer of voting eers of the governing ody (Part V, line 1a) 3 Nuer of independent voting eers of the governing ody (Part V, line 1) 4 Total nuer of eployees (Part V, line 2a) 5 Total nuer of volunteers (estiate if necessary) 6 Total gross unrelated usiness revenue fro Part V, colun (C), line 12 7a Net unrelated usiness taxale incoe fro For 990-T, line 34 7 Prior Year Contriutions and grants (Part V, line 1h) Progra service revenue (Part V, line 2g) nvestent incoe (Part V, colun (A), lines 3, 4, and 7d) Other revenue (Part V, colun (A), lines 5, 6d, 8c, 9c, 10c, and 11e) Total revenue - add lines 8 through 11 (ust equal Part V, colun (A), line 12) Grants and siilar aounts paid (Part, colun (A), lines 1-3) Benefits paid to or for eers (Part, colun (A), line 4) 8,991,188. Salaries, other copensation, eployee enefits (Part, colun (A), lines 5-10) Professional fundraising fees (Part, colun (A), line 11e) Total fundraising expenses, Part, colun (D), line 25) Other expenses (Part, colun (A), lines 11a-11d, 11f-24f) Total expenses. Add lines (ust equal Part, colun (A), line 25) Revenue less expenses. Sutract line 18 fro line 12 Total assets (Part, line 16) Total liailities (Part, line 26) Net assets or fund alances. Sutract line 21 fro line 20 Signature Block PUBLC DSCLOSURE COPY 30 SPEEN STREET (508) SPEEN STREET FRAMNGHAM, MA R TO ELMNATE CANCER AS A MAJOR HEALTH PROBLEM BY PREVENTNG CANCER, SAVNG LVES, AND DMNSHNG SUFFERNG FROM THE DSEASE THROUGH RESEARCH, EDUCATON, ADVOCACY AND SERVCE. Beginning of Year ,570 Current Year 58,962, ,543, , ,56-263, ,07 58,550,67 59,194,027. 1,370,413. 1,517, ,885, ,445, , , ,764, ,491, ,255, ,649, ,704, ,712. End of Year 92,658, ,321, ,109, ,151, ,549, ,169,494. Under penalties of perjury, declare that have exained this return, including accopanying schedules and stateents, and to the est of y knowledge and elief, it is true, correct, and coplete. Declaration of preparer (other than officer) is ased on all inforation of which preparer has any knowledge. M Signature of officer Date M Type or print nae and title Date Check if Preparer's Paid selfeployed signature M Preparer's Fir's nae (or yours EN Use Only if self-eployed), M address, and ZP + 4 Phone no. Preparer's identifying nuer (see instructions) ERNST & YOUNG U.S. LLP TH AVENUE NORTH, STE 1200 BRMNGHAM, AL May the RS discuss this return with the preparer shown aove? (see instructions) Yes No For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions. For 990 (2009) 9E *

3 For 990 (2009) Page 3 Part V Checklist of Required Schedules s the organization descried in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? f "Yes," coplete Schedule A 1 s the organization required to coplete Schedule B, Schedule of Contriutors? 2 Did the organization engage in direct or indirect political capaign activities on ehalf of or in opposition to candidates for pulic office? f "Yes," coplete Schedule C, Part 3 Section 501(c)(3) organizations. Did the organization engage in loying activities? f "Yes," coplete Schedule C, Part 4 Sections 501(c)(4), 501(c)(5), and 501(c)(6) organizations. s the organization suject to the section 6033(e) notice and reporting requireent and proxy tax? f "Yes," coplete Schedule C, Part 5 Did the organization aintain any donor advised funds or any siilar funds or accounts where donors have the right to provide advice on the distriution or investent of aounts in such funds or accounts? f "Yes," coplete Schedule D, Part 6 Did the organization receive or hold a conservation easeent, including easeents to preserve open space, the environent, historic land areas, or historic structures? f "Yes," coplete Schedule D, Part 7 Did the organization aintain collections of works of art, historical treasures, or other siilar assets? f "Yes," coplete Schedule D, Part 8 Did the organization report an aount in Part, line 21; serve as a custodian for aounts not listed in Part ; or provide credit counseling, det anageent, credit repair, or det negotiation services? f "Yes," coplete Schedule D, Part V 9 Did the organization, directly or through a related organization, hold assets in ter, peranent, or quasi-endowents? f" Yes," coplete Schedule D, Part V 10 s the organization s answer to any of the following questions "Yes"? f so, coplete Schedule D, Parts V, V, V,, or as applicale 11 Did the organization report an aount for land, uildings, and equipent in Part, line 10? f "Yes," coplete Schedule D, Part V. Did the organization report an aount for investents other-securities in Part, line 12 that is 5% or ore of its total assets reported in Part, line 16? f "Yes," coplete Schedule D, Part V. Did the organization report an aount for investents-progra related in Part, line 13 that is 5% or ore of its total assets reported in Part, line 16? f "Yes," coplete Schedule D, Part V. Did the organization report an aount for other assets in Part, line 15 that is 5% or ore of its total assets reported in Part, line 16? f "Yes," coplete Schedule D, Part. Did the organization report an aount for other liailities in Part, line 25? f "Yes," coplete Schedule D, Part. % % % % % Did the organization s separate or consolidated financial stateents for the tax year include a footnote that addresses the organization's liaility for uncertain tax positions under FN 48? f "Yes," coplete Schedule D, Part. 12 Did the organization otain separate, independent audited financial stateents for the tax year? f "Yes," coplete Schedule D, Parts,, and A Was the organization included in consolidated, independent audited financial stateent for the tax year? Yes No f "Yes," copleting Schedule D, Parts,, and is optional. 12A 13 s the organization a school descried in section 170()(1)(A)(ii)? f "Yes," coplete Schedule E a Did the organization aintain an office, eployees, or agents outside of the United States? 14a Did the organization have aggregate revenues or expenses of ore than $10,000 fro grantaking, fundraising, usiness, and progra service activities outside the United States? f "Yes," coplete Schedule F, Part Did the organization report on Part, colun (A), line 3, ore than $5,000 of grants or assistance to any organization or entity located outside the United States? f "Yes," coplete Schedule F, Part Did the organization report on Part, colun (A), line 3, ore than $5,000 of aggregate grants or assistance to individuals located outside the United States? f "Yes," coplete Schedule F, Part Did the organization report a total of ore than $15,000 of expenses for professional fundraising services on Part, colun (A), lines 6 and 11e? f "Yes," coplete Schedule G, Part Did the organization report ore than $15,000 total of fundraising event gross incoe and contriutions on Part V, lines 1c and 8a? f "Yes," coplete Schedule G, Part Did the organization report ore than $15,000 of gross incoe fro gaing activities on Part V, line 9a? f "Yes," coplete Schedule G, Part Did the organization operate one or ore hospitals? f "Yes," coplete Schedule H 20 Yes No For 990 (2009) 9E

4 For 990 (2009) Page 4 Part V Checklist of Required Schedules (continued) Did the organization report ore than $5,000 of grants and other assistance to governents and organizations in the United States on Part, colun (A), line 1? f "Yes," coplete Schedule, Parts and Did the organization report ore than $5,000 of grants and other assistance to individuals in the United States on Part, colun (A), line 2? f "Yes," coplete Schedule, Parts and Did the organization answer "Yes" to Part V, Section A, line 3, 4, or 5 aout copensation of the organization's current and forer officers, directors, trustees, key eployees, and highest copensated eployees? f "Yes," coplete Schedule J a Did the organization have a tax-exept ond issue with an outstanding principal aount of ore than $100,000 as of the last day of the year, that was issued after Deceer 31, 2002? f "Yes," answer lines 24 through 24d and coplete Schedule K. f No, go to question 25 24a Did the organization invest any proceeds of tax-exept onds eyond a teporary period exception? 24 c Did the organization aintain an escrow account other than a refunding escrow at any tie during the year to defease any tax-exept onds? 24c d Did the organization act as an "on ehalf of" issuer for onds outstanding at any tie during the year? 24d 25 a Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess enefit transaction with a disqualified person during the year? f "Yes," coplete Schedule L, Part 25a s the organization aware that it engaged in an excess enefit transaction with a disqualified person in a prior year, and that the transaction has not een reported on any of the organization's prior Fors 990 or 990-EZ? f "Yes," coplete Schedule L, Part Was a loan to or y a current or forer officer, director, trustee, key eployee, highly copensated eployee, or disqualified person outstanding as of the end of the organization's tax year? f "Yes," coplete Schedule L, Part Did the organization provide a grant or other assistance to an officer, director, trustee, key eployee, sustantial contriutor, or a grant selection coittee eer, or to a person related to such an individual? f "Yes," coplete Schedule L, Part Was the organization a party to a usiness transaction with one of the following parties (see Schedule L, Part V instructions for applicale filing thresholds, conditions, and exceptions): a A current or forer officer, director, trustee, or key eployee? f "Yes," coplete Schedule L, Part V 28a A faily eer of a current or forer officer, director, trustee, or key eployee? f "Yes," coplete Schedule L, Part V 28 c An entity of which a current or forer officer, director, trustee, or key eployee of the organization (or a faily eer) was an officer, director, trustee, or direct or indirect owner? f "Yes," coplete Schedule L, Part V 28c 29 Did the organization receive ore than $25,000 in non-cash contriutions? f "Yes," coplete Schedule M Did the organization receive contriutions of art, historical treasures, or other siilar assets, or qualified conservation contriutions? f "Yes," coplete Schedule M Did the organization liquidate, terinate, or dissolve and cease operations? f "Yes," coplete Schedule N, Part Did the organization sell, exchange, dispose of, or transfer ore than 25% of its net assets? f "Yes," coplete Schedule N, Part Did the organization own 100% of an entity disregarded as separate fro the organization under Regulations sections and ? f "Yes," coplete Schedule R, Part Was the organization related to any tax-exept or taxale entity? f "Yes," coplete Schedule R, Parts,, V, and V, line s any related organization a controlled entity within the eaning of section 512()(13)? f "Yes," coplete Schedule R, Part V, line Section 501(c)(3) organizations. Did the organization ake any transfers to an exept non-charitale related organization? f "Yes," coplete Schedule R, Part V, line Did the organization conduct ore than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal incoe tax purposes? f "Yes," coplete Schedule R, Part V Did the organization coplete Schedule O and provide explanations in Schedule O for Part V, lines 11 and 19? Note. All For 990 filers are required to coplete Schedule O. 38 For 990 (2009) Yes No 9E

5 For 990 (2009) Page 5 Part V 4a Stateents Regarding Other RS Filings and Tax Copliance 1a Enter the nuer reported in Box 3 of For 1096, Annual Suary and Transittal of U.S. nforation Returns. Enter -0- if not applicale 1a 157 Enter the nuer of Fors W-2G included in line 1a. Enter -0- if not applicale 1 0 c Did the organization coply with ackup withholding rules for reportale payents to vendors and reportale gaing (galing) winnings to prize winners? 1c 2a Enter the nuer of eployees reported on For W-3, Transittal of Wage and Tax Stateents, filed for the calendar year ending with or within the year covered y this return 2a 541 f at least one is reported on line 2a, did the organization file all required federal eployent tax returns? 2 Note. f the su of lines 1a and 2a is greater than 250, you ay e required to e-file this return. (see instructions) 3a Did the organization have unrelated usiness gross incoe of $1,000 or ore during the year covered y this return? 3a f "Yes," has it filed a For 990-T for this year? f "No," provide an explanation in Schedule O 3 At any tie during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a ank account, securities account, or other financial account)? 4a f Yes, enter the nae of the foreign country: See the instructions for exceptions and filing requireents for For TD F , Report of Foreign Bank and Financial Accounts. 5a Was the organization a party to a prohiited tax shelter transaction at any tie during the tax year? 5a Did any taxale party notify the organization that it was or is a party to a prohiited tax shelter transaction? 5 c f "Yes," to question 5a or 5, did the organization file For 8886-T, Disclosure y Tax-Exept Entity Regarding Prohiited Tax Shelter Transaction? 5c 6a Does the organization have annual gross receipts that are norally greater than $100,000, and did the organization solicit any contriutions that were not tax deductile? 6a f "Yes," did the organization include with every solicitation an express stateent that such contriutions or gifts were not tax deductile? 6 7 Organizations that ay receive deductile contriutions under section 170(c). a Did the organization receive a payent in excess of $75 ade partly as a contriution and partly for goods and services provided to the payor? 7a f "Yes," did the organization notify the donor of the value of the goods or services provided? 7 c Did the organization sell, exchange, or otherwise dispose of tangile personal property for which it was required to file For 8282? 7c d f "Yes," indicate the nuer of Fors 8282 filed during the year 7d e Did the organization, during the year, receive any funds, directly or indirectly, to pay preius on a personal enefit contract? 7e f Did the organization, during the year, pay preius, directly or indirectly, on a personal enefit contract? 7f g For all contriutions of qualified intellectual property, did the organization file For 8899 as required? 7g h For contriutions of cars, oats, airplanes, and other vehicles, did the organization file a For 1098-C as required? 7h 8 Sponsoring organizations aintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund aintained y a sponsoring organization, have excess usiness holdings at any tie during the year? 8 9 Sponsoring organizations aintaining donor advised funds. a Did the organization ake any taxale distriutions under section 4966? 9a Did the organization ake a distriution to a donor, donor advisor, or related person? 9 10 Section 501(c)(7) organizations. Enter: a nitiation fees and capital contriutions included on Part V, line 12 10a Gross receipts, included on For 990, Part V, line 12, for pulic use of clu facilities Section 501(c)(12) organizations. Enter: a Gross incoe fro eers or shareholders 11a Gross incoe fro other sources (Do not net aounts due or paid to other sources against aounts due or received fro the.) a Section 4947(a)(1) non-exept charitale trusts. s the organization filing For 990 in lieu of For 1041? 12a f "Yes," enter the aount of tax-exept interest received or accrued during the year 12 9E Yes No For 990 (2009)

6 Part V Governance, Manageent, and Disclosure For each "Yes" response to lines 2 through 7 elow, and for a "No" response to line 8a, 8, or 10 elow, descrie the circustances, processes, or changes in Schedule O. See instructions. Section A. Governing Body and Manageent For 990 (2009) Page 6 1a a 8 a 9 10a 11 11A 12a a Enter the nuer of voting eers of the governing ody Enter the nuer of voting eers that are independent Did any officer, director, trustee, or key eployee have a faily relationship or a usiness relationship with any other officer, director, trustee, or key eployee? Did the organization delegate control over anageent duties custoarily perfored y or under the direct supervision of officers, directors or trustees, or key eployees to a anageent copany or other person? Did the organization ake any significant changes to its organizational docuents since the prior For 990 was filed? Did the organization ecoe aware during the year of a aterial diversion of the organization's assets? Does the organization have eers or stockholders? Does the organization have eers, stockholders, or other persons who ay elect one or ore eers of the governing ody? Are any decisions of the governing ody suject to approval y eers, stockholders, or other persons? Did the organization conteporaneously docuent the eetings held or written actions undertaken during the year y the following: The governing ody? Each coittee with authority to act on ehalf of the governing ody? s there any officer, director, trustee, or key eployee listed in Part V, Section A, who cannot e reached at 8a 8 the organization's ailing address? f "Yes," provide the naes and addresses in Schedule O 9a Section B. Policies(This Section B requests inforation aout policies not required y the nternal Revenue Code.) c a Does the organization have local chapters, ranches, or affiliates? f "Yes," does the organization have written policies and procedures governing the activities of such chapters, affiliates, and ranches to ensure their operations are consistent with those of the organization? Has the organization provided a copy of this For 990 to all eers of its governing ody efore filing the for? Descrie in Schedule O the process, if any, used y the organization to review this For 99 Does the organization have a written conflict of interest policy? f "No," go to line 13 Are officers, directors or trustees, and key eployees required to disclose annually interests that could give rise to conflicts? Does the organization regularly and consistently onitor and enforce copliance with the policy? f "Yes," descrie in Schedule O how this is done Does the organization have a written whistlelower policy? Does the organization have a written docuent retention and destruction policy? Did the process for deterining copensation of the following persons include a review and approval y independent persons, coparaility data, and conteporaneous sustantiation of the delieration and decision? The organization's CEO, Executive Director, or top anageent official Other officers or key eployees of the organization f "Yes" to line 15a or 15, descrie the process in Schedule O. (See instructions.) Did the organization invest in, contriute assets to, or participate in a joint venture or siilar arrangeent with a taxale entity during the year? f "Yes," has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangeents under applicale federal tax law, and taken steps to safeguard the organization's exept status with respect to such arrangeents? 1a Section C. Disclosure 17 List the states with which a copy of this For 990 is required to e filed CT,ME,MA,NH,R,VT, 18 Section 6104 requires an organization to ake its Fors 1023 (or 1024 if applicale), 990, and 990-T (501(c)(3)s only) availale for pulic inspection. ndicate how you ake these availale. Check all that apply. Own wesite Another's wesite Upon request 19 Descrie in Schedule O whether (and if so, how), the organization akes its governing docuents, conflict of interest policy, and financial stateents availale to the pulic. 20 State the nae, physical address, and telephone nuer of the person who possesses the ooks and records of the organization: DANA C.VALLS, 30 SPEEN ST. FRAMNGHAM, MA For 990 (2009) 9E a 7 10a a 12 12c a 15 16a Yes Yes No No

7 Copensation of Officers, Directors, Trustees, Key Eployees, Highest Copensated Eployees, and ndependent Contractors For 990 (2009) Page 7 Part V Section A. Officers, Directors, Trustees, Key Eployees, and Highest Copensated Eployees 1a Coplete this tale for all persons required to e listed. Report copensation for the calendar year ending with or within the organization's tax year. Use Schedule J-2 if additional space is needed. % % List all of the organization's current officers, directors, trustees (whether individuals or organizations), regardless of aount of copensation. Enter -0- in coluns (D), (E), and (F) if no copensation was paid. List all of the organization's current key eployees. See instructions for definition of "key eployee." List the organization's five current highest copensated eployees (other than an officer, director, trustee, or key eployee) who received reportale copensation (Box 5 of For W-2 and/or Box 7 of For 1099-MSC) of ore than $100,000 fro the organization and any related organizations. % % List all of the organization's forer officers, key eployees, and highest copensated eployees who received ore than $100,000 of reportale copensation fro the organization and any related organizations. List all of the organization's forer directors or trustees that received, in the capacity as a forer director or trustee of the organization, ore than $10,000 of reportale copensation fro the organization and any related organizations. List persons in the following order: individual trustees or directors; institutional trustees; officers; key eployees; highest copensated eployees; and forer such persons. 9E Check this ox if the organization did not copensate any current officer, director, or trustee. (A) (B) (C) (D) (E) (F) Nae and Title Average hours per week Position (check all that apply) ndividual trustee or director nstitutional trustee Officer Key eployee Highest copensated eployee Forer Reportale copensation fro the organization (W-2/1099-MSC) Reportale copensation fro related organizations (W-2/1099-MSC) Estiated aount of other copensation fro the organization and related organizations NANCY E KANE MS RN AOCN CHAR 5.00 ANDREW B MACLEAN JD VCE CHAR 5.00 LAURA J HLDERLY RN MS CHEF MEDCAL OFFCER 5.00 ROBERT F STOTT TREASURER 5.00 DAVD W GLDDEN SECRETARY 5.00 BURT ADELMAN MD DRECTOR 3.00 SUSAN W BARRON DRECTOR 3.00 TRACY A BATTAGLA MD MPH DRECTOR 3.00 DENNS R CATALDO DRECTOR 3.00 DEBORAH J CORNWALL DRECTOR 3.00 THOMAS A DPETRLLO MD DRECTOR 3.00 KM D GATOF PHD DRECTOR 3.00 TED A JAMES MD DRECTOR 3.00 LESLE CHARLES LOCKRDGE MD DRECTOR 3.00 JANET L MARCANTONO CFP DRECTOR 3.00 SUSAN MESFELDT MD DRECTOR For 990 (2009)

8 Section A. Officers, Directors, Trustees, Key Eployees, and Highest Copensated Eployees (continued) For 990 (2009) Page 8 Part V (A) (B) (C) (D) (E) (F) Nae and title Average hours per week Position (check all that apply) ndividual trustee or director nstitutional trustee Officer Key eployee Highest copensated eployee Forer Reportale copensation fro the organization (W-2/1099-MSC) Reportale copensation fro related organizations (W-2/1099-MSC) Estiated aount of other copensation fro the organization and related organizations JAMES E MLLER DRECTOR 3.00 GUY RUSSO DRECTOR 3.00 MARKOS W SAMOS DRECTOR 3.00 WLLAM SHERRY DRECTOR 3.00 ANDREA SLBER MD DRECTOR 3.00 JENNFER P STONE MD DRECTOR 3.00 KARL W TURNER DRECTOR 3.00 BARBARA WARD MD DRECTOR 3.00 LOR LYNN WLSON MD FACS DRECTOR 3.00 DONALD GUDATS CHEF EECUTVE OFFCER , ,307. DANA C VALLS CHEF FNANCAL OFFCER ,047. 4,658. MARGARET A CAMP CHEF OPERATNG OFFCER , ,377. BRUCE W MARSHALL SENOR VP OF DEVELOPMENT , , Total CONTNUED AT SCHEDULE J-2 1,340,533. 1,135,14 2 Total nuer of individuals (including ut not liited to those listed aove) who received ore than $100,000 in reportale copensation fro the organization 12 3 Did the organization list any forer officer, director or trustee, key eployee, or highest copensated eployee on line 1a? f "Yes," coplete Schedule J for such individual 3 4 For any individual listed on line 1a, is the su of reportale copensation and other copensation fro the organization and related organizations greater than $150,000? f "Yes," coplete Schedule J for such individual 4 5 Did any person listed on line 1a receive or accrue copensation fro any unrelated organization for services rendered to the organization? f "Yes," coplete Schedule J for such person 5 Section B. ndependent Contractors 1 Coplete this tale for your five highest copensated independent contractors that received ore than $100,000 of copensation fro the organization. ATTACHMENT 3 (A) Nae and usiness address (B) Description of services Yes (C) Copensation No 2 Total nuer of independent contractors (including ut not liited to those listed aove) who received ore than $100,000 in copensation fro the organization 2 For 990 (2009) 9E

9 For 990 (2009) Page 9 Part V Contriutions, gifts, grants and other siilar aounts Progra Service Revenue Other Revenue 9E a c d e Stateent of Revenue f All other contriutions, gifts, grants, and siilar aounts not included aove 1f 21,496,772. g Noncash contriutions included in lines 1a-1f: $ 641,639. h Total. Add lines 1a-1f Business Code 2a c d e f g 6a c d 7a and sales expenses 38,604, c Gain or (loss) 72, d Net gain or (loss) 8a 11a c Federated capaigns Meership dues Fundraising events Related organizations Governent grants (contriutions) All other progra service revenue Total. Add lines 2a-2f d All other revenue e Total. Add lines 11a-11d 12 Total Revenue. See instructions 1a 1 1c 1d 1e nvestent incoe (including dividends, interest, and other siilar aounts) ncoe fro investent of tax-exept ond proceeds Royalties Gross Rents (i) Real (ii) Personal Less: rental expenses Rental incoe or (loss) Net rental incoe or (loss) Gross aount fro sales of (i) Securities (ii) Other assets other than inventory 38,676,998. Less: cost or other asis Gross incoe fro fundraising events (not including $ 35,059,492. of contriutions reported on line 1c). See Part V, line 18 a 2,561,178. Less: direct expenses 2,561,178. c Net incoe or (loss) fro fundraising events 9a Gross incoe fro gaing activities. See Part V, line 19 a 8,32 Less: direct expenses c Net incoe or (loss) fro gaing activities 10a Gross sales of inventory, less returns and allowances a 705,34 Less: cost of goods sold 867,201. c Net incoe or (loss) fro sales of inventory Miscellaneous Revenue Business Code 1,801, ,059, ,865. (A) Total revenue 58,543, (B) Related or exept function revenue (C) Unrelated usiness revenue (D) Revenue excluded fro tax under sections 512, 513, or , , , ,125. 8,32 8,32-161, ,861. ALL OTHER REVENUE , , , ,194, ,49 For 990 (2009)

10 For 990 (2009) Page 10 Part Stateent of Functional Expenses Section 501(c)(3) and 501(c)(4) organizations ust coplete all coluns. All other organizations ust coplete colun (A) ut are not required to coplete coluns (B), (C), and (D). Do not include aounts reported on lines 6, 7, 8, 9, and 10 of Part V. 1 2 Grants and other assistance to governents and organizations in the U.S. See Part V, line 21 Grants and other assistance to individuals in the U.S. See Part V, line 22 3 Grants and other assistance to governents, organizations, and individuals outside the U.S. See Part V, lines 15 and 16 4 Benefits paid to or for eers 5 Copensation of current officers, directors, trustees, and key eployees 6 Copensation not included aove, to disqualified persons (as defined under section 4958(f)(1)) and persons descried in section 4958(c)(3)(B) 7 Other salaries and wages 8 Pension plan contriutions (include section 401(k) and section 403() eployer contriutions) Other eployee enefits a c d e f g a c d e f Payroll taxes Fees for services (non-eployees): Manageent Legal Accounting Loying Professional fundraising services. See Part V, line 17 nvestent anageent fees Other Advertising and prootion Office expenses nforation technology Royalties Occupancy Travel Payents of travel or entertainent expenses for any federal, state, or local pulic officials Conferences, conventions, and eetings nterest Payents to affiliates Depreciation, depletion, and aortization nsurance Other expenses. teize expenses not covered aove. (Expenses grouped together and laeled iscellaneous ay not exceed 5% of total expenses shown on line 25 elow.) All other expenses Total functional expenses. Add lines 1 through 24f 26 Joint Costs. Check here f following SOP Coplete this line only if the organization reported in colun (B) joint costs fro a coined educational capaign and fundraising solicitation 9E (A) (B) (C) (D) Total expenses Progra service Manageent and Fundraising expenses general expenses expenses 40,30 40,30 1,477,309. 1,477, , ,80 137, , , , , ,510, ,331, ,50 4,646,59 2,476,93 1,905, , ,914. 2,755,189. 2,113, , ,072. 1,545, , , , , ,344. 3,96 11, ,00 88,00 115,05 115,05 194, , , , , , , ,087. 2, ,757. 2,391,273. 1,507, , , , , , ,037. 3,417,183. 1,314,976. 1,876, , , ,118. 8, , , ,749. 6, , , , , ,799, ,799,048. 2,047,198. 1,565, , , , ,364. 5, ,56 PRNTNG-EDUCATON/FR 1,154,79 700, , ,929. GRANTS TO AFFLATES 25,00 25,00 MEMBERSHP DUES 17,07 11, ,946. MSCELLANEOUS 14, ,067. 1,237. 2, ,649, ,246,104. 3,412,023. 8,991,188. 9,595,609. 5,705, ,046. 3,448, For 990 (2009)

11 For 990 (2009) Page 11 Part Assets Liailities Net Assets or Fund Balances Balance Sheet Cash - non-interest-earing Savings and teporary cash investents Pledges and grants receivale, net Accounts receivale, net Receivales fro current and forer officers, directors, trustees, key eployees, and highest copensated eployees. Coplete Part of Schedule L Receivales fro other disqualified persons (as defined under section 4958(f)(1)) and persons descried in section 4958(c)(3)(B). Coplete Part of Schedule L Notes and loans receivale, net nventories for sale or use Prepaid expenses and deferred charges 10a other asis. Coplete Part V of Schedule D Less: accuulated depreciation 10 nvestents - pulicly traded securities nvestents - other securities. See Part V, line 11 nvestents - progra-related. See Part V, line 11 ntangile assets Other assets. See Part V, line 11 Total assets. Add lines 1 through 15 (ust equal line 34) Accounts payale and accrued expenses Grants payale Deferred revenue Tax-exept ond liailities a Land, uildings, and equipent: cost or Escrow or custodial account liaility. Coplete Part V of Schedule D Payales to current and forer officers, directors, trustees, key eployees, highest copensated eployees, and disqualified persons. Coplete Part of Schedule L Secured ortgages and notes payale to unrelated third parties Unsecured notes and loans payale to unrelated third parties Other liailities. Coplete Part of Schedule D Total liailities. Add lines 17 through 25 Organizations that follow SFAS 117, check here and coplete lines 27 through 29, and lines 33 and 34. Unrestricted net assets Teporarily restricted net assets Peranently restricted net assets Organizations that do not follow SFAS 117, check here and coplete lines 30 through 34. Capital stock or trust principal, or current funds Paid-in or capital surplus, or land, uilding, or equipent fund Retained earnings, endowent, accuulated incoe, or other funds Total net assets or fund alances Total liailities and net assets/fund alances 51,490, (A) Beginning of year (B) End of year 3,172,048. 7,178,602. 5,149, ,117, ,154,494. 3,957, , , , ,34 9,115, ,646, c 42,375,365. 6,567, ,430, ,025, ,699, ,658, ,321,001. 6,834, ,477, , , ,636, ,109, ,335, ,151, ,062, ,562, ,360, ,122, ,126, ,483, ,549, ,658, ,169, ,321,001. For 990 (2009) 9E

12 For 990 (2009) Page 12 1 Part 2a c d 3a Financial Stateents and Reporting Accounting ethod used to prepare the For 990: Cash Accrual Other f the organization changed its ethod of accounting fro a prior year or checked "Other," explain in Schedule O. Were the organization's financial stateents copiled or reviewed y an independent accountant? Were the organization's financial stateents audited y an independent accountant? f "Yes" to line 2a or 2, does the organization have a coittee that assues responsiility for oversight of the audit, review, or copilation of its financial stateents and selection of an independent accountant? f the organization changed either its oversight process or selection process during the tax year, explain in Schedule O. f "Yes" to line 2a or 2, check a ox elow to indicate whether the financial stateents for the year were issued on a consolidated asis, separate asis, or oth: Separate asis Consolidated asis Both consolidated and separate asis As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? f "Yes," did the organization undergo the required audit or audits? f the organization did not undergo the required audit or audits, explain why in Schedule O and descrie any steps taken to undergo such audits. 2a 2 2c 3a 3 Yes No For 990 (2009) 9E

13 SCHEDULE A (For 990 or 990-EZ) Departent of the Treasury nternal Revenue Service Pulic Charity Status and Pulic Support Coplete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexept charitale trust. Attach to For 990 or For 990-EZ. See separate instructions. OMB No À¾ ½ Open to Pulic nspection Nae of the organization AMERCAN CANCER SOCETY NC, NEW ENGLAND Eployer identification nuer DVSON NC Part Reason for Pulic Charity Status (All organizations ust coplete this part.) See instructions. The organization is not a private foundation ecause it is: (For lines 1 through 11, check only one ox.) 1 2 A church, convention of churches, or association of churches descried in A school descried in section 170()(1)(A)(ii). (Attach Schedule E.) section 170()(1)(A)(i). 3 A hospital or a cooperative hospital service organization descried in section 170()(1)(A)(iii). 4 A edical research organization operated in conjunction with a hospital descried in section 170()(1)(A)(iii). Enter the hospital's nae, city, and state: 5 An organization operated for the enefit of a college or university owned or operated y a governental unit descried in section 170()(1)(A)(iv). (Coplete Part.) e f g h A federal, state, or local governent or governental unit descried in section 170()(1)(A)(v). An organization that norally receives a sustantial part of its support fro a governental unit or fro the general pulic descried in section 170()(1)(A)(vi). (Coplete Part.) A counity trust descried in section 170()(1)(A)(vi). (Coplete Part.) An organization that norally receives: (1) ore than 33 1/3 % of its support fro contriutions, eership fees, and gross receipts fro activities related to its exept functions - suject to certain exceptions, and (2) no ore than 33 1/3% of its support fro gross investent incoe and unrelated usiness taxale incoe (less section 511 tax) fro usinesses acquired y the organization after June 30, See section 509(a)(2). (Coplete Part.) An organization organized and operated exclusively to test for pulic safety. See section 509(a)(4). An organization organized and operated exclusively for the enefit of, to perfor the functions of, or to carry out the purposes of one or ore 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 coplete lines 11e through 11h. a Type Type c Type - Functionally integrated d Type - Other By checking this ox, certify that the organization is not controlled directly or indirectly y one or ore disqualified persons other than foundation anagers and other than one or ore pulicly supported organizations descried in section 509(a)(1) or section 509(a)(2). f the organization received a written deterination fro the RS that it is a Type, Type, or Type supporting organization, check this ox Since August 17, 2006, has the organization accepted any gift or contriution fro any of the following persons? (i) A person who directly or indirectly controls, either alone or together with persons descried in (ii) Yes No and (iii) elow, the governing ody of the supported organization? 11g(i) (ii) A faily eer of a person descried in (i) aove? 11g(ii) (iii) A 35% controlled entity of a person descried in (i) or (ii) aove? 11g(iii) Provide the following inforation aout the supported organization(s). (i) Nae of supported organization (ii) EN (iii) Type of organization (descried on lines 1-9 aove or RC section (see instructions)) (iv) s the organization in col. (i) listed in your governing docuent? (v) Did you notify the organization in col. (i) of your support? (vi) s the organization in col. (i) organized in the U.S.? Yes No Yes No Yes No (vii) Aount of support Total For Privacy Act and Paperwork Reduction Act Notice, see the nstructions for For 990 or 990-EZ. Schedule A (For 990 or 990-EZ) E

14 Part Support Schedule for Organizations Descried in Sections 170()(1)(A)(iv) and 170()(1)(A)(vi) (Coplete only if you checked the ox on line 5, 7, or 8 of Part.) Section A. Pulic Support (a) 2005 () 2006 (c) 2007 (d) 2008 (e) 2009 (f) Total Schedule A (For 990 or 990-EZ) 2009 Page 2 Calendar year (or fiscal year eginning in) 1 Gifts, grants, contriutions, and eership 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 governental unit to the organization without charge 4 Total. Add lines 1 through 3 5 The portion of total contriutions y each person (other than a governental unit or pulicly supported organization) included on line 1 that exceeds 2% of the aount shown on line 11, colun (f) 6 Pulic support. Sutract line 5 fro line 4. Section B. Total Support Calendar year (or fiscal year eginning in) 7 Aounts fro line 4 8 Gross incoe fro interest, dividends, payents received on securities loans, rents, royalties and incoe fro siilar sources 70,119, ,295,41 66,531, ,962, ,543, ,452, ,119, ,295,41 66,531, ,962, ,543, ,452, ,452,811. (a) 2005 () 2006 (c) 2007 (d) 2008 (e) 2009 (f) Total 70,119, ,295,41 66,531, ,962, ,543, ,452,811. 1,979,262. 2,732,788. 1,996,323. 1,339, ,435. 8,919, Net incoe fro unrelated usiness activities, whether or not the usiness is regularly carried on -139, , Other incoe. Do not include gain or loss fro the sale of capital assets (Explain in Part V.) 11 Total support. Add lines 7 through ,232, Gross receipts fro related activities, etc. (see instructions) 12 20,115, First five years. f the For 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. Coputation of Pulic Support Percentage 14 Pulic support percentage for 2009 (line 6, colun (f) divided y line 11, colun (f)) % 15 Pulic support percentage fro 2008 Schedule A, Part, line % 16a 33 1/3 % support test f the organization did not check the ox on line 13, and line 14 is 33 1/3 % or ore, check this ox and stop here. The organization qualifies as a pulicly supported organization 33 1/3 % support test f the organization did not check a ox on line 13 or 16a, and line 15 is 33 1/3 % or ore, check this ox and stop here. The organization qualifies as a pulicly supported organization 17a 10%-facts-and-circustances test f the organization did not check a ox on line 13, 16a or 16, and line 14 is 10% or ore, and if the organization eets the "facts-and-circustances" test, check this ox and stop here. Explain in Part V how the organization eets the "facts-and-circustances test. The organization qualifies as a pulicly supported organization 10%-facts-and-circustances test f the organization did not check a ox on line 13, 16a, 16, or 17a, and line 15 is 10% or ore, and if the organization eets the "facts-and-circustances" test, check this ox and stop here. Explain in Part V how the organzation eets the "facts-and-circustances" test. The organization qualifies as a pulicly supported organization 18 Private foundation. f the organization did not check a ox on line 13, 16a, 16, 17a, or 17, check this ox and see instructions Schedule A (For 990 or 990-EZ) E

15 Part Support Schedule for Organizations Descried in Section 509(a)(2) (Coplete only if you checked the ox on line 9 of Part.) Section A. Pulic Support Schedule A (For 990 or 990-EZ) 2009 Page 3 Calendar year (or fiscal year eginning in) (a) 2005 () 2006 (c) 2007 (d) 2008 (e) 2009 (f) Total 1 Gifts, grants, contriutions, and eership fees received. (Do not include any "unusual grants.") 2 Gross receipts fro adissions, erchandise sold or services perfored, or facilities furnished in any activity that is related to the organization's tax-exept purpose 3 Gross receipts fro 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 5 The value of services or facilities furnished y a governental unit to the organization without charge 6 Total. Add lines 1 through 5 7a Aounts included on lines 1, 2, and 3 received fro disqualified persons Aounts included on lines 2 and 3 received fro other than disqualified persons that exceed the greater of $5,000 or 1% of the aount on line 13 for the year c Add lines 7a and 7 8 Pulic support (Sutract line 7c fro line 6.) Section B. Total Support Calendar year (or fiscal year eginning in) 9 Aounts fro line 6 (a) 2005 () 2006 (c) 2007 (d) 2008 (e) 2009 (f) Total 10 a Gross incoe fro interest, dividends, payents received on securities loans, rents, royalties and incoe fro siilar sources Unrelated usiness taxale incoe (less section 511 taxes) fro usinesses acquired after June 30, 1975 c Add lines 10a and Net incoe fro unrelated usiness activities not included in line 10, whether or not the usiness is regularly carried on 12 Other incoe. Do not include gain or loss fro the sale of capital assets (Explain in Part V.) 13 Total support. (Add lines 9, 10c, 11, and 12.) 14 First five years. f the For 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. Coputation of Pulic Support Percentage 15 Pulic support percentage for 2009 (line 8, colun (f) divided y line 13, colun (f)) 16 Pulic support percentage fro 2008 Schedule A, Part, line 15 Section D. Coputation of nvestent ncoe Percentage nvestent incoe percentage for 2009 (line 10c, colun (f) divided y line 13, colun (f)) nvestent incoe percentage fro 2008 Schedule A, Part, line a 33 1/3 % support tests f the organization did not check the ox on line 14, and line 15 is ore than 33 1/3 %, and line 17 is not ore than 33 1/3 %, check this ox and stop here. The organization qualifies as a pulicly supported organization 33 1/3 % support tests f the organization did not check a ox on line 14 or line 19a, and line 16 is ore than 33 1/3 %, and line 18 is not ore than 33 1/3 %, check this ox and stop here. The organization qualifies as a pulicly supported organization 20 Private foundation. f the organization did not check a ox on line 14, 19a, or 19, check this ox and see instructions 9E Schedule A (For 990 or 990-EZ) % % % %

16 Schedule A (For 990 or 990-EZ) 2009 Page 4 Part V Suppleental nforation. Coplete this part to provide the explanation required y Part, line 10; Part, line 17a or 17; or Part, line 12. Provide any other additional inforation. See instructions Schedule A (For 990 or 990-EZ) E

17 Schedule B (For 990, 990-EZ, or 990-PF) Departent of the Treasury nternal Revenue Service Nae of the organization Organization type (check one): Schedule of Contriutors Attach to For 990, 990-EZ, or 990-PF. OMB No À¾ ½ Eployer identification nuer AMERCAN CANCER SOCETY NC, NEW ENGLAND DVSON NC Filers of: For 990 or 990-EZ Section: 501(c)( 3 ) (enter nuer) organization 4947(a)(1) nonexept charitale trust not treated as a private foundation 527 political organization For 990-PF 501(c)(3) exept private foundation 4947(a)(1) nonexept charitale trust treated as a private foundation 501(c)(3) taxale private foundation Check if your organization is covered y the General Rule or a Special Rule. Note. Only a section 501(c)(7), (8), or (10) organization can check oxes for oth the General Rule and a Special Rule. See instructions. General Rule For an organization filing For 990, 990-EZ, or 990-PF that received, during the year, $5,000 or ore (in oney or property) fro any one contriutor. Coplete Parts and. Special Rules For a section 501(c)(3) organization filing For 990 or 990-EZ that et the 33 1/3 % support test of the regulations under sections 509(a)(1) and 170()(1)(A)(vi), and received fro any one contriutor, during the year, a contriution of the greater of (1) $5,000 or (2) 2% of the aount on (i) For 990, Part V, line 1h or (ii) For 990-EZ, line 1. Coplete Parts and. For a section 501(c)(7), (8), or (10) organization filing For 990 or 990-EZ that received fro any one contriutor, during the year, aggregate contriutions of ore than $1,000 for use exclusively for religious, charitale, scientific, literary, or educational purposes, or the prevention of cruelty to children or anials. Coplete Parts,, and. For a section 501(c)(7), (8), or (10) organization filing For 990 or 990-EZ that received fro any one contriutor, during the year, contriutions for use exclusively for religious, charitale, etc., purposes, ut these contriutions did not aggregate to ore than $1,00 f this ox is checked, enter here the total contriutions that were received during the year for an exclusively religious, charitale, etc., purpose. Do not coplete any of the parts unless the General Rule applies to this organization ecause it received nonexclusively religious, charitale, etc., contriutions of $5,000 or ore during the year $ Caution. An organization that is not covered y the General Rule and/or the Special Rules does not file Schedule B (For 990, 990-EZ, or 990-PF), ut it ust answer "No" on Part V, line 2 of its For 990, or check the ox on line H of its For 990-EZ, or on line 2 of its For 990-PF, to certify that it does not eet the filing requireents of Schedule B (For 990, 990-EZ, or 990-PF). For Privacy Act and Paperwork Reduction Act Notice, see the nstructions for For 990, 990-EZ, or 990-PF. Schedule B (For 990, 990-EZ, or 990-PF) (2009) 9E

18 Schedule B (For 990, 990-EZ, or 990-PF) (2009) Page of of Part Nae of organization Part Contriutors (see instructions) AMERCAN CANCER SOCETY NC, NEW ENGLAND DVSON NC Eployer identification nuer (a) No. () Nae, address, and ZP + 4 (c) Aggregate contriutions (d) Type of contriution 1 Person Payroll $ 2,175,089. Noncash (Coplete Part if there is a noncash contriution.) (a) No. () Nae, address, and ZP + 4 (c) Aggregate contriutions (d) Type of contriution $ Person Payroll Noncash (Coplete Part if there is a noncash contriution.) (a) No. () Nae, address, and ZP + 4 (c) Aggregate contriutions (d) Type of contriution $ Person Payroll Noncash (Coplete Part if there is a noncash contriution.) (a) No. () Nae, address, and ZP + 4 (c) Aggregate contriutions (d) Type of contriution $ Person Payroll Noncash (Coplete Part if there is a noncash contriution.) (a) No. () Nae, address, and ZP + 4 (c) Aggregate contriutions (d) Type of contriution $ Person Payroll Noncash (Coplete Part if there is a noncash contriution.) (a) No. () Nae, address, and ZP + 4 (c) Aggregate contriutions (d) Type of contriution $ Person Payroll Noncash (Coplete Part if there is a noncash contriution.) Schedule B (For 990, 990-EZ, or 990-PF) (2009) 9E

19 SCHEDULE C Political Capaign and Loying Activities (For 990 or 990-EZ) For Organizations Exept Fro ncoe Tax Under section 501(c) and section 527 Departent of the Treasury Attach to For 990 or For 990-EZ. Section 501(c)(3) organizations: Coplete Parts -A and B. Do not coplete Part -C. % Section 527 organizations: Coplete Part -A only. % OMB No À¾ ½ Coplete if the organization is descried elow. Open to Pulic See separate instructions nternal Revenue Service nspection f the organization answered "Yes," to For 990, Part V, line 3, or For 990-EZ, Part V, line 46 (Political Capaign Activities), then Section 501(c) (other than section 501(c)(3)) organizations: Coplete Parts -A and C elow. Do not coplete Part -B. f the organization answered "Yes," to For 990, Part V, line 4, or For 990-EZ, Part V, line 47 (Loying Activities), then % Section 501(c)(3) organizations that have filed For 5768 (election under section 501(h)): Coplete Part -A. Do not coplete Part -B. Section 501(c)(3) organizations that have NOT filed For 5768 (election under section 501(h)): Coplete Part -B. Do not coplete Part -A. f the % organization answered "Yes," to For 990, Part V, line 5 (Proxy Tax), then Section 501(c)(4), (5), or (6) organizations: Coplete Part. Nae of organization Eployer identification nuer AMERCAN CANCER SOCETY NC, NEW ENGLAND DVSON NC Part -A Coplete if the organization is exept under section 501(c) or is a section 527 organization. 1 Provide a description of the organization's direct and indirect political capaign activities in Part V. 2 Political expenditures $ 3 Volunteer hours Coplete if the organization is exept under section 501(c)(3). Enter the aount of any excise tax incurred y the organization under section 4955 $ Enter the aount of any excise tax incurred y organization anagers under section 4955 $ f the organization incurred ṃ a section 4955 tax, did it file For 4720 for this year? Was a correction ade? f "Yes," descrie in Part V Part -B a Part -C Coplete if the organization is exept under section 501(c), except section 501(c)(3). 1 Enter the aount directly expended y the filing organization for section 527 exept function activities $ 2 Enter the aount of the filing organization's funds contriuted to other organizations for section 527 exept function activities $ 3 Total exept function expenditures. Add lines 1 and 2. Enter here and on For 1120-POL, line 17 $ 4 Did the filing organization file For 1120-POL for this year? Yes No 5 Enter the naes, addresses and eployer identification nuer (EN) of all section 527 political organizations to which payents were ade. For each organization listed, enter the aount paid fro the filing organization's funds. Also enter the aount of political contriutions received that were proptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action coittee (PAC). f additional space is needed, provide inforation in Part V. Yes Yes No No (a) Nae () Address (c) EN (d) Aount paid fro filing organization's funds. f none, enter -0-. (e) Aount of political contriutions received and proptly and directly delivered to a separate political organization. f none, enter -0-. For Privacy Act and Paperwork Reduction Act Notice, see the nstructions for For 990 or 990-EZ. 9E Schedule C (For 990 or 990-EZ)

20 Part -A Coplete if the organization is exept under section 501(c)(3) and filed For 5768 (election under section 501(h)). A Check if the filing organization elongs to an affiliated group. B Check if the filing organization checked ox A and "liited control" provisions apply. Schedule C (For 990 or 990-EZ) 2009 Page 2 1 a c d e f g h i j Liits on Loying Expenditures (The ter "expenditures" eans aounts paid or incurred.) Total loying expenditures to influence pulic opinion (grass roots loying) Total loying expenditures to influence a legislative ody (direct loying) Total loying expenditures (add lines 1a and 1) Other exept purpose expenditures Total exept purpose expenditures (add lines 1c and 1d) Loying nontaxale aount. Enter the aount fro the following tale in oth coluns. f the aount on line 1e, colun (a) or () is: Not over $500,000 Over $500,000 ut not over $1,000,000 Over $1,000,000 ut not over $1,500,000 Over $1,500,000 ut not over $17,000,000 The loying nontaxale aount is: 20% of the aount on line 1e. $100,000 plus 15% of the excess over $500,00 $175,000 plus 10% of the excess over $1,000,00 $225,000 plus 5% of the excess over $1,500,00 (a) Filing organization's totals Over $17,000,000 $1,000,00 Grassroots nontaxale aount (enter 25% of line 1f) Sutract line 1g fro line 1a. f zero or less, enter -0- Sutract line 1f fro line 1c. f zero or less, enter -0- f these is an aount other than zero on either line 1h or line 1i, did the organization file For 4720 reporting section 4911 tax for this year? 4-Year Averaging Period Under Section 501(h) (Soe organizations that ade a section 501(h) election do not have to coplete all of the five coluns elow. See the instructions for lines 2a through 2f on page 4.) Loying Expenditures During 4-Year Averaging Period 58, , , ,373, ,657,547. 1,000,00 250,00 () Affiliated group totals Yes No Calendar year (or fiscal year eginning in) (a) 2006 () 2007 (c) 2008 (d) 2009 (e) Total 2 a Loying non-taxale aount Loying ceiling aount (150% of line 2a, colun (e)) c Total loying expenditures d Grassroots nontaxale aount e Grassroots ceiling aount (150% of line 2d, colun (e)) f Grassroots loying expenditures 1,000,00 1,000,00 1,000,00 1,000,00 4,000,00 6,000,00 351, ,81 351, ,242. 1,375, ,00 250,00 250,00 250,00 1,000,00 1,500,00 61,22 77,58 52, , ,225. Schedule C (For 990 or 990-EZ) E

Form 990 (2012) Page 2

Form 990 (2012) Page 2 For 99 (212) Page 2 Part AMERCAN NATONAL RED CROSS & TS CONSTTUENT 53-19665 Stateent of Progra Service Accoplishents Check if Schedule O contains a response to any question in this Part 1 Briefly descrie

More information

MARCH OF DIMES FOUNDATION FORM 990 TAX YEAR 2014

MARCH OF DIMES FOUNDATION FORM 990 TAX YEAR 2014 MARCH OF DMES FOUNDATON FORM 99 TA YEAR 4 OMB. 545-47 Return of Organization Exept Fro ncoe Tax For 99 Under section 5(c), 57, or 4947(a)() of the nternal Revenue Code (except private foundations) À¾µ

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

3706JK K925 11/16/2015 12:59:31 PM V 11-6.5 71302 PAGE 4

3706JK K925 11/16/2015 12:59:31 PM V 11-6.5 71302 PAGE 4 For 99 (211) Page 2 Part III Stateent of Progra Service Accoplishents Check if Schedule O contains a response to any question in this Part III 1 Briefly describe the organization's ission: ATTACHMENT 1

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

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 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 (2011) Page 2

Form 990 (2011) Page 2 2/13/14 2/13/14 For 99 (211) Page 2 Part Stateent of Progra Service Accoplishents Check if Schedule O contains a response to any question in this Part 1 Briefly describe the organization's ission: ATTACHMENT

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

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

AMERICAN ACADEMY OF FAMILY PHYSICIANS FOUNDATION FORM 990 TAX YEAR 2013

AMERICAN ACADEMY OF FAMILY PHYSICIANS FOUNDATION FORM 990 TAX YEAR 2013 AMERCAN ACADEMY OF FAMLY PHYSCANS FOUNDATON FORM 99 TA YEAR 213 F RS e-file Signature Authorization for an Exept Organization 8879-EO For calendar year 213, or fiscal year eginning OMB 1545-1878, 213,

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

P.O. BOX 3870 360.337.2978 SILVERDALE, WA 98383-3870

P.O. BOX 3870 360.337.2978 SILVERDALE, WA 98383-3870 Form 990 Department of the Treasury Internal Revenue Service OMB No. 1545-0047 Return of Organization Exempt From Income Tax 2014 Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except

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

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

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

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

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

ALASKA LEGAL SERVICES CORPORATION FORM 990 TAX YEAR 2013

ALASKA LEGAL SERVICES CORPORATION FORM 990 TAX YEAR 2013 ALASKA LEGAL SERVCES CORPORATON FORM 99 TA YEAR 213 Tel: 97-278-8878 Fax: 97-278-5779 www.do.com 361 C Street, Suite 6 Anchorage, AK 9953 Novemer 14, 214 Alaska Legal Services Corporation 116 W. 6th Avenue

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

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

Inspection A For the 2013 calendar year, or tax year beginning, 2013, and ending, B Check if applicable: C 45-1611066 ROSS, CA 94957 415-386-1200

Inspection A For the 2013 calendar year, or tax year beginning, 2013, and ending, B Check if applicable: C 45-1611066 ROSS, CA 94957 415-386-1200 Form 990 OMB No. 1545-0047 Return of Organization Exempt From Income Tax 2013 Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) G Do not enter Social Security

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

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

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

Inspection A For the 2014 calendar year, or tax year beginning Jul 1, 2014, and ending Jun 30, 2015

Inspection A For the 2014 calendar year, or tax year beginning Jul 1, 2014, and ending Jun 30, 2015 Form 990 OMB No. 1545-0047 Return of Organization Exempt From Income Tax 2014 Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) G 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

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

2013 Exempt Org. Return prepared for: ATLANTA VOLUNTEER LAWYERS FOUNDATION, INC 235 PEACHTREE ST NE, 1750 N TOWER ATLANTA, GA 30303

2013 Exempt Org. Return prepared for: ATLANTA VOLUNTEER LAWYERS FOUNDATION, INC 235 PEACHTREE ST NE, 1750 N TOWER ATLANTA, GA 30303 2013 Exempt Org. Return prepared for: ATLANTA VOLUNTEER LAWYERS FOUNDATION, INC 235 PEACHTREE ST NE, 1750 N TOWER ATLANTA, GA 30303 FULTON & KOZAK, CPA 7187 JONESBORO RD STE 100A MORROW, GA 30260-2944

More information

**PUBLIC DISCLOSURE COPY** Return of Organization Exempt From Income Tax

**PUBLIC DISCLOSURE COPY** Return of Organization Exempt From Income Tax Form Department of the Treasury Internal Revenue Service Under section 501, 527, or 4947(1) of the Internal Revenue Code (except lack lung enefit trust or private foundation) The organization may have

More information

November 16, 2015. The support of our contributors and grantors made it possible for our initiatives to make great progress in 2014.

November 16, 2015. The support of our contributors and grantors made it possible for our initiatives to make great progress in 2014. Noveer 16, 215 Dear Reader: At the Clinton Foundation, we work around the world helping farers lift theselves out of poverty, assisting island nations with renewale energy projects, epowering girls and

More information

NATIONAL COUNCIL OF YMCAS OF THE USA. 2012 Form 990 for the Year Ended December 31, 2012. Public Disclosure Copy

NATIONAL COUNCIL OF YMCAS OF THE USA. 2012 Form 990 for the Year Ended December 31, 2012. Public Disclosure Copy NATIONAL COUNCIL OF YMCAS OF THE USA 2012 Form 990 for the Year Ended December 31, 2012 Public Disclosure Copy Form 990 (2012) Page 2 Part III Statement of Program Service Accomplishments Check if Schedule

More information

How To Check If A Charity Is Doing Well

How To Check If A Charity Is Doing Well PUBLIC DISCLOSURE COPY OMB No. 545-47 Form 99 Return of Organization Exempt From Income Tax Under section 5(c), 527, or 4947(a)() of the Internal Revenue Code (except private foundations) 23 Do not enter

More information

AmeriCares Foundation, Inc. IRS Form 990. Fiscal Year 2015

AmeriCares Foundation, Inc. IRS Form 990. Fiscal Year 2015 AmeriCares Foundation, nc. RS Form 99 Fiscal Year 5 Electronic Filing Page of Cumulative e-file History 4 Federal Locator: 774N Taxpayer Name: AmeriCares Foundation, nc. Return Type: 99, 99 Submitted Date:

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

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

CONTINUATION OPTION FORM EXECUTIVE INCOME PROTECTION & LIFE COVER FOR EXISTING FRIENDS FIRST POLICYHOLDERS

CONTINUATION OPTION FORM EXECUTIVE INCOME PROTECTION & LIFE COVER FOR EXISTING FRIENDS FIRST POLICYHOLDERS CONTINUATION OPTION FORM EXECUTIVE INCOME PROTECTION & LIFE COVER FOR EXISTING FRIENDS FIRST POLICYHOLDERS Agency Nuber: Agency Nae: OFFICE USE: Contract Type: Policy/Contract No.: Client No. (Eployer):

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

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

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

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

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

Paid Preparer ' s Firm 's name (or yours if self-employed), Use Only. l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93493135041513

Paid Preparer ' s Firm 's name (or yours if self-employed), Use Only. l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93493135041513 l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93493135041513 OMB No 1545-0047 Return of Organization Exempt From Income Tax Form 990 Under 501 (c), 527, or 4947 ( a)(1) of the Internal Revenue

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 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

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

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

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

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

INCOME PROTECTION InsURANCE INITIAL CLAIM form

INCOME PROTECTION InsURANCE INITIAL CLAIM form INCOME PROTECTION InsURANCE INITIAL CLAIM for Sales Person: Agent/Agency No.: We need the inforation in this for, together with any other edical or financial evidence which ay be requested, so that we

More information

ENGAGEMENT LETTER. From: The Board of

ENGAGEMENT LETTER. From: The Board of ENGAGEMENT LETTER From: The Board of To: Clifford & Associates, LLC We have engaged you to prepare and file the applicable tax forms for our organization for the year(s) ended,. We state that to the best

More information

Professional Indemnity Select

Professional Indemnity Select Allianz Insurance plc Professional Indemnity Select Miscellaneous Proposal Form Contents Miscellaneous Professional Indemnity Insurance 1 General Information 2 Thank you for choosing Allianz Insurance

More information

L Year of formation 2001 M State of leoal domicile MS Summary

L Year of formation 2001 M State of leoal domicile MS Summary ii' Form 990 1 Return of Organization Exempt From Income Tax Under section 501 (c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation) Department of

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

The Pennsylvania State University Right-to-Know Law Report May 25, 2012

The Pennsylvania State University Right-to-Know Law Report May 25, 2012 The Pennsylvania State University Right-to-Know Law Report May 25, 2012 This Report is filed in accordance with the provisions of Chapter 15 of the Right-to-Know Law for the Fiscal Year commencing July

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

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

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

Club & LSC Financial Management. Jill J. Goodwin, CPA Waugh & Goodwin, LLP jgoodwin@waughgoodwinllp.com

Club & LSC Financial Management. Jill J. Goodwin, CPA Waugh & Goodwin, LLP jgoodwin@waughgoodwinllp.com Club & LSC Financial Management Jill J. Goodwin, CPA Waugh & Goodwin, LLP jgoodwin@waughgoodwinllp.com Form 990 Forms 1099 and W 2 State taxes Other current issues TAX ISSUES Form 990 File Form 990, 990

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

Return of Organization Exempt From Income Tax

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

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

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

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

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

Return of Organization Exempt From Income Tax

Return of Organization Exempt From Income Tax Form 990 PUBLIC DISCLOSURE COPY Return of Organization Exempt From Income Tax OMB 1545-0047 Under section 501, 527, or 4947(1) of the Internal Revenue Code (except private foundations) 2014 Do not enter

More information

Professional Indemnity Select

Professional Indemnity Select Allianz Insurance plc Professional Indemnity Select Management Consultants Proposal Form Professional Management Indemnity Consultants Insurance Professional Indemnity Select Management Consultants Professional

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 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

North Carolina s Reference to the Internal Revenue Code Updated - Impact on 2015 North Carolina Corporate and Individual income Tax Returns

North Carolina s Reference to the Internal Revenue Code Updated - Impact on 2015 North Carolina Corporate and Individual income Tax Returns June 3 2016 North Carolina s Reference to the Internal Revenue Code Updated - Impact on 2015 North Carolina Corporate and Individual income Tax Returns Governor McCrory signed into law Session Law 2016-6

More information

Paid Preparer's Firm's name (or yours EISNERAMPER LLP Use Only. l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93493130023463.

Paid Preparer's Firm's name (or yours EISNERAMPER LLP Use Only. l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93493130023463. l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 934931323463 OMB 1545-47 Return of Organization Exempt From Income Tax Form 99 Under section 51 (c), 527, or 4947 ( a)(1) of the Internal Revenue

More information

GREATER KANSAS CITY COMMUNITY FOUNDATION FORM 990 TAX YEAR 2013

GREATER KANSAS CITY COMMUNITY FOUNDATION FORM 990 TAX YEAR 2013 GREATER KANSAS CTY COMMUNTY FOUNDATON FORM 990 TA YEAR 203 Form 8879-EO RS e-file Signature Authorization for an Exempt Organization OMB. 545-878 For calendar year 203, or fiscal year beginning, 203, and

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), 57, or 4947(a)(1) of the Internal Revenue Code (except black lung 1 benefit trust or private foundation) Open

More information

North Carolina s Reference to the Internal Revenue Code Updated - Impact on 2015 North Carolina Corporate and Individual income Tax Returns

North Carolina s Reference to the Internal Revenue Code Updated - Impact on 2015 North Carolina Corporate and Individual income Tax Returns June 3 2016 North Carolina s Reference to the Internal Revenue Code Updated - Impact on 2015 North Carolina Corporate and Individual income Tax Returns Governor McCrory signed into law Session Law 2016-6

More information

Internal Revenue And Form 990

Internal Revenue And Form 990 8/22/205 8:5:58 PM 204 Return YOUNG MEN'S CHRISTIAN ASSOCIATION OF METROPOLITAN ATLANTA (36)- 58-0566253 OMB No. 545-0047 Form 990 Return of Organization Exempt From Income Tax Under section 50(c), 527,

More information

Important Compliance Information. How to obtain and use the new documents (if fillable PDF s are mentioned above)

Important Compliance Information. How to obtain and use the new documents (if fillable PDF s are mentioned above) Copliance This Copliance is being sent to infor you that one or ore of the docuents currently contained in your Wolters Kluwer Financial Services Bankers Systes software syste or electronic docuents odule

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

4e Total program service expensesl-$ 4,532,833 Form 990 (2011 )

4e Total program service expensesl-$ 4,532,833 Form 990 (2011 ) l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93493133036723 OMB 1545-0047 Return of Organization Exempt From Income Tax Form 990 Under section 501 (c), 527, or 4947 ( a)(1) of the Internal

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

Management Consultants Professional Indemnity Insurance Proposal Form

Management Consultants Professional Indemnity Insurance Proposal Form Management Consultants Professional Indemnity Insurance Proposal Form Important Notes Please read efore completing this form: a) If you are unsure whether this proposal is suitale for your usiness or require

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

H(a) Is this a group return for affiliates? Yes No CHRIS SHIVERS

H(a) Is this a group return for affiliates? Yes No CHRIS SHIVERS IN ABBA 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

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

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 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

Independent Auditor s Report

Independent Auditor s Report Combined Financial Statements Christian Care Retirement Apartments, Inc. Christian Care Assisted Living (Phoenix), Inc. Christian Care Mesa, Inc. www.eidebailly.com Table of Contents Independent Auditor

More information