Short Form 990-EZ Return of Organization Exempt From Income Tax 2018

Transcription

1 Form Short Form 990-EZ Return of Orgniztion Exempt From Inome Tx 0 Deprtment of the Tresury Internl Revenue Servie Under setion 0(),, or 9()() of the Internl Revenue Code (exept privte foundtions) Do not enter soil seurity numers on this form s it my e mde puli. A For the 0 lendr yer, or tx yer eginning, 0, nd ending, 0 B G I J K L (Prt II, olumn (B)) re $00,000 or more, file Form 990 insted of Form 990-EZ $ Prt I Revenue, Expenses, nd Chnges in Net Assets or Fund Blnes (see the instrutions for Prt I) Chek if the orgniztion used Shedule O to respond to ny question in this Prt I Open to Puli Inspetion D Employer identifition numer Aounting Method: Csh Arul Other (speify) H Chek if the orgniztion is not Wesite: Tx-exempt sttus (hek only one) - Contriutions, gifts, grnts, nd similr mounts reeived Progrm servie revenue inluding government fees nd ontrts Memership dues nd ssessments Investment inome Less: ost or other sis nd sles expenses Gross inome from fundrising events (not inluding $ of ontriutions d Less: ost of goods sold Other revenue (desrie in Shedule O) 9 Totl revenue. Add lines,,,,, d,, nd 9 0 Grnts nd similr mounts pid (list in Shedule O) 0 Benefits pid to or for memers Slries, other ompenstion, nd employee enefits Professionl fees nd other pyments to independent ontrtors Oupny, rent, utilities, nd mintenne Printing, pulitions, postge, nd shipping Other expenses (desrie in Shedule O) Totl expenses. Add lines 0 through Exess or (defiit) for the yer (Sutrt line from line 9) 9 0 Other hnges in net ssets or fund lnes (explin in Shedule O) 0 Net ssets or fund lnes t end of yer. Comine lines through 0 For Pperwork Redution At tie, see the seprte instrutions. Chek if pplile: Address hnge Nme hnge Initil return Finl return/terminted Amended return Applition pending Go to for instrutions nd the ltest informtion. Form of orgniztion: Corportion Trust Assoition Other Add lines,, nd to line 9 to determine gross reeipts. If gross reeipts re $00,000 or more, or if totl ssets Gross mount from sle of ssets other thn inventory Gin or (loss) from sle of ssets other thn inventory (Sutrt line from line ) Gming nd fundrising events: Gross inome from gming (tth Shedule G if greter thn $,000) from fundrising events reported on line ) (tth Shedule G if the sum of suh gross inome nd ontriutions exeeds $,000) Less: diret expenses from gming nd fundrising events Net inome or (loss) from gming nd fundrising events (dd lines nd nd sutrt line ) C Nme of orgniztion Numer nd street (or P.O. ox, if mil is not delivered to street ddress) City or town, stte or provine, ountry, nd ZIP or foreign postl ode Gross sles of inventory, less returns nd llownes Gross profit or (loss) from sles of inventory (Sutrt line from line ) Net ssets or fund lnes t eginning of yer (from line, olumn (A)) (must gree with end-of-yer figure reported on prior yer's return) Room/suite 0()() 0()( ) (insert no.) 9()() or E F Telephone numer Group Exemption Numer required to tth Shedule B (Form 990, 990-EZ, or 990-PF). d 9 OMB. -0 Form 990-EZ (0)

2 Form 990-EZ (0) Prt II Blne Sheets (see the instrutions for Prt II) Chek if the orgniztion used Shedule O to respond to ny question in this Prt II (A) Beginning of yer Csh, svings, nd investments Lnd nd uildings Other ssets (desrie in Shedule O) Totl ssets Totl liilities (desrie in Shedule O) Net ssets or fund lnes (line of olumn (B) must gree with line ) Prt III Sttement of Progrm Servie Aomplishments (see the instrutions for Prt III) Chek if the orgniztion used Shedule O to respond to ny question in this Prt III Wht is the orgniztion's primry exempt purpose? Desrie the orgniztion's progrm servie omplishments for eh of its three lrgest progrm servies, s mesured y expenses. In ler nd onise mnner, desrie the servies provided, the numer of persons enefited, nd other relevnt informtion for eh progrm title. (B) End of yer (Required for setion 0()() nd 0()() orgniztions; optionl for others.) Expenses Pge 9 (Grnts $ ) If this mount inludes foreign grnts, hek here 0 (Grnts $ ) If this mount inludes foreign grnts, hek here 9 (Grnts $ ) If this mount inludes foreign grnts, hek here 0 Other progrm servies (desrie in Shedule O) (Grnts $ ) If this mount inludes foreign grnts, hek here Totl progrm servie expenses (dd lines through ) Prt IV List of Offiers, Diretors, Trustees, nd Key Employees (list eh one even if not ompensted - see the instrutions for Prt IV) Chek if the orgniztion used Shedule O to respond to ny question in this Prt IV () Reportle (d) Helth enefits, () Averge ompenstion ontriutions to employee (e) Estimted mount of () Nme nd title hours per week (Forms W-/099-MISC) enefit plns, nd other ompenstion devoted to position (if not pid, enter -0-) deferred ompenstion Form 990-EZ (0)

3 Form 990-EZ (0) Prt V Other Informtion (te the Shedule A nd personl enefit ontrt sttement requirements in the instrutions for Prt V.) Chek if the orgniztion used Shedule O to respond to ny question in this Prt V Did the orgniztion engge in ny signifint tivity not previously reported to the IRS? If "," provide detiled desription of eh tivity in Shedule O Were ny signifint hnges mde to the orgnizing or governing douments? If "," tth onformed opy of the mended douments if they reflet hnge to the orgniztion's nme. Otherwise, explin the hnge on Shedule O. See instrutions Did the orgniztion hve unrelted usiness gross inome of $,000 or more during the yer from usiness tivities (suh s those reported on lines,, nd, mong others)? If "," to line, hs the orgniztion filed Form 990-T for the yer? If "," provide n explntion in Shedule O Ws the orgniztion setion 0()(), 0()(), or 0()() orgniztion sujet to setion 0(e) notie, reporting, nd proxy tx requirements during the yer? If "," omplete Shedule C, Prt III Did the orgniztion undergo liquidtion, dissolution, termintion, or signifint disposition of net ssets during the yer? If "," omplete pplile prts of Shedule N Enter mount of politil expenditures, diret or indiret, s desried in the instrutions Did the orgniztion file Form 0-POL for this yer? Did the orgniztion orrow from, or mke ny lons to, ny offier, diretor, trustee, or key employee or were ny suh lons mde in prior yer nd still outstnding t the end of the tx yer overed y this return? If "," omplete Shedule L, Prt II nd enter the totl mount involved 9 Setion 0()() orgniztions. Enter: Initition fees nd pitl ontriutions inluded on line 9 9 Gross reeipts, inluded on line 9, for puli use of lu filities 9 0 Setion 0()() orgniztions. Enter mount of tx imposed on the orgniztion during the yer under: setion 9 ; setion 9 ; setion 9 Setion 0()(), 0()(), nd 0()(9) orgniztions. Did the orgniztion engge in ny setion 9 exess enefit trnstion during the yer, or did it engge in n exess enefit trnstion in prior yer tht hs not een reported on ny of its prior Forms 990 or 990-EZ? If "," omplete Shedule L, Prt I Setion 0()(), 0()(), nd 0()(9) orgniztions. Enter mount of tx imposed on orgniztion mngers or disqulified persons during the yer under setions 9, 9, nd 9 d Setion 0()(), 0()(), nd 0()(9) orgniztions. Enter mount of tx on line 0 reimursed y the orgniztion e All orgniztions. At ny time during the tx yer, ws the orgniztion prty to prohiited tx shelter trnstion? If "," omplete Form -T List the sttes with whih opy of this return is filed The orgniztion's ooks re in re of Telephone no. d Pge 0 0e Loted t ZIP + At ny time during the lendr yer, did the orgniztion hve n interest in or signture or other uthority over finnil ount in foreign ountry (suh s nk ount, seurities ount, or other finnil ount)? If "," enter the nme of the foreign ountry See the instrutions for exeptions nd filing requirements for FinCEN Form, Report of Foreign Bnk nd Finnil Aounts (FBAR). At ny time during the lendr yer, did the orgniztion mintin n offie outside the United Sttes? If "," enter the nme of the foreign ountry Setion 9()() nonexempt hritle trusts filing Form 990-EZ in lieu of Form 0-Chek here nd enter the mount of tx-exempt interest reeived or rued during the tx yer Did the orgniztion mintin ny donor dvised funds during the yer? If "," Form 990 must e ompleted insted of Form 990-EZ Did the orgniztion operte one or more hospitl filities during the yer? If "," Form 990 must e ompleted insted of Form 990-EZ Did the orgniztion reeive ny pyments for indoor tnning servies during the yer? If "," to line, hs the orgniztion filed Form 0 to report these pyments? If "," provide n explntion in Shedule O d Did the orgniztion hve ontrolled entity within the mening of setion ()()? Did the orgniztion reeive ny pyment from or engge in ny trnstion with ontrolled entity within the mening of setion ()()? If "," Form 990 nd Shedule R my need to e ompleted insted of Form 990-EZ. See instrutions Form 990-EZ (0)

4 Form 990-EZ (0) to ndidtes for puli offie? If "," omplete Shedule C, Prt I Prt VI Setion 0()() Orgniztions Only All setion 0()() orgniztions must nswer questions - 9 nd, nd omplete the tles for lines 0 nd. Chek if the orgniztion used Shedule O to respond to ny question in this Prt VI Is the orgniztion shool s desried in setion 0()()(A)(ii)? If "," omplete Shedule E 9 0 Did the orgniztion engge, diretly or indiretly, in politil mpign tivities on ehlf of or in opposition Did the orgniztion engge in loying tivities or hve setion 0(h) eletion in effet during the tx yer? If "," omplete Shedule C, Prt II Did the orgniztion mke ny trnsfers to n exempt non-hritle relted orgniztion? If "," ws the relted orgniztion setion orgniztion? Complete this tle for the orgniztion's five highest ompensted employees (other thn offiers, diretors, trustees nd key employees) who eh reeived more thn $00,000 of ompenstion from the orgniztion. If there is none, enter "ne." () (d) Helth enefits, () Averge Reportle ontriutions to employee (e) Estimted mount of () Nme nd title of eh employee hours per week ompenstion enefit plns, nd deferred other ompenstion devoted to position (Forms W-/099-MISC) ompenstion 9 9 Pge f Totl numer of other employees pid over $00,000 Complete this tle for the orgniztion's five highest ompensted independent ontrtors who eh reeived more thn $00,000 of ompenstion from the orgniztion. If there is none, enter "ne." () Nme nd usiness ddress of eh independent ontrtor () Type of servie () Compenstion d Totl numer of other independent ontrtors eh reeiving over $00,000 Did the orgniztion omplete Shedule A? te: All setion 0()() orgniztions must tth ompleted Shedule A Under penlties of perjury, I delre tht I hve exmined this return, inluding ompnying shedules nd sttements, nd to the est of my knowledge nd elief, it is true, orret, nd omplete. Delrtion of preprer (other thn offier) is sed on ll informtion of whih preprer hs ny knowledge. Sign Here Pid Preprer Use Only My the IRS disuss this return with the preprer shown ove? See instrutions Signture of offier Type or print nme nd title Print/Type preprer's nme Preprer's signture Dte Chek if PTIN Firm's nme Firm's ddress Dte Firm's EIN Phone no. self-employed Form 990-EZ (0)

5 SCHEDULE A (Form 990 or 990-EZ) Deprtment of the Tresury Internl Revenue Servie Nme of the orgniztion Puli Chrity Sttus nd Puli Support OMB. -00 Complete if the orgniztion is setion 0()() orgniztion or setion 9()() nonexempt hritle trust. 0 Atth to Form 990 or Form 990-EZ. Open to Puli Go to for instrutions nd the ltest informtion. Inspetion Employer identifition numer Prt I Reson for Puli Chrity Sttus (All orgniztions must omplete this prt.) See instrutions. The orgniztion is not privte foundtion euse it is: (For lines through, hek only one ox.) 9 0 d e f g A hurh, onvention of hurhes, or ssoition of hurhes desried in setion 0()()(A)(i). A shool desried in setion 0()()(A)(ii). (Atth Shedule E (Form 990 or 990-EZ).) A hospitl or oopertive hospitl servie orgniztion desried in setion 0()()(A)(iii). A medil reserh orgniztion operted in onjuntion with hospitl desried in setion 0()()(A)(iii). Enter the hospitl's nme, ity, nd stte: An orgniztion operted for the enefit of ollege or university owned or operted y governmentl unit desried in setion 0()()(A)(iv). (Complete Prt II.) A federl, stte, or lol government or governmentl unit desried in setion 0()()(A)(v). An orgniztion tht normlly reeives sustntil prt of its support from governmentl unit or from the generl puli desried in setion 0()()(A)(vi). (Complete Prt II.) A ommunity trust desried in setion 0()()(A)(vi). (Complete Prt II.) An griulturl reserh orgniztion desried in setion 0()()(A)(ix) operted in onjuntion with lnd-grnt ollege or university or non-lnd-grnt ollege of griulture (see instrutions). Enter the nme, ity, nd stte of the ollege or university: An orgniztion tht normlly reeives: () more thn /% of its support from ontriutions, memership fees, nd gross reeipts from tivities relted to its exempt funtions - sujet to ertin exeptions, nd () no more thn /% of its support from gross investment inome nd unrelted usiness txle inome (less setion tx) from usinesses quired y the orgniztion fter June 0, 9. See setion 09()(). (Complete Prt III.) An orgniztion orgnized nd operted exlusively to test for puli sfety. See setion 09()(). An orgniztion orgnized nd operted exlusively for the enefit of, to perform the funtions of, or to rry out the purposes of one or more pulily supported orgniztions desried in setion 09()() or setion 09()(). See setion 09()(). Chek the ox in lines through d tht desries the type of supporting orgniztion nd omplete lines e, f, nd g. Type I. A supporting orgniztion operted, supervised, or ontrolled y its supported orgniztion(s), typilly y giving the supported orgniztion(s) the power to regulrly ppoint or elet mjority of the diretors or trustees of the supporting orgniztion. You must omplete Prt IV, Setions A nd B. Type II. A supporting orgniztion supervised or ontrolled in onnetion with its supported orgniztion(s), y hving ontrol or mngement of the supporting orgniztion vested in the sme persons tht ontrol or mnge the supported orgniztion(s). You must omplete Prt IV, Setions A nd C. Type III funtionlly integrted. A supporting orgniztion operted in onnetion with, nd funtionlly integrted with, its supported orgniztion(s) (see instrutions). You must omplete Prt IV, Setions A, D, nd E. Type III non-funtionlly integrted. A supporting orgniztion operted in onnetion with its supported orgniztion(s) tht is not funtionlly integrted. The orgniztion generlly must stisfy distriution requirement nd n ttentiveness requirement (see instrutions). You must omplete Prt IV, Setions A nd D, nd Prt V. Chek this ox if the orgniztion reeived written determintion from the IRS tht it is Type I, Type II, Type III funtionlly integrted, or Type III non-funtionlly integrted supporting orgniztion. Enter the numer of supported orgniztions Provide the following informtion out the supported orgniztion(s). (i) Nme of supported orgniztion (ii) EIN (iii) Type of orgniztion (iv) Is the orgniztion (v) Amount of monetry (vi) Amount of (desried on lines -0 listed in your governing support (see other support (see ove (see instrutions)) doument? instrutions) instrutions) (A) (B) (C) (D) (E) Totl For Pperwork Redution At tie, see the Instrutions for Form 990 or 990-EZ. Shedule A (Form 990 or 990-EZ) 0

6 Shedule A (Form 990 or 990-EZ) 0 Pge Prt II Support Shedule for Orgniztions Desried in Setions 0()()(A)(iv) nd 0()()(A)(vi) (Complete only if you heked the ox on line,, or of Prt I or if the orgniztion filed to qulify under Prt III. If the orgniztion fils to qulify under the tests listed elow, plese omplete Prt III.) Setion A. Puli Support Clendr yer (or fisl yer eginning in) () 0 () 0 () 0 (d) 0 (e) 0 (f) Totl Gifts, grnts, ontriutions, nd memership fees reeived. (Do not inlude ny "unusul grnts.") Tx revenues levied for the orgniztion's enefit nd either pid to or expended on its ehlf Puli support. Sutrt line from line Setion B. Totl Support Clendr yer (or fisl yer eginning in) The vlue of servies or filities furnished y governmentl unit to the orgniztion without hrge Totl. Add lines through The portion of totl ontriutions y eh person (other thn governmentl unit or pulily supported orgniztion) inluded on line tht exeeds % of the mount shown on line, olumn (f) Amounts from line Gross inome from interest, dividends, pyments reeived on seurities lons, rents, roylties nd inome from similr soures () 0 () 0 () 0 (d) 0 (e) 0 (f) Totl 9 Net inome from unrelted usiness tivities, whether or not the usiness is regulrly rried on 0 Gross reeipts from relted tivities, et. (see instrutions) First five yers. If the Form 990 is for the orgniztion's first, seond, third, fourth, or fifth tx yer s setion 0()() orgniztion, hek this ox nd stop here Setion C. Computtion of Puli Support Perentge Puli support perentge for 0 (line, olumn (f) divided y line, olumn (f)) % Puli support perentge from 0 Shedule A, Prt II, line % Other inome. Do not inlude gin or loss from the sle of pitl ssets (Explin in Prt VI.) Totl support. Add lines through 0 /% support test - 0. If the orgniztion did not hek the ox on line, nd line is /% or more, hek this ox nd stop here. The orgniztion qulifies s pulily supported orgniztion /% support test - 0. If the orgniztion did not hek ox on line or, nd line is /% or more, hek this ox nd stop here. The orgniztion qulifies s pulily supported orgniztion 0%-fts-nd-irumstnes test - 0. If the orgniztion did not hek ox on line,, or, nd line is 0% or more, nd if the orgniztion meets the "fts-nd-irumstnes" test, hek this ox nd stop here. Explin in Prt VI how the orgniztion meets the "fts-nd-irumstnes" test. The orgniztion qulifies s pulily supported orgniztion 0%-fts-nd-irumstnes test - 0. If the orgniztion did not hek ox on line,,, or, nd line is 0% or more, nd if the orgniztion meets the "fts-nd-irumstnes" test, hek this ox nd stop here. Explin in Prt VI how the orgniztion meets the "fts-nd-irumstnes" test. The orgniztion qulifies s pulily supported orgniztion Privte foundtion. If the orgniztion did not hek ox on line,,,, or, hek this ox nd see instrutions Shedule A (Form 990 or 990-EZ) 0

7 Shedule A (Form 990 or 990-EZ) 0 Pge Prt III Support Shedule for Orgniztions Desried in Setion 09()() (Complete only if you heked the ox on line 0 of Prt I or if the orgniztion filed to qulify under Prt II. If the orgniztion fils to qulify under the tests listed elow, plese omplete Prt II.) Setion A. Puli Support Clendr yer (or fisl yer eginning in) () 0 () 0 () 0 (d) 0 (e) 0 (f) Totl Gifts, grnts, ontriutions, nd memership fees reeived. (Do not inlude ny "unusul grnts.") Gross reeipts from dmissions, merhndise sold or servies performed, or filities furnished in ny tivity tht is relted to the orgniztion's tx-exempt purpose Gross reeipts from tivities tht re not n unrelted trde or usiness under setion Tx revenues levied for the orgniztion's enefit nd either pid to or expended on its ehlf The vlue of servies or filities furnished y governmentl unit to the orgniztion without hrge Totl. Add lines through Amounts inluded on lines,, nd reeived from disqulified persons Amounts inluded on lines nd reeived from other thn disqulified persons tht exeed the greter of $,000 or % of the mount on line for the yer Add lines nd Puli support. (Sutrt line from line.) Setion B. Totl Support Clendr yer (or fisl yer eginning in) 9 Amounts from line () 0 () 0 () 0 (d) 0 (e) 0 (f) Totl 0 Gross inome from interest, dividends, pyments reeived on seurities lons, rents, roylties, nd inome from similr soures Unrelted usiness txle inome (less setion txes) from usinesses quired fter June 0, 9 Add lines 0 nd 0 Net inome from unrelted usiness tivities not inluded in line 0, whether or not the usiness is regulrly rried on First five yers. If the Form 990 is for the orgniztion's first, seond, third, fourth, or fifth tx yer s setion 0()() orgniztion, hek this ox nd stop here Setion C. Computtion of Puli Support Perentge Puli support perentge for 0 (line, olumn (f), divided y line, olumn (f)) % Puli support perentge from 0 Shedule A, Prt III, line % Setion D. Computtion of Investment Inome Perentge Investment inome perentge for 0 (line 0, olumn (f), divided y line, olumn (f)) % Investment inome perentge from 0 Shedule A, Prt III, line % 9 0 Other inome. Do not inlude gin or loss from the sle of pitl ssets (Explin in Prt VI.) Totl support. (Add lines 9, 0,, nd.) /% support tests - 0. If the orgniztion did not hek the ox on line, nd line is more thn /%, nd line is not more thn /%, hek this ox nd stop here. The orgniztion qulifies s pulily supported orgniztion /% support tests - 0. If the orgniztion did not hek ox on line or line 9, nd line is more thn /%, nd line is not more thn /%, hek this ox nd stop here. The orgniztion qulifies s pulily supported orgniztion Privte foundtion. If the orgniztion did not hek ox on line, 9, or 9, hek this ox nd see instrutions Shedule A (Form 990 or 990-EZ) 0

8 Shedule A (Form 990 or 990-EZ) 0 Pge Prt IV Supporting Orgniztions (Complete only if you heked ox in line on Prt I. If you heked of Prt I, omplete Setions A nd B. If you heked of Prt I, omplete Setions A nd C. If you heked of Prt I, omplete Setions A, D, nd E. If you heked d of Prt I, omplete Setions A nd D, nd omplete Prt V.) Setion A. All Supporting Orgniztions 9 0 Are ll of the orgniztion's supported orgniztions listed y nme in the orgniztion's governing douments? If "," desrie in Prt VI how the supported orgniztions re designted. If designted y lss or purpose, desrie the designtion. If histori nd ontinuing reltionship, explin. Did the orgniztion hve ny supported orgniztion tht does not hve n IRS determintion of sttus under setion 09()() or ()? If "," explin in Prt VI how the orgniztion determined tht the supported orgniztion ws desried in setion 09()() or (). Did the orgniztion hve supported orgniztion desried in setion 0()(), (), or ()? If "," nswer () nd () elow. Did the orgniztion onfirm tht eh supported orgniztion qulified under setion 0()(), (), or () nd stisfied the puli support tests under setion 09()()? If "," desrie in Prt VI when nd how the orgniztion mde the determintion. Did the orgniztion ensure tht ll support to suh orgniztions ws used exlusively for setion 0()()(B) purposes? If "," explin in Prt VI wht ontrols the orgniztion put in ple to ensure suh use. Ws ny supported orgniztion not orgnized in the United Sttes ("foreign supported orgniztion")? If "," nd if you heked or in Prt I, nswer () nd () elow. Did the orgniztion hve ultimte ontrol nd disretion in deiding whether to mke grnts to the foreign supported orgniztion? If "," desrie in Prt VI how the orgniztion hd suh ontrol nd disretion despite eing ontrolled or supervised y or in onnetion with its supported orgniztions. Did the orgniztion support ny foreign supported orgniztion tht does not hve n IRS determintion under setions 0()() nd 09()() or ()? If "," explin in Prt VI wht ontrols the orgniztion used to ensure tht ll support to the foreign supported orgniztion ws used exlusively for setion 0()()(B) purposes. Did the orgniztion dd, sustitute, or remove ny supported orgniztions during the tx yer? If "," nswer () nd () elow (if pplile). Also, provide detil in Prt VI, inluding (i) the nmes nd EIN numers of the supported orgniztions dded, sustituted, or removed; (ii) the resons for eh suh tion; (iii) the uthority under the orgniztion's orgnizing doument uthorizing suh tion; nd (iv) how the tion ws omplished (suh s y mendment to the orgnizing doument). Type I or Type II only. Ws ny dded or sustituted supported orgniztion prt of lss lredy designted in the orgniztion's orgnizing doument? Sustitutions only. Ws the sustitution the result of n event eyond the orgniztion's ontrol? Did the orgniztion provide support (whether in the form of grnts or the provision of servies or filities) to nyone other thn (i) its supported orgniztions, (ii) individuls tht re prt of the hritle lss enefited y one or more of its supported orgniztions, or (iii) other supporting orgniztions tht lso support or enefit one or more of the filing orgniztion's supported orgniztions? If "," provide detil in Prt VI. Did the orgniztion provide grnt, lon, ompenstion, or other similr pyment to sustntil ontriutor (s defined in setion 9()()(C)), fmily memer of sustntil ontriutor, or % ontrolled entity with regrd to sustntil ontriutor? If "," omplete Prt I of Shedule L (Form 990 or 990-EZ). Did the orgniztion mke lon to disqulified person (s defined in setion 9) not desried in line? If "," omplete Prt I of Shedule L (Form 990 or 990-EZ). Ws the orgniztion ontrolled diretly or indiretly t ny time during the tx yer y one or more disqulified persons s defined in setion 9 (other thn foundtion mngers nd orgniztions desried in setion 09()() or ())? If "," provide detil in Prt VI. Did one or more disqulified persons (s defined in line 9) hold ontrolling interest in ny entity in whih the supporting orgniztion hd n interest? If "," provide detil in Prt VI. Did disqulified person (s defined in line 9) hve n ownership interest in, or derive ny personl enefit from, ssets in whih the supporting orgniztion lso hd n interest? If "," provide detil in Prt VI. Ws the orgniztion sujet to the exess usiness holdings rules of setion 9 euse of setion 9(f) (regrding ertin Type II supporting orgniztions, nd ll Type III non-funtionlly integrted supporting orgniztions)? If "," nswer 0 elow. Did the orgniztion hve ny exess usiness holdings in the tx yer? (Use Shedule C, Form 0, to determine whether the orgniztion hd exess usiness holdings.) Shedule A (Form 990 or 990-EZ) 0

9 Shedule A (Form 990 or 990-EZ) 0 Prt IV Supporting Orgniztions (ontinued) Hs the orgniztion epted gift or ontriution from ny of the following persons? A person who diretly or indiretly ontrols, either lone or together with persons desried in () nd () elow, the governing ody of supported orgniztion? A fmily memer of person desried in () ove? A % ontrolled entity of person desried in () or () ove? If "" to,, or, provide detil in Prt VI. Setion B. Type I Supporting Orgniztions Did the diretors, trustees, or memership of one or more supported orgniztions hve the power to regulrly ppoint or elet t lest mjority of the orgniztion's diretors or trustees t ll times during the tx yer? If "," desrie in Prt VI how the supported orgniztion(s) effetively operted, supervised, or ontrolled the orgniztion's tivities. If the orgniztion hd more thn one supported orgniztion, desrie how the powers to ppoint nd/or remove diretors or trustees were lloted mong the supported orgniztions nd wht onditions or restritions, if ny, pplied to suh powers during the tx yer. Pge Did the orgniztion operte for the enefit of ny supported orgniztion other thn the supported orgniztion(s) tht operted, supervised, or ontrolled the supporting orgniztion? If "," explin in Prt VI how providing suh enefit rried out the purposes of the supported orgniztion(s) tht operted, supervised, or ontrolled the supporting orgniztion. Setion C. Type II Supporting Orgniztions Were mjority of the orgniztion's diretors or trustees during the tx yer lso mjority of the diretors or trustees of eh of the orgniztion's supported orgniztion(s)? If "," desrie in Prt VI how ontrol or mngement of the supporting orgniztion ws vested in the sme persons tht ontrolled or mnged the supported orgniztion(s). Setion D. All Type III Supporting Orgniztions Did the orgniztion provide to eh of its supported orgniztions, y the lst dy of the fifth month of the orgniztion's tx yer, (i) written notie desriing the type nd mount of support provided during the prior tx yer, (ii) opy of the Form 990 tht ws most reently filed s of the dte of notifition, nd (iii) opies of the orgniztion's governing douments in effet on the dte of notifition, to the extent not previously provided? Were ny of the orgniztion's offiers, diretors, or trustees either (i) ppointed or eleted y the supported orgniztion(s) or (ii) serving on the governing ody of supported orgniztion? If "," explin in Prt VI how the orgniztion mintined lose nd ontinuous working reltionship with the supported orgniztion(s). By reson of the reltionship desried in (), did the orgniztion's supported orgniztions hve signifint voie in the orgniztion's investment poliies nd in direting the use of the orgniztion's inome or ssets t ll times during the tx yer? If "," desrie in Prt VI the role the orgniztion's supported orgniztions plyed in this regrd. Setion E. Type III Funtionlly Integrted Supporting Orgniztions Chek the ox next to the method tht the orgniztion used to stisfy the Integrl Prt Test during the yer (see instrutions). The orgniztion stisfied the Ativities Test. Complete line elow. The orgniztion is the prent of eh of its supported orgniztions. Complete line elow. The orgniztion supported governmentl entity. Desrie in Prt VI how you supported government entity (see instrutions). Ativities Test. Answer () nd () elow. Did sustntilly ll of the orgniztion's tivities during the tx yer diretly further the exempt purposes of the supported orgniztion(s) to whih the orgniztion ws responsive? If "," then in Prt VI identify those supported orgniztions nd explin how these tivities diretly furthered their exempt purposes, how the orgniztion ws responsive to those supported orgniztions, nd how the orgniztion determined tht these tivities onstituted sustntilly ll of its tivities. Did the tivities desried in () onstitute tivities tht, ut for the orgniztion's involvement, one or more of the orgniztion's supported orgniztion(s) would hve een engged in? If "," explin in Prt VI the resons for the orgniztion's position tht its supported orgniztion(s) would hve engged in these tivities ut for the orgniztion's involvement. Prent of Supported Orgniztions. Answer () nd () elow. Did the orgniztion hve the power to regulrly ppoint or elet mjority of the offiers, diretors, or trustees of eh of the supported orgniztions? Provide detils in Prt VI. Did the orgniztion exerise sustntil degree of diretion over the poliies, progrms, nd tivities of eh of its supported orgniztions? If "," desrie in Prt VI the role plyed y the orgniztion in this regrd. Shedule A (Form 990 or 990-EZ) 0

10 Shedule A (Form 990 or 990-EZ) 0 Pge Prt V Type III n-funtionlly Integrted 09()() Supporting Orgniztions Chek here if the orgniztion stisfied the Integrl Prt Test s qulifying trust on v. 0, 90 (explin in Prt VI). See instrutions. All other Type III non-funtionlly integrted supporting orgniztions must omplete Setions A through E. Setion A - Adjusted Net Inome (A) Prior Yer (B) Current Yer (optionl) Net short-term pitl gin Reoveries of prior-yer distriutions Other gross inome (see instrutions) Add lines through. Depreition nd depletion Portion of operting expenses pid or inurred for prodution or olletion of gross inome or for mngement, onservtion, or mintenne of property held for prodution of inome (see instrutions) Other expenses (see instrutions) Adjusted Net Inome (sutrt lines,, nd from line ) Setion B - Minimum Asset Amount (A) Prior Yer (B) Current Yer (optionl) Aggregte fir mrket vlue of ll non-exempt-use ssets (see instrutions for short tx yer or ssets held for prt of yer): Averge monthly vlue of seurities Averge monthly sh lnes Fir mrket vlue of other non-exempt-use ssets d Totl (dd lines,, nd ) d e Disount limed for lokge or other ftors (explin in detil in Prt VI): Aquisition indetedness pplile to non-exempt-use ssets Sutrt line from line d. Csh deemed held for exempt use. Enter -/% of line (for greter mount, see instrutions). Net vlue of non-exempt-use ssets (sutrt line from line ) Multiply line y.0. Reoveries of prior-yer distriutions Minimum Asset Amount (dd line to line ) Setion C - Distriutle Amount Current Yer Adjusted net inome for prior yer (from Setion A, line, Column A) Enter % of line. Minimum sset mount for prior yer (from Setion B, line, Column A) Enter greter of line or line. Inome tx imposed in prior yer Distriutle Amount. Sutrt line from line, unless sujet to emergeny temporry redution (see instrutions). Chek here if the urrent yer is the orgniztion's first s non-funtionlly integrted Type III supporting orgniztion (see instrutions). Shedule A (Form 990 or 990-EZ) 0

11 Shedule A (Form 990 or 990-EZ) 0 Prt V Type III n-funtionlly Integrted 09()() Supporting Orgniztions (ontinued) Setion D - Distriutions Current Yer Pge 9 0 d e f g h i j Amounts pid to supported orgniztions to omplish exempt purposes Amounts pid to perform tivity tht diretly furthers exempt purposes of supported orgniztions, in exess of inome from tivity Administrtive expenses pid to omplish exempt purposes of supported orgniztions Amounts pid to quire exempt-use ssets Qulified set-side mounts (prior IRS pprovl required) Other distriutions (desrie in Prt VI). See instrutions. Totl nnul distriutions. Add lines through. Distriutions to ttentive supported orgniztions to whih the orgniztion is responsive (provide detils in Prt VI). See instrutions. Distriutle mount for 0 from Setion C, line Line mount divided y Line 9 mount (ii) (iii) (i) Setion E - Distriution Allotions (see instrutions) Underdistriutions Distriutle Exess Distriutions Pre-0 Amount for 0 Distriutle mount for 0 from Setion C, line Underdistriutions, if ny, for yers prior to 0 (resonle use required - explin in Prt VI). See instrutions. Exess distriutions rryover, if ny, to 0 From 0 From 0 From 0 From 0 From 0 Totl of lines through e Applied to underdistriutions of prior yers Applied to 0 distriutle mount Crryover from 0 not pplied (see instrutions) Reminder. Sutrt lines g, h, nd i from f. Distriutions for 0 from Setion D, line : $ Applied to underdistriutions of prior yers Applied to 0 distriutle mount Reminder. Sutrt lines nd from. Remining underdistriutions for yers prior to 0, if ny. Sutrt lines g nd from line. For result greter thn zero, explin in Prt VI. See instrutions. Remining underdistriutions for 0. Sutrt lines h nd from line. For result greter thn zero, explin in Prt VI. See instrutions. Exess distriutions rryover to 09. Add lines j nd. Brekdown of line : Exess from 0 Exess from 0 Exess from 0 Exess from 0 Exess from 0 d e Shedule A (Form 990 or 990-EZ) 0

12 Prt VI Pge Supplementl Informtion. Provide the explntions required y Prt II, line 0; Prt II, line or ; Prt III, line ; Prt IV, Setion A, lines,,,,,,,, 9, 9, 9,,, nd ; Prt IV, Setion B, lines nd ; Prt IV, Setion C, line ; Prt IV, Setion D, lines nd ; Prt IV, Setion E, lines,,,, nd ; Prt V, line ; Prt V, Setion B, line e; Prt V, Setion D, lines,, nd ; nd Prt V, Setion E, lines,, nd. Also omplete this prt for ny dditionl informtion. (See instrutions.) Shedule A (Form 990 or 990-EZ) 0 Shedule A (Form 990 or 990-EZ) 0

13 SCHEDULE O (Form 990 or 990-EZ) Deprtment of the Tresury Internl Revenue Servie Nme of the orgniztion Supplementl Informtion to Form 990 or 990-EZ Complete to provide informtion for responses to speifi questions on Form 990 or 990-EZ or to provide ny dditionl informtion. Atth to Form 990 or 990-EZ. Go to for the ltest informtion. OMB Open to Puli Inspetion Employer identifition numer For Pperwork Redution At tie, see the Instrutions for Form 990 or 990-EZ. Shedule O (Form 990 or 990-EZ) (0)

14 Shedule O (Form 990 or 990-EZ) (0) Nme of the orgniztion Employer identifition numer Pge Shedule O (Form 990 or 990-EZ) (0)