Form For alendar year 014 or other tax year eginning, and ending. 4 Unrelated usiness taxale inome. Sutrat line from line. If line is greater than line, enter the smaller of zero or line 401 01-1-15 LHA For Paperwork Redution At Notie, see instrutions. OMB No. 1545-0 Information aout Form 0-T and its instrutions is availale at Department of the Treasury www.irs.gov/form0t. Open to Puli Inspetion for Internal Revenue Servie Do not enter SSN numers on this form as it may e made puli if your organization is a 501()(). 501()() Organizations Only Employer identifiation numer A Chek ox if Name of organization ( Chek ox if name hanged and see instrutions.) D (Employees trust, see address hanged instrutions.) B Exempt under setion Print WASHINGTON 5-0051 X 501( )( ) or E Unrelated usiness ativity odes Numer, street, and room or suite no. If a P.O. ox, see instrutions. (See instrutions.) Type 40(e) 0(e) 15 MONTROSE ROAD Book value of all assets C at end of year F Group exemption numer (See instrutions.) 4,04,4 G Chek organization type X 501() orporation 501() trust 401(a) trust Other trust H Desrie the organization s primary unrelated usiness ativity. ADVERTISING I During the tax year, was the orporation a susidiary in an affiliated group or a parent-susidiary ontrolled group? ~~~~~~ Yes X No If "Yes," enter the name and identifying numer of the parent orporation. J The ooks are in are of RUTH E. CARSKI Telephone numer (01) 1-0100 Part I Unrelated Trade or Business Inome (A) Inome (B) Expenses (C) Net 1 a Gross reeipts or sales 5 10 11 Less returns and allowanes Balane ~~~ 1 Other inome (See instrutions; attah shedule) ~~~~~~~~~~~~ 1 1 Total. Comine lines through 1 1,,55. 5,4. Part II Dedutions Not Taken Elsewhere (See instrutions for limitations on dedutions.) (Exept for ontriutions, dedutions must e diretly onneted with the unrelated usiness inome.) 14 15 1 1 1 1 0 1 4 5 0 1 0-T 40A 50(a) City or town, state or provine, ountry, and ZIP or foreign postal ode 5(a) ROCKVILLE, MD 05 54100 Cost of goods sold (Shedule A, line ) ~~~~~~~~~~~~~~~~~ Gross profit. Sutrat line from line 1 ~~~~~~~~~~~~~~~~ 4 a Capital gain net inome (attah Shedule D) ~~~~~~~~~~~~~~~ Net gain (loss) (Form 4, Part II, line 1) (attah Form 4) ~~~~~~ Capital loss dedution for trusts ~~~~~~~~~~~~~~~~~~~~ Inome (loss) from partnerships and S orporations (attah statement) ~~~ Rent inome (Shedule C) ~~~~~~~~~~~~~~~~~~~~~~ Unrelated det-finaned inome (Shedule E) ~~~~~~~~~~~~~~ Interest, annuities, royalties, and rents from ontrolled organizations (Sh. F)~ Investment inome of a setion 501()(), (), or organization (Shedule G) Exploited exempt ativity inome (Shedule I) ~~~~~~~~~~~~~~ Advertising inome (Shedule J) ~~~~~~~~~~~~~~~~~~~~ Compensation of offiers, diretors, and trustees (Shedule K) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Salaries and wages ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Repairs and maintenane Bad dets ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Interest (attah shedule) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Taxes and lienses ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Charitale ontriutions (See instrutions for limitation rules) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Depreiation (attah Form 45) Less depreiation laimed on Shedule A and elsewhere on return Depletion Contriutions to deferred ompensation plans ** PUBLIC DISCLOSURE COPY ** Exempt Organization Business Inome Tax Return (and proxy tax under setion 0(e)) JUL 1, 014 JUN 0, 015 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Total dedutions. Add lines 14 through ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Unrelated usiness taxale inome efore net operating loss dedution. Sutrat line from line 1 ~~~~~~~~~~~~ Net operating loss dedution (limited to the amount on line 0) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ SEE STATEMENT 1 4a 4 4 5 10 11 ~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Employee enefit programs ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Exess exempt expenses (Shedule I) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Exess readership osts (Shedule J) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Other dedutions (attah shedule) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ SEE STATEMENT 1 Unrelated usiness taxale inome efore speifi dedution. Sutrat line 1 from line 0 ~~~~~~~~~~~~~~~~~ Speifi dedution (Generally $1,000, ut see line instrutions for exeptions) ~~~~~~~~~~~~~~~~~~~~~ 1 a 14 15 1 1 1 1 0 4 5 0 1 014,,55. 5,4. 5,4. 1,50,4. -1,50-1,50 1,00 4-1,50 Form 0-T (014) 4 1151001 JCCGW 014.0500 JEWISH COMMUNITY CENTER COPY OF JCCGW 1
Form 0-T (014) WASHINGTON 5-0051 Part III Tax Computation 5 Organizations Taxale as Corporations. See instrutions for tax omputation. Controlled group memers (setions 151 and 15) hek here See instrutions and: a Enter your share of the $50,000, $5,000, and $,5,000 taxale inome rakets (in that order): Enter organization s share of: Additional 5 tax (not more than $11,50) $ $ () $ () $ () Additional tax (not more than $100,000) ~~~~~~~~~~~~~ $ Trusts Taxale at Trust Rates. See instrutions for tax omputation. Inome tax on the amount on line 4 from: Proxy tax. See instrutions ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Total. Add lines and to line 5 or, whihever applies Part IV Tax and Payments 40a Foreign tax redit (orporations attah Form 111; trusts attah Form 111) ~~~~~~~~ 40a 41 4 Other redits (see instrutions) d Credit for prior year minimum tax (attah Form 01 or ) ~~~~~~~~~~~~~~ e Total redits. Add lines 40a through 40d ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Other taxes. Chek if from: Form 455 Form 11 Form Form Other (attah shedule) 4 Total tax. Add lines 41 and 4 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 44 a Payments: A 01 overpayment redited to 014 ~~~~~~~~~~~~~~~~~~~ 44a 014 estimated tax payments ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 44 Tax deposited with Form ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 44 d Foreign organizations: Tax paid or withheld at soure (see instrutions) ~~~~~~~~~~ 44d e Bakup withholding (see instrutions) ~~~~~~~~~~~~~~~~~~~~~~~~ 44e f Credit for small employer health insurane premiums (Attah Form 41) ~~~~~~~~ 44f g Other redits and payments: Form 4 45 4 4 4 Total payments. Add lines 44a through 44g ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 45 Tax due. If line 45 is less than the total of lines 4 and 4, enter amount owed ~~~~~~~~~~~~~~~~~~~ Overpayment. If line 45 is larger than the total of lines 4 and 4, enter amount overpaid ~~~~~~~~~~~~~~ 4 Enter the amount of line 4 you want: Credited to 015 estimated tax Refunded 4 Part V Statements Regarding Certain Ativities and Other Information (see instrutions) 1 At any time during the 014 alendar year, did the organization have an interest in or a signature or other authority over a finanial aount (ank, Yes No seurities, or other) in a foreign ountry? If YES, the organization may have to file Form FinCEN Form 114, Report of Foreign Bank and Finanial Aounts. If YES, enter the name of the foreign ountry here During the tax year, did the organization reeive a distriution from, or was it the grantor of, or transferor to, a foreign trust? If YES, see instrutions for other forms the organization may have to file. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Enter the amount of tax-exempt interest reeived or arued during the tax year $ Shedule A - Cost of Goods Sold. Enter method of inventory valuation 1 4 a Inome tax on the amount on line 4 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Tax rate shedule or Shedule D (Form 1041) ~~~~~~~~~~~~~~~~~~~~~~~~~~~ Alternative minimum tax Inventory at eginning of year ~~~ 1 Inventory at end of year ~~~~~~~~~~~~ Cost of laor~~~~~~~~~~~ from line 5. Enter here and in Part I, line ~~~~ Additional setion A osts (att. shedule) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~ General usiness redit. Attah Form 00 ~~~~~~~~~~~~~~~~~~~~~~ Sutrat line 40e from line ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Form 41 Other Total Estimated tax penalty (see instrutions). Chek if Form 0 is attahed ~~~~~~~~~~~~~~~~~~~ Purhases ~~~~~~~~~~~ Cost of goods sold. Sutrat line Other osts (attah shedule) ~~~ 4a 4 40 40 40d 44g Do the rules of setion A (with respet to property produed or aquired for resale) apply to 5 Total. Add lines 1 through 4 5 the organization? Under penalties of perjury, I delare that I have examined this return, inluding aompanying shedules and statements, and to the est of my knowledge and elief, it is true, orret, and omplete. Delaration of preparer (other than taxpayer) is ased on all information of whih preparer has any knowledge. Sign CHIEF FINANCIAL May the IRS disuss this return with Here OFFICER the preparer shown elow (see Signature of offier Date Title instrutions)? X Yes No = = Print/Type preparer s name Preparer s signature Date Chek self- employed Paid FRANK H. SMITH 0/01/1 P0005 Preparer Firm s name RAFFA, P.C. Firm s EIN 5-15115 Use Only 1 L STREET, NW, SUITE 50 Firm s address WASHINGTON, DC 00 Phone no. (0) -5000 411 01-1-15 Form 0-T (014) 4 1151001 JCCGW 014.0500 JEWISH COMMUNITY CENTER COPY OF JCCGW 1 N/A if 5 40e 41 4 4 4 4 4 PTIN Yes Page X X No
Form 0-T (014) WASHINGTON 5-0051 Page Shedule C - Rent Inome (From Real Property and Personal Property Leased With Real Property) (see instrutions) 1. Desription of property () () () () (a). From personal property (if the perentage of rent for personal property is more than 10 ut not more than 50) Rent reeived or arued () From real and personal property (if the perentage of rent for personal property exeeds 50 or if the rent is ased on profit or inome) (a) Dedutions diretly onneted with the inome in olumns (a) and () (attah shedule) Total Total () Total inome. Add totals of olumns (a) and (). Enter () Total dedutions. here and on line, olumn (A) Part I, line, olumn (B) Shedule E - Unrelated Det-Finaned Inome (see instrutions). Dedutions diretly onneted with or alloale. Gross inome from to det-finaned property 1. Desription of det-finaned property or alloale to detfinaned property (a) Straight line depreiation () Other dedutions (attah shedule) (attah shedule) () () () () 4. Amount of average aquisition 5. Average adjusted asis. Column 4 divided. Gross inome. Alloale dedutions det on or alloale to det-finaned of or alloale to y olumn 5 reportale (olumn (olumn x total of olumns property (attah shedule) det-finaned property x olumn ) (a) and ()) (attah shedule) Part I, line, olumn (A). Part I, line, olumn (B). ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Total dividends-reeived dedutions inluded in olumn Shedule F - Interest, Annuities, Royalties, and Rents From Controlled Organizations (see instrutions) Exempt Controlled Organizations 1. Name of ontrolled organization.. 4. 5. Part of olumn 4 that is. Dedutions diretly Employer identifiation Net unrelated inome Total of speified inluded in the ontrolling onneted with inome numer (loss) (see instrutions) payments made organization s gross inome in olumn 5 () () Nonexempt Controlled Organizations. Taxale Inome. Net unrelated inome (loss). Total of speified payments 1 Part of olumn that is inluded 11. Dedutions diretly onneted (see instrutions) made in the ontrolling organization s with inome in olumn 10 gross inome () () Add olumns 5 and 1 Part I, line, olumn (A). Add olumns and 11. Part I, line, olumn (B). J 41 01-1-15 Form 0-T (014) 4 1151001 JCCGW 014.0500 JEWISH COMMUNITY CENTER COPY OF JCCGW 1
Form 0-T (014) WASHINGTON 5-0051 Shedule G - Investment Inome of a Setion 501()(), (), or Organization (see instrutions) () () 1. Desription of exploited ativity 1. Desription of inome. Amount of inome. Gross unrelated usiness inome from trade or usiness line 10, ol. (A).. Expenses diretly onneted with prodution of unrelated usiness inome line 10, ol. (B). Part I, line, olumn (A). 4. Net inome (loss) from unrelated trade or usiness (olumn minus olumn ). If a gain, ompute ols. 5 through.. Dedutions Total dedutions diretly onneted 4. Set-asides 5. and set-asides (attah shedule) (attah shedule) (ol. plus ol. 4) 5. Gross inome. Expenses from ativity that attriutale to is not unrelated olumn 5 usiness inome Part I, line, olumn (B). Shedule I - Exploited Exempt Ativity Inome, Other Than Advertising Inome (see instrutions) () (). Exess exempt expenses (olumn minus olumn 5, ut not more than olumn 4). Enter here and on page 1, Part II, line. Shedule J - Advertising Inome (see instrutions) Part I Inome From Periodials Reported on a Consolidated Basis Page 4 1. Name of periodial. Gross. Diret advertising advertising osts inome 4. Advertising gain or (loss) (ol. minus ol. ). If a gain, ompute ols. 5 through. 5. Cirulation. Readership inome osts. Exess readership osts (olumn minus olumn 5, ut not more than olumn 4). () () (arry to Part II, line (5)) Part II Inome From Periodials Reported on a Separate Basis (For eah periodial listed in Part II, fill in olumns through on a line-y-line asis.) from Part I 41 01-1-15 1. Name of periodial. Gross. Diret advertising advertising osts inome line 11, ol. (A). line 11, ol. (B). 4. Advertising gain or (loss) (ol. minus ol. ). If a gain, ompute ols. 5 through. 5. Cirulation. Readership inome osts. Exess readership osts (olumn minus olumn 5, ut not more than olumn 4). CENTER SCENE AND () PROGRAM GUIDES,,55. 5,4. 15,51.,104. 5,4. () Enter here and on page 1, Part II, line., Part II (lines 1-5),,55. 5,4. Shedule K - Compensation of Offiers, Diretors, and Trustees (see instrutions). Perent of 4. Compensation attriutale Title time devoted to 1. Name. to unrelated usiness usiness () () Total. Part II, line 14 Form 0-T (014) COPY 50 1151001 JCCGW 014.0500 JEWISH COMMUNITY CENTER OF JCCGW 1
WASHI 5-0051 }}}}}}}}}}}} }}}}}}}}}} ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ FORM 0-T OTHER DEDUCTIONS STATEMENT 1 }}}}}}}} DESCRIPTION AMOUNT }}}}}}}}}}} TAX PREPARATION FEES 1,50 TOTAL TO FORM 0-T, PAGE 1, LINE 1,50 ~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ FORM 0-T NET OPERATING LOSS DEDUCTION STATEMENT }}}}}}}} LOSS PREVIOUSLY LOSS AVAILABLE TAX YEAR LOSS SUSTAINED APPLIED REMAINING THIS YEAR }}}}}}}} 0/0/1 1,50 1,50 1,50 0/0/14 1,50 1,50 1,50 NOL CARRYOVER AVAILABLE THIS YEAR,00,00 ~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~ COPY 51 STATEMENT(S) 1, 1151001 JCCGW 014.0500 JEWISH COMMUNITY CENTER OF JCCGW 1