OMB No. 1545-0687 Form 0-T Exempt Organization Business Income Tax Return Department of the Treasury (and proxy tax under section 60(e)) 00 Open to Public Inspection for Internal Revenue Service (77) For calendar year 00 or other tax year beginning, and ending 501(c) Organizations Only Employer identification number A Check box if Name of organization ( Check box if name changed and see instructions.) D (Employees trust, see instructions address changed for Block D on page.) B Exempt under section Print RECREATION UNLIMITED FARM & FUN 1-1816 X 501( c )( ) or E Unrelated business activity codes Number, street, and room or suite no. If a P.O. box, see page 8 of instructions. (See instructions for Block E Type 408(e) 0(e) 7700 PIPER ROAD on page.) C Book value of all assets F Group exemption number (See instructions for Block F.) at end of year G Check organization type X 501(c) corporation 501(c) trust 401(a) trust Other trust 1,1,6. H Describe the organization s primary unrelated business activity. SEE STATEMENT 1 I During the tax year, was the corporation a subsidiary in an affiliated group or a parent-subsidiary controlled group? Yes X No If "Yes," enter the name and identifying number of the parent corporation. J The books are in care of CYNTHIA WUELLNER Telephone number (740) 548-7006 Part I Unrelated Trade or Business Income (A) Income (B) Expenses (C) Net 1a Gross receipts or sales 175,7. b Less returns and allowances c Balance 1c 175,7. 5 6 7 8 10 11 b c 1 Other income (See instructions; attach schedule.) 1 1 Total. Combine lines through 1 1 175,7. 175,7. Part II Deductions Not Taken Elsewhere (See instructions for limitations on deductions.) (Except for contributions, deductions must be directly connected with the unrelated business income.) 14 15 16 17 18 1 0 1 4 5 6 7 8 0 1 408A 50(a) City or town, state, and ZIP code 5(a) ASHLEY, OH 400 7110 Cost of goods sold (Schedule A, line 7) ~~ Gross profit. Subtract line from line 1c ~ 4a Capital gain net income (attach Schedule D) Net gain (loss) (Form 477, Part II, line 17) (attach Form 477) Capital loss deduction for trusts ~~ Income (loss) from partnerships and S corporations (attach statement) Rent income (Schedule C) ~ Unrelated debt-financed income (Schedule E) ~~ Interest, annuities, royalties, and rents from controlled organizations (Sch. F)~ Investment income of a section 501(c)(7), (), or (17) organization (Schedule G) ~ Exploited exempt activity income (Schedule I) ~~ Advertising income (Schedule J) ~~ Compensation of officers, directors, and trustees (Schedule K) ~~ Salaries and wages Repairs and maintenance Bad debts ~ Interest Taxes and licenses Charitable contributions (See instructions for limitation rules.) ~~ Depreciation (attach Form 456) ~ 1 4,47. Less depreciation claimed on Schedule A and elsewhere on return Depletion Contributions to deferred compensation plans Total deductions. Add lines 14 through 8 Unrelated business taxable income before net operating loss deduction. Subtract line from line 1 4 Unrelated business taxable income. Subtract line from line. If line is greater than line, enter the smaller of zero or line 701 01-08-10 LHA For Privacy Act and Paperwork Reduction Act Notice, see instructions. 4a 4b 4c 5 6 7 8 10 11 ~ ~ Employee benefit programs ~~ Excess exempt expenses (Schedule I) ~ Excess readership costs (Schedule J) ~ Other deductions ~~ SEE STATEMENT Net operating loss deduction (limited to the amount on line 0) ~~ Unrelated business taxable income before specific deduction. Subtract line 1 from line 0 ~~ Specific deduction (Generally 1,000, but see instructions for exceptions.) 0 175,7. 175,7. a 14 15 16 17 18 1 0 b 4 5 6 7 8 0 1 4 16,845.,7.,017. 1,88. 4,47. 168,551. 16,55. -0,56. -0,56. 1,00-0,56. Form 0-T (00)
Form 0-T (00) RECREATION UNLIMITED FARM & FUN 1-1816 Part III Tax Computation 5 Organizations Taxable as Corporations. See instructions for tax computation. 6 7 8 711 01-08-10 Controlled group members (sections 1561 and 156) check here See instructions and: a Enter your share of the 50,000, 5,000, and,5,000 taxable income brackets (in that order): b Enter organization s share of: Additional 5 tax (not more than 11,750) c Additional tax (not more than 100,000) ~ Trusts Taxable at Trust Rates. See instructions for tax computation. Income tax on the amount on line 4 from: Proxy tax. See instructions ~~ Total. Add lines 7 and 8 to line 5c or 6, whichever applies Part IV Tax and Payments 40a Foreign tax credit (corporations attach Form 1118; trusts attach Form 1116) ~~ 40a 41 4 b Other credits (see instructions) c d Credit for prior year minimum tax (attach Form 8801 or 887) ~~ e Total credits. Add lines 40a through 40d ~ Other taxes. Check if from: Form 455 Form 8611 Form 867 Form 8866 Other 4 Total tax. Add lines 41 and 4 ~~ 44 a Payments: A 008 overpayment credited to 00 ~ 44a b 00 estimated tax payments ~ 44b c Tax deposited with Form 8868 ~ 44c d Foreign organizations: Tax paid or withheld at source (see instructions) ~ 44d e Backup withholding (see instructions) 44e f Other credits and payments: Form 4 45 46 47 48 Total payments. Add lines 44a through 44f 45 Tax due. If line 45 is less than the total of lines 4 and 46, enter amount owed ~ Overpayment. If line 45 is larger than the total of lines 4 and 46, enter amount overpaid ~~ 4 Enter the amount of line 48 you want: Credited to 010 estimated tax Refunded 4 Part V Statements Regarding Certain Activities and Other Information (See instructions on page 17) 1 At any time during the 00 calendar year, did the organization have an interest in or a signature or other authority over a financial account Yes No (bank, securities, or other) in a foreign country? If YES, the organization may have to file Form TD F 0-.1, Report of Foreign Bank and X Financial Accounts. If YES, enter the name of the foreign country here During the tax year, did the organization receive a distribution from, or was it the grantor of, or transferor to, a foreign trust? If YES, see page 5 of the instructions for other forms the organization may have to file. X Enter the amount of tax-exempt interest received or accrued during the tax year Schedule A - Cost of Goods Sold. Enter method of inventory valuation N/A 1 4a b Inventory at beginning of year 1 6 Inventory at end of year Cost of labor~~ from line 5. Enter here and in Part I, line ~ Additional section 6A costs 4a 8 Do the rules of section 6A (with respect to 5 Total. 5 Sign Here Paid Preparer s Use Only Income tax on the amount on line 4 ~ Tax rate schedule or Schedule D (Form 1041) Alternative minimum tax ~~ General business credit. Attach Form 800 ~ Subtract line 40e from line Form 416 Other Total Estimated tax penalty (see instructions). Check if Form 0 is attached ~ Purchases ~~ 7 Cost of goods sold. Subtract line 6 Other costs 4b Add lines 1 through 4b the organization? Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. 40b 40c 40d 44f property produced or acquired for resale) apply to 5c 6 7 8 40e 41 4 4 46 47 48 6 7 Yes Page May the IRS discuss this return with EXEC DIR & CEO the preparer shown below (see Signature of officer Date Title instructions)? X Yes No Preparer s Date Check if Preparer s SSN or PTIN signature = self-employed Firm s name (or GBQ PARTNERS LLC yours if selfemployed), 0 WEST STREET, SUITE 700 Phone no. EIN 0-106 address, and ZIP code = COLUMBUS, OH 415-66 (614) 1-110 Form 0-T (00) = = 1 No X
Form 0-T (00) RECREATION UNLIMITED FARM & FUN 1-1816 Page Schedule C - Rent Income (From Real Property and Personal Property Leased With Real Property) (see instr. on pg 18) 1. Description of property (a). From personal property (if the percentage of rent for personal property is more than 10 but not more than 50) Rent received or accrued (b) From real and personal property (if the percentage of rent for personal property exceeds 50 or if the rent is based on profit or income) Deductions directly connected with the income in columns (a) and (b) Total Total (c) Total income. Add totals of columns (a) and (b). Enter (b) Total deductions. here and on page 1, Part I, line 6, column (A) Part I, line 6, column (B) Schedule E - Unrelated Debt-Financed Income (See instructions on page 1). Deductions directly connected with or allocable. Gross income from to debt-financed property 1. Description of debt-financed property or allocable to debtfinanced property (a) Straight line depreciation (b) Other deductions 4. Amount of average acquisition 5. Average adjusted basis 6. Column 4 divided 7. Gross income 8. Allocable deductions debt on or allocable to debt-financed of or allocable to by column 5 reportable (column (column 6 x total of columns property debt-financed property x column 6) (a) and (b)) Part I, line 7, column (A). Part I, line 7, column (B). Totals ~~ Total dividends-received deductions included in column 8 Schedule F - Interest, Annuities, Royalties, and Rents From Controlled Organizations (See instructions on page 0) Exempt Controlled Organizations 1. Name of controlled organization.. 4. 5. Part of column 4 that is 6. Deductions directly Employer identification Net unrelated income Total of specified included in the controlling connected with income number (loss) (see instructions) payments made organization s gross income in column 5 (a) Nonexempt Controlled Organizations 7. Taxable Income 8. Net unrelated income (loss). Total of specified payments 1 Part of column that is included 11. Deductions directly connected (see instructions) made in the controlling organization s with income in column 10 gross income Totals J 71 01-08-10 Add columns 5 and 1 Part I, line 8, column (A). Add columns 6 and 11. Part I, line 8, column (B). Form 0-T (00)
Form 0-T (00) Schedule G - Investment Income of a Section 501(c)(7), (), or (17) Organization (see instructions on page 0) 1. Description of exploited activity 1. Name of periodical 1. Name of periodical 1. Description of income. Amount of income. Gross unrelated business income from trade or business Enter here and on page 1, Part I, line 10, col. (A).. Expenses directly connected with production of unrelated business income Enter here and on page 1, Part I, line 10, col. (B).. Gross. Direct advertising advertising costs income. Gross. Direct advertising advertising costs income Part I, line, column (A). 4. Net income (loss) from unrelated trade or business (column minus column ). If a gain, compute cols. 5 through 7. 4. Advertising gain or (loss) (col. minus col. ). If a gain, compute cols. 5 through 7. 4. Advertising gain or (loss) (col. minus col. ). If a gain, compute cols. 5 through 7. Page 4. Deductions Total deductions directly connected 4. Set-asides 5. and set-asides (col. plus col. 4) 5. Gross income 6. Expenses from activity that attributable to is not unrelated column 5 business income 5. Circulation 6. Readership income costs 5. Circulation 6. Readership income costs Part I, line, column (B). Totals Schedule I - Exploited Exempt Activity Income, Other Than Advertising Income (see instructions on page 1) 7. Excess exempt expenses (column 6 minus column 5, but not more than column 4). Enter here and on page 1, Part II, line 6. Totals Schedule J - Advertising Income (see instructions on page 1) Part I Income From Periodicals Reported on a Consolidated Basis RECREATION UNLIMITED FARM & FUN 1-1816 7. Excess readership costs (column 6 minus column 5, but not more than column 4). Totals (carry to Part II, line (5)) Part II Income From Periodicals Reported on a Separate Basis (For each periodical listed in Part II, fill in columns through 7 on a line-by-line basis.) 7. Excess readership costs (column 6 minus column 5, but not more than column 4). (5) 71 01-08-10 Totals from Part I Enter here and on page 1, Part I, line 11, col. (A). Enter here and on page 1, Part I, line 11, col. (B). Enter here and on page 1, Part II, line 7. Totals, Part II (lines 1-5) Schedule K - Compensation of Officers, Directors, and Trustees (see instructions on page 1). Percent of 4. Compensation attributable Title time devoted to 1. Name. to unrelated business business Total. Part II, line 14 Form 0-T (00)
RECREATION UNLIMITED FARM & FUN 1-1816 }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}} FORM 0-T DESCRIPTION OF ORGANIZATION S PRIMARY UNRELATED STATEMENT 1 BUSINESS ACTIVITY }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} PROVIDING HOUSING AND FOOD SERVICES TO GROUPS LEASING THE FACILITY WHOSE MEMBERS DO NOT HAVE PHYSICAL OR DEVELOPMENTAL DISABILITIES. TO FORM 0-T, PAGE 1 FOOTNOTES STATEMENT }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} NOL CARRIED FORWARD TO 005 7,84 NOL USED IN 005-7,467. NOL USED IN 006-1,1. NOL USED IN 007-17,06. NOL USED IN 008-18,51. ~ NOL CARRIED FORWARD TO 00,807. 4 STATEMENT(S) 1,
RECREATION UNLIMITED FARM & FUN 1-1816 }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}} FORM 0-T OTHER DEDUCTIONS STATEMENT }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} DESCRIPTION AMOUNT }}}}}}}}}}} }}}}}}}}}}}}}} CONTRACT LABOR & SERVICES,1. TRAVEL 86 DUES AND MEMBERSHIPS 175. MEETINGS AND CONFERENCES 1. ACCOMODATIONS 54. OCCUPANCY 80,57. MANAGEMENT FEES,51. INSURANCE 17,7. FUEL 7. SUPPLIES 8. POSTAGE 187. TELEPHONE 54. HOUSEKEEPING,458. MEDICAL SERVICES 1,68. CAMP STORE,771. PROFESSIONAL FEES,64. FOOD SERVICE 0,14. }}}}}}}}}}}}}} TOTAL TO FORM 0-T, PAGE 1, LINE 8 168,551. ~~ 5 STATEMENT(S)
Form Department of the Treasury Internal Revenue Service Name See separate instructions. Attach to the corporation s tax return. Note: Generally, the corporation is not required to file Form 0 (see Part II below for exceptions) because the IRS will figure any penalty owed and bill the corporation. However, the corporation may still use Form 0 to figure the penalty. If so, enter the amount from page, line 8 on the estimated tax penalty line of the corporation s income tax return, but do not attach Form Part I 0 Underpayment of Estimated Tax by Corporations OMB No. 1545-014 Employer identification number RECREATION UNLIMITED FARM & FUN 1-1816 Required Annual Payment FORM 0-T 00 1 Total tax (see instructions) 1 a Personal holding company tax (Schedule PH (Form 110), line 6) included on line 1 ~~ b Look-back interest included on line 1 under section 460(b) for completed long-term contracts or section 167(g) for depreciation under the income forecast method ~~ a b 4 5 c Credit for federal tax paid on fuels (see instructions) ~ d Total. Add lines a through c ~ Subtract line d from line 1. If the result is less than 500, do not complete or file this form. The corporation Enter the tax shown on the corporation s 008 income tax return (see instructions). Caution: If the tax is zero or the tax year was for less than 1 months, skip this line and enter the amount from line on line 5 ~~ Required annual payment. Enter the smaller of line or line 4. If the corporation is required to skip line 4, enter the amount from line 5 Part II Reasons for Filing - Check the boxes below that apply. If any boxes are checked, the corporation must file Form 0 even if it does not owe a penalty (see instructions). 6 7 8 The corporation is a "large corporation" figuring its first required installment based on the prior year s tax. Part III Figuring the Underpayment (a) (b) (c) (d) 10 11 1 1 14 15 16 17 18 does not owe the penalty Installment due dates. Enter in columns (a) through (d) the 15th day of the 4th ( Form 0-PF filers: Use 5th month), 6th, th, and 1th months of the corporation s tax year ~ Required installments. If the box on line 6 and/or line 7 Complete lines 1 through 18 of one column before going to the next column. The corporation is using the adjusted seasonal installment method. The corporation is using the annualized income installment method. above is checked, enter the amounts from Sch A, line 8. If the box on line 8 (but not 6 or 7) is checked, see instructions for the amounts to enter. If none of these boxes are checked, enter 5 of line 5 above in each column. ~ Estimated tax paid or credited for each period (see instructions). For column (a) only, enter the amount from line 11 on line 15 Enter amount, if any, from line 18 of the preceding column Add lines 11 and 1 ~~ Add amounts on lines 16 and 17 of the preceding column Subtract line 14 from line 1. If zero or less, enter -0- ~~ If the amount on line 15 is zero, subtract line 1 from line 14. Otherwise, enter -0- Underpayment. If line 15 is less than or equal to line 10, subtract line 15 from line 1 Then go to line 1 of the next column. Otherwise, go to line 18 ~~ Overpayment. If line 10 is less than line 15, subtract line 10 from line 15. Then go to line 1 of the next column 10 11 1 1 14 15 16 17 18 c Go to Part IV on page to figure the penalty. Do not go to Part IV if there are no entries on line 17 - no penalty is owed. JWA For Paperwork Reduction Act Notice, see separate instructions. Form 0 (00) d 4 1801 01-05-10 5.1
FORM 0-T Form 0 (00) RECREATION UNLIMITED FARM & FUN 1-1816 Part IV Figuring the Penalty Page 1 0 Enter the date of payment or the 15th day of the rd month after the close of the tax year, whichever is earlier (see instructions). (Form 0-PF and Form 0-T filers: Use 5th month instead of rd month.) Number of days from due date of installment on line to the date shown on line 1 ~~ 1 0 (a) (b) (c) (d) 1 Number of days on line 0 after 4/15/00 and before 7/1/00 ~~ 1 Underpayment on line 17 x Number of days on line 1 x 4 Number of days on line 0 after 06/0/00 and before 10/1/00 ~ 4 Underpayment on line 17 x Number of days on line x 4 4 5 Number of days on line 0 after /0/00 and before 1/1/010 ~~ 5 6 7 8 0 1 Underpayment on line 17 x Number of days on line 5 X 4 Number of days on line 0 after 1/1/00 and before 4/1/010 Underpayment on line 17 x Number of days on line 7 X 4 Number of days on line 0 after /1/010 and before 7/1/010 ~~ Underpayment on line 17 x Number of days on line x * Number of days on line 0 after 6/0/010 and before 10/01/010 ~ Underpayment on line 17 x Number of days on line 1 x * Number of days on line 0 after /0/010 and before 1/1/011 ~~ ~ 6 7 8 0 1 4 Underpayment on line 17 x Number of days on line x * 4 5 Number of days on line 0 after 1/1/010 and before /16/011 ~ 5 6 Underpayment on line 17 x Number of days on line 5 x * 6 7 Add lines, 4, 6, 8, 0,, 4, and 6 7 8 Penalty. Add columns (a) through (d) of line 7. Enter the total here and on Form 110; line ; or the comparable line for other income tax returns * Use the penalty interest rate for each calendar quarter, which the IRS will determine during the first month in the preceding quarter. These rates are published quarterly in an IRS News Release and in a revenue ruling in the Internal Revenue Bulletin. To obtain this information on the Internet, access the IRS website at www.irs.gov. You can also call 1-800-8-4 to get interest rate information. 8 JWA Form 0 (00) 180 01-05-10 5.