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pdfSCHEDULE A
Organization Exempt Under Section 501(c)(3)
(Form 990 or 990-EZ)
(Except Private Foundation) and Section 501(e), 501(f), 501(k), 501(n),
or 4947(a)(1) Nonexempt Charitable Trust
Department of the Treasury
Internal Revenue Service
Supplementary Information—(See separate instructions.)
©
2006
MUST be completed by the above organizations and attached to their Form 990 or 990-EZ
Name of the organization
Part I
OMB No. 1545-0047
Employer identification number
Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees
(See page 2 of the instructions. List each one. If there are none, enter “None.”)
(a) Name and address of each employee paid more
than $50,000
Total number of other employees paid over $50,000
(b) Title and average hours
per week devoted to position
(c) Compensation
(d) Contributions to
employee benefit plans &
deferred compensation
(e) Expense
account and other
allowances
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Part II-A Compensation of the Five Highest Paid Independent Contractors for Professional Services
(See page 2 of the instructions. List each one (whether individuals or firms). If there are none, enter “None.”)
(a) Name and address of each independent contractor paid more than $50,000
(b) Type of service
(c) Compensation
Total number of others receiving over $50,000 for
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professional services
Part II-B Compensation of the Five Highest Paid Independent Contractors for Other Services
(List each contractor who performed services other than professional services, whether individuals or
firms. If there are none, enter “None.” See page 2 of the instructions.)
(a) Name and address of each independent contractor paid more than $50,000
(b) Type of service
(c) Compensation
Total number of other contractors receiving over
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$50,000 for other services
For Paperwork Reduction Act Notice, see the Instructions for Form 990 and Form 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2006
Schedule A (Form 990 or 990-EZ) 2006
Part III
1
Page
Statements About Activities (See page 2 of the instructions.)
2
Yes No
During the year, has the organization attempted to influence national, state, or local legislation, including any
attempt to influence public opinion on a legislative matter or referendum? If “Yes,” enter the total expenses paid
or incurred in connection with the lobbying activities © $
(Must equal amounts on line 38,
1
Part VI-A, or line i of Part VI-B.)
Organizations that made an election under section 501(h) by filing Form 5768 must complete Part VI-A. Other
organizations checking “Yes” must complete Part VI-B AND attach a statement giving a detailed description of
the lobbying activities.
During the year, has the organization, either directly or indirectly, engaged in any of the following acts with any
substantial contributors, trustees, directors, officers, creators, key employees, or members of their families, or
with any taxable organization with which any such person is affiliated as an officer, director, trustee, majority
owner, or principal beneficiary? (If the answer to any question is “Yes,” attach a detailed statement explaining the
transactions.)
2
a Sale, exchange, or leasing of property?
2a
b Lending of money or other extension of credit?
2b
c Furnishing of goods, services, or facilities?
2c
d Payment of compensation (or payment or reimbursement of expenses if more than $1,000)?
2d
e Transfer of any part of its income or assets?
2e
3a Did the organization make grants for scholarships, fellowships, student loans, etc.? (If “Yes,” attach an explanation
of how the organization determines that recipients qualify to receive payments.)
3a
b Did the organization have a section 403(b) annuity plan for its employees?
3b
c Did the organization receive or hold an easement for conservation purposes, including easements to preserve open
space, the environment, historic land areas or historic structures? If “Yes,” attach a detailed statement
3c
d Did the organization provide credit counseling, debt management, credit repair, or debt negotiation services?
3d
4a Did the organization maintain any donor advised funds? If “Yes,” complete lines 4b through 4g. If “No,” complete
lines 4f and 4g
b Did the organization make any taxable distributions under section 4966?
4a
4b
c Did the organization make a distribution to a donor, donor advisor, or related person?
4c
d Enter the total number of donor advised funds owned at the end of the tax year
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e Enter the aggregate value of assets held in all donor advised funds owned at the end of the tax year
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f
Enter the total number of separate funds or accounts owned at the end of the tax year (excluding donor advised
funds included on line 4d) where donors have the right to provide advice on the distribution or investment of
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amounts in such funds or accounts
g Enter the aggregate value of assets held in all funds or accounts included on line 4f at the end of the tax year
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Schedule A (Form 990 or 990-EZ) 2006
Schedule A (Form 990 or 990-EZ) 2006
Part IV
Page
3
Reason for Non-Private Foundation Status (See pages 4 through 7 of the instructions.)
I certify that the organization is not a private foundation because it is: (Please check only ONE applicable box.)
5
A church, convention of churches, or association of churches. Section 170(b)(1)(A)(i).
6
A school. Section 170(b)(1)(A)(ii). (Also complete Part V.)
7
A hospital or a cooperative hospital service organization. Section 170(b)(1)(A)(iii).
8
A federal, state, or local government or governmental unit. Section 170(b)(1)(A)(v).
9
A medical research organization operated in conjunction with a hospital. Section 170(b)(1)(A)(iii). Enter the hospital’s name, city,
and state ©
10
An organization operated for the benefit of a college or university owned or operated by a governmental unit. Section 170(b)(1)(A)(iv).
(Also complete the Support Schedule in Part IV-A.)
11a
An organization that normally receives a substantial part of its support from a governmental unit or from the general public. Section
170(b)(1)(A)(vi). (Also complete the Support Schedule in Part IV-A.)
11b
A community trust. Section 170(b)(1)(A)(vi). (Also complete the Support Schedule in Part IV-A.)
12
An organization that normally receives: (1) more than 331⁄ 3 % of its support from contributions, membership fees, and gross receipts
from activities related to its charitable, etc., functions—subject to certain exceptions, and (2) no more than 331⁄ 3 % of its support
from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the
organization after June 30, 1975. See section 509(a)(2). (Also complete the Support Schedule in Part IV-A.)
13
An organization that is not controlled by any disqualified persons (other than foundation managers) and otherwise meets the
requirements of section 509(a)(3). Check the box that describes the type of supporting organization:
Type I
Type II
Type III-Functionally Integrated
Type III-Other
Provide the following information about the supported organizations. (See page 7 of the instructions.)
(a)
(b)
(c)
(d)
(e)
Name(s) of supported organization(s)
Employer
Type of
Is the supported
Amount of
identification
organization
organization listed in
support
number (EIN)
(described in lines
the supporting
5 through 12
organization’s
above or IRC
governing documents?
section)
Yes
Total
14
No
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An organization organized and operated to test for public safety. Section 509(a)(4). (See page 7 of the instructions.)
Schedule A (Form 990 or 990-EZ) 2006
Schedule A (Form 990 or 990-EZ) 2006
Part IV-A
Page
Note: You may use the worksheet in the instructions for converting from the accrual to the cash method of accounting.
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Calendar year (or fiscal year beginning in)
(a) 2005
(b) 2004
(c) 2003
(d) 2002
15 Gifts, grants, and contributions received. (Do
not include unusual grants. See line 28.)
16 Membership fees received
17 Gross receipts from admissions, merchandise
sold or services performed, or furnishing of
facilities in any activity that is related to the
organization’s charitable, etc., purpose
18 Gross income from interest, dividends,
amounts received from payments on securities
loans (section 512(a)(5)), rents, royalties, and
unrelated business taxable income (less
section 511 taxes) from businesses acquired
by the organization after June 30, 1975
19
Net income from unrelated
activities not included in line 18
20
Tax revenues levied for the organization’s
benefit and either paid to it or expended on
its behalf
21
The value of services or facilities furnished to
the organization by a governmental unit
without charge. Do not include the value of
services or facilities generally furnished to the
public without charge
22
23
24
25
Other income. Attach a schedule. Do not
include gain or (loss) from sale of capital assets
Total of lines 15 through 22
Line 23 minus line 17
Enter 1% of line 23
26
Organizations described on lines 10 or 11:
(e) Total
business
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a Enter 2% of amount in column (e), line 24
b Prepare a list for your records to show the name of and amount contributed by each person (other than a
governmental unit or publicly supported organization) whose total gifts for 2002 through 2005 exceeded the
amount shown in line 26a. Do not file this list with your return. Enter the total of all these excess amounts ©
©
c Total support for section 509(a)(1) test: Enter line 24, column (e)
d Add: Amounts from column (e) for lines: 18
19
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22
26b
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e Public support (line 26c minus line 26d total)
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f Public support percentage (line 26e (numerator) divided by line 26c (denominator))
27
4
Support Schedule (Complete only if you checked a box on line 10, 11, or 12.) Use cash method of accounting.
26a
26b
26c
26d
26e
26f
%
Organizations described on line 12: a For amounts included in lines 15, 16, and 17 that were received from a “disqualified
person,” prepare a list for your records to show the name of, and total amounts received in each year from, each “disqualified person.”
Do not file this list with your return. Enter the sum of such amounts for each year:
(2005)
(2004)
(2003)
(2002)
b For any amount included in line 17 that was received from each person (other than “disqualified persons”), prepare a list for your records to
show the name of, and amount received for each year, that was more than the larger of (1) the amount on line 25 for the year or (2) $5,000.
(Include in the list organizations described in lines 5 through 11b, as well as individuals.) Do not file this list with your return. After computing
the difference between the amount received and the larger amount described in (1) or (2), enter the sum of these differences (the excess
amounts) for each year:
(2005)
(2004)
(2003)
(2002)
c Add: Amounts from column (e) for lines: 15
16
17
20
21
d Add: Line 27a total
and line 27b total
e Public support (line 27c total minus line 27d total)
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27f
f Total support for section 509(a)(2) test: Enter amount from line 23, column (e)
g Public support percentage (line 27e (numerator) divided by line 27f (denominator))
h Investment income percentage (line 18, column (e) (numerator) divided by line 27f (denominator))
28
©
27c
©
27d
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27e
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27g
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27h
%
%
Unusual Grants: For an organization described in line 10, 11, or 12 that received any unusual grants during 2002 through 2005,
prepare a list for your records to show, for each year, the name of the contributor, the date and amount of the grant, and a brief
description of the nature of the grant. Do not file this list with your return. Do not include these grants in line 15.
Schedule A (Form 990 or 990-EZ) 2006
Schedule A (Form 990 or 990-EZ) 2006
Part V
29
30
31
32
Page
5
Private School Questionnaire (See page 9 of the instructions.)
(To be completed ONLY by schools that checked the box on line 6 in Part IV)
Yes No
Does the organization have a racially nondiscriminatory policy toward students by statement in its charter, bylaws,
other governing instrument, or in a resolution of its governing body?
29
Does the organization include a statement of its racially nondiscriminatory policy toward students in all its
brochures, catalogues, and other written communications with the public dealing with student admissions,
programs, and scholarships?
30
Has the organization publicized its racially nondiscriminatory policy through newspaper or broadcast media during
the period of solicitation for students, or during the registration period if it has no solicitation program, in a way
that makes the policy known to all parts of the general community it serves?
If “Yes,” please describe; if “No,” please explain. (If you need more space, attach a separate statement.)
31
Does the organization maintain the following:
a Records indicating the racial composition of the student body, faculty, and administrative staff?
32a
b Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory
basis?
32b
c Copies of all catalogues, brochures, announcements, and other written communications to the public dealing
with student admissions, programs, and scholarships?
d Copies of all material used by the organization or on its behalf to solicit contributions?
32c
32d
If you answered “No” to any of the above, please explain. (If you need more space, attach a separate statement.)
33
Does the organization discriminate by race in any way with respect to:
a Students’ rights or privileges?
33a
b Admissions policies?
33b
c Employment of faculty or administrative staff?
33c
d Scholarships or other financial assistance?
33d
e Educational policies?
33e
f Use of facilities?
33f
g Athletic programs?
33g
h Other extracurricular activities?
33h
If you answered “Yes” to any of the above, please explain. (If you need more space, attach a separate statement.)
34a
34a Does the organization receive any financial aid or assistance from a governmental agency?
34b
b Has the organization’s right to such aid ever been revoked or suspended?
If you answered “Yes” to either 34a or b, please explain using an attached statement.
35
Does the organization certify that it has complied with the applicable requirements of sections 4.01 through 4.05
of Rev. Proc. 75-50, 1975-2 C.B. 587, covering racial nondiscrimination? If “No,” attach an explanation
35
Schedule A (Form 990 or 990-EZ) 2006
Schedule A (Form 990 or 990-EZ) 2006
Part VI-A
Check
©
a
Page
if the organization belongs to an affiliated group.
Check
©
b
if you checked “a” and “limited control” provisions apply.
(a)
Affiliated group
totals
Limits on Lobbying Expenditures
(The term “expenditures” means amounts paid or incurred.)
36
37
38
39
40
41
Total lobbying expenditures to influence public opinion (grassroots lobbying)
Total lobbying expenditures to influence a legislative body (direct lobbying)
Total lobbying expenditures (add lines 36 and 37)
Other exempt purpose expenditures
Total exempt purpose expenditures (add lines 38 and 39)
Lobbying nontaxable amount. Enter the amount from the following table—
If the amount on line 40 is—
The lobbying nontaxable amount is—
Not over $500,000
20% of the amount on line 40
Over $500,000 but not over $1,000,000
$100,000 plus 15% of the excess over $500,000
Over $1,000,000 but not over $1,500,000
$175,000 plus 10% of the excess over $1,000,000
Over $1,500,000 but not over $17,000,000
$225,000 plus 5% of the excess over $1,500,000
Over $17,000,000
$1,000,000
Grassroots nontaxable amount (enter 25% of line 41)
Subtract line 42 from line 36. Enter -0- if line 42 is more than line 36
Subtract line 41 from line 38. Enter -0- if line 41 is more than line 38
42
43
44
6
Lobbying Expenditures by Electing Public Charities (See page 10 of the instructions.)
(To be completed ONLY by an eligible organization that filed Form 5768)
(b)
To be completed
for all electing
organizations
36
37
38
39
40
%
41
42
43
44
Caution: If there is an amount on either line 43 or line 44, you must file Form 4720.
4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five columns below.
See the instructions for lines 45 through 50 on page 13 of the instructions.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or
fiscal year beginning in)
©
45
Lobbying nontaxable amount
46
Lobbying ceiling amount (150% of line 45(e))
47
Total lobbying expenditures
48
Grassroots nontaxable amount
49
Grassroots ceiling amount (150% of line 48(e))
50
Grassroots lobbying expenditures
Part VI-B
(a)
2006
(b)
2005
(c)
2004
(d)
2003
Lobbying Activity by Nonelecting Public Charities
(For reporting only by organizations that did not complete Part VI-A) (See page 13 of the instructions.)
During the year, did the organization attempt to influence national, state or local legislation, including any
attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
b
c
d
e
f
g
h
i
(e)
Total
Yes No
Amount
Volunteers
Paid staff or management (Include compensation in expenses reported on lines c through h.)
Media advertisements
Mailings to members, legislators, or the public
Publications, or published or broadcast statements
Grants to other organizations for lobbying purposes
Direct contact with legislators, their staffs, government officials, or a legislative body
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any other means
Total lobbying expenditures (Add lines c through h.)
If “Yes” to any of the above, also attach a statement giving a detailed description of the lobbying activities.
Schedule A (Form 990 or 990-EZ) 2006
Page 7
Information Regarding Transfers To and Transactions and Relationships With Noncharitable
Exempt Organizations (See page 13 of the instructions.)
Schedule A (Form 990 or 990-EZ) 2006
Part VII
51
Did the reporting organization directly or indirectly engage in any of the following with any other organization described in section
501(c) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
Yes No
a Transfers from the reporting organization to a noncharitable exempt organization of:
51a(i)
(i) Cash
a(ii)
(ii) Other assets
b Other transactions:
b(i)
(i) Sales or exchanges of assets with a noncharitable exempt organization
b(ii)
(ii) Purchases of assets from a noncharitable exempt organization
b(iii)
(iii) Rental of facilities, equipment, or other assets
b(iv)
(iv) Reimbursement arrangements
b(v)
(v) Loans or loan guarantees
b(vi)
(vi) Performance of services or membership or fundraising solicitations
c
c Sharing of facilities, equipment, mailing lists, other assets, or paid employees
d If the answer to any of the above is “Yes,” complete the following schedule. Column (b) should always show the fair market value of the
goods, other assets, or services given by the reporting organization. If the organization received less than fair market value in any
transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received:
(a)
Line no.
(b)
Amount involved
(c)
Name of noncharitable exempt organization
(d)
Description of transfers, transactions, and sharing arrangements
52a Is the organization directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
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described in section 501(c) of the Code (other than section 501(c)(3)) or in section 527?
b If “Yes,” complete the following schedule:
(a)
Name of organization
(b)
Type of organization
Yes
No
(c)
Description of relationship
Schedule A (Form 990 or 990-EZ) 2006
File Type | application/pdf |
File Title | 2006 Form 990 or 990-EZ (Schedule A) |
Subject | Organization Exempt Under Section 501(c)(3) |
Author | SE:W:CAR:MP |
File Modified | 2007-01-17 |
File Created | 2007-01-14 |