Form Schedule J (F 990) Schedule J (F 990) Compensation Information

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I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
INSTRUCTIONS TO PRINTERS
FORM 990 Schedule J, PAGE 1 of 3
MARGINS: TOP 13 mm (1⁄2 "), CENTER SIDES.
PRINTS: HEAD TO HEAD
PAPER: WHITE WRITING, SUB. 20.
INK: BLACK
FLAT SIZE: 216 mm (81⁄2 ")  835 mm (327⁄8 ),
FOLDED TO 216 mm (81⁄2 ")  279 mm (11")
PERFORATE: ON FOLD
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

Action

Revised proofs
requested

OMB No. 1545-0047

2008

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
To be completed by organizations that answered “Yes” to
Form 990, Part IV, line 23.

Department of the Treasury
Internal Revenue Service

Signature

O.K. to print

Compensation Information

SCHEDULE J
(Form 990)

Name of the organization

Part I

Date

Open to Public
Inspection

Employer identification number

Questions Regarding Compensation
Yes

No

1a Check the appropriate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
first-class or charter travel
travel for companions
tax indemnification and gross-up payments
discretionary spending account

housing allowance or residence for personal use
payments for business use of personal residence
health or social club dues or initiation fees
personal services (e.g., maid, chauffeur, chef)

b If line 1a is checked, did the organization follow a written policy regarding payment or reimbursement or
provision of all of the expenses described above? If “No,” complete Part III to explain
2 Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a?

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Indicate which, if any, of the following the organization uses to establish the compensation of the
organization’s CEO/Executive Director. Check all that apply.
compensation committee
written employment contract
compensation survey or study
independent compensation consultant
approval by the board or compensation committee
Form 990 of other organizations

4
a
b
c

During the year, did any person listed in Form 990, Part VII, Section A, line 1a:
receive a severance payment or change of control payment?
participate in, or receive payment from, a supplemental nonqualified retirement plan?
participate in, or receive payment from, an equity-based compensation arrangement?
If “Yes” to any of 4a–c, list the persons and provide the applicable amounts for each item in Part III.

5
a
b
6
a
b
7
8

Cat. No. 50053T

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4a
4b
4c

501(c)(3) and 501(c)(4) organizations only must complete lines 5–8.
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
the organization?
any related organization?
If “Yes,” describe in Part III.
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
the organization?
any related organization?
If “Yes,” describe in Part III.
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If “Yes,” describe in Part III
Were any amounts reported in Form 990, Part VII, paid or accrued pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If “Yes,” describe
in Part III

For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.

1b

5a
5b

6a
6b

7

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Schedule J (Form 990) 2008

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I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
INSTRUCTIONS TO PRINTERS
SCHEDULE J (FORM 990), PAGE 2 of 3
MARGINS: TOP 13 mm (1⁄2 "), CENTER SIDES.
PRINTS: ONE SIDED
PAPER: WHITE WRITING, SUB. 20.
INK: BLACK
FLAT SIZE: 279 mm (11")  216 mm (81⁄2 ")
PERFORATE: (NONE)
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

Page 2

Schedule J (Form 990) 2008

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space is needed.

For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note: The sum of columns (B)(i)–(iii) must equal the applicable column (D) or (E) amounts on Form 990, Part VII, line 1a.
(B) Breakdown of W-2 and/or 1099-MISC compensation
(i) Base
compensation
($)

(A) Name

(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)

(C) Deferred
compensation
($)

(D) Nontaxable
benefits
($)

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(ii) Bonus & incentive
compensation
($)

(iii) Other
compensation
($)

(E) Total of columns
(B)(i)–(D)
($)

(F) Compensation
reported in prior
Form 990 or
Form 990-EZ

(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
Schedule J (Form 990) 2008

1
I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
INSTRUCTIONS TO PRINTERS
SCHEDULE J (FORM 990), PAGE 3 of 3
MARGINS: TOP 13 mm (1⁄2 "), CENTER SIDES.
PRINTS: ONE SIDED
PAPER: WHITE WRITING, SUB. 20.
INK: BLACK
FLAT SIZE: 279 mm (11")  216 mm (81⁄2 ")
PERFORATE: (NONE)
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

Page 3
Supplemental Information
Part III
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part
for any additional information.
Schedule J (Form 990) 2008

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Schedule J (Form 990) 2008