Form Schedule L (Form 9 Schedule L (Form 9 Transactions with Interested Persons

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I.R.S. SPECIFICATIONS

TO BE REMOVED BEFORE PRINTING

INSTRUCTIONS TO PRINTERS
SCHEDULE L (FORM 990), PAGE 1 of 2 (PAGE 2 IS BLANK)
PRINTS: HEAD to HEAD
MARGINS: TOP 13 mm (1⁄2 "), CENTER SIDES.
PAPER: WHITE WRITING, SUB. 20.
INK: BLACK
FLAT SIZE: 216 mm (81⁄2 ") x 835 mm (327⁄8 ),
PERFORATE: ON FOLD
FOLDED TO: 216 mm (81⁄2 ") x 279 mm (11")

OMB No. 1545-0047

Transactions with Interested Persons

2008

To be completed by organizations that answered “Yes” on Form 990, Part IV,
lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V lines 38b or 40b.

Name of the organization

1

Signature

Revised proofs
requested

䊳

Department of the Treasury
Internal Revenue Service

Part I

Date

O.K. to print

DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

SCHEDULE L
(Form 990 or 990-EZ)

Action

Open To Public
Inspection

Employer identification number

Excess Benefit Transactions (501(c)(3) and (c)(4) organizations only)
To be completed by organizations that answered “Yes” on Form 990, Part IV, lines 25a or b, or Form 990-EZ, Part V, line 40b.
(a) Name of disqualified person

(c) Corrected?

(b) Description of transaction

Yes

No

2 Enter the amount of tax imposed on the organization managers or disqualified persons during the year
䊳 $
under section 4958
䊳 $
3 Enter the amount of tax, if any, on line 2, above, reimbursed by the organization

Part II

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Loans to and from Interested Persons
To be completed by organizations that answered “Yes” on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.

(a) Name of interested person and purpose

(b) Loan to or from
the organization?

To

(c) Original
principal amount
$

(d) Balance due
$

From

(e) In default? (f) Approved
by board or
committee?
Yes

No

Yes

No

(g) Written
agreement?

Yes

No

䊳

Total

Part III

$
Grants or Assistance Benefitting Interested Persons
To be completed by organizations that answered “Yes” on Form 990, Part IV, line 27.
(a) Name of interested person

Part IV

(b) Relationship between interested person and the
organization

(c) Amount of grant or type of assistance

Business Transactions Involving Interested Persons
To be completed by organizations that answered “Yes” on Form 990, Part IV, lines 28a, b, or c.

(a) Name of interested person

(b) Relationship between
interested person and the
organization

(c) Amount of
transaction $

(d) Description of transaction

(e) Sharing of
organization’s
revenues?
Yes

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50056A

No

Schedule L (Form 990, or 990-EZ) 2008