Form 990-T Exempt Organization Business Income Tax Return

Form

990-T

Department of the Treasury
Internal Revenue Service (77)

Check box if
address changed
B Exempt under section

408(e)
408A

) (

)
220(e)
530(a)

2009

(and proxy tax under section 6033(e))
For calendar year 2009 or other tax year beginning
, 2009, and
䊳 See separate instructions.
ending
, 20
.
Name of organization (

A

501(

OMB No. 1545-0687

Exempt Organization Business Income Tax Return

Open to Public Inspection
for 501(c)(3) Organizations Only

D Employer identification number

Check box if name changed and see instructions.)

(Employees’ trust, see instructions for Block D
on page 9.)

Print
or
Type

Number, street, and room or suite no. If a P.O. box, see page 8 of instructions.
E Unrelated business activity codes
(See instructions for Block E on page 9.)

City or town, state, and ZIP code

529(a)
C Book value of all assets
at end of year

F Group exemption number (See instructions for Block F on page 9.) 䊳
G Check organization type 䊳
501(c) corporation
501(c) trust
401(a) trust
H Describe the organization’s primary unrelated business activity. 䊳
䊳
I During the tax year, was the corporation a subsidiary in an affiliated group or a parent-subsidiary controlled group?
If “Yes,” enter the name and identifying number of the parent corporation. 䊳
J The books are in care of 䊳
Telephone number 䊳 (
)

Part I
1a
b
2
3
4a
b
c
5
6
7
8
9
10
11
12
13

Gross receipts or sales
c Balance 䊳
Less returns and allowances
Cost of goods sold (Schedule A, line 7)
Gross profit. Subtract line 2 from line 1c
Capital gain net income (attach Schedule D)
Net gain (loss) (Form 4797, Part II, line 17) (attach Form 4797)
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 (Schedule F)
Investment income of a section 501(c)(7), (9), or (17)
organization (Schedule G)
Exploited exempt activity income (Schedule I)
Advertising income (Schedule J)
Other income (See page 10 of the instructions; attach schedule.)
Total. Combine lines 3 through 12

Part II
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34

Unrelated Trade or Business Income

(A) Income

(B) Expenses

Other trust
Yes

No

(C) Net

1c
2
3
4a
4b
4c
5
6
7
8
9
10
11
12
13

Deductions Not Taken Elsewhere (See page 11 of the instructions for limitations on deductions.)
(Except for contributions, deductions must be directly connected with the unrelated business income.)

14
Compensation of officers, directors, and trustees (Schedule K)
15
Salaries and wages
16
Repairs and maintenance
17
Bad debts
18
Interest (attach schedule)
19
Taxes and licenses
20
Charitable contributions (See page 13 of the instructions for limitation rules.)
21
Depreciation (attach Form 4562)
22a
22b
Less depreciation claimed on Schedule A and elsewhere on return
23
Depletion
24
Contributions to deferred compensation plans
25
Employee benefit programs
26
Excess exempt expenses (Schedule I)
27
Excess readership costs (Schedule J)
28
Other deductions (attach schedule)
29
Total deductions. Add lines 14 through 28
Unrelated business taxable income before net operating loss deduction. Subtract line 29 from line 13 30
31
Net operating loss deduction (limited to the amount on line 30)
32
Unrelated business taxable income before specific deduction. Subtract line 31 from line 30
33
Specific deduction (Generally $1,000, but see line 33 instructions for exceptions.)
Unrelated business taxable income. Subtract line 33 from line 32. If line 33 is greater than line
32, enter the smaller of zero or line 32
34

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

Cat. No. 11291J

Form

990-T

(2009)

Form 990-T (2009)

Page

2

Tax Computation

Part III
35

Organizations Taxable as Corporations. See instructions for tax computation on page 15.
See instructions and:
Controlled group members (sections 1561 and 1563) check here 䊳
a Enter your share of the $50,000, $25,000, and $9,925,000 taxable income brackets (in that order):
(1) $
(2) $
(3) $
b Enter organization’s share of: (1) Additional 5% tax (not more than $11,750) $
$
(2) Additional 3% tax (not more than $100,000)
䊳 35c
c Income tax on the amount on line 34
36 Trusts Taxable at Trust Rates. See instructions for tax computation on page 16. Income tax on
36
䊳
the amount on line 34 from:
Tax rate schedule or
Schedule D (Form 1041)
37
䊳
37 Proxy tax. See page 16 of the instructions
38
38 Alternative minimum tax
39 Total. Add lines 37 and 38 to line 35c or 36, whichever applies
39

Tax and Payments

Part IV

40a
Foreign tax credit (corporations attach Form 1118; trusts attach Form 1116)
40b
Other credits (see page 16 of the instructions)
40c
General business credit. Attach Form 3800
40d
Credit for prior year minimum tax (attach Form 8801 or 8827)
Total credits. Add lines 40a through 40d
Subtract line 40e from line 39
Other taxes. Check if from:
Form 4255
Form 8611
Form 8697
Form 8866
Other (attach schedule)
Total tax. Add lines 41 and 42
44a
Payments: A 2008 overpayment credited to 2009
44b
2009 estimated tax payments
44c
Tax deposited with Form 8868
44d
Foreign organizations: Tax paid or withheld at source (see instructions)
44e
Backup withholding (see instructions)
Form 2439
Other credits and payments:
Form 4136
Other
Total 䊳 44f
45 Total payments. Add lines 44a through 44f
䊳
46 Estimated tax penalty (see page 4 of the instructions). Check if Form 2220 is attached
䊳
47 Tax due. If line 45 is less than the total of lines 43 and 46, enter amount owed
䊳
48 Overpayment. If line 45 is larger than the total of lines 43 and 46, enter amount overpaid
49 Enter the amount of line 48 you want: Credited to 2010 estimated tax 䊳
Refunded 䊳
Statements Regarding Certain Activities and Other Information (see instructions
Part V

40a
b
c
d
e
41
42
43
44a
b
c
d
e
f

40e
41
42
43

45
46
47
48
49
on page 17)

1

At any time during the 2009 calendar year, did the organization have an interest in or a signature
or other authority over a financial account (bank, securities, or other) in a foreign country?
If YES, the organization may have to file Form TD F 90-22.1, Report of Foreign Bank and
Financial Accounts. If YES, enter the name of the foreign country here 䊳

2

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.
Enter the amount of tax-exempt interest received or accrued during the tax year 䊳 $

3

Schedule A—Cost of Goods Sold. Enter method of inventory valuation
1
2
3
4a

Inventory at beginning of year
Purchases
Cost of labor
Additional section 263A costs
(attach schedule)
b Other costs (attach schedule)
5 Total. Add lines 1 through 4b

Sign
Here

1
2
3

Yes

No

䊳

6

6 Inventory at end of year

7 Cost of goods sold. Subtract line
6 from line 5. Enter here and in
7
Part I, line 2
8 Do the rules of section 263A (with respect to Yes No
property produced or acquired for resale) apply
to the organization?

4a
4b
5

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.

䊳

䊳

Signature of officer

Paid
Preparer’s
Use Only

Preparer’s
signature

Date

䊳

Firm’s name (or
yours if self-employed),
address, and ZIP code

Title
Date

䊳

May the IRS discuss this return with
the preparer shown below (see
instructions)?
Yes
No

Preparer’s SSN or PTIN

Check if
self-employed
EIN
Phone no.

(

)
Form

990-T

(2009)

Form 990-T (2009)

Page

3

Schedule C—Rent Income (From Real Property and Personal Property Leased With Real Property)
(see instructions on page 18)
1. Description of property
(1)
(2)
(3)
(4)
2. Rent received or accrued
(a) From personal property (if the percentage of rent
for personal property is more than 10% but not
more than 50%)

(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)

3(a) Deductions directly connected with the income
in columns 2(a) and 2(b) (attach schedule)

(1)
(2)
(3)
(4)

Total

Total

(b) Total deductions.
Enter here and on page 1,
Part I, line 6, column (B) 䊳

(c) Total income. Add totals of columns 2(a) and 2(b). Enter
䊳
here and on page 1, Part I, line 6, column (A)

Schedule E—Unrelated Debt-Financed Income (see instructions on page 19)
2. Gross income from or
allocable to debt-financed
property

1. Description of debt-financed property

3. Deductions directly connected with or allocable to
debt-financed property
(b) Other deductions
(a) Straight line depreciation
(attach schedule)
(attach schedule)

(1)
(2)
(3)
(4)
4. Amount of average
acquisition debt on or
allocable to debt-financed
property (attach schedule)

5. Average adjusted basis
of or allocable to
debt-financed property
(attach schedule)

6. Column
4 divided
by column 5

7. Gross income reportable
(column 2  column 6)

8. Allocable deductions
(column 6  total of columns
3(a) and 3(b))

%

(1)
(2)

%

(3)

%

(4)

%
Enter here and on page 1, Enter here and on page 1,
Part I, line 7, column (A). Part I, line 7, column (B).

Totals
Total dividends-received deductions included in column 8

䊳
䊳

Schedule F—Interest, Annuities, Royalties, and Rents From Controlled Organizations (see instructions on page 20)
Exempt Controlled Organizations
1. Name of controlled
organization

2. Employer
identification number

3. Net unrelated income 4. Total of specified
(loss) (see instructions)
payments made

5. Part of column 4 that is
included in the controlling
organization’s gross income

6. Deductions directly
connected with income
in column 5

(1)
(2)
(3)
(4)

Nonexempt Controlled Organizations
7. Taxable Income

8. Net unrelated income
(loss) (see instructions)

10. Part of column 9 that is
11. Deductions directly
included in the controlling connected with income in
organization’s gross income
column 10

9. Total of specified
payments made

(1)
(2)
(3)
(4)
Add columns 5 and 10.
Enter here and on page 1,
Part I, line 8, column (A).

Totals

Add columns 6 and 11.
Enter here and on page 1,
Part I, line 8, column (B).

䊳
Form 990-T (2009)

Form 990-T (2009)

Page

4

Schedule G—Investment Income of a Section 501(c)(7), (9), or (17) Organization (see instructions on page 20)
1. Description of income

2. Amount of income

3. Deductions
directly connected
(attach schedule)

5. Total deductions
and set-asides (col. 3
plus col. 4)

4. Set-asides
(attach schedule)

(1)
(2)
(3)
(4)

Enter here and on page 1,
Part I, line 9, column (A).

Enter here and on page 1,
Part I, line 9, column (B).

䊳

Totals

Schedule I—Exploited Exempt Activity Income, Other Than Advertising Income (see instructions on page 21)

1. Description of exploited activity

2. Gross
unrelated
business income
from trade or
business

3. Expenses
directly
connected with
production of
unrelated
business income

Enter here and on
page 1, Part I,
line 10, col. (A).

Enter here and on
page 1, Part I,
line 10, col. (B).

4. Net income
(loss) from
unrelated trade or
business (column
2 minus column
3). If a gain,
compute cols. 5
through 7.

5. Gross income
from activity that
is not unrelated
business income

6. Expenses
attributable to
column 5

7. Excess exempt
expenses
(column 6 minus
column 5, but not
more than
column 4).

(1)
(2)
(3)
(4)
Enter here and
on page 1,
Part II, line 26.

䊳

Totals

Schedule J—Advertising Income (see instructions on page 21)
Part I
Income From Periodicals Reported on a Consolidated Basis
2. Gross
advertising
income

1. Name of periodical

3. Direct
advertising costs

4. Advertising
gain or (loss) (col.
2 minus col. 3). If
a gain, compute
cols. 5 through 7.

6. Readership
costs

5. Circulation
income

7. Excess readership
costs (column 6
minus column 5, but
not more than
column 4).

(1)
(2)
(3)
(4)

Totals (carry to Part II, line (5))

Part II

䊳

Income From Periodicals Reported on a Separate Basis (For each periodical listed in Part II, fill in
columns 2 through 7 on a line-by-line basis.)
1. Name of periodical

2. Gross
advertising
income

3. Direct
advertising costs

Enter here and on
page 1, Part I,
line 11, col. (A).

Enter here and on
page 1, Part I,
line 11, col. (B).

4. Advertising
gain or (loss) (col.
2 minus col. 3). If
a gain, compute
cols. 5 through 7.

6. Readership
costs

5. Circulation
income

7. Excess readership
costs (column 6
minus column 5, but
not more than
column 4).

(1)
(2)
(3)
(4)

Totals from Part I
Enter here and
on page 1,
Part II, line 27.

䊳

Totals, Part II (lines 1-5)

Schedule K—Compensation of Officers, Directors, and Trustees (see instructions on page 21)
1. Name

2. Title

3. Percent of
time devoted to
business

(1)

%

(2)

%

(3)

%

(4)

%

Total. Enter here and on page 1, Part II, line 14

4. Compensation attributable to
unrelated business

䊳

Form 990-T (2009)