Schedule O Supplemental Information to Form 990

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SCHEDULE O
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
▶

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2012

Open to Public
Inspection

Employer identification number

Name of the organization

DRAFT AS OF
November 21, 2012
DO NOT FILE

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) (2012)

Schedule O (Form 990 or 990-EZ) (2012)
Name of the organization

Page

2

Employer identification number

DRAFT AS OF
November 21, 2012
DO NOT FILE

Schedule O (Form 990 or 990-EZ) (2012)

Schedule O (Form 990 or 990-EZ) (2012)

General Instructions
Section references are to the Internal
Revenue Code unless otherwise noted.
Future developments. For the latest
information about developments related to
Schedule O (Form 990 or 990-EZ), such as
legislation enacted after the schedule and
its instructions were published, go to
www.irs.gov/form990.

Page

3

attachment to list the name, address, and
EIN of each affiliated organization included
in the group return. Do not use this
schedule. See the Instructions for Form
990, I. Group Return.

for services), including the type and
amount of each expense included in line
11g, if the amount in Part IX, line 11g,
exceeds 10% of the amount in Part IX, line
25 (total functional expenses).

Form 990, Parts III, V, VI, VII, IX, XI, and
XII. Use Schedule O (Form 990 or 990-EZ)
to provide any narrative information
required for the following questions in the
Form 990.

6. Explanation for Part IX, Statement of
Functional Expenses, line 24e (all other
expenses), including the type and amount
of each expense included in line 24e, if the
amount on line 24e exceeds 10% of the
amount in Part IX, line 25 (total functional
expenses).

DRAFT AS OF
November 21, 2012
DO NOT FILE
Purpose of Schedule

An organization should use Schedule O
(Form 990 or 990-EZ), rather than separate
attachments, to provide the IRS with
narrative information required for
responses to specific questions on Form
990 or 990-EZ, and to explain the
organization’s operations or responses to
various questions. It allows organizations
to supplement information reported on
Form 990 or 990-EZ.

Do not use Schedule O to supplement
responses to questions in other schedules of
the Form 990 or 990-EZ. Each of the other
schedules includes a separate part for
supplemental information.

Who Must File

All organizations that file Form 990 and certain
organizations that file Form 990-EZ must file
Schedule O (Form 990 or 990-EZ). At a
minimum, the schedule must be used to
answer Form 990, Part VI, lines 11b and 19. If
an organization is not required to file Form 990
or 990-EZ but chooses to do so, it must file a
complete return and provide all of the
information requested, including the required
schedules.

Specific Instructions
Use as many continuation sheets of
Schedule O (Form 990 or 990-EZ) as
needed.
Complete the required information on
the appropriate line of Form 990 or 990-EZ
prior to using Schedule O (Form 990 or
990-EZ).
Identify clearly the specific part and
line(s) of Form 990 or 990-EZ to which
each response relates. Follow the part and
line sequence of Form 990 or 990-EZ.
Late return. If the return is not filed by
the due date (including any extension
granted), attach a separate statement
giving the reasons for not filing on time. Do
not use this schedule to provide the latefiling statement.
Amended return. If the organization
checked the Amended return box on Form
990, Heading, item B, or Form 990-EZ,
Heading, item B, use Schedule O (Form
990 or 990-EZ) to list each part or schedule
and line item of the Form 990 or 990-EZ
that was amended.
Group return. If the organization
answered “Yes” to Form 990, line H(a), but
“No” to line H(b), use a separate

1. Part III, Statement of Program Service
Accomplishments.
a. “Yes” response to line 2.

b. “Yes” response to line 3.

c. Other program services on line 4d.

2. Part V, Statements Regarding Other
IRS Filings and Tax Compliance.
a. “No” response to line 3b.

b. “Yes” or “No” response to line 13a.
c. “No” response to line 14b.

3. Part VI, Governance, Management,
and Disclosure.

7. Part XI, Reconciliation of Net Assets.
Explain any other changes in net assets or
fund balances reported on line 9.
8. Part XII, Financial Statements and
Reporting.

a. Change in accounting method or
description of other accounting method
used on line 1.
b. Change in committee oversight
review from prior year on line 2c.
c. “No” response to line 3b.

a. Material differences in voting rights
among members of the governing body in
line 1a.

Form 990-EZ, Parts I, II, III, and V. Use
Schedule O (Form 990 or 990-EZ) to
provide any narrative information required
for the following questions:

b. Delegation of governing board's
authority to executive committee.

1. Part I, Revenue, Expenses, and
Changes in Net Assets or Fund Balances.

c. “Yes” responses to lines 2 through 7b.
d. “No” responses to lines 8a, 8b, and
10b.
e. “Yes” response to line 9.
f. Description of process for review of
Form 990, if any, in response to line 11b.
g. “Yes” response to line 12c.
h. Description of process for
determining compensation in response to
lines 15a and 15b.
i. If applicable, in response to line 18,
an explanation as to why the organization
checked the "Other" box or did not make
any of Forms 1023, 1024, 990, or 990-T
publicly available.
j. Description of public disclosure of
documents in response to line 19.
4. Part VII, Compensation of Officers,
Directors, Trustees, Key Employees,
Highest Compensated Employees, and
Independent Contractors.
a. Explain if reporting of compensation
paid by a related organization is provided
only for the period during which the related
organization was related, not the entire
calendar year ending with or within the tax
year, and state the period during which the
related organization was related.
b. Description of reasonable efforts
undertaken to obtain information on
compensation paid by related
organizations, if the organization is unable
to obtain such information to report in
column (E).
5. Explanation for Part IX, Statement of
Functional Expenses, line 11g (other fees

a. Description of other revenue, in
response to line 8.
b. List of grants and similar amounts
paid, in response to line 10.
c. Description of other expenses, in
response to line 16.
d. Explanation of other changes in net
assets or fund balances, in response to line
20.
2. Part II, Balance Sheets.
a. Description of other assets, in
response to line 24.
b. Description of total liabilities, in
response to line 26.
3. Description of other program services
in response to Part III, Statement of
Program Service Accomplishments, line 31.
4. Part V, Other Information.
a. “Yes” response to line 33.
b. “Yes” response to line 34.
c. Explanation of why organization did
not report unrelated business gross income
of $1,000 or more to the IRS on Form
990-T, in response to line 35b.
Other. Use Schedule O (Form 990 or
990-EZ) to provide narrative explanations
and descriptions in response to other
specific questions. The narrative provided
should refer and relate to a particular line
and response on the form.
Do not include on Schedule O
(Form 990 or 990-EZ) any social
security number(s), because this
CAUTION schedule will be made available
for public inspection.

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