Form 990-Ez - Short Form Return Of Organization Exempt From Income Tax
Download a blank fillable Form 990-Ez - Short Form Return Of Organization Exempt From Income Tax in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form 990-Ez - Short Form Return Of Organization Exempt From Income Tax with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3
4Short Form
OMB No. 1545-1150
990-EZ
Return of Organization Exempt From Income Tax
2010
Form
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code
(except black lung benefit trust or private foundation)
Sponsoring organizations of donor advised funds, organizations that operate one or more hospital facilities,
▶
Open to Public
and certain controlling organizations as defined in section 512(b)(13) must file Form 990 (see instructions).
All other organizations with gross receipts less than $200,000 and total assets less than $500,000
Inspection
Department of the Treasury
at the end of the year may use this form.
Internal Revenue Service
The organization may have to use a copy of this return to satisfy state reporting requirements.
▶
A For the 2010 calendar year, or tax year beginning
, 2010, and ending
, 20
B
C Name of organization
D
Employer identification number
Check if applicable:
Address change
Room/suite
Name change
Number and street (or P.O. box, if mail is not delivered to street address)
E Telephone number
Initial return
Terminated
City or town, state or country, and ZIP + 4
F Group Exemption
Amended return
Number
▶
Application pending
G Accounting Method:
Cash
Accrual
H Check
if the organization is not
Other (specify)
▶
▶
I Website:
required to attach Schedule B
▶
(Form 990, 990-EZ, or 990-PF).
J Tax-exempt status (check only one) —
501(c)(3)
501(c) (
)
4947(a)(1) or
527
(insert no.)
◀
K
if the organization is not a section 509(a)(3) supporting organization and its gross receipts are normally not more than $50,000. A
Check
▶
Form 990-EZ or Form 990 return is not required though Form 990-N (e-postcard) may be required (see instructions). But if the organization chooses
to file a return, be sure to file a complete return.
L
Add lines 5b, 6c, and 7b, to line 9 to determine gross receipts. If gross receipts are $200,000 or more, or if total assets (Part II,
line 25, column (B) below) are $500,000 or more, file Form 990 instead of Form 990-EZ
.
.
.
.
.
.
.
.
.
.
.
▶
$
Part I
Revenue, Expenses, and Changes in Net Assets or Fund Balances (see the instructions for Part I.)
Check if the organization used Schedule O to respond to any question in this Part I . . . . . . . . . .
1
1
Contributions, gifts, grants, and similar amounts received .
.
.
.
.
.
.
.
.
.
.
.
.
2
Program service revenue including government fees and contracts
.
.
.
.
.
.
.
.
.
2
3
Membership dues and assessments .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
3
4
4
Investment income
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
5 a Gross amount from sale of assets other than inventory
.
.
.
.
5a
b Less: cost or other basis and sales expenses .
.
.
.
.
.
.
.
5b
c Gain or (loss) from sale of assets other than inventory (Subtract line 5b from line 5a) .
5c
.
.
.
Gaming and fundraising events
6
a Gross income from gaming (attach Schedule G if greater than
$15,000) .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
6a
b Gross income from fundraising events (not including $
of contributions
from fundraising events reported on line 1) (attach Schedule G if the
sum of such gross income and contributions exceeds $15,000) .
.
6b
c Less: direct expenses from gaming and fundraising events
6c
.
.
.
d Net income or (loss) from gaming and fundraising events (add lines 6a and 6b and subtract
line 6c)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
6d
7 a Gross sales of inventory, less returns and allowances .
7a
.
.
.
.
b Less: cost of goods sold
.
.
.
.
.
.
.
.
.
.
.
.
.
.
7b
c Gross profit or (loss) from sales of inventory (Subtract line 7b from line 7a) .
.
.
.
.
.
.
7c
8
8
Other revenue (describe in Schedule O) .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
9
Total revenue. Add lines 1, 2, 3, 4, 5c, 6d, 7c, and 8
.
.
.
.
.
.
.
.
.
.
.
.
.
9
▶
10
Grants and similar amounts paid (list in Schedule O)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
10
11
11
Benefits paid to or for members .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
12
12
Salaries, other compensation, and employee benefits .
.
.
.
.
.
.
.
.
.
.
.
.
.
13
Professional fees and other payments to independent contractors .
.
.
.
.
.
.
.
.
.
13
14
Occupancy, rent, utilities, and maintenance
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
14
15
15
Printing, publications, postage, and shipping .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
16
Other expenses (describe in Schedule O) .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
16
17
Total expenses. Add lines 10 through 16 .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
17
▶
18
18
Excess or (deficit) for the year (Subtract line 17 from line 9)
.
.
.
.
.
.
.
.
.
.
.
.
19
Net assets or fund balances at beginning of year (from line 27, column (A)) (must agree with
end-of-year figure reported on prior year’s return)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
19
20
20
Other changes in net assets or fund balances (explain in Schedule O) .
.
.
.
.
.
.
.
.
21
21
Net assets or fund balances at end of year. Combine lines 18 through 20
.
.
.
.
.
.
▶
990-EZ
For Paperwork Reduction Act Notice, see the separate instructions.
Form
(2010)
Cat. No. 10642I
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial