Part II Organizations with gross receipts of more than $50,000 and private foundations
regardless of amount of gross receipts — complete Part II or furnish substitute information.
1
00
1 Gross sales or receipts from all business activities. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
00
2 Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
00
3 Dividends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Receipts
4
00
from
4 Gross rents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other
5
00
5 Gross royalties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Sources
6
00
6 Gross amount received from sale of assets (See Instructions). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
00
7 Other income. Attach schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8 Total gross sales or receipts from other sources. Add line 1 through line 7. Enter here and on Side 1, Part I, line 1 . . . 8
00
9
00
9 Contributions, gifts, grants, and similar amounts paid. Attach schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10
00
10 Disbursements to or for members . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11
00
11 Compensation of officers, directors, and trustees. Attach schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12
00
12 Other salaries and wages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13
00
13 Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Expenses
and
14
00
14 Taxes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Disburse-
15
00
15 Rents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ments
16
00
16 Depreciation and depletion (See instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
17
00
17 Other Expenses and Disbursements. Attach schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
18 Total expenses and disbursements. Add line 9 through line 17. Enter here and on Side 1, Part I, line 9 . . . . . . . . . 18
00
Schedule L Balance Sheet
Beginning of taxable year
End of taxable year
Assets
(a)
(b)
(c)
(d)
1 Cash . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 Net accounts receivable . . . . . . . . . . . . . . . . . . . . . . .
3 Net notes receivable . . . . . . . . . . . . . . . . . . . . . . . . . .
4 Inventories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5 Federal and state government obligations . . . . . . . . .
6 Investments in other bonds . . . . . . . . . . . . . . . . . . . .
7 Investments in stock . . . . . . . . . . . . . . . . . . . . . . . . .
8 Mortgage loans . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9 Other investments. Attach schedule . . . . . . . . . . . . . .
10 a Depreciable assets . . . . . . . . . . . . . . . . . . . . . . . . .
(
)
(
)
b Less accumulated depreciation . . . . . . . . . . . . . . .
11 Land . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12 Other assets. Attach schedule . . . . . . . . . . . . . . . . . .
13 Total assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Liabilities and net worth
14 Accounts payable . . . . . . . . . . . . . . . . . . . . . . . . . . . .
15 Contributions, gifts, or grants payable . . . . . . . . . . . .
16 Bonds and notes payable . . . . . . . . . . . . . . . . . . . . . . .
17 Mortgages payable. . . . . . . . . . . . . . . . . . . . . . . . . . .
18 Other liabilities. Attach schedule . . . . . . . . . . . . . . . .
19 Capital stock or principal fund. . . . . . . . . . . . . . . . . . .
20 Paid-in or capital surplus. Attach reconciliation . . . . .
21 Retained earnings or income fund . . . . . . . . . . . . . . .
22 Total liabilities and net worth . . . . . . . . . . . . . . . . . .
Schedule M-1
Reconciliation of income per books with income per return
Do not complete this schedule if the amount on Schedule L, line 13, column (d), is less than $50,000
1 Net income per books . . . . . . . . . . . . . . . . . . . . . . . .
7 Income recorded on books this year
2 Federal income tax . . . . . . . . . . . . . . . . . . . . . . . . . . .
not included in this return. Attach schedule . .
3 Excess of capital losses over capital gains . . . . . . . . .
8 Deductions in this return not charged
4 Income not recorded on books this year.
against book income this year.
Attach schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Attach schedule . . . . . . . . . . . . . . . . . . . . . . .
5 Expenses recorded on books this year not
9 Total. Add line 7 and line 8 . . . . . . . . . . . . . . .
deducted in this return. Attach schedule . . . . . . . . . .
10 Net income per return.
6 Total. Add line 1 through line 5. . . . . . . . . . . . . . . . . .
Subtract line 9 from line 6 . . . . . . . . . . . . . . .
Side 2 Form 199
2016
3652163
C1