Form M-990t-62 Draft - Exempt Trust And Unincorporated Association Income Tax Return - 2015

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2015
Form M-990T-62
Massachusetts
Exempt Trust and Unincorporated Association
Department of
Income Tax Return
Revenue
For calendar year 2015 or taxable year beginning
2015 and ending
Name of trust or unincorporated association
Employer Identification number
Unrelated business activity codes
Mailing address
City/Town
State
Zip
Exempt under section
Group exemption number
Check organization type
3
501
3
3
501(c) trust 
408A
529(a)
220(e)
530(a)
Other trust
Describe the primary unrelated business activity of the trust or unincorporated association
Books are in care of
Telephone number
Name of treasurer
Is a Taxpayer Disclosure Statement enclosed?
Yes 
No
3
5.15% Unrelated Trade or Business Income
Use whole dollar method
01 Gross profit (from U.S. Form 990-T, line 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 1
02 5.15% long-term capital gain net income (from Massachusetts Form 2, Schedule D, line 18). . . . . . . . . . . . . . . . . . . . . . . . . . 3 2
03 5.15% interest and dividend income (from Massachusetts Form 2, Schedule B, line 35) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 3
04 Income (loss) from partnerships and S corporations (from U.S. Form 990-T, line 5. Do not include any interest or dividend
income included in line 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 4
05 Rent income (from U.S. Form 990-T, line 6). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 5
06 Unrelated debt-financed income (from U.S. Form 990-T, line 7. Do not include any interest or dividend income included in
line 3). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 6
DRAFT AS OF
07 Interest, annuities, royalties, and rents from controlled organizations (from U.S. Form 990-T, line 8. Do not include any
interest or dividend income included in line 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 7
OCTOBER 9, 2015
08 Investment income of a 501(c)(7), (9), or (17) organization (from U.S. Form 990-T, line 9. Do not include any interest or
dividend income included in line 3). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 8
(SUBJECT TO CHANGE)
09 Exploited exempt activity income (from U.S. Form 990-T, line 10. Do not include any interest or dividend income included
in line 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 9
10 Advertising income (from U.S. Form 990-T, line 11. Do not include any interest or dividend income included in line 3). . . . . 3 10
11 Other income (from U.S. Form 990-T, line 12. Do not include any interest or dividend income included in line 3) . . . . . . . . . 3 11
12 5.15% unrelated trade or business income. Add lines 1 through 11. Not less than “0” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Deductions Not Taken Elsewhere and Massachusetts Adjustments
13 Total deductions (from U.S. Form 990-T, line 29) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 13
14 Charitable contributions (from U.S. Form 990-T, line 20) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 14
15 168(k) bonus depreciation (included on U.S. Form 990-T, line 21) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 15
16 Production activity deduction (included on U.S. Form 990-T, lines 13 and 28). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 16
17 Add lines 14 through 16. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
18 Subtract line 17 from line 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
19 Massachusetts deduction for amounts payable to or permanently set aside for charitable purposes . . . . . . . . . . . . . . . . . . . 3 19
20 Total deductions after Massachusetts adjustments. Add lines 18 and 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
5.15% Tax
21 5.15% unrelated trade or business taxable income. Subtract line 20 from line 12. Not less than “0” . . . . . . . . . . . . . . . . . . . 3 21
22 5.15% tax. Multiply line 21 by .0515 (5.15%). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 22
Under the penalties of perjury, I declare that to the best of my knowledge and belief, this return and enclosures are true, correct and complete.
Signature of officer
Social Security number
Telephone number
Date
Signature of paid preparer
Employer Identification number
Address
Date
The Privacy Act Notice is available upon request. Mail to: Massachusetts Department of Revenue, PO Box 7067, Boston, MA 02204.

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