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2006

Form 3M

Income Tax Return for Clubs and Other

Massachusetts

Organizations not Engaged in Business for Profit

Department of

Revenue

(Organizations whose gross income is $100 or less are not required to file a return)

For calendar year 2006 or taxable year beginning

, 2006 and ending

Name of organization

Federal identification number

Street address

City or town

State

Zip

Date of organization

If using the whole-dollar method,

check box

Organization’s books are in care of

Principal organization activity

Street address

City or town

State

Zip

Has the federal government changed your taxable income for any prior year which you have not yet reported to Massachusetts? 3

Yes

No. If “Yes,”

complete a new Form 3M for that year and mark “Amended” across the top of the form. This must be done within one year after final U.S. determination.

Computation of Tax

11 5.3% income, including interest from Mass. banks.* List sources and amounts ______________________________

3 1

12 Interest and dividend income (from Massachusetts Schedule B, line 28) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 2

13 Total 5.3% income. Add line 1 and line 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

14 Tax on 5.3% income. Multiply line 3 by .053 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 4

25 Taxable 12% capital gains (from Massachusetts Schedule B, line 29) . . . . . . . . . . . . . . . . . . . . 3 5

16 Tax on 12% capital gains. Multiply line 5 by .12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 6

27 Tax on long-term capital gains (from Massachusetts Schedule D, line 16; not less than “0”). . . . . . . . . . . . . . . . . . . . . . . 3 7

18 Total tax. Add lines 4, 6 and 7. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 8

19 2005 overpayment applied to your 2007 estimated tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 9

10 2006 Massachusetts estimated tax payments (do not include amount in line 9) . . . . . . . . . . . 3 10

11 Payments made with extension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 11

12 Total payments. Add lines 9, 10 and 11. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

13 Overpayment. If line 8 is smaller than line 12, subtract line 8 from line 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

14 Amount of overpayment to be credited to your 2006 estimated tax. . . . . . . . . . . . . . . . . . . . . 3 14

15 Amount of your refund. Subtract line 14 from line 13. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 15

16 Amount of tax due. If line 12 is smaller than line 8, subtract line 12 from line 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

17 M-2210 penalty 3 $ ____________ ; Late file/pay penalties* 3 $ _______________ . . . . . . . . . . . . . . . . Total penalty

18 Interest on unpaid balance* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 18

19 Total payment due at time of filing. Add lines 16, 17 and 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 19

Make check payable to: Commonwealth of Massachusetts.

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

he/she has any knowledge.

Your signature

Date

Paid preparer’s signature

Date

Title

Firm name

PTIN or SSN

Street address

City/Town

State

Zip

This return is due on or before the fifteenth day of the fourth month after the close of the taxable year, calendar or fiscal. Make check or money order

payable to Commonwealth of Massachusetts. Mail return, together with payment in full, to: Massachusetts Department of Revenue, PO Box 7018,

Boston, MA 02204.

*See Form 1 instructions.