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Check the "Amended report" box if the organization is filing

The aggregate amount of the contributions accepted from

an amended report.

that person during the calendar year as of the end of this

reporting period was at least $200, and

Check the "Final report" box if the organization will not be

required to file Form 8872 in the future.

Any of those contributions were accepted during this

reporting period.

Employer Identification Number (EIN)

Treat contributions as accepted if the contributor has

Enter the correct EIN in the space provided as shown on the

contracted or is otherwise obligated to make the contribution.

Form 8871 the organization filed.

In-kind contributions must be included. These

DO NOT enter social security numbers on Form

contributions may be identified by including “(In-kind)” in the

8872 or on any attachments to this form.

contributor's name field.

CAUTION

Foreign Address

As an entry on the last page of Schedule A, enter the total

amount of all contributions received from contributors whose

Enter the information in the following order: city or town, state

aggregate contributions were less than $200 and are not

or province, and country. Follow the country's practice for

reported elsewhere. Enter “Aggregate below Threshold”

entering the postal code, if any. Do not abbreviate the

instead of the contributor's name. If filing electronically, also

country name.

enter your organization's address and the last day of the

Lines 5a and 5b

reporting period (for example, Jan. 31); and enter “N/A” for

employer, occupation, and date.

Enter the name and address of the person in possession of

the organization's books and records.

Name of Contributor's Employer

Lines 6a and 6b

If the contributor is an individual, enter the name of the

organization or person by whom the contributor is employed

Enter the name and address of the person whom the public

(and not the name of his or her supervisor). If the individual is

may contact for more information about the organization.

self-employed, enter "Self-employed." If the individual is not

Lines 8a through 8h

employed, enter “Not employed.” If filing electronically and

the contributor is not an individual, enter “N/A.”

Check only one box. See When To File earlier for details on

the types of reports and the periods covered.

Contributor's Occupation

Line 8f. If the organization is filing on a monthly basis, enter

If the contributor is an individual, enter the principal job title or

the month for which this report is being filed. During

position of that contributor. If the individual is self-employed,

even-numbered years, do not check this box to report

enter the principal job title or position of that contributor. If the

October, November, or December activity. Instead, file a

individual is not employed, enter a descriptive title to explain

pre-general election report, post-general election report, a

the individual's status such as “Retired,” “Student,”

year-end report, and check the appropriate box on line 8d,

“Homemaker,” or “Unemployed.” If filing electronically and

8g, or 8h.

the contributor is not an individual, enter “N/A.”

Line 8g. If the organization is filing a pre-election report also

Aggregate Year-to-Date Contributions

indicate the type of election (primary, general, convention,

Enter the total amount of contributions accepted from the

special, or runoff) on line 8g(1), the date of the election on

contributor during this calendar year as of the end of this

line 8g(2), and the state in which the election is held on

reporting period.

line 8g(3).

Amount of Contribution

Line 8h. If the organization is filing a post-general election

report, indicate the date of the election on line 8h(1) and the

If a contributor made more than one contribution in a

state in which the election was held on line 8h(2).

reporting period, report each contribution separately. If the

Line 9

contribution is an in-kind contribution, report the fair market

value of the contribution.

If the organization is required to file Schedule(s) A, enter the

total of all subtotals shown on those schedules. If the

Non-Disclosed Amounts

organization is not required to file Schedule A, enter zero.

As the last entry on Schedule A, list the aggregate amount of

Line 10

contributions that are required to be reported on this

schedule for which the organization does not disclose all of

If the organization is required to file Schedule(s) B, enter the

the information required under section 527(j). Enter

total of all subtotals shown on those schedules. If the

“Withheld” as the contributor's name. If filing electronically,

organization is not required to file Schedule B, enter zero.

enter the organization's address, the date of the report, and

Schedule A—Itemized Contributions

“N/A” for occupation and employer. This amount is subject to

the penalty for the failure to provide all the information

Note. Multiple Schedules A can be filed with any report.

required. See Penalty for details, earlier.

Number each schedule in the box in the top right corner of

Schedule B—Itemized Expenditures

the schedule. Be sure to include both the number of the

specific page and the total number of Schedules A (for

Note. Multiple Schedules B can be filed with any report.

example, "Schedule A, page 2 of 5").

Number each schedule in the box in the top right corner of

The organization must list on Schedule A each contributor

the schedule. Be sure to include both the number of the

from whom it accepted contributions during the calendar year

specific page and the total number of Schedules B (for

if:

example, "Schedule B, page 2 of 10").

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Instructions For Form 8872 - Political Organization Report Of Contributions And Expenditures Page 3

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