Form 990 - Schedule Of Contributors Template

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Schedule B
Schedule of Contributors
OMB No. 1545-0047
(Form 990, 990-EZ,
or 990-PF)
Supplementary Information for
2005
line 1 of Form 990, 990-EZ, and 990-PF (see instructions)
Department of the Treasury
Internal Revenue Service
Name of organization
Employer identification number
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ
501(c)(
) (enter number) organization
4947(a)(1) nonexempt charitable trust not treated as a private foundation
527 political organization
501(c)(3) exempt private foundation
Form 990-PF
4947(a)(1) nonexempt charitable trust treated as a private foundation
501(c)(3) taxable private foundation
Check if your organization is covered by the General Rule or a Special Rule. (Note: Only a section 501(c)(7), (8), or (10)
organization can check boxes for both the General Rule and a Special Rule—see instructions.)
General Rule—
For organizations filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. (Complete Parts I and II.)
Special Rules—
For a section 501(c)(3) organization filing Form 990, or Form 990-EZ, that met the 33
1
% support test under Regulations
3
sections 1.509(a)-3/1.170A-9(e) and received from any one contributor, during the year, a contribution of the greater of
$5,000 or 2% of the amount on line 1 of these forms. (Complete Parts I and II.)
For a section 501(c)(7), (8), or (10) organization filing Form 990, or Form 990-EZ, that received from any one contributor,
during the year, aggregate contributions or bequests of more than $1,000 for use exclusively for religious, charitable,
scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. (Complete Parts I, II, and
III.)
For a section 501(c)(7), (8), or (10) organization filing Form 990, or Form 990-EZ, that received from any one contributor,
during the year, some contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not aggregate to more than $1,000. (If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the Parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year.)
$
Caution: Organizations that are not covered by the General Rule and/or the Special Rules do not file Schedule B (Form 990,
990-EZ, or 990-PF), but they must check the box in the heading of their Form 990, Form 990-EZ, or on line 2 of their Form
990-PF, to certify that they do not meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
Cat. No. 30613X
Schedule B (Form 990, 990-EZ, or 990-PF) (2005)
for Form 990, Form 990-EZ, and Form 990-PF.

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