Form 199 - California Exempt Organization Annual Information Return - 2007

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California Exempt Organization
TAXABLE YEAR
FORM
199
2007
Annual Information Return
For calendar year 2007 or fiscal year beginning month _______ day _______ year _______, and ending month _______ day _______ year _______ .
A Final return? Check applicable box.    
Yes
No
IMPORTANT: Your number is required.
 
Dissolved
Withdrawn
Merged/Reorganized (attach explanation)
California corporation number
Federal employer identification number (FEIN)
-
___________________________
If a box is checked, enter date
B Check forms filed this year: State:
  109
  100
100S
100W
Corporation/Organization name
Federal:
990
990EZ
990T
990PF
1041
1120H
1120
C If organization is exempt under R&TC Section 23701d and is a school, public
charity, religious organization, or is controlled by a religious operation,
check box. See General Instruction F. No filing fee is required.
Address (including suite, room, or PMB no.)
D Is this a group filing? See General Instruction N . . . . . . . . . . . .
  Yes
  No
E Accounting method used ______________________________________________
City
State
ZIP Code
F Type of organization
  Exempt under Section 23701 ____ (insert letter)
  IRC Section 4947(a)(1) trust
Part I Complete Part I unless not required to file this form. See General Instructions B and C.
00
 Gross sales or receipts from other sources. From Side 2, Part II, line 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2 Gross dues and assessments from members and affiliates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
00
Receipts
00
3 Gross contributions, gifts, grants, and similar amounts received. See instructions . . . . . . . . . . . . . . . . . . . . . .
3
and
4 Total gross receipts for filing requirement test. Add line 1 through line 3.
Revenues
00
This line must be completed. If the result is less than $25,000, see General Instruction C. . . . . . . . . . . . . . . .
4
(Enclose, but
00
5 Cost of goods sold . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
do not staple,
6 Cost or other basis, and sales expenses of assets sold . . . . . . . . . . . . . . . . . . . .
6
00
any payment.)
00
7 Total costs. Add line 5 and line 6. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
8 Total gross income. Subtract line 7 from line 4. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8
00
00
9 Total expenses and disbursements. From Side 2, Part II, line 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9
Expenses
00
0 Excess of receipts over expenses and disbursements. Subtract line 9 from line 8 . . . . . . . . . . . . . . . . . . . . . . . . .
0
00
 Filing fee $10 or $25. See General Instruction F . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

00
2 Penalty for failure to file on time. See General Instruction L . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
Filing
Fee
3 Use tax. See “General Instruction M” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
00
00
4 Balance due. Add line 11, line 12, and line 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4
5 If exempt under R&TC Section 23701d, has the organization during the year: (1) participated in any political campaign or
(2) attempted to influence legislation or any ballot measure, or (3) made an election under R&TC Section 23704.5 (relating to lobbying
by public charities)? If “Yes,” complete and attach form FTB 3509, Political or Legislative Activities by Section 23701d Organizations. . . . . .
Yes
No
6 Did the organization have any changes in its activities, governing instrument, articles of incorporation, or bylaws that have not
been reported to the Franchise Tax Board? If “Yes,” complete an explanation and attach copies of revised documents . . . . . . . . . . . . . . . . . .
Yes
No
7 Is the organization exempt under R&TC Section 23701g?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
If “Yes,” enter amount of gross receipts from nonmember sources $________________________________________________
8 Did the organization file Form 100, Form 100S, Form 100W, or Form 109 to report taxable income?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
If “Yes,” enter amount of total income reported $________________________________________
9 The financial records are in care of ________________________________________________________ Daytime telephone (____)___________________
located at ____________________________________________________________________________________________________________________
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 preparer has any knowledge.
Please
Sign
(
)
Here
Signature of officer
Date
Title
Daytime telephone
Paid
Date
Paid preparer’s SSN or PTIN
Check if
Preparer’s
self-employed
signature
Paid
Preparer’s
FEIN
-
Use Only
Firm’s name (or yours, if
self-employed) and address
Daytime telephone (
)
3651073
Form 199
2007 Side 
C1
For Privacy Notice, get form FTB 1131.

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