Form 199 - California Exempt Organization Annual Information Return - 2008

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California Exempt Organization
TAXABLE YEAR
FORM
199
2008
Annual Information Return
Calendar Year 2008 or fiscal year beginning month _______ day _______ year _______, and ending month _______ day _______ year _______ .
B Type of organization
A First Return Filed?
CORP #
Yes
Exempt under Section 23701 ____ (insert letter)
No
IRC Section 4947(a)(1) trust
Corporation/Organization Name
FEIN
-
Address
City
State
ZIP Code
 
C Amended Return? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
H Accounting method used (1)
Cash (2)
Accrual (3)
Other
D Are you a subordinate/affiliate in a group exemption? . . . . . . . . . . . . . . . . . . .
Yes
No
If exempt under R&TC Section 23701d, has the organization during the year: (1) participated
I
 
(a) Is this a group filing for affiliates? See General Instruction L . . . . . . .
Yes
No
in any political campaign or (2) attempted to influence legislation or any ballot measure, or
(b) If “Yes,” enter the number of affiliates . . . . . . . . . . . . . . . . . . . . . . . . . . . ____________
(3) made an election under R&TC Section 23704.5 (relating to lobbying by public charities)?
(c) Are all affiliates included? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
If “Yes,” complete and attach form FTB 3509, Political or Legislative Activities by Section
 
(If “No,” attach a list. See instructions.)
23701d Organizations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
  Yes
  No
(d) Is this a separate return filed by an organization covered by a
J Did the organization have any changes in its activities, governing instrument, articles of
group ruling? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
incorporation, or bylaws that have not been reported to the Franchise Tax Board? If “Yes,”
 
(e) Federal Group Exemption Number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ____________
complete an explanation and attach copies of revised documents . . . . . . .
  Yes
  No
 
(f) Is a roster of subordinates attached? . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
K Is the organization exempt under R&TC Section 23701g? . . . . . . . . . . . . .
  Yes
  No
E Final return?
If “Yes,” enter amount of gross receipts from nonmember sources $____________________
 
 
Dissolved
Surrendered (Withdrawn)
L Is the organization under audit by the IRS or has the IRS audited in
 
 
Merged/Reorganized (attach explanation)
a prior year? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
  Yes
  No
___________________________
 
If a box is checked, enter date
M Is the organization a Limited Liability Company? . . . . . . . . . . . . . . . . . . . .
  Yes
  No
 
 
 
F Check the box if the organization filed: (1)
990T (2)
990PF (3)
990H
N Did the organization file Form 100 or Form 109 to report taxable
 
G If organization is exempt under R&TC Section 23701d and is exclusively religious,
income? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
  Yes
  No
educational, or charitable, and is supported primarily (50% or more) by public contributions,
 
check box. See General Instruction F. No filing fee is required. . . . . . . . . .
Part I Complete Part I unless not required to file this form. See General Instructions B and C.
00
1 Gross sales or receipts from other sources. From Side 2, Part II, line 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
00
2 Gross dues and assessments from members and affiliates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
Receipts
3 Gross contributions, gifts, grants, and similar amounts received. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
00
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
5 Cost of goods sold . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
00
00
6 Cost or other basis, and sales expenses of assets sold . . . . . . . . . . . . . . . . . . . .
6
00
7 Total costs. Add line 5 and line 6. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
00
8 Total gross income. Subtract line 7 from line 4. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8
00
9 Total expenses and disbursements. From Side 2, Part II, line 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9
Expenses
00
10 Excess of receipts over expenses and disbursements. Subtract line 9 from line 8 . . . . . . . . . . . . . . . . . . . . . . . . .
10
00
11 Filing fee $10 or $25. See General Instruction F . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11
12 Total payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12
00
Filing
00
Fee
13 Penalties and Interest. See General Instruction J . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13
00
14 Use tax. See General Instruction K . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14
15 Balance due. Add line 11, line 13, and line 14. Then subtract line 12 from the result . . . . . . . . . . . . . . . . . . . . . .
15
00
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
Sign
true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Here
Title
Date
Telephone
Signature
of officer
(
)
Date
Preparer’s SSN/PTIN
Check if self-
Preparer’s
Paid
signature
employed 
Preparer’s
FEIN
-
Use Only
Firm’s name (or yours,
if self-employed)
Telephone
and address
(
)
May the FTB discuss this return with the preparer shown above? See instructions . . . . . . . . . . . . . . . . . .
 Yes  No
3651083
Form 199
2008 Side 1
C1
For Privacy Notice, get form FTB 1131.

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