Form 109 - California Exempt Organization Business Income Tax Return - 2004 Page 2

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Unrelated Business Taxable Income

Part I

Unrelated Trade or Business Income

1 a Gross receipts or gross sales______________ b Less returns and allowances______________ Balance . . . . . .

2 Cost of goods sold and/or operations from Schedule A, line 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3 Gross profit. Subtract line 2 from line 1c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4 a Capital gain net income. See Specific Line Instructions – Trusts attach Schedule D (541) . . . . . . . . . . . . . . . . . . . .

b Net gain (loss) from Part II, Schedule D-1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c Capital loss deduction for trusts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5 Income (or loss) from partnerships, limited liability companies, or S corporations. See specific line instructions.

Attach Schedule K-1 (565, 568, or 100S) or similar schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6 Rental income from Schedule C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7 Unrelated debt-financed income from Schedule D . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

8 Investment income of an R&TC Section 23701g, 23701i, or 23701n organization from Schedule E . . . . . . . . . . . . . . .

9 Annuities, interest, rents, and royalties of controlled organizations from Schedule F . . . . . . . . . . . . . . . . . . . . . . . . . . .

10 Exploited exempt activity income from Schedule G . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11 Advertising income from Schedule H, Part III, Column A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12 Other income. Attach schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

13 Total unrelated trade or business income. Add line 3 through line 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Part II Deductions Not Taken Elsewhere (Except for contributions, deductions must be directly connected with the unrelated business income.)

14 Compensation of officers, directors, and trustees from Schedule I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

15 Salaries and wages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

16 Repairs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

17 Bad debts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18 Interest. Attach schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

19 Taxes. Attach schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5

20 Contributions. See instructions and attach schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5

21 a Depreciation

)

21a

(Corporations and Associations – Schedule J) (Trusts – form FTB 3885F

1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5

b Less: depreciation claimed on Schedule A . . . . . . . . . . . . . . . . . . . . . . . . . . . .

21b

22 Depletion. Attach schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

23 a Contributions to deferred compensation plans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

23a

b Employee benefit programs. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

23b

24 Other deductions. Attach schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25 Total deductions. Add line 14 through line 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

26 Unrelated business taxable income before allowable excess advertising costs. Subtract line 25 from line 13 . . . . . . . .

27 Excess advertising costs from Schedule H, Part III, Column B . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

28 Unrelated business taxable income before specific deduction. Subtract line 27 from line 26 . . . . . . . . . . . . . . . . . . . . .

29 Specific deduction. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

30 Unrelated business taxable income. Subtract line 29 from line 28. If line 28 is a loss, enter line 28 . . . . . . . . . . . . . . . .

Schedule A Cost of Goods Sold and/or Operations Method of inventory valuation (specify) _______________________________________________

1 Inventory at beginning of year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2 Purchases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3 Cost of labor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4 a Additional IRC Section 263A costs. Attach schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

b Other costs. Attach schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5 Total. Add line 1 through line 4b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6 Inventory at end of year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7 Cost of goods sold and/or operations. Subtract line 6 from line 5. Enter here and on Part I, line 2 . . . . . . . . . . . . . . . .

Do the rules of IRC Section 263A (with respect to property produced or acquired for resale) apply to this organization?

Yes

Schedule B Tax Credits Do not complete if you must file Schedule P (100 or 541).

1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5

1 Enter credit name__________________________code no.__________ . . . . .

1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5

2 Enter credit name__________________________code no.__________ . . . . .

1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5

3 Enter credit name__________________________code no.__________ . . . . .

1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5

4 Enter credit name__________________________code no.__________ . . . . .

1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5

5 Enter credit name__________________________code no.__________ . . . . .

1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5

6 Enter credit name__________________________code no.__________ . . . . .

7 Total. Add line 1 through line 6. Enter here and on Side 1, line 8, for corporations and associations,

or line 16 for trusts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Side 2 Form 109

2004

10904203