Form 109 - California Exempt Organization Business Income Tax Return - 2011 Page 3

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

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

Purchases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

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

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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 Side 2, 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  No

Schedule B Tax Credits. Do not claim the New Jobs Credit on Schedule B.

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

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

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

Total. Add line 1 through line 3. If claiming more than 3 credits, enter the total of all claimed credits,

except New Jobs Credit, on line 4. Enter here and on Side 1, line 11c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Schedule K Add-On Taxes or Recapture of Tax. See instructions.

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Interest computation under the look-back method for completed long-term contracts. Attach form FTB 3834 . . . . . . . .

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Interest on tax attributable to installment: a Sales of certain timeshares or residential lots. . . . . . . . . . . . . . . . . . . . .

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b Method for non-dealer installment obligations . . . . . . . . . . . . . . . . . . . .

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IRC Section 197(f)(9)(B)(ii) election to recognize gain on the disposition of intangibles. . . . . . . . . . . . . . . . . . . . . . . . .

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Credit recapture. Credit name___________________________________________. . . . . . . . . . . . . . . . . . . . . . . . . . .

Total. Combine the amounts on line 1 through line 4. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Schedule R Apportionment Formula Worksheet

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Is this organization electing the Alternate Method – Single-Sales Factor Formula? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

 Yes  No

If “Yes,” skip Part A and complete Part B. If “No,” complete Part A and skip Part B.

Part A. Standard Method – Three Factor Formula. Complete this part only if the corporation uses the three-factor formula. (The three-factor formula includes

the double-weighted sales factor.)

Use only for unrelated trade or business amounts

(a) Total within and

(b) Total within California

outside California

California (b) ÷ (a)

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Property factor: See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Payroll factor: Wages and other compensation of employees . . . . . . . . . . . . . . . . . . . . . . .

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Sales factor: Gross sales and/or receipts less returns and allowances . . . . . . . . . . . . . . . .

Multiply the factor on line 3, column (c) by 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total percentage: Add the percentages in column (c), line 1, line 2, and line 4. . . . . . . . . .

Average apportionment percentage: Divide the factor on line 5 by 4 and enter the

result here and on Form 109, Side 1, line 2. See instructions for exceptions. . . . . . . . . . . .

Part B. Alternate Method – Single-Sales Factor Formula. Complete this part only if the corporation elects the single-sales factor formula.

This is an irrevocable annual election.

Use only for unrelated trade or business amounts

(a) Total within and

(b) Total within California

outside California

California (b) ÷ (a)

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Total Sales. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Apportionment percentage. Divide total sales column (b) by total sales column (a) and

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enter the result here and on Form 109, Side 1, line 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Schedule C Rental Income from Real Property and Personal Property Leased with Real Property

For rental income from debt-financed property, use Schedule D, R&TC Section 23701g, Section 23701i, and Section 23701n organizations. See instructions for exceptions.

1 Description of property

Rent received

3 Percentage of rent attributable

or accrued

to personal property

Complete if any item in column 3 is more than 50%, or for any item

5 Complete if any item in column 3 is more than 10%, but not more than 50%

if the rent is determined on the basis of profit or income

(a) Deductions directly connected

(b) Income includible, column 2

(a) Gross income reportable,

(b) Deductions directly connected with

(attach schedule)

less column 4(a)

column 2 x column 3

personal property (attach schedule)

less column 5(b)

Add columns 4(b) and column 5(c). Enter here and on Side 2, Part I, line 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Form 109

2011 Side 3

3643113