Fillable Form Ct-12 - Charitable Activities Section

The organization may provide an attachment to

“Fair market value” is the amount a reasonable

Who Keeps the Books?

explain the entire compensation package for any

person would pay for the item at the time it was

person listed in this part, including whether the

donated to the organization.

Indicate the person to be contacted if the

compensation includes the payment of amounts

organization's books need to be accessed for

Important Note—Do not include the value of

previously deferred.

information or review. Either a business or

services donated to the organization, or items

personal phone number and mailing address are

such as the free use of materials, equipment, or

Section II.

acceptable.

facilities in reporting Total Revenue.

Important Note—If Total Revenue is zero,

Officers, Directors,

Total Revenue

attach an explanation of why Total Revenue is

Trustees, and Other Key

zero and indicate whether the organization plans

The Charitable Activities Section has adopted

Employees

to continue operations. See the instructions for

the definition for “Total Revenue” used by the

line 6 if this is the organization’s final report.

List each person who was an officer, director,

Internal Revenue Service. If the organization

trustee, or key employee (defined below) of the

completed one of the following IRS Forms for

10.

organization at any time during the year even if

this reporting period, the Total Revenue figure

Revenue Fee

they are a volunteer and do not receive any

should come from the line number listed:

•

compensation from the organization. Give the

Use the Total Revenue figure from line 9 to

IRS Form 990, Part I, line 12 (current

daytime phone number and preferred mailing

calculate the revenue fee according to the

year)

•

address at which officers, etc., want the

following schedule.

IRS Form 990-EZ, Part I, line 9

•

Charitable Activities Section to contact them.

IRS Form 990-PF, Part I, line 12a

Use an attachment if there are more persons to

•

Revenue Fee Schedule

IRS Form 1041, line 9

list than there are lines available.

Amount on Line 9

Revenue Fee

If the organization was not required to complete

$ 24,999

$ 20

A failure to fully complete this part can subject

one of these IRS Forms, or filed an IRS Form

25,000

49,999

the organization to penalties for filing an

990-N, a summary of what constitutes Total

50,000

99,999

incomplete Form.

100,000

249,999

150

Revenue is provided within these instructions. A

250,000

499,999

200

more detailed definition can be found in the IRS

If the organization is an Oregon public benefit

500,000

1,000,000

300

instructions for the forms listed above.

corporation, it must have a minimum of three

1,000,000

400

individuals serving on its board of directors.

“Total Revenue” includes such items as:

The maximum amount subject to a revenue fee is

•

contributions

$1,000,000. The maximum revenue fee is $400.

A "key employee" is any person having

•

gifts

The minimum revenue fee is $20, even if total

responsibilities or powers similar to those of

•

grants

revenue is zero or a negative amount.

officers, directors, or trustees. The term includes

•

donated real property

the

chief

management

and

administrative

•

donated thrift items

officials of an organization (such as executive

11.

•

Net Assets or Fund

membership dues & assessments

director) but does not include the heads of

•

separate departments or smaller units within an

program service revenue

Balances at the End of the

•

organization.

government fees & contracts

Reporting Period

•

interest income

•

A chief financial officer and the officer in charge

The Charitable Activities Section has adopted

dividend income

•

of administration or program operations are both

the definitions for “Net Assets” and “Fund

net rental gain or loss as determined by

key employees if they have the authority to

Balances” used by the Internal Revenue Service.

gross rental income less rental expense

control the organization's activities, it's finances,

•

If the organization completed one of the

other investment income

or both. The "heads of separate departments"

•

following IRS forms for this reporting period,

gain or loss on sales of assets other than

reference applies to persons such as the head of

the Net Assets or Fund Balances figure should

inventory as calculated by gross sale

the radiology department or coronary care unit

come from the line number listed:

price less cost or other basis

•

of a hospital or the head of the chemistry or

•

IRS Form 990, Part I, line 22 (end of

gain or loss from special events &

history or English department at a college. These

year)

activities which may include bingo

•

persons are managers within their specific areas

IRS Form 990-EZ, Part I, line 21

games, raffle events, Monte Carlo events,

•

but not for the organization as a whole and,

IRS Form 990-PF, Part III, line 6,

dinners, and door-to-door sales of

therefore, are not key employees.

merchandise as calculated by gross

If the organization was not required to complete

proceeds minus direct expenses

Column (C)

•

one of these IRS forms, or filed an IRS Form

gain or loss on sale of inventory as

If an IRS form is attached that includes complete

900-N, a summary of what constitutes Net

calculated by sales price less returns &

and accurate compensation information the

Assets or Fund Balances is provided within these

allowances and the cost of goods sold

phrase “See IRS Form” may be entered in lieu of

•

instructions. A more detailed definition can be

all other sources of revenue.

completing this section.

•

found in the IRS instructions for the forms listed

include amounts obtained from both

above.

Oregon and out of state sources.

Otherwise, for each person listed, report the total

amount of compensation paid or deferred for

Net Assets and Fund Balances refer to the

To report contributions received in a form other

payment to a later date, including salary, fees,

organization’s assets minus liabilities.

than cash, use the market value as of the date of

bonuses,

benefits,

taxable

allowances

the contribution. When market value cannot be

reimbursements,

the

value

noncash

“Assets” are items of value to the organization,

readily

determined,

use an appraised

compensation, and severance payments.

such as cash, receivables less any allowance for

estimated value.

doubtful accounts, inventory, prepaid expenses,

Enter a zero in column (C) if the person was a

investments, land, buildings & equipment less

To determine the amount of any noncash

volunteer and was not paid or did not accrue any

any accumulated depreciation if the organization

contribution that is subject to an outstanding

compensation during the reporting year.

records depreciation.

debt, subtract the debt from the property’s fair

market value in assigning a value to the revenue

received.

Form Ct-12 - Charitable Activities Section - 2016 Page 5

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