Form 8879-Eo - Irs E-File Signature Authorization For An Exempt Organization Sample - 2015 Page 14
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41SCHEDULE A
OMB No. 1545-0047
Public Charity Status and Public Support
2015
(Form 990 or 990-EZ)
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Open to Public
| Attach to Form 990 or Form 990-EZ.
Department of the Treasury
Inspection
Internal Revenue Service
|
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at
Name of the organization
Employer identification number
CANCER SUPPORT COMMUNITY MONTANA
81-0542266
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
A church, convention of churches, or association of churches described in
section 170(b)(1)(A)(i).
2
A school described in
section 170(b)(1)(A)(ii).
(Attach Schedule E (Form 990 or 990-EZ).)
3
A hospital or a cooperative hospital service organization described in
section 170(b)(1)(A)(iii).
A medical research organization operated in conjunction with a hospital described in
section 170(b)(1)(A)(iii).
Enter the hospital's name,
4
city, and state:
An organization operated for the benefit of a college or university owned or operated by a governmental unit described in
5
section 170(b)(1)(A)(iv).
(Complete Part II.)
6
A federal, state, or local government or governmental unit described in
section 170(b)(1)(A)(v).
X
7
An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in
section 170(b)(1)(A)(vi).
(Complete Part II.)
8
A community trust described in
section 170(b)(1)(A)(vi).
(Complete Part II.)
9
An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from
activities related to its exempt functions - subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment
income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975.
See
section 509(a)(2).
(Complete Part III.)
10
An organization organized and operated exclusively to test for public safety. See
section 509(a)(4).
11
An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or
more publicly supported organizations described in
section 509(a)(1)
or
section 509(a)(2)
. See
section 509(a)(3).
Check the box in
lines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.
a
Type I.
A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving
the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting
organization.
You must complete Part IV, Sections A and B.
b
Type II.
A supporting organization supervised or controlled in connection with its supported organization(s), by having
control or management of the supporting organization vested in the same persons that control or manage the supported
organization(s).
You must complete Part IV, Sections A and C.
c
Type III functionally integrated.
A supporting organization operated in connection with, and functionally integrated with,
its supported organization(s) (see instructions).
You must complete Part IV, Sections A, D, and E.
d
Type III non-functionally integrated.
A supporting organization operated in connection with its supported organization(s)
that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness
requirement (see instructions).
You must complete Part IV, Sections A and D, and Part V.
e
Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III
functionally integrated, or Type III non-functionally integrated supporting organization.
f
Enter the number of supported organizations ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
g
Provide the following information about the supported organization(s).
(i)
Name of supported
(ii)
EIN
(iii)
Type of organization
(iv)
Is the organization
(v)
Amount of monetary
(vi)
Amount of
listed in your
(described on lines 1-9
organization
support (see
other support (see
governing document?
above (see instructions))
instructions)
instructions)
Yes
No
Total
LHA
For Paperwork Reduction Act Notice, see the Instructions for
Schedule A (Form 990 or 990-EZ) 2015
Form 990 or 990-EZ.
532021 09-23-15
13
13340919 792194 141677
2015.04020 CANCER SUPPORT COMMUNITY MO 141677_1
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