Form 8879-Eo - Irs E-File Signature Authorization For An Exempt Organization Sample - 2015 Page 2
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41EXTENDED TO NOVEMBER 15, 2016
990
OMB No. 1545-0047
Return of Organization Exempt From Income Tax
2015
Form
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
| Do not enter social security numbers on this form as it may be made public.
Open to Public
Department of the Treasury
Inspection
Internal Revenue Service
| Information about Form 990 and its instructions is at
A For the 2015 calendar year, or tax year beginning
and ending
B
C
Name of organization
D Employer identification number
Check if
applicable:
CANCER SUPPORT COMMUNITY MONTANA
Address
change
81-0542266
Name
Doing business as
change
Initial
(or P.O. box if mail is not delivered to street address)
Room/suite
Number and street
E
Telephone number
return
102 S 11TH AVE
406-582-1600
Final
return/
471,067.
termin-
City or town, state or province, country, and ZIP or foreign postal code
G
Gross receipts $
ated
BOZEMAN, MT
59715
Amended
H(a)
Is this a group return
return
DICK WALTER
X
Applica-
F
Name and address of principal officer:
for subordinates?
~~
Yes
No
tion
pending
102 S 11TH AVE, BOZEMAN, MT
59715
H(b)
Yes
No
Are all subordinates included?
X
§
501(c)(3)
501(c) (
)
(insert no.)
4947(a)(1) or
527
I
Tax-exempt status:
If "No," attach a list. (see instructions)
J
Website: |
H(c)
Group exemption number |
X
2001
MT
Corporation
Trust
Association
Other
|
Form of organization:
Year of formation:
State of legal domicile:
K
L
M
Part I Summary
OUR MISSION IS TO ENSURE THAT
1
Briefly describe the organization's mission or most significant activities:
ALL PEOPLE IMPACTED BY CANCER ARE EMPOWERED BY KNOWLEDGE,
|
2
Check this box
if the organization discontinued its operations or disposed of more than 25% of its net assets.
13
3
Number of voting members of the governing body (Part VI, line 1a)
~~~~~~~~~~~~~~~~~~~~
3
13
4
Number of independent voting members of the governing body (Part VI, line 1b)
~~~~~~~~~~~~~~
4
9
5
Total number of individuals employed in calendar year 2015 (Part V, line 2a)
~~~~~~~~~~~~~~~~
5
62
6
Total number of volunteers (estimate if necessary)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6
-621.
7
a
Total unrelated business revenue from Part VIII, column (C), line 12
~~~~~~~~~~~~~~~~~~~~
7a
-620.
b
Net unrelated business taxable income from Form 990-T, line 34
••••••••••••••••••••••
7b
Prior Year
Current Year
357,403.
314,891.
8
Contributions and grants (Part VIII, line 1h) ~~~~~~~~~~~~~~~~~~~~~
5,000.
0.
9
Program service revenue (Part VIII, line 2g) ~~~~~~~~~~~~~~~~~~~~~
1,747.
353.
10
Investment income (Part VIII, column (A), lines 3, 4, and 7d)
~~~~~~~~~~~~~
99,922.
119,746.
11
Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) ~~~~~~~~
464,072.
434,990.
12
Total revenue - add lines 8 through 11 (must equal Part VIII, column (A), line 12) •••
0.
0.
13
Grants and similar amounts paid (Part IX, column (A), lines 1-3)
~~~~~~~~~~~
0.
0.
14
Benefits paid to or for members (Part IX, column (A), line 4)
~~~~~~~~~~~~~
197,716.
219,235.
15
Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10)
~~~
0.
0.
16
a
Professional fundraising fees (Part IX, column (A), line 11e)
~~~~~~~~~~~~~~
14,912.
|
b
Total fundraising expenses (Part IX, column (D), line 25)
163,777.
180,900.
17
Other expenses (Part IX, column (A), lines 11a-11d, 11f-24e)
~~~~~~~~~~~~~
361,493.
400,135.
18
Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25)
~~~~~~~
102,579.
34,855.
19
Revenue less expenses. Subtract line 18 from line 12
••••••••••••••••
Beginning of Current Year
End of Year
1,313,892.
1,345,569.
20
Total assets (Part X, line 16)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~
427.
238.
21
Total liabilities (Part X, line 26)
~~~~~~~~~~~~~~~~~~~~~~~~~~~
1,313,465.
1,345,331.
22
••••••••••••••
Net assets or fund balances. Subtract line 21 from line 20
Part II
Signature Block
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
true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
=
Signature of officer
Date
Sign
=
DICK WALTER, TREASURER
Here
Type or print name and title
Date
PTIN
Print/Type preparer's name
Preparer's signature
Check
WILLIAM G. MILLS
WILLIAM G. MILLS
09/19/16
if
P00366517
9
9
Paid
self-employed
ANDERSON ZURMUEHLEN & CO., P.C.
81-0385940
9
Preparer
Firm's name
Firm's EIN
1019 EAST MAIN, STE 201
Use Only
Firm's address
BOZEMAN, MT 59715
406-556-6160
Phone no.
X
May the IRS discuss this return with the preparer shown above? (see instructions) •••••••••••••••••••••
Yes
No
990
LHA
For Paperwork Reduction Act Notice, see the separate instructions.
Form
(2015)
532001 12-16-15
SEE SCHEDULE O FOR ORGANIZATION MISSION STATEMENT CONTINUATION
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