Form 8879-Eo - Irs E-File Signature Authorization For An Exempt Organization Sample - 2015 Page 23
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Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Page
Name of organization
Employer identification number
COLLATERAL REPAIR PROJECT
20-4928141
Part I
Contributors
(see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
(b)
(c)
(d)
No.
Name, address, and ZIP + 4
Total contributions
Type of contribution
1
DINING FOR WOMEN
X
†
Person
†
Payroll
PO BOX 25633
37058.
†
Noncash
$
(Complete Part II for
GREENVILLE, SC 29616
noncash contributions.)
(a)
(b)
(c)
(d)
No.
Name, address, and ZIP + 4
Total contributions
Type of contribution
2
DUTCH EMBASSY
X
†
Person
†
Payroll
FEZ-KT-TR POSTBUS 20061 2500 EB
26980.
†
Noncash
$
(Complete Part II for
THE HAGUE, NETHERLANDS
noncash contributions.)
(a)
(b)
(c)
(d)
No.
Name, address, and ZIP + 4
Total contributions
Type of contribution
3
ZIMMER FAMILY FOUNDATION
X
†
Person
†
Payroll
501 SILVERSIDE ROAD, SUITE 123
12000.
†
Noncash
$
(Complete Part II for
WILMINGTON, DE 19809
noncash contributions.)
(a)
(b)
(c)
(d)
No.
Name, address, and ZIP + 4
Total contributions
Type of contribution
4
SALAAM CULTURAL MUSEUM
†
Person
†
Payroll
3806 WHITMAN AVE N.
9847.
X
†
Noncash
$
(Complete Part II for
SEATTLE, WA 98103
noncash contributions.)
(a)
(b)
(c)
(d)
No.
Name, address, and ZIP + 4
Total contributions
Type of contribution
†
Person
†
Payroll
†
Noncash
$
(Complete Part II for
noncash contributions.)
(a)
(b)
(c)
(d)
No.
Name, address, and ZIP + 4
Total contributions
Type of contribution
†
Person
†
Payroll
†
Noncash
$
(Complete Part II for
noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
523452 10-26-15
22
12030810 758338 41096
2015.04010 COLLATERAL REPAIR PROJECT
41096__1
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