Liquidation, Termination, Dissolution, or Significant Disposition of Assets
OMB No. 1545-0047
SCHEDULE N
2017
Complete if the organization answered "Yes" on Form 990, Part IV, lines 31 or 32; or Form 990-EZ, line 36.
▶
(Form 990 or 990-EZ)
Attach certified copies of any articles of dissolution, resolutions, or plans.
▶
Open to Public
Attach to Form 990 or 990-EZ.
▶
Department of the Treasury
Go to for the latest information.
Inspection
Internal Revenue Service
▶
Name of the organization
Employer identification number
Part I
Liquidation, Termination, or Dissolution. Complete this part if the organization answered “Yes” on Form 990, Part IV, line 31, or Form 990-EZ, line 36.
Part I can be duplicated if additional space is needed.
1
(a) Description of asset(s)
(b) Date of
(c) Fair market value of
(d) Method of
(e) EIN of recipient
(f) Name and address of recipient
(g) IRC section of
distributed or transaction
distribution
asset(s) distributed or
determining FMV for
recipient(s) (if
expenses paid
amount of transaction
asset(s) distributed or
tax-exempt) or type
expenses
transaction expenses
of entity
Yes No
2
Did or will any officer, director, trustee, or key employee of the organization:
a Become a director or trustee of a successor or transferee organization? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
2a
b Become an employee of, or independent contractor for, a successor or transferee organization? .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
2b
c Become a direct or indirect owner of a successor or transferee organization?
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
2c
d Receive, or become entitled to, compensation or other similar payments as a result of the organization’s liquidation, termination, or dissolution? .
2d
.
.
e If the organization answered “Yes” to any of the questions on lines 2a through 2d, provide the name of the person involved and explain in Part III.
▶
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or Form 990-EZ.
Cat. No. 50087Z
Schedule N (Form 990 or 990-EZ) 2017