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tax year. If the organization needs more

formed to administer charitable gaming,

management of the gaming operation.

space, use Part IV.

check “Yes.” For purposes of this

Generally, this person has responsibilities

question, “a partnership or other entity”

that can include recordkeeping, money

Line 9a. Check “Yes” only if the

means two or more organizations that are

counting, hiring and firing of workers, and

organization is licensed or otherwise

authorized under state law to conduct

making the bank deposits for the gaming

registered to operate gaming in each

bingo or other gaming at the same

operation. If the gaming manager is a

state listed on line 9.

location joining together to account for or

director, officer, or employee of the

Line 9b. If the organization is not licensed

share revenues, authorized expenses,

organization, report only the portion of that

or otherwise registered to operate gaming

and inventory related to bingo and gaming

person's compensation that is allocable to

in any state listed on line 9, explain in the

operations.

gaming management. If more than one

space provided. If the organization needs

person shares this responsibility, report

Line 13a. Enter the percentage of

more space, use Part IV.

the additional person(s) in Part IV.

gaming conducted during the tax year in

Line 10a. Check “Yes” if any of the

a facility or facilities owned by the

Line 17a. Some states require that

organization's gaming licenses were

organization. The facility or facilities need

charitable organizations make mandatory

revoked, suspended, or terminated during

not have been used exclusively for

distributions from gaming proceeds to

the tax year.

gaming.

obtain and retain a valid gaming license.

Check “Yes” or “No” to indicate whether

Line 10b. Provide an explanation for

Line 13b. Enter the percentage of

the organization is required to make

each state in which the organization's

gaming conducted during the year in a

mandatory distributions from its gaming

gaming license or registration was

facility or facilities not owned by the

proceeds to retain its gaming license or

revoked, suspended, or terminated during

organization.

registration in any state.

the tax year. If the organization needs

Line 14. Enter the person's name and

more space, use Part IV.

Line 17b. For all states in which the

business address (or the organization's

organization operated gaming, enter the

Line 11. If any nonmembers participated

business address if the books and records

aggregate amount of distributions required

in gaming conducted by the organization

are kept by such person at a personal

under state law to be distributed to other

during the tax year, check “Yes.”

residence). The organization is not

exempt organizations or spent in the

Membership is determined in accordance

required to provide the address of a

organization's own exempt activities

with the organization's organizing

personal residence of an individual.

during the tax year. Provide a breakdown

documents and applicable law. For

Line 15a. An organization can pay its

of required distributions, by each state, in

purposes of this question, bona fide

own employees to operate gaming, or

Part IV.

guests of members attending with them

contract with a third party for such

For more information, see Pub. 3079,

should also be treated as members. “Bona

services. Check “Yes” or “No” to indicate

Tax-Exempt Organizations and Gaming.

fide guests” are individuals whom the

whether the organization has a contract

member invites and for whom the member

with a third party from which it receives

Part IV. Supplemental

pays. If, for example, a nonmember pays

gaming revenue.

Information

for his or her own wagers in gaming

activities, he or she is considered a

Line 15b. If the organization checked

Use Part IV to provide the narrative

nonmember, even though he or she may

“Yes” to line 15a, enter the gaming

explanations required, if applicable, to

have entered the organization’s premises

revenue amount received by the

supplement responses to Part I, line 2b,

with a member. Also, if an organization

organization and the gaming revenue

columns (iii) and (v), and Part III, lines 9,

requires only a nominal payment to join as

amount retained by the third party. If there

9b, 10b, 15b, 15c, 16, and 17b. Part IV

a “member,” individuals making such a

is more than one third-party operator,

may also be used to supplement other

payment to gain admission to the

report the additional operator(s) in Part IV.

responses to questions on Schedule G

organization’s facilities or activities are not

Line 15c. If the organization checked

(Form 990 and 990-EZ). In Part IV, identify

considered members or bona fide guests.

“Yes” to line 15a, enter the name and

the specific part and line number that each

See Pub. 3079, Tax-Exempt

address of the third party. If there is more

response supports, in the order in which

Organizations and Gaming, for more

than one third-party operator, report the

those parts and lines appear on

information.

additional operator(s) in Part IV.

Schedule G (Form 990 or 990-EZ). Part IV

Line 12. If the organization is a grantor,

can be duplicated if more space is

Line 16. Complete this line for the

beneficiary, or trustee of a trust or a

needed.

person who has overall supervision and

member of a partnership or other entity

-3-

Instructions For Schedule G (Form 990 Or 990-Ez) - Supplemental Information Regarding Fundraising Or Gaming Activities - 2012 Page 3

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