Form 990-T - Exempt Organization Business Income Tax Return - 2012 Page 2

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2
Form 990-T (2012)
Page
Part III
Tax Computation
35
Organizations taxable as corporations (see instructions for tax computation). Controlled group
members (sections 1561 and 1563) check here
See instructions and:
a Enter your share of the $50,000, $25,000, and $9,925,000 taxable income brackets (in that order):
(1) $
(2) $
(3) $
b Enter organization’s share of: (1) Additional 5% tax (not more than $11,750)
$
(2) Additional 3% tax (not more than $100,000)
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$
c Income tax on the amount on line 34 .
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35c
36
Trusts taxable at trust rates (see instructions for tax computation). Income tax on
the amount on line 34 from:
Tax rate schedule or
Schedule D (Form 1041) .
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36
37
Proxy tax (see instructions) .
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37
38
Alternative minimum tax .
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38
39
Total. Add lines 37 and 38 to line 35c or 36, whichever applies .
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39
Part IV
Tax and Payments
40a Foreign tax credit (corporations attach Form 1118; trusts attach Form 1116)
40a
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b Other credits (see instructions) .
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40b
c General business credit. Attach Form 3800 (see instructions) .
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40c
d Credit for prior year minimum tax (attach Form 8801 or 8827) .
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40d
e Total credits. Add lines 40a through 40d
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40e
41
41
Subtract line 40e from line 39 .
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42
42
Other taxes. Check if from:
Form 4255
Form 8611
Form 8697
Form 8866
Other (attach statement).
43
Total tax. Add lines 41 and 42 .
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43
44a Payments: A 2011 overpayment credited to 2012
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44a
b 2012 estimated tax payments .
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44b
c Tax deposited with Form 8868 .
44c
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d Foreign organizations: Tax paid or withheld at source (see instructions)
44d
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e Backup withholding (see instructions)
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44e
f
Credit for small employer health insurance premiums (Attach Form 8941) .
44f
g Other credits and payments:
Form 2439
Form 4136
Other
Total
44g
45
Total payments. Add lines 44a through 44g
45
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46
46
Estimated tax penalty (see instructions). Check if Form 2220 is attached .
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47
Tax due. If line 45 is less than the total of lines 43 and 46, enter amount owed .
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47
48
Overpayment. If line 45 is larger than the total of lines 43 and 46, enter amount overpaid
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48
49
Enter the amount of line 48 you want:
Credited to 2013 estimated tax
Refunded
49
Part V
Statements Regarding Certain Activities and Other Information
(see instructions)
Yes
No
1
At any time during the 2012 calendar year, did the organization have an interest in or a signature
or
other
authority
over
a
financial
account
(bank,
securities,
or
other)
in
a
foreign
country?
If “Yes,” the organization may have to file Form TD F 90-22.1, Report of Foreign Bank and
Financial Accounts. If “Yes,” enter the name of the foreign country here
2
During the tax year, did the organization receive a distribution from, or was it the grantor of, or transferor to, a foreign trust? .
If “Yes,” see instructions for other forms the organization may have to file.
3
Enter the amount of tax-exempt interest received or accrued during the tax year
$
Schedule A—Cost of Goods Sold. Enter method of inventory valuation
1
Inventory at beginning of year
1
6
Inventory at end of year .
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6
2
Purchases
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2
7
Cost of goods sold. Subtract
line 6 from line 5. Enter here and
3
3
Cost of labor .
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in Part I, line 2 .
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4 a Additional section 263A costs
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(attach statement) .
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Yes
No
4a
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Do the rules of section 263A (with respect to
property produced or acquired for resale) apply
b Other costs (attach statement)
4b
to the organization? .
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5
Total. Add lines 1 through 4b
5
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,
Sign
correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
May the IRS discuss this return
Here
with the preparer shown below
Yes
No
(see instructions)?
Signature of officer
Date
Title
Print/Type preparer’s name
Preparer’s signature
Date
PTIN
Paid
Check
if
self-employed
Preparer
Firm’s name
Firm's EIN
Use Only
Firm’s address
Phone no.
990-T
Form
(2012)

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