Schedule B (Form 990, 990-Ez, Or 990-Pf) - Schedule Of Contributors - 2012 Page 2

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2
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
Page
Name of organization
Employer identification number
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
Part I
(a)
(b)
(c)
(d)
No.
Name, address, and ZIP + 4
Total contributions
Type of contribution
Person
Payroll
$
Noncash
(Complete Part II if there is
a noncash contribution.)
(a)
(b)
(c)
(d)
No.
Name, address, and ZIP + 4
Total contributions
Type of contribution
Person
Payroll
$
Noncash
(Complete Part II if there is
a noncash contribution.)
(a)
(b)
(c)
(d)
No.
Name, address, and ZIP + 4
Total contributions
Type of contribution
Person
Payroll
$
Noncash
(Complete Part II if there is
a noncash contribution.)
(a)
(b)
(c)
(d)
No.
Name, address, and ZIP + 4
Total contributions
Type of contribution
Person
Payroll
$
Noncash
(Complete Part II if there is
a noncash contribution.)
(a)
(b)
(c)
(d)
No.
Name, address, and ZIP + 4
Total contributions
Type of contribution
Person
Payroll
$
Noncash
(Complete Part II if there is
a noncash contribution.)
(a)
(b)
(c)
(d)
No.
Name, address, and ZIP + 4
Total contributions
Type of contribution
Person
Payroll
$
Noncash
(Complete Part II if there is
a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

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