Form 109 - California Exempt Organization Business Income Tax Return - 2015 Page 2
ADVERTISEMENT
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26 Refund. If line 25 is less than line 24, then subtract line 25 from line 24. . . . . . . . . . . . . . . . . . . . . . . . . . . .
26
00
a Fill in the account information to have the refund directly deposited. Routing number. . .
. . . . . .
26a
b Type: Checking
Savings
c Account Number . . . . . . . . . . . . . . . . . . . . . . .
. . . . . .
26c
Refund or
Amount
27 Penalties and interest. See General Information M. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . .
27
00
Due
28
Check if estimate penalty computed using Exception B or C and attach form FTB 5806
. . . . . . . . . . . . .
29 Total amount due. Add line 22, line 23, line 25, and line 27, then subtract line 24. . . . . . . . . .
. . . . . . . . . . .
29
00
Unrelated Business Taxable Income
Part I Unrelated Trade or Business Income
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1 a Gross receipts or gross sales______________ b Less returns and allowances______________ c Balance
1c
00
2 Cost of goods sold and/or operations (Schedule A, line 7) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . .
2
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3 Gross profit. Subtract line 2 from line 1c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
00
4 a Capital gain net income. See Specific Line Instructions – Trusts attach Schedule D (541) . . . . . . . . . . . . . . . . . . . . .
4a
b Net gain (loss) from Part II, Schedule D-1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4b
00
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c Capital loss deduction for trusts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4c
5 Income (or loss) from partnerships, limited liability companies, or S corporations. See specific line instructions.
Attach Schedule K-1 (565, 568, or 100S) or similar schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
00
00
6 Rental income (Schedule C) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6
00
7 Unrelated debt-financed income (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
00
8 Investment income of an R&TC Section 23701g, 23701i, or 23701n organization (Schedule E) . . . . . . . . . . . . . . . . . . .
8
00
9 Interest, Annuities, Royalties and Rents from controlled organizations (Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9
00
10 Exploited exempt activity income (Schedule G) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10
00
11 Advertising income (Schedule H, Part III, Column A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11
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12 Other income. Attach schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12
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13 Total unrelated trade or business income. Add line 3 through line 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13
Part II Deductions Not Taken Elsewhere (Except for contributions, deductions must be directly connected with the unrelated business income.)
14 Compensation of officers, directors, and trustees from Schedule I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14
00
00
15 Salaries and wages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
15
00
16 Repairs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
16
17 Bad debts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
17
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18 Interest. Attach schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
18
00
19 Taxes. Attach schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
19
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20 Contributions. See instructions and attach schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
20
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21 a Depreciation
21a
(Corporations and Associations – Schedule J) (Trusts – form FTB 3885F)
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b Less: depreciation claimed on Schedule A. See instructions . . . . . . . . . . . . . . .
21b
21
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22 Depletion. Attach schedule. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
22
23 a Contributions to deferred compensation plans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23a
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b Employee benefit programs. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23b
00
24 Other deductions. Attach schedule. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
24
25 Total deductions. Add line 14 through line 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
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26 Unrelated business taxable income before allowable excess advertising costs. Subtract line 25 from line 13 . . . . . . . . .
26
00
27 Excess advertising costs (Schedule H, Part III, Column B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
27
00
28 Unrelated business taxable income before specific deduction. Subtract line 27 from line 26 . . . . . . . . . . . . . . . . . . . . .
28
00
29 Specific deduction. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
29
00
30 Unrelated business taxable income. Subtract line 29 from line 28. If line 28 is a loss, enter line 28.. . . . . . . . . . . . . . . . . . 30
To learn about your privacy rights, how we may use your information, and the consequences for not providing the requested information, go to ftb.ca.gov and
search for privacy notice. To request this notice by mail, call 800.852.5711.
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
Sign
belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Here
Title
Date
Telephone
Signature
of officer
(
)
Date
PTIN
Check if self-
Preparer’s
employed
signature
Paid
FEIN
-
Preparer’s
Firm’s name (or yours,
Use Only
if self-employed)
Telephone
and address
(
)
Yes No
May the FTB discuss this return with the preparer shown above? See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Side 2 Form 109
2015
C1
3642153
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