Sample Form 990 - Return Of Organization Exempt From Income Tax - 2015 Page 27
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3026P0007 10/13/2016 12:54 PM
2
PHILADELPHIA VETERANS COMFORT HOUSE 23-2694118
Schedule G (Form 990 or 990-EZ) 2015
Page
Part II
Fundraising Events. Complete if the organization answered “Yes” on Form 990, Part IV, line 18, or reported more
than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with
gross receipts greater than $5,000.
(a) Event #1
(b) Event #2
(c) Other events
(d) Total events
SPECIAL EVENTS
None
(add col. (a) through
col. (c))
(event type)
(event type)
(total number)
43,960
43,960
1
Gross receipts
. . . . . . . .
2
Less: Contributions
. .
Gross income (line 1 minus
3
43,960
43,960
line 2)
. . . . . . . . . . . . . . . . . .
4
Cash prizes
. . . . . . . . . .
5
Noncash prizes
. . . . . . .
6
Rent/facility costs
. . . .
9,612
9,612
7
Food and beverages
.
8
Entertainment
. . . . . . . .
9
Other direct expenses
9,612
10
Direct expense summary. Add lines 4 through 9 in column (d)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
34,348
11
Net income summary. Subtract line 10 from line 3, column (d)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Part III
Gaming. Complete if the organization answered “Yes” on Form 990, Part IV, line 19, or reported more
than $15,000 on Form 990-EZ, line 6a.
(b) Pull tabs/instant
(d) Total gaming (add
(a) Bingo
(c) Other gaming
bingo/progressive bingo
col. (a) through col. (c))
1
Gross revenue
. . . . . . .
2
Cash prizes
. . . . . . . . . .
3
Noncash prizes
. . . . . . .
4
Rent/facility costs
. . . .
5
Other direct expenses
Yes
%
Yes
%
Yes
%
. . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . .
. . . . . . . . . . . . .
6
Volunteer labor
No
No
No
. . . . . . .
7
Direct expense summary. Add lines 2 through 5 in column (d)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8
Net gaming income summary. Subtract line 7 from line 1, column (d)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9
Enter the state(s) in which the organization conducts gaming activities:
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
a
Is the organization licensed to conduct gaming activities in each of these states?
Yes
No
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b
If “No,” explain:
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10a
Were any of the organization’s gaming licenses revoked, suspended or terminated during the tax year?
Yes
No
. . . . . . . . . . . . . . . . . . . . . . . . .
b
If “Yes,” explain:
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Schedule G (Form 990 or 990-EZ) 2015
DAA
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