Form 990 Schedule A Instructions Page 6

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See Rev. Rul. 76-440, 1976-2 C.B.
Schedule A (Form 990 or 990-EZ), Part
Organizations operated for the
58; Regulations section
II, that it doesn't report on Form 990, as
benefit of a college or university owned
1.170A-9(f)(6)(ii); and Regulations
revenue in Part VIII or as assets in Part
or operated by a governmental unit
sections 1.509(a)-3(c)(3) and (4) for
X, or as revenue or assets on Form
described in section 170(b)(1)(A)(iv);
details about unusual grants.
990-EZ, explain in Part VI the basis for
and
characterizing such transfers as
Agricultural research organizations
Include in Part VI a list showing the
contributions but not as revenue or
described in section 170(b)(1)(A)(ix).
amount, but not the grantor, of each
assets. For example, if an organization
unusual grant actually received each
The organization should keep for its
is a community foundation that receives
year (if the cash accounting method is
records a list showing the name of and
and holds a cash transfer for another
used) or accrued each year (if the
amount contributed by each donor
tax-exempt organization and reports
accrual accounting method is used).
(other than a governmental unit or
contributions of such property on
publicly supported organization) whose
Don't include the names of the
Schedule A (Form 990 or 990-EZ), Part
total gifts during the years reported
grantors because Part VI will be
!
II, line 1, without reporting it on Form
exceed 2% of the amount reported on
made available for public
990, as revenue in Part VIII or assets in
line 11, column (f). An example of this
CAUTION
inspection.
Part X, explain the basis for
list is given later.
characterizing the property as
Unusual grants recordkeeping.
Don't file this list with the
contributions but not as revenue or
An organization that received any
organization's Form 990 or
!
assets.
unusual grants during the 5-year period
990-EZ because it may be
CAUTION
Line 2. Enter tax revenue levied for the
should also keep for its records a list
made available for public inspection.
organization's benefit by a
showing, for each year, the name of the
governmental unit and either paid to
Line 8. Include the gross income from
contributor, the date and amount of the
the organization or expended on its
interest, dividends, payments with
grant, and a brief description of the
behalf. Report this amount whether or
respect to securities loans (section
grant. If the organization used the cash
not the organization includes this
512(a)(5)), rents, royalties, and income
method for the applicable year, show
amount as revenue on its financial
from similar sources. Don't include on
only the amounts the organization
statements or elsewhere on Form 990
this line payments that result from
actually received during that year. If the
or 990-EZ.
activities of the organization that further
organization used the accrual method
its exempt purpose. Instead, report
for the applicable year, show only the
Line 3. Enter the value of services or
these amounts on line 12.
amounts the organization accrued for
facilities furnished by a governmental
that year. An example of this list is given
unit to the organization without charge.
Line 9. Enter the organization's net
below.
Don't include the value of services or
income from conducting unrelated
facilities generally furnished to the
business activities, whether or not the
Don't file this list with the
public without charge. For example,
activities are regularly conducted as a
organization's Form 990 or
!
include the fair rental value of office
trade or business. See sections 512 and
990-EZ because it may be
CAUTION
space furnished by a governmental unit
513 and the applicable regulations.
made available for public inspection.
to the organization without charge but
Include membership fees to the extent
only if the governmental unit doesn't
they are payments to purchase
Line 1. Example—List of unusual
generally furnish similar office space to
admissions, merchandise, services, or
the public without charge. Report these
grants
the use of facilities in an activity that is
amounts whether or not the organization
an unrelated business.
includes these amounts as revenue on
Description
Net income and net losses from all of
Year
2016
its financial statements or elsewhere on
the organization's unrelated business
Form 990 or 990-EZ.
Undeveloped land
activities should be aggregated. If a net
Name
Mr.
Line 5. Enter in column (f) the portion
loss results, enter “-0-” on this line.
Distinguished Donor
of total contributions by each
Line 10. Include all support as defined
Date of Grant
individual, trust, or corporation included
in section 509(d) that isn't included
on line 1 for the years reported that
January 15, 2016
elsewhere in Part II. Explain in Part VI
exceeds 2% of the amount reported on
the nature and source of each amount
Amount of Grant
line 11, column (f). However, the 2%
reported. Don't include gain or loss from
$600,000
limitation doesn't apply to contributions
amounts reportable on line 12 or from
from organizations qualifying as publicly
the sale of capital assets.
Conservation easements and quali-
supported organizations under section
fied conservation contributions.
Line 12. Enter the total amount of
170(b)(1)(A)(vi), governmental units
The organization must report any
gross receipts the organization received
described in section 170(b)(1)(A)(v),
qualified conservation contributions and
from related activities for all years
and other organizations, such as the
contributions of conservation
reported in Part II. The organization
following, but only if they also qualify as
easements consistently with how it
won't be treated as meeting the section
publicly supported organizations under
reports revenue from such contributions
170(b)(1)(A)(vi), 33
% public support
section 170(b)(1)(A)(vi).
1
3
in its books, records, and financial
test or the 10% facts and circumstances
Churches described in section
statements and in Form 990, Part VIII,
public support test, if almost all of its
170(b)(1)(A)(i);
Statement of Revenue.
support consists of gross receipts from
Educational institutions described in
related activities and an insignificant
section 170(b)(1)(A)(ii);
Reporting contributions not reported
amount of its support comes from
Hospitals described in section
as revenue. If the organization reports
governmental units and public
170(b)(1)(A)(iii);
any contributions on line 1 of
-6-
Instructions for Schedule A (Form 990 or 990-EZ)

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