Form 990 Schedule B Schedule Of Contributors Page 4
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Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Page
Name of organization
Employer identification number
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or
(10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and
the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.)
$
▶
Use duplicate copies of Part III if additional space is needed.
(a) No.
(b) Purpose of gift
(c) Use of gift
(d) Description of how gift is held
from
Part I
(e) Transfer of gift
Transferee’s name, address, and ZIP + 4
Relationship of transferor to transferee
(a) No.
(b) Purpose of gift
(c) Use of gift
(d) Description of how gift is held
from
Part I
(e) Transfer of gift
Transferee’s name, address, and ZIP + 4
Relationship of transferor to transferee
(a) No.
(b) Purpose of gift
(c) Use of gift
(d) Description of how gift is held
from
Part I
(e) Transfer of gift
Transferee’s name, address, and ZIP + 4
Relationship of transferor to transferee
(a) No.
(b) Purpose of gift
(c) Use of gift
(d) Description of how gift is held
from
Part I
(e) Transfer of gift
Transferee’s name, address, and ZIP + 4
Relationship of transferor to transferee
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
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