Instructions For Form 8872 (Rev. November 2002) (Page 3 of 4) in pdf

Employer Identification Number (EIN)

employed (and not the name of his or her supervisor). If

the individual is self-employed, enter ‘‘Self-employed.’’ If

Enter the correct EIN in the space provided as shown on

filing electronically and the contributor is not an

the Form 8871 the organization filed.

individual, enter “NA”.

Lines 5a and 5b

Contributor’s Occupation

Enter the name and address of the person in possession

If the contributor is an individual, enter the principal job

of the organization’s books and records.

title or position of that contributor. If filing electronically

and the contributor is not an individual, enter “NA”.

Lines 6a and 6b

Enter the name and address of the person whom the

Aggregate Year-to-Date Contributions

public may contact for more information about the

Enter the total amount of contributions accepted from the

organization.

contributor during this calendar year as of the end of this

Lines 8a through 8h

reporting period.

Check only one box. See When To File beginning on

Amount of Contribution

page 1 for details on the types of reports and the periods

If a contributor made more than one contribution in a

covered.

reporting period, report each contribution separately.

Line 8f. If the organization is filing on a monthly basis,

enter the month for which this report is being filed. During

Non-Disclosed Amounts

a year in which a regularly scheduled general election is

held, do not check this box to report October, November,

As the last entry on Schedule A, list the aggregate

or December activity. Instead, file a pre-general election

amount of contributions that are required to be reported

report, post-general election report, a year-end report,

on this schedule for which the organization does not

and check the appropriate box on line 8d, 8g, or 8h.

disclose all of the information required under section

527(j). Enter “Withheld” as the contributor’s name. If filing

Line 8g. If the organization is filing a pre-election report

electronically, enter the organization’s address, the date

also indicate the type of election (primary, general,

of the report, and “NA” for occupation and employer. This

convention, special, or run-off) on line 8g(1), the date of

amount is subject to the penalty for the failure to provide

the election on line 8g(2), and the state in which the

all the information required. See Penalty on page 2 for

election is held on line 8g(3).

details.

Line 8h. If the organization is filing a post-general

election report, indicate the date of the election on line

Schedule B — Itemized Expenditures

8h(1) and the state in which the election was held on line

8h(2).

Note: Multiple Schedules B can be filed with any report.

Number each schedule in the box in the top right corner

Line 9

of the schedule. Be sure to include both the number of

If the organization is required to file Schedule(s) A, enter

the specific page and the total number of Schedules B

the total of all subtotals shown on those schedules. If the

(e.g., ‘‘Schedule B page 2 of 10’’).

organization is not required to file Schedule A, enter zero.

The organization must list on Schedule B each

recipient to whom it made expenditures during the

Line 10

calendar year if:

•

If the organization is required to file Schedule(s) B, enter

The aggregate amount of expenditures made to that

the total of all subtotals shown on those schedules. If the

person during the calendar year as of the end of this

organization is not required to file Schedule B, enter zero.

reporting period was at least $500 and

•

Any of those expenditures were made during this

Schedule A — Itemized Contributions

reporting period.

Treat expenditures as made if the organization has

Note: Multiple Schedules A can be filed with any report.

contracted or is otherwise obligated to make the

Number each schedule in the box in the top right corner

expenditure.

of the schedule. Be sure to include both the number of

the specific page and the total number of Schedules A

Do not include any independent expenditures. An

(e.g., ‘‘Schedule A page 2 of 5’’).

independent expenditure means an expenditure

The organization must list on Schedule A each

by a person for a communication expressly

CAUTION

contributor from whom it accepted contributions during

advocating the election or defeat of a clearly identified

the calendar year if:

•

candidate that is not made with the cooperation or prior

The aggregate amount of the contributions accepted

consent of, in consultation with, or at the request or

from that person during the calendar year as of the end

suggestion of, a candidate or agent or authorized

of this reporting period was at least $200 and

•

committee of a candidate.

Any of those contributions were accepted during this

reporting period.

Name of Recipient’s Employer

Treat contributions as accepted if the contributor has

If the recipient is an individual, enter the name of the

contracted or is otherwise obligated to make the

organization or person by whom the recipient is

contribution.

employed (and not the name of his or her supervisor). If

Name of Contributor’s Employer

the individual is self-employed, enter ‘‘Self-employed.’’ If

If the contributor is an individual, enter the name of the

filing electronically and the recipient is not an individual,

organization or person by whom the contributor is

enter “NA”.

-3-

Instructions For Form 8872 (Rev. November 2002) Page 3

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