Form 990-T - Exempt Organization Business Income Tax Return - Irs - 2016
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5Exempt Organization Business Income Tax Return
OMB No. 1545-0687
990-T
(and proxy tax under section 6033(e))
Form
2016
For calendar year 2016 or other tax year beginning
, 2016, and ending
, 20
.
Information about Form 990-T and its instructions is available at
Department of the Treasury
▶
Open to Public Inspection for
Internal Revenue Service
Do not enter SSN numbers on this form as it may be made public if your organization is a 501(c)(3).
▶
501(c)(3) Organizations Only
Check box if
Name of organization (
Check box if name changed and see instructions.)
D Employer identification number
A
address changed
(Employees’ trust, see instructions.)
B Exempt under section
Print
) (
)
Number, street, and room or suite no. If a P.O. box, see instructions.
501(
or
E Unrelated business activity codes
408(e)
220(e)
Type
(See instructions.)
City or town, state or province, country, and ZIP or foreign postal code
408A
530(a)
529(a)
C Book value of all assets
F Group exemption number (See instructions.)
▶
at end of year
G Check organization type
501(c) corporation
501(c) trust
401(a) trust
Other trust
▶
H Describe the organization’s primary unrelated business activity.
▶
I
During the tax year, was the corporation a subsidiary in an affiliated group or a parent-subsidiary controlled group? .
.
Yes
No
▶
If “Yes,” enter the name and identifying number of the parent corporation.
▶
J The books are in care of
Telephone number
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▶
Part I
Unrelated Trade or Business Income
(A) Income
(B) Expenses
(C) Net
1a Gross receipts or sales
b Less returns and allowances
c Balance
1c
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2
Cost of goods sold (Schedule A, line 7) .
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Gross profit. Subtract line 2 from line 1c .
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4a Capital gain net income (attach Schedule D)
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4a
b Net gain (loss) (Form 4797, Part II, line 17) (attach Form 4797)
4b
c Capital loss deduction for trusts
4c
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Income (loss) from partnerships and S corporations (attach statement)
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Rent income (Schedule C)
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Unrelated debt-financed income (Schedule E) .
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Interest, annuities, royalties, and rents from controlled organizations (Schedule F)
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Investment income of a section 501(c)(7), (9), or (17) organization (Schedule G)
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Exploited exempt activity income (Schedule I) .
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Advertising income (Schedule J)
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11
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Other income (See instructions; attach schedule) .
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12
13
Total. Combine lines 3 through 12
13
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Part II
Deductions Not Taken Elsewhere (See instructions for limitations on deductions.) (Except for contributions,
deductions must be directly connected with the unrelated business income.)
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Compensation of officers, directors, and trustees (Schedule K) .
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Salaries and wages
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Repairs and maintenance
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Bad debts
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Interest (attach schedule)
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Taxes and licenses .
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Charitable contributions (See instructions for limitation rules) .
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Depreciation (attach Form 4562)
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Less depreciation claimed on Schedule A and elsewhere on return .
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22a
22b
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Depletion .
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Contributions to deferred compensation plans
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Employee benefit programs .
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Excess exempt expenses (Schedule I)
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Excess readership costs (Schedule J)
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Other deductions (attach schedule)
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Total deductions. Add lines 14 through 28
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30
Unrelated business taxable income before net operating loss deduction. Subtract line 29 from line 13
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Net operating loss deduction (limited to the amount on line 30) .
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Unrelated business taxable income before specific deduction. Subtract line 31 from line 30 .
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Specific deduction (Generally $1,000, but see line 33 instructions for exceptions) .
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Unrelated business taxable income. Subtract line 33 from line 32. If line 33 is greater than line 32,
enter the smaller of zero or line 32 .
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34
990-T
For Paperwork Reduction Act Notice, see instructions.
Form
(2016)
Cat. No. 11291J
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