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Form 990 Return Of Organization Exempt For Income Tax 990 - Official Federal Forms
| Form 990 Return Of Organization Exempt For Income Tax Form. This is a national form and can be used in Department Of Treasury . |
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Form 990 Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation) The organization may have to use a copy of this return to satisfy state reporting requirements. , 2012, and ending OMB No. 1545-0047 Department of the Treasury Internal Revenue Service Open to Public Inspection , 20 2012 A B For the 2012 calendar year, or tax year beginning Check if applicable: C Name of organization Address change Name change Initial return Terminated Amended return Application pending F Name and address of principal officer: ) (insert no.) City, town or post office, state, and ZIP code Doing Business As D Employer identification number Number and street (or P.O. box if mail is not delivered to street address) Room/suite E Telephone number G Gross receipts $ H(a) Is this a group return for affiliates? Yes No I Tax-exempt status: Website: Form of organization: 501(c)(3) Corporation Trust 501(c) ( Association 4947(a)(1) or 527 H(b) Are all affiliates included? Yes No If "No," attach a list. (see instructions) H(c) Group exemption number J K Other L Year of formation: M State of legal domicile: Part I 1 Activities & Governance Summary Briefly describe the organization's mission or most significant activities: 2 3 4 5 6 7a b 8 9 10 11 12 13 14 15 16a b 17 18 19 20 21 22 Check this box if the organization discontinued its operations or disposed of more than 25% of its net assets. 3 Number of voting members of the governing body (Part VI, line 1a) . . . . . . . . . Number of independent voting members of the governing body (Part VI, line 1b) . . . . 4 Total number of individuals employed in calendar year 2012 (Part V, line 2a) ..... 5 Total number of volunteers (estimate if necessary) . . . . . . . . . . . . . . 6 Total unrelated business revenue from Part VIII, column (C), line 12 . . . . . . . . 7a Net unrelated business taxable income from Form 990-T, line 34 . . . . . . . . . 7b Prior Year Current Year Contributions and grants (Part VIII, line 1h) . . . . . . . . . . . . Program service revenue (Part VIII, line 2g) ........... Investment income (Part VIII, column (A), lines 3, 4, and 7d) . . . . . . Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) . . . Total revenue--add lines 8 through 11 (must equal Part VIII, column (A), line 12) Grants and similar amounts paid (Part IX, column (A), lines 13) . . . . . Benefits paid to or for members (Part IX, column (A), line 4) . . . . . . Salaries, other compensation, employee benefits (Part IX, column (A), lines 510) Professional fundraising fees (Part IX, column (A), line 11e) . . . . . . Total fundraising expenses (Part IX, column (D), line 25) Other expenses (Part IX, column (A), lines 11a11d, 11f24e) ..... Total expenses. Add lines 1317 (must equal Part IX, column (A), line 25) . Revenue less expenses. Subtract line 18 from line 12 . . . . . . . . Beginning of Current Year End of Year Net Assets or Fund Balances Expenses Revenue Total assets (Part X, line 16) . . . . . . . . . . Total liabilities (Part X, line 26) . . . . . . . . . . Net assets or fund balances. Subtract line 21 from line 20 . . . . . . . . . . . . . . . . . . Part II Signature Block Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge. Sign Here Signature of officer Date Type or print name and title Paid Preparer Use Only Print/Type preparer's name Preparer's signature Date Check if self-employed Firm's EIN Phone no. PTIN Firm's name Firm's address May the IRS discuss this return with the preparer shown above? (see instructions) . For Paperwork Reduction Act Notice, see the separate instructions. . . . . . . . . . . . Yes No Cat. No. 11282Y Form 990 (2012) American LegalNet, Inc. www.FormsWorkFlow.com Form 990 (2012) Page 2 Part III 1 Statement of Program Service Accomplishments Check if Schedule O contains a response to any question in this Part III . . . . . . . . . . . . . . Briefly describe the organization's mission: 2 Did the organization undertake any significant program services during the year which were not listed on the prior Form 990 or 990-EZ? . . . . . . . . . . . . . . . . . . . . . . . . . . . If "Yes," describe these new services on Schedule O. Did the organization cease conducting, or make significant changes in how it conducts, any program services? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No 3 4 Yes No If "Yes," describe these changes on Schedule O. Describe the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported. (Code: ) (Expenses $ including grants of $ ) (Revenue $ ) 4a 4b (Code: ) (Expenses $ including grants of $ ) (Revenue $ ) 4c (Code: ) (Expenses $ including grants of $ ) (Revenue $ ) 4d Other program services (Describe in Schedule O.) (Expenses $ including grants of $ 4e Total program service expenses ) (Revenue $ ) Form 990 (2012) American LegalNet, Inc. www.FormsWorkFlow.com Form 990 (2012) Page 3 Yes No Part IV 1 2 3 4 5 Checklist of Required Schedules Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? . . . Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I . . . . . . . . . . . . . . Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II . . . . . . . . . . . Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part III . . . .
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