Unrelated Business Income Expense Allocation Description of Activity: Department Name:
Who-Key Description: Who-Key:
Contact Name: Contact Number:
Net Unrelated
Revenue (list by institutional account) Unrelated Revenue Business Income
Revenue $0.00 $0.00
Expense Related Expense Related Indicate Allocable Expense Total UBI
Exclusively to To Dual Use Methodology Related To Activity
Expense (list by institutional account) UBI Activity Facilities/Personnel Allocation Ratio Code Below UBI Activity Expense
COGS $0.00 $0.00 $0.00
Officers Compensation $0.00 $0.00 $0.00
Salaries and Wages $0.00 $0.00 $0.00
Repairs and Maintenance $0.00 $0.00 $0.00
Bad Debts $0.00 $0.00 $0.00
Interest $0.00 $0.00 $0.00
Taxes and Licenses $0.00 $0.00 $0.00
Charitable Contributions $0.00 $0.00 $0.00
Depreciation $0.00 $0.00 $0.00
Contributions to Deferred Comp Plans $0.00 $0.00 $0.00
Employee Benefit Programs $0.00 $0.00 $0.00
Other: $0.00 $0.00 $0.00
Utilities $0.00 $0.00 $0.00
Insurance $0.00 $0.00 $0.00
Rents/Leases $0.00 $0.00 $0.00
General Supplies $0.00 $0.00 $0.00
Computer Supplies $0.00 $0.00 $0.00
Postage and Shipping $0.00 $0.00 $0.00
Purchased Services $0.00 $0.00 $0.00
Printing/Duplicating/AV/Photography Services $0.00 $0.00 $0.00
Laundry $0.00 $0.00 $0.00
Conferences and Training $0.00 $0.00 $0.00
Dues and Subscriptions $0.00 $0.00 $0.00
Travel $0.00 $0.00 $0.00
Vehicles/Parking $0.00 $0.00 $0.00
Business Meals and Entertainment $0.00 $0.00 $0.00
Administrative Overhead $0.00 $0.00 $0.00
Advertising $0.00 $0.00 $0.00
Royalties $0.00 $0.00 $0.00
Miscellaneous $0.00 $0.00 $0.00
Total Expense $0.00 $0.00 $0.00 $0.00 $0.00
Net Unrelated Business Income $0.00 $0.00
Allocation Methodology Codes:
1 = Labor Hours (Unrelated Activity Labor Hours/Total Activity Labor Hours) =
2 = Units Sold (# of Units Sold to Unrelated Parties/Total # of Units Sold) =
3 = Sq.Footage (Sq.Footage Used for Unrelated Activity/Total Sq.Footage) =
4 = Revenue Where Same Rates Charged to Internal and External Customers =
(Revenue Received from Unrelated Parties/Total Revenue Received)
5 = Revenue Ratio Adjusted for Difference Between Internal and External Rates =
=
6 = Other (Please Detail):______________________________________________________________