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Initial Return Non Accounting Information document sample
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MAP for Non-Profits, Inc.
Form 990EZ - Checklist
MAP requires the following in order to complete your 990EZ
CLIENTS NEW TO MAP COMPLETE
A copy of your IRS determination letter
A copy of your previous years 990 or 990EZ
(unless this is your initial return)
RETURNING CLIENTS and NEW CLIENTS
Completed Questionnaire
Year end Balance Sheet (current and previous year)
Year end Income and Expense Statement
List Special/Fundraising Events separately:
Provide gross revenue and expenses from each event
Separate contributions from event fees
(e.g. If the dinner event fee is $50 and an individual writes a check for $100, $50
of the total event income is Contribution income and $50 is event income)
Functional Expense Statement
Expenses broken down by:
Program Expenses
Fund Raising Expenses
Management and General (Admin) Expenses
Schedule of Contributors of $5,000 or more
Name of Individual/Organization
Complete Address
Contribution Amount
* IMPORTANT NOTES *
These materials must be received by MAP at least 30 days prior to filing deadline in order
for MAP to guarantee completion by deadline (initial deadline is the 15th of the 5th month
after year-end). If MAP feels return cannot be completed by the initial deadline, MAP
consultant will file an automatic 3-month extension on behalf of the client in an effort to
avoid late fees/penalties. If a second extension is required, MAP will notify client and
provide form for client to sign and submit. Second extensions are also for 3 months and
require an explanation and officer signature.
If MAP is required to perform additional work to finalize year-end financial statements, that
work (hours) will be charged to the client at MAP's project rate of $85/hour) on top of the
990EZ flat fee.
b6eb308e-0e4c-4951-8b06-fc69104af2e8.xls, Checklist
MAP for Non-Profits, Inc.
Form 990EZ - Organization Information
YES NO
Is this an initial return?
Is this address the same as your last IRS return?
Organization Legal Name
Mailing Address 1
Mailing Address 2
City, State, Zip Code
Please note a mailing and physical address is required (if different)
Physical Address 1
Physical Address 2
City, State, Zip Code
Telephone Number
Accounting Method Cash Accrual
Website Address
Person/Officer who will sign the return:
Name:
Title:
MAP For Nonprofits, Inc. b6eb308e-0e4c-4951-8b06-fc69104af2e8.xls; Org Info
Email Address:
Name, address, and phone of the person who possesses the accounting books and records:
Name:
Street and Number:
City, State, Zip Code:
Phone:
YES NO
Did the organization receive written multiple year promises to give (grants) during the reporting
year, or previous reporting year, for which cash has not yet been received?
If yes, please provide MAP a schedule of these promises to give (grants).
Did the organization earn income during the reporting year for which is not recorded as income as
of the end of the year?
Are these recorded as accounts receivable on the Balance Sheet?
Did the organization receive vendor invoices (accounts payable) after the close of the reporting
year which were for services performed or goods received during the reporting year?
Are these recorded as accounts payable on the Balance Sheet?
MAP For Nonprofits, Inc. b6eb308e-0e4c-4951-8b06-fc69104af2e8.xls; Org Info
MAP for Non-Profits, Inc.
Form 990EZ - Part III
Statement of Program Service Accomplishments
What is the Organization's primary exempt purpose? (This is the mission provided on your 501 c application)
Purpose /
Mission
Statement
Describe what was achieved in carrying out the organization's exempt purpose by identifying the top 3 programs
(initiatives) and providing as much information as desired to promote the achievements and effectiveness of the
organization. In a clear and concise manner, describe the services provided and the number of persons benefited or
other numeric outcome, grants made, and total expenses.
Program /
Initiative 1
Grants made, if any $ Any foreign grants?
No of Persons Benefited Total Expenses (incl grants) $
MAP For Nonprofits, Inc. 4 b6eb308e-0e4c-4951-8b06-fc69104af2e8.xls; Part III
Program /
Initiative 2
Grants made, if any $ Any foreign grants?
No of Persons Benefited Total Expenses (incl grants) $
Program /
Initiative 3
Grants made, if any $ Any foreign grants?
No of Persons Benefited Total Expenses (incl grants) $
Program /
Initiative
Others
Note: If more than three programs, copy this schedule and complete for each program.
Grants made, if any $ Any foreign grants?
No of Persons Benefited Total Expenses (incl grants) $
MAP For Nonprofits, Inc. 5 b6eb308e-0e4c-4951-8b06-fc69104af2e8.xls; Part III
Note: The summation of "Grants made" amounts for each initiative must equal orgs total grants made on the
Statement of Functional Expenses
Note: The summation of "Total Expenses" for each initiative must equal orgs total Program Expenses
(excluding administrative and fundraising expenses) as listed on the Statement of Functional Expenses
Note: For "Grants made", provide detail ledger report and include the following: grant amount, recipient name,
recipient full address, grant description.
MAP For Nonprofits, Inc. 6 b6eb308e-0e4c-4951-8b06-fc69104af2e8.xls; Part III
MAP for Non-Profits, Inc.
Form 990EZ - Part IV
Officers, Directors, Trustees, and Key Employees
List all of the organization’s officers, directors, trustees (whether individuals or organizations), regardless of amount of compensation,
and key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.
(list all that apply ANY TIME throughout the reporting year)
A B C D E F
Avg
Name and Address (use org address Hours Compensation Contributions Expense
unless individual cannot be reached via Board or per (salary or to Employee Acct or
org address) Director Title Week contract) Benefit Plan Allowance
$ - $ - $ -
Add additional sheets as is necessary.
MAP For Nonprofits, Inc. 7 b6eb308e-0e4c-4951-8b06-fc69104af2e8.xls; Part IV
MAP for Non-Profits, Inc.
Form 990EZ - Part V
Other Information YES NO
33 Did the organization engage in any activity (program) not previously reported to the IRS?
(Attach a description of each activity)
(respond yes if this is your organizations initial tax return)
34 Were any changes made to the organizing or governing documents but not reported to the IRS?
- see Glossary for Organizing/Governing documents
(Attach a conformed copy of the changes)
35 Does the organization generally receive income from business related activities (i.e. program services,
special events, merchandise sales) for which the organization does not report as unrelated business
income on form 990-T?
If yes, provide a statement explaining why this income is not necessary to be reported as unrelated
business income on Form 990-T.
35a Did the organization have unrelated business gross income of $1,000 or more or was it subject to
section 6033(e) notice, reporting, and proxy tax requirements?
- see Glossary for Unrelated Business Income
- see Glossary for Proxy Tax Requirements; Section 6033(e)
35b If "yes", was a tax return Form 990-T filed for this year
36 Was there a liquidation, dissolution, termination, or substantial contraction during the year?
If "yes" request and complete Schedule N from MAP
37a Enter the amount of political expenditures, direct or indirect.
- see Glossary for Political Campaign Activities
37b Did the organization file Form 1120-POL for this year?
MAP For Nonprofits, Inc. 8 b6eb308e-0e4c-4951-8b06-fc69104af2e8.xls; Part V
38a Did the organization borrow from, or make any loans to, any office, director, trustee, or key employee,
or were any such loans made in a prior year and still unpaid at the start of the period covered by this
return?
38b If "yes", request and complete Schedule L, part II and enter the total amount
39 Section 501(c)(7) orgs only:
39a Initiation fees and capital contributions included in total revenue for this reporting year:
39b Total gross receipts, included in total revenue for the year, for public use of club facilities:
40a Enter the amount of tax imposed on the organization during the year under:
Section 4911 $_____________ Section 4912 $_____________ Section 4955 $_____________
(Section 4911 - Excess Lobbying Expenditures)
(Section 4912 - Disqualifying Lobbying Expenditures)
(Section 4955 - Political Expenditures)
40b Did the organization engage in any Section 4958 excess benefit transaction during the year or did it
become aware of an excess benefit transaction from a prior year?
If "yes", request and complete Schedule L, Part I
- see Glossary for Excess Benefit Transaction
40c Enter amount of tax imposed on organizations managers or disqualified persons during the year under
sections 4911, 4912, and 4955:
- see Glossary for Disqualified Persons
40d Enter amount of tax on line 40c reimbursed by the organization:
40e At any time during the year was the organization a party to a prohibited tax shelter transaction? If yes,
request and complete Form 8886-T:
- see Glossary for Prohibited Tax Shelter
41 List the states in which a copy of this return will be filed to meet state reporting requirements:
MAP For Nonprofits, Inc. 9 b6eb308e-0e4c-4951-8b06-fc69104af2e8.xls; Part V
42b At any time during the calendar year, did the organization have an interest in or a signature or other
authority over a financial account in a foreign country (such as a bank account, securities account, or
other financial account)?
If "yes", name the country(s)
Consult your accountant if Form TD F 90-22.1 will be required (Report of Foreign Bank Accounts):
42c At any time during the calendar year, did the organization maintain an office outside of the U.S.?
Name the country:
44 Did the organization maintain any donor advised funds?
If "yes", form 990 must be used instead of Form 990-EZ, request long form questionnaire from MAP
- see Glossary for Donor Advised Fund
45 Is any related organization a controlled entity within the meaning of section 512(b)(13)?
If "yes", form 990 must be used instead of Form 990-EZ, request long form questionnaire from MAP
- see Glossary for Controlled Entity
Call your MAP accountant for addition forms if:
1 You are a 501c7 organization
2 You paid any taxes other than Unrelated Business Income Taxes
3 You are a nonexempt charitable trust
MAP For Nonprofits, Inc. 10 b6eb308e-0e4c-4951-8b06-fc69104af2e8.xls; Part V
MAP for Non-Profits, Inc.
Form 990EZ - Part VI - 501(c)(3) Organizations Only
Other Information
YES NO SCHEDULE
46 Did the organization engage in direct or indirect political campaign activities on behalf of or
in opposition to candidates for public office? C
If "yes", request and complete Schedule C, Part I
- see Glossary for Political Campaign Activities
47 Did the organization engage in lobbying activities? C
If "yes", request complete Schedule C, Part II
- see Glossary for Lobbying Activities
48 Is the organization operating as a school? E
If "yes", request and complete Schedule E
49a Did the organization make any transfers to an exempt non-charitable related organization?
49b If "yes", was the organization a section 527 organization (Political Organization)?
- see Glossary for Related Organization
50 Did any employees receive over $100,000 in compensation?
If "yes", request and complete a schedule to list those employees.
51 Did any independent contractors receive over $100,000 in compensation?
If "yes", request and complete a schedule to list those employees.
MAP For Nonprofits, Inc. b6eb308e-0e4c-4951-8b06-fc69104af2e8.xls; Part VI 501c3 only
MAP for Non-Profits, Inc.
Form 990EZ - Glossary of Definitions
Business Relationship Business relationships between two persons include the following:
1 One person is employed by the other in a sole proprietorship or by an organization with which the other is associated as a
trustee, director, officer, key employee, or greater-than-35% owner.
2 One person is conducting business with the other (other than in the ordinary course of either party’s business), directly or
indirectly, in one or more contracts of sale, lease, license, loan, performance of services, or other transaction involving
transfers of cash or property valued in excess of $10,000 in the aggregate during the organization’s tax year. Indirect
transactions are transactions with an organization with which the one person is associated as a trustee, director, officer, key
employee, or greater-than-35% owner.
3 The two persons are each a director, trustee, officer, or greater than 10% owner in the same business or investment entity.
(Ownership is measured by stock ownership (either voting power or value) of a corporation, profits or capital interest in a
partnership or limited liability company, membership interest in a nonprofit organization, or beneficial interest in a trust.
Ownership includes indirect ownership (e.g., ownership in an entity that has ownership in the entity in question); there may be
ownership through multiple tiers of entities.)
Compensation Refers to all forms of cash and noncash payments or benefits provided in exchange for services, including salary and wages,
bonuses, severance payments, deferred payments, retirement benefits, fringe benefits, and other financial arrangements or
transactions such as personal vehicles, meals, housing, personal and family educational benefits, below-market loans,
payment of personal or family travel, entertainment, and personal use of the organization’s property.
Conflict of Interest Policy A policy that defines conflict of interest, identifies the classes of individuals within the organization covered by the policy,
facilitates disclosure of information that may help identify conflicts of interest, and specifies procedures to be followed in
managing conflicts of interest. A conflict of interest arises when a person in a position of authority over an organization, such
as an officer, director, or manager, may benefit financially from a decision he or she could make in such capacity, including
indirect benefits such as to family members or businesses with which the person is closely associated. For this purpose, a
conflict of interest does not include questions involving a person’s competing or respective duties to the
organization and to another organization, such as by serving on the boards of both organizations, that do not involve
a material financial interest of, or benefit to, the person.
Contribution donations, gifts, bequests, grants, and other transfers of money or property to the extent that adequate consideration is not
provided in exchange and that the contributor intends to make a gift, whether or not made for charitable purposes. A
transaction may be partly a sale and partly a contribution (i.e. individual pays an amount above a fundraising dinner
fee).
Deferred Compensation Compensation that is earned, or is attributable to, one year and deferred on the accounting records to a future year for any
reason.
12 b6eb308e-0e4c-4951-8b06-fc69104af2e8.xls, Glossary
Disqualified Person any person who was in a position to exercise substantial influence over the affairs of the organization at any time during a 5-
year period ending on the date of
the transaction. Persons who hold certain powers, responsibilities, or interests are among those who are in a position to
exercise substantial influence over the affairs of the organization.
A disqualified person includes:
* a disqualified person’s family member
* a 35% controlled entity of a (1) disqualified person and/or (2) family members of the disqualified person,
* a donor or donor advisor to a donor advised fund,
* an investment advisor of a sponsoring organization
* a substantial contributor, which is any person who gave an aggregate amount of more than $5,000, if that amount is more
than 2% of the total contributions the foundation or organization received from its inception through the end of the year in
which that person’s contributions were received.
Disregarded Entity An entity wholly owned by the organization that is not a separate entity for Federal tax purposes
Donor Advised Funds A fund or account:
1 that is separately identified by reference to contributions of a donor or donors;
2 that is owned and controlled by a sponsoring organization; and
3 for which the donor or donor advisor has or reasonably expects to have advisory privileges in the distribution or investment of
amounts held in the donor advised funds or accounts because of the donor’s status as a donor
- a donor simply providing advice or specified programmatic restrictions (restricted grant) does not fall under a Donor
Advised Fund
Escrow or Custodial Refers to an account (whether a segregated account at a financial institution or a set-aside on the organization’s books and
Account records) over which the organization has signature authority, in which the funds are held for the benefit of other organizations
or individuals.
Excess Benefit Transaction a transaction in which an organization directly or indirectly provides to or for the use of a disqualified person an economic
benefit the value of which exceeds the value of the consideration received by the organization for providing such benefit.
Fundraising Activities Activities undertaken to induce potential donors to contribute money, securities, services, materials, facilities, other assets, or
time. They include publicizing and conducting fundraising campaigns; maintaining donor mailing lists; conducting fundraising
events, preparing and distributing fundraising manuals, instructions, and other materials; and conducting other activities
involved with soliciting contributions from individuals, foundations, governments, and others. Fundraising activities do not
include gaming (other than gaming that is incidental to a fundraising activity) or the conduct of any trade or business
that is regularly carried on.
13 b6eb308e-0e4c-4951-8b06-fc69104af2e8.xls, Glossary
Fundraising Events Dinners and dances, door-to-door sales of merchandise, concerts, carnivals, sports events, auctions, and casino nights not
regularly carried on. Fundraising events do not include sales of gifts or goods or services of only nominal value,
sweepstakes, lotteries, or raffles where the names of contributors or other respondents are entered in a drawing for
prizes, raffle, or lotteries where prizes have only nominal value, or solicitation campaigns that generate only
contributions.
Governing Body The group of persons authorized under state law to make governance decisions on behalf of the organization and its
shareholders or members. Generally referred to as the board of directors (or board of trustees).
Grants and Other Includes awards, prizes, cash allocations, stipends, scholarships, fellowships, research grants, and similar payments and
Assistance distributions made by the organization during the tax year. It does not include salaries or other compensation to
employees.
Highly Compensated One of the five highest compensated employees of the organization (including employees of a disregarded entity of the
Employee organization) other than officers or key employees with total compensation of more than $100,000 for the calendar year ending
with or within the organization’s tax year.
Joint Venture Unless otherwise provided, a partnership, limited liability company, or other entity treated as a partnership for federal tax
purposes
Key Employee For purposes of Form 990 reporting, an employee of the organization (other than an officer, director, or trustee) who meets all
three of the following tests:
1 $150,000 Test
Receives reportable compensation from the organization and all related organizations in excess of $150,000
2 Responsibility Test, the employee:
a. has responsibilities, powers or influence over the organization as a whole similar to those of officers, directors, or trustees;
b. manages a discrete segment or activity of the organization that represents 10% or more of the activities, assets, income, or
expenses of the organization, as compared to the organization as a whole;
c. or has or shares authority to control or determine 10% or more of the organization’s capital expenditures, operating budget,
or compensation for employees
3 Top 20 Test
Is one of the 20 employees (that satisfy the $150,000 Test and Responsibility Test) with the highest reportable compensation
from the organization and related organizations
Lobbying Activities All activities intended to influence foreign, national, state or local legislation. Such activities include direct lobbying (attempting
to influence the legislators) and grassroots lobbying (attempting to influence legislation by influencing the general public).
Attending legislative meetings and rallies alone does not constitute lobbying for IRS 990 purposes.
14 b6eb308e-0e4c-4951-8b06-fc69104af2e8.xls, Glossary
Material Diversion of Assets A diversion of assets includes any unauthorized conversion or use of the organization’s assets other than for the
organization’s authorized purposes, including but not limited to embezzlement or theft. Report diversions by the organization’s
officers, directors, trustees, employees, volunteers, independent contractors, grantees (diverting grant funds), or any other
person, even if not associated with the organization other than by the diversion. A diversion of assets does not include an
authorized transfer of assets for fair market value consideration, such as to a joint venture or for-profit subsidiary in
exchange for an interest in the joint venture or subsidiary.
Member any person who, pursuant to a provision of the organization’s governing documents or applicable state law, has the right to
participate in the organization’s governance or to receive distributions of income or assets from the organization.
Non-cash (In-kind) Contributions of property, tangible or intangible, other than money. Noncash contributions include, but are not limited to,
Contributions stocks, bonds, and other securities; real estate; works of art; stamps, coins, and other collectibles; clothing and household
goods; vehicles, boats, and airplanes; inventories of food, medical equipment or supplies, books, or seeds; intellectual
property, including patents, trademarks, copyrights, and trade secrets; donated items that are sold immediately after donation,
such as publicly traded stock or used cars; and items donated for sale at a charity auction. Noncash contributions do not
include volunteer services performed for the reporting organization or use of facilities.
Officer Unless otherwise provided, a person elected or appointed to manage the organization’s daily operations, such as a president,
vice-president, secretary, or treasurer. The officers of an organization are determined by reference to its organizing document,
bylaws, or resolutions of its governing body, or as otherwise designated consistent with state law, but at a minimum include
those officers required by applicable state law. For purposes of Form 990 reporting, treat the organization’s top
management official and top financial official (the person who has ultimate responsibility for managing the
organization’s finances) as officers.
Organizing/Governing Refers to organizations Articles of Incorporation or Bylaws
Documents
Permanent (true) Endowment funds that are maintained to provide a permanent source of income, with the stipulation that principal must be
Endowment invested and kept intact in perpetuity, while only the income generated can be used by the organization.
Personal Benefit Contract Any life insurance, annuity, or endowment contract purchased by the organization from funds that were provided by an
individual, that benefits, directly or indirectly, , the organization and a designated individual (other than the original contributor).
IRS intent here is to avoid the original contributor from being able to claim the gift as a charitable contribution.
Political Campaign All activities that support or oppose candidates for elective federal, state or local public office. It does not matter whether the
Activities candidate is elected. Political campaign activity does not include any activity to encourage participation in the
electoral process, such as voter registration or voter education, provided that the activity does not directly or
indirectly support or oppose any candidate.
15 b6eb308e-0e4c-4951-8b06-fc69104af2e8.xls, Glossary
Professional Fundraising Services performed for the organization requiring the exercise of professional judgment or discretion consisting of planning,
Services management, preparation of materials (such as direct mail solicitation packages), provision of advice and consulting regarding
solicitation of contributions, and direct solicitation of contributions. Include any paid employee, non-employee, or
contracted grant writers to do fundraising for the organization. Professional fundraising does not include purely
administrative tasks, such as printing, mailing services, or receiving and depositing contributions to a charity, such
as services provided by a bank or caging service.
Prohibited Tax Shelter A transaction entered into by a tax exempt organization that reduces the organizations liability for applicable Federal taxes
Transaction (i.e., employment taxes, excise taxes, and in appropriate cases unrelated business income tax).
Proxy Tax Requirements; The section 6033(e) reporting and notice requirements do not apply to the following organizations:
Section 6033(e) • Section 501(c)(3) organizations.
• Organizations whose lobbying and political expenditures consist solely of in-house lobbying expenditures that do not exceed
$2,000.
• Organizations that establish to the satisfaction of the IRS that substantially all the dues or similar amounts they receive are
not deducted by its members as business expenses.
Quasi-Endowment Funds functioning as an endowment that are established by the organization itself, either from donor or institutional funds, and
which must retain the purpose and intent as specified by the donor or source of the original funds. (i.e. Board Designated
Endowment)
Quid Pro Quo Contribution This is a payment a donor makes to a charity partly as a contribution and partly for goods or services. For example, if a donor
gives a charity $100 and receives a concert ticket valued at $40, the donor has made a quid pro quo contribution. In this
example, the charitable contribution part of the payment is $60. Even though the deductible part of the payment is not more
than $75, a disclosure statement must be provided by the organization to the donor because the donor's payment (quid pro
quo contribution) is more than $75. Failure to make the required disclosure may result in a penalty to the organization.
Reasonable Compensation The value that would ordinarily be paid for like services by like enterprises under similar circumstances.
Related Organization An organization that stands in one or more of the following relationships to the filing organization:
* Parent: an organization that controls (see examples of control in the definition above) the filing organization
* Subsidiary: an organization controlled (see examples of control in the definition above) by the filing organization
* Brother/Sister: an organization controlled (see examples of control in the definition above) by the same person or persons that
control the filing organization
* Supporting/Supported: an organization that is (or claims to be) at any time during the organization’s tax year (i) a supporting
organization of the filing organization within the meaning of section 509(a)(3), if the filing organization is a supported
organization within the meaning of section 509(f)(3); (ii) or a supported organization, if the filing organization is a supporting
organization
16 b6eb308e-0e4c-4951-8b06-fc69104af2e8.xls, Glossary
Reportable Compensation Compensation that is reported on Form W-2, box 5 (or box 1 if the employee’s compensation is not reported in box 5), or
Form 1099-MISC, box 7, filed for the calendar year ending with or within the organization’s tax year.
Security/Securities Any bond, debenture, note, or certificate or other evidence of indebtedness issued by a corporation, government or political
subdivision, share of stock, voting trust certificate, or any certificate of interest or participation in, certificate of deposit or
receipt for, temporary or interim certificate for, or warrant or right to subscribe to or purchase, any of the foregoing.
Term Endowment An endowment fund maintained to provide a source of income for either a specified period of time or until a specific event
occurs.
Top Management Official A person who has ultimate responsibility for implementing the decisions of the organization’s governing body or for supervising
the management, administration, or operation of the organization (for example, the organization’s CEO or ED).
Top Financial Official The person who has ultimate responsibility for managing the organization’s finances (typically the CFO, Treasurer or ED).
Unrelated Business Income Gross income from a trade or business that is regularly carried on by an exempt organization and that is not substantially
related to the performance by the organization of its exempt purpose or function, except that the organization uses any profits
derived from this activity. (Examples include but are not limited to: publication advertising, vending machine sales,
organizational merchandise sales (except donated merchandise and merchandise only sold during fundraising
events), rental income, etc.)
17 b6eb308e-0e4c-4951-8b06-fc69104af2e8.xls, Glossary
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