Form 990-T (1970) Page 4
Continuation of Schedule G
— _ _ ten

ao 6. Gross income reportable 7. Allowable deductions income

____5. Nonexempt controled Net
| Taxable income or ‘amount (Column 2 x column 4(c) (Column 3 x column 4(c) include (Column 6
(2) Excess taxable in column (ah, whichever | (© Percentage which ctumn OF column B(e) or column 3(0) Tess column
is greater

Total (enter here and on line 9, page 2)... . . . . ee ee

Schedule H—ALLOWABLE EXEMPT ACTIVITY EXPENSES

7, Excess exempt expenses,

2, Gass untaed_ | & pesos ceatly | 4 Net income fam | &, Gross apne (om |

6. Expenses directly
connected with unrelated trade | exempt function that | (Column 6 less column 5
1. Description of exploited function | business income trom |proquction of unrelated] or business isnot unrelated | coRnected with | STPTet to exceed amount
rade or Bus business income | (Cal. 2 less col. 3) ness income in column 4)

Total (enter here and on line 28 page 2) . . . . wo ee

Schedule I—INTEREST ON INDEBTEDNESS (See Taste, 76) Schedule J—TAXES (See Instruction 17)

Explanation | Amount Explanation Amount

Total (enter here and on line 16, page 2). . Total (enter here and on line 17, page 2).

Schedule K—OTHER DEDUCTIONS (See Instruction 25)

Explanation "Amount

Total (enter here and on line 25, page 2)... . . . ) te te

Schedule L—RECORD OF FORM 503 FEDERAL TAX DEPOSITS (ist deposits order of date mad

e Instruction

Serial number

Serial number | Date of
of Form 503,

‘of Form 503 deposit Amount

Did you, at any time during | the taxable year, have any interest in, or signature, or other authority over a bank, securities, or other financial account
in a foreign country? Yes [] No []. If “Yes,” attach Form 4683. (For definitions, see Form 4683.)

Schedule M—COMPENSATION OF OFFICERS

: 3. Time |
i ‘i 4. Amount of 5, Expense Account
1, Name and Social Security Number of Officer 2. Title Devoted to Compansaticn —xpense Ace

Total compensation of officers (enter here and on line 11, page 2)... . . . . . | WH@Z@Z@=000—.—
TAX RATE SCHEDULE FOR TRUSTS TAXABLE AT INDIVIDUAL RATES

If the amount on line 5, page 1 or If the amount on line 5, page 1 or
‘on line 33, page 2, is: Enter on line 16, page 1: on line 33, page 2, is: Enter on line 16, page 1:
Not over $500 14% of the amount. Over $20,000 but not over $22,000 $6,070, plus 48% of excess over $20,000.
Over $500 but not over $1,000. $70, plus 15% of excess over $500. Over $22,000 but not over $26,000.... $7,030, plus 50% of excess over $22,000.
Over $1,000 but not over $1,500 $145, plus 16% of excess over $1,000. Over $26,000 but not over $32,000 $9,030, plus 53% of excess over $26,000.
Over $1,500 but not over $2,000...... $225, plus 1794 of excess over $1,500. Over $32,000 but nat over $38,000... $12,210, plus 559% of excess over $32,000.
Over $2,000 but not over $4,000 $310, plus 19% of excess over $2,000. Over $38,000 but not over $44,000 $15,510, plus 58% of excess over $38,000.
Over $4,000 but not over $6,000 $680, plus 22% of excess over $4,000. Over $44,000 but not aver $50,000... $18,990, plus 60% of excess over $44,000.
Over $6,000 but not over $8,000 .. $1,130, plus 25% of excess over $6,000.

Over $50,000 but not over $60,000 $22,590, plus 62% of excess over $50,000.
Over $8,000 but not over $10,000 $1,630, plus 28% of excess over $8,000.

Over $60,000 but not over $70,000 $28,790, plus 64% of excess over $60,000.
Over $10,000 but not over $12,000 $2,190, plus 32% of excess over $10,000.
Over $12,000 but not over $14,000 $2,830, plus 36% of excess over $12,000. Over $70,000 but not over $80,000 $35,190, plus 66% of excess over $70,000.

" " _— uu Over $80,000 but not over $90,000 $41,790, plus 68% of excess over $80,000.

Over $14,000 but not over $16,000 $3,550, plus 39% of excess over $14,000.
Over $16,000 but not over $18,000.... $4,330, plus 42% of excess over $16,000. Over $90,000 but not over $100,000... $48,590, plus 69% of excess over $90,000.
Over $18,000 but not over $20,000 $5,170, plus 45% of excess over $18,000. Over $100,000 $55,490, plus 70% of excess over $100,000.

‘3 U.S. GOVERNMENT PRINTING OFFICE: 1971—O-370-039 34.8442679 .——



Exempt Organization Business Income
Form 990-T Tax Return (uncer section 511 of the Internal Revenue Code) | 1870

For the calendar year 1970 or other taxable year beginning

Department of the Treasury
1970, and ending .

Internal Revenue Service

Name of Organization Employer Identifi ber

(ar case Sf employees" trust described. in
section 401(a) and exempt under section
—] 501(a), ‘insert the trust's identification
number.)

Number and street

nd ZIP code Entor activity code from Instructions for
Form 990 if stated, If not stated describe
nature of unrelated trade or business activity.

City or town, State,

Name and address of trust's fiduciary Date of current exemption letter and
code section under which you are exempt.

Complete only page 1 if unrelated trade or business gross income is $5,000 or less.
Complete the entire form (except lines 1 thru 5) if unrelated trade or business gross income is over $5,000.

"Unrelated business taxable income computation—When unrelated trade or business gross income is $5,000 or less

1 Unrelated trade or business gross income (State sources ...
2 Less deductions toe :
3 Unrelated business taxable income before specific deduction

4 Less specific deduction (See instruction “K(4)")
5 Unrelated business taxable income soe

Organizations Taxable as Corporations (See General Instruction B(1))
6 Unrelated business taxable income (line 5 above, or line 33, page 2) tee
| 7 surtax exemption (line 6 or $25,000, whichever is lesser). (Component members of a controlled group see page

6 of instructions and enter your surtax exemption or line 6, whichever is lesser.) . . . . . « « + e
8 Line 6 less line 7 |
9 (a) 22% of line 6. 2 ee ee ee

(b) 26% of line 8 :
(©) If multiple surtax exemption is elected under section 1562, enter 6 percent of line 7 |____
10 Alternative tax from separate Schedule D
11 Income tax (a) (line 9 or 10, whichever is lesser) Se
(b) Tax Surcharge—21/% of line 11(a) (Fiscal Years, see instruction page 6)
12 Less: (a) Foreign tax credit (attach Form 1118)
(b) Investment credit (attach Form 3468)
13 Balance of income tax . So
14 Tax from recomputing prior year investment credit (attach Form 4255)
15 Income tax (line 13 plus line 14). Enter here and on line 23

Tax Computation

Trusts Taxable at Individual Rates (See General Instruction B(2))
16 Tax on line 5 above or line 33, page 2 (from Tax Rate Schedule, page 4)... 2 2 ee 2 ee

17 Alternative tax from separate Schedule D .
18 Income tax (a) (line 16 or 17, whichever is lesser) . ©. - ee ee ee |
(b) Tax Surcharge—21/ % of line 18(a) (Fiscal Years, see instruction page 5)
19 Less: (a) Foreign tax credit (attach Form 1116)... 1 1 ee eee ee fe
(b) Investment credit (attach Form 3468)... . . 1 ee ee ee _
20 Balance of income tax. . - + See
21 Tax from recomputing prior year investment credit (attach Form 1 4258) cee

] 22 Income tax (line 20 plus line 21). Enter here and on line 23

24 Minimum tax on tax preference items (attach Form 4626) ‘|
25 Total tax (add lines 23 and 24). . 2. we ee re 7
|
|

| 23 Income tax (from line 15 or 22, whichever is applicable)
|
|

Credits: (a) Credit from regulated investment companies (attach Form : 2438)
(b) Tax deposited—Form 7004 application for extension (attach copy)

(©) Credit for U.S. tax on special fuels, nonhighway gas and lube oil (attach Form 4136) ———
27 TAX DUE (line 25 less line 26). See instruction E for Tax Deposit System

Total Income Tax
n
&

rs
-_—-~>

28 OVERPAYMENT (line 26 less line 25) . :
Tnder_poralios of perp 1 dacare That I have evanined Tis Tali, Tnoluing Accompanying choduTes ad atements, ond To The Dost of my Krontedge and bared Ws
true, correct, and complete. If prepared by @ person other than taxpayer, his declaration is based on all information of which he has any knowledge.

‘Signatiire of officer or trustee

CORPORATE
‘SEAL

Date individual or firm signature of preparer



Form 990-T (1970)

Page 2

UNRELATED BUSINESS TAXABLE INCOME COMPUTATION

UNRELATED TRADE OR BUSINESS GROSS INCOME
Gross receipts or gross sales Less: Returns and allowances ..

Less: Cost of goods sold (Schedule A) and/or operations (Schedule B) .

Gross profit . foe
(a) Net gain from sale of debt-financed property, depreciable property, and from cutting timber

1
2
3
4

(b) Capital loss deduction for trusts

5 Income (or loss) from partnerships (attach statement)

6 Rent income (Schedule E)

7 Unrelated debt financed income (Schedule 5) Se Soe

8 Gross investment income of a 501(c)(7) or (9) organization $. _... less: set asides $. .. (See instructions)
(Enter gross income from members, dependents and their guests . eevee )

9 Interest, annuities, royalties, and rents from controlled organizations (Schedule oe

10 Total unrelated trade or business income—add lines 3 through 9

DEDUCTIONS

(Except for contributions, deductions must be directly connected with the unrelated business income)

A. Total

B. Directly connected

11 Compensation of officers or trustees (Schedule M)
12 Salaries and wages (not deducted elsewhere) .
13 Rents . :

14 Repairs (do not include capital expenditures) .

15 Bad debts :

16 Interest (Schedule !) .

17 Taxes (Schedule J) :
18 Contributions (see instructions for “
19 Depreciation (Schedule C)

20 Amortization (attach schedule) .

2:

Attach schedule)

&

x

Depletion .
22 Advertising . .

23 Pension, profit-sharing, stock bonus, annuity plans (attach Form 2950)
24 Other employee benefit plans (See instructions)

25 Other deductions (Schedule K)

26 Total deductions on lines 11 through 25

N

27 Unrelated business taxable income before allowable exempt activity € expenses (line 10 less line 26, column B) .
28 Less: Allowable exempt activity expenses (Schedule H)

2
30 Less: Net operating loss deduction (attach statement)

31 Unrelated business taxable income before specific deduction

32 Less: Specific deduction (See instruction “K(4)")
33 Unrelated business taxable income (line 31 less line 32)

Unrelated business taxable income before net operating loss deduction (line 27 less line 28)

3

i}

Schedule A—COST OF GOODS SOLD (See Instruction 2) Schedule B—COST OF OPERATIONS

Method of inventory valuation (specify) pe

a 1 Salaries and wages . .
1 Inventory at beginning of year. . . . . «| 2 Other costs (to be detailed):
2 Merchandise bought for manufacture or sale . |
3 Salaries and wages .

4 Other costs (attach schedule) .

5 Total. 2 es
6 Less inventory at end of year . toe
7 Cost of goods sold (enter here and on line 2, |

page2). . . . +. eee ee 3 Total (enter here and on line 2, page 2).

1


Form 990-T (1970) Page 3

Schedule C—DEPRECIATION (See Instruction 19)
Taxpayers using Revenue Procedures 62-21 and 65-13: Make no entry in column 2, enter the cost or other
__basis of assets held at end of year in column 3, and enter the accumulated depreciation at end of year in column 4.

5. Method of | 6 Lite or
rate

1, Group and guideline class
or description of property

tio
2, Date 3, Cost or |
acquired | __other basis | sive towable

preciati
for this year

1 Total additional first-year depreciation (do not include in items below)

Buildings 2 2 2 ee eee
Furniture and fixtures... .
Transportation equipment . . -
Machinery and other equipment -
Other (specify).

2 Total. . . - woe eee .
3 Less amount of depreciation claimed elsewhere on return. 1 - ee ee ee ee
4 Balance—Enter here and on line 19, page2. . . - . . . . . .
‘Schedule E—RENT INCOME FROM REAL PROPERTY AND PERSONAL PROPERTY LEASED WITH REAL PROPERTY (See Instr. 6)

“3. Percentage of rent
attributable to
personal property

2. Rent received

1. Description of property or accrued

~ Continuation of Schedule E

4, Complete if any jem in ea rit the ;
onset irnanstinas Asmar than 5095 o if the rot 5. Complete for any item in column 3 which exceeds 109% and is nat more than 50%

(6) Deductions directly connected
(2) Deductions direct connected | (b) Income reportable, column 2 ue ‘ (©) Net income includible,
(Attach schedule) tess column 4(a) (2) Column 2x column 3 wiahech seheduloy column 5(a) less column 5(b)

dd 4(b) and 5(6) and enter total here and on line 6, page2. - . ss
___ Schedule _F-UNRELATED DEBT-| FINANCED INCOME (See Instruction 7)
2. Percentage of 4. Stra depreciation | ect
tion of debt financed property unrelated use 3. Gross income ian in'Schedute oy) Oath Statement

Continuation of Schedule F

vie ot| 8: Percentage which | 9. Gross income. Net i
6. Amount of average | 7. Average adjusted basis of 10. Allocable deductions (Total of | 11. Net income (or loss) includibl
acquisition indebtedness | property (Attach statement) | column 6 is of | reportable (Column 3 | “columns 4 and 5X column 8) | sign esscolorm 10 eolumn 2)

Total (enter here and on line 7, page 2). . ee ee ee
8) From Controlled Organizations (See Instruction 9)

Schedule G—GROSS INCOME (Annuities, Interest, Rents and Royal

H | a, Exempt controlled organizations

(6) Taxable income com- | ( percentage

3. Directly connected

1, Name and address of controlted organizations | 2. Gross income deductions | (a) Unrelated business| Puted 2s thoud not GrePt | which column
(attach schedule) |" taxable income |antnt in col. (ak wnichever| (2) 18 of
is greater column (b)

oT