Form 990-T (1963) Schedule G.—TAXES. (See Instruction 17)

Page 4

Explanation

‘Amount

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

Schedule H.-CONTRIBUTIONS OR GIFTS PAID. (See Instruction 18)

Name of organization ‘Address of organization

‘Amount

Total .

Organizations describe:

1. Contributions carry-over (see Instruction 18). : se eeeeeee .
2. Total contributions (limited to 5% of line 31, page 2, computed without regard to line 18, page 2). Enter here and on

line 18, page 2

3. Total contributions (not to exceed 20% of line 31, page 2, except in special cases described in Instruction 18, computed
without regard to line 18, page 2). Enter here and on line 18, page 2............ ss

Schedule I.—DEPRECIATION. (See Instruction 20)
This schedule is designed for taxpayers using the alternative guid:

ines and administrative procedures described in Revenue Procedure 62-21

as well as for those taxpayers who wish to continue using procedures authorized prior to the Revenue Procedure. Where double headings

appear use the first heading for the new procedure and the second heading for the older procedure.

: Asset additi
a Weenigg ef year’ | lngear amount) | 4: Asset retirements | 5, Depreciation
|_ at beginning of year oR jn year (amount) | allowed or allowable | comhting | Rate (9%)
Gest or ster acquir aa AY im prior years | ganmeattea| "arte
asis

6, Method | 7. Class life
OR - —

8. Depreciation for
this year

[I

. Less: Amount of depreciation claimed in Schedule C and elsewhere on return. .

2.
3. Balance—Enter here and on line 20, page 2 ..
4.

._ Cost or other basis of fully depreciated assets still in use |

Schedule J.—OTHER DEDUCTIONS. (See Instruction 25)

Explanation

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

r U.S. GOVERNMENT PRINTING OFFICE: 1963—-O-693-311


U.S, Treasury Department—Internal Revenue Service 1 9 6 3

rorm §90-T | EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN

(Under Section 511 of the Internal Revenue Code) Do not write in space below
FOR CALENDAR YEAR 1963 Serial No.
or other taxable
year beginning 1963, and ending a)

PLEASE TYPE OR PRINT

LEGAL NAME OF ORGANIZATION

ADDRESS (Number and street)

(City or town, State and Postal ZIP code)

NAME OF TRUST'S FIDUCIARY

‘ADDRESS OF TRUST'S FIDUCIARY Employer identification number (except
employees" trust ‘desoribed under sec.
40l{a) and exempt under sec. 501(@))

Nature of unrelated trade or business activity | Date of current exemption or determination letter and code
| Seton under which you are exempt

TAX COMPUTATION

ORGANIZATIONS TAXABLE AS CORPORATIONS. (See General Instruction A(1))
1, Combined normal tax and surtax. If amount on line 31, page 2, is:
(a) Not over $25,000; enter 30 percent of line 31, page 2.........
(b) Over $25,000. Compute 52 percent of line 31, page 2.

2, If alternative tax computation is made in separate statement, enter such tax here.......6. 2.0. 0eeeeeeee eee a

3. Total income tax (line 1 or 2, whichever is applicable)
4. Less: (a) Foreign tax credit. (attach Form 1118) .

(b) Investment credit. (attach Form 3468) .
5. Balance of income tax. a
6. Tax from recomputing prior year investment credit (attach statement)

1. Total income tax (line 5 plus line 6. Enter here and on line 15)......

TRUSTS TAXABLE AT INDIVIDUAL RATES. (See General Instruction A(2))

8. Tax on line 31, page 2. (See tax table, page 4 of the Instructions)....... 0.6.60 see cece eee eee eee tenes a
9. If alternative tax computation is made in separate statement, enter such tax here......... 0600s e cence eens en eT
10. Total income tax (line 8 or 9, whichever is applicable). .

11, Less: (a) Foreign tax credit. (attach Form 1116).
(b) Investment credit, (attach Form 3468) .

12. Balance of income tax
13. Tax from recomputing prior year investment credit (attach statement) .
14. Total income tax (line 12 plus line 13. Enter here and on line 15).........................

TOTAL INCOME TAX

15, Total income tax due (from line 7 or 14, whichever is applicable). .

SIGNATURE AND VERIFICATION

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. If prepared by a person other than taxpayer, his declaration is based

on all information of which he has any knowledge.

CORPORATE
SEAL

Signature of officer Title



Form 990-T (1963) Page 2
UNRELATED BUSINESS TAXABLE INCOME COMPUTATION

Line and No, UNRELATED TRADE OR BUSINESS GROSS INCOME
1. Gross sales (where inventories are Less: Returns and

an income-determining factor) .. ...... <i allowances...
2. Less: Cost of goods sold (from Schedule A).
3. Gross profit from sales
4. Gross receipts (where inventories are not an income-determin-
ing factor) 6... ee cece ee eeveeeeeeeeeeeeeeueeeeetenees
5. Less: Cost of operations (from Schedule B)...........

6. Gross profit where inventories are not an income-determining factor.

1. (a) Net capital gain from cutting timber. (attach statement). ..

(b) Net ordinary loss from cutting timber. (attach statement). . .
8. Income (or loss) from partnerships. (attach statement)... .
9. Business lease rents (from Schedule C)
10. Total unrelated trade or business income on lines 3, “and 6 to 9, inclusive.

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

11. Compensation of officers or trustees (from Schedule D).........
12. Salaries and wages (not deducted elsewhere)...
13, Rents .
14. Repairs (do not include cost of improvements or capital exponditures)
18. Bad debis (from Schedule E if reserve method is used)
16. Interest (from Schedule F)
17. Taxes (from Schedule G)
18. Contributions or gifts paid (from Schedule H).....
19. Losses by fire, storm, shipwreck, or other casualty, or theft. (attach schedule). .
20. Depreciation (from Schedule I).........- 000s see eee eee eee eee eee
21. Amortization. (attach schedule)
22. Depletion. (attach schedule)
23. Advertising...........
24, Amount contributed under: (a) A pension, profit-sharing, stock bonus, annuity plan.
(b) Other employee benefit plans...........
25. Other deductions (from Schedule J)
26. Total deductions in lines 11 to 25, inclusive
27. Unrelated business taxable income before net operating Joss deduction (line 10 less line 26).
28. Less: Net operating loss deduction. (attach statement).............. +0... eee eee eee eee .
29. Unrelated business taxable income before specific exemption.
30. Less: Specific exemption..........
31. Unrelated business taxable income. . .

‘Schedule A.—COST OF GOODS SOLD. (See Instruction 2) Schedule B.—COST OF OPERATIONS
(Where inventories are an income-determining factor) _| _ (Where inventories are not an income-determining factor) _

1. Salaries and wages........
2. Other costs (to be detailed):

1. Inventory at beginning of year
2. Merchandise bought for manufacture or sale. . .

3. Salaries and wages.
4. Other costs per books. (attach schedule) .
5.
6. Less: Inventory at end of year.......... |__

1. Cost of goods sold (enter here and on line 2,
Fi) aT 3. Total (enter here and on line 5, page 2)...



Form 990-T (1963) Page 3
Schedule C.—BUSINESS LEASE RENTS. (See Instruction 9)

1, Description of Leased Property 2. Total Rent Received | 3. Taxes and Other Expenses 4, Interest

5. Depreciation
Expiain in Schedule |)

Continuation of Schedule C

7, Adjusted Basis of Leased | 8. Percentage which | 9. Gross Rental Income | 10. Allocable Deductions (Total ot | 11. Net Rental Income (or loss) In-
6. Amount of Unpaid Indebtedness | pionerty (Attach Statement) | Col.6 Is of Col.7 | (Golumn2x Column 8) | Columns 3, 4, and 5 x Column 8) | cludible (Column 9 less Column 10)

Total (enter here and on line 9, page 2)... 6.66... eee eee eee ee te tee ttetteeeeeeeee

3. Time
6. Amount of
1, Name and Address of Officer 2. Official Title Sovated to | Compensation

4, Common |5. Preferred

Total compensation of officers (enter here and on line 11, page 2).

Schedule E.—BAD DEBTS—-RESERVE METHOD. (See Instruction 18)

2, Trade Notes and Accounts
1 Taabte | > Recevale Outstanding 2, Sales on Account 4, Gros Amount Added 5. Amount Charged 6. Regty for Ba Debts
at End of Year
1960
1961
1962

1963....

Schedule F.—_INTEREST ON INDEBTEDNESS. (See Instruction 16)

Explanation Amount

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