Schedule B

(Form 990, 990-EZ, 

or 990-PF)

Department of the Treasury 

Internal Revenue Service

Schedule of Contributors

▶ Attach to Form 990, Form 990-EZ, or Form 990-PF.

▶ Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2016

Name of the organization Employer identification number

Organization type (check one):

Filers of: Section:

Form 990 or 990-EZ 501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF 501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.

Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See

instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 

or more (in money or property) from any one contributor. Complete Parts I and II. See instructions for determining a 

contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 331/3 % support test of the 

regulations under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 

13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) 

$5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one 

contributor, during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, 

literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one 

contributor, during the year, contributions exclusively for religious, charitable, etc., purposes, but no such 

contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received 

during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the 

General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions 

totaling $5,000 or more during the year . . . . . . . . . . . . . . . . . . ▶ $

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,

990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ or on its 

Form 990-PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions for Form 990, 990-EZ, or 990-PF. Cat. No. 30613X Schedule B (Form 990, 990-EZ, or 990-PF) (2016)
Schedule B (Form 990, 990-EZ, or 990-PF) (2016) Page 2

Name of organization Employer identification number

Part I Contributors (See instructions). Use duplicate copies of Part I if additional space is needed.

(a) 

No.

(b) 

Name, address, and ZIP + 4

(c) 

Total contributions

(d) 

Type of contribution

$

Person

Payroll

Noncash

(Complete Part II for 

noncash contributions.)

(a) 

No.

(b) 

Name, address, and ZIP + 4

(c) 

Total contributions

(d) 

Type of contribution

$

Person

Payroll

Noncash

(Complete Part II for 

noncash contributions.)

(a) 

No.

(b) 

Name, address, and ZIP + 4

(c) 

Total contributions

(d) 

Type of contribution

$

Person

Payroll

Noncash

(Complete Part II for 

noncash contributions.)

(a) 

No.

(b) 

Name, address, and ZIP + 4

(c) 

Total contributions

(d) 

Type of contribution

$

Person

Payroll

Noncash

(Complete Part II for 

noncash contributions.)

(a) 

No.

(b) 

Name, address, and ZIP + 4

(c) 

Total contributions

(d) 

Type of contribution

$

Person

Payroll

Noncash

(Complete Part II for 

noncash contributions.)

(a) 

No.

(b) 

Name, address, and ZIP + 4

(c) 

Total contributions

(d) 

Type of contribution

$

Person

Payroll

Noncash

(Complete Part II for 

noncash contributions.)

Schedule B (Form 990, 990-EZ, or 990-PF) (2016)
Schedule B (Form 990, 990-EZ, or 990-PF) (2016) Page 3

Name of organization Employer identification number

Part II Noncash Property (See instructions). Use duplicate copies of Part II if additional space is needed.

(a) No. 

from 

Part I

(b) 

Description of noncash property given

(c) 

FMV (or estimate) 

(See instructions)

(d) 

Date received

$

(a) No. 

from 

Part I

(b) 

Description of noncash property given

(c) 

FMV (or estimate) 

(See instructions)

(d) 

Date received

$

(a) No. 

from 

Part I

(b) 

Description of noncash property given

(c) 

FMV (or estimate) 

(See instructions)

(d) 

Date received

$

(a) No. 

from 

Part I

(b) 

Description of noncash property given

(c) 

FMV (or estimate) 

(See instructions)

(d) 

Date received

$

(a) No. 

from 

Part I

(b) 

Description of noncash property given

(c) 

FMV (or estimate) 

(See instructions)

(d) 

Date received

$

(a) No. 

from 

Part I

(b) 

Description of noncash property given

(c) 

FMV (or estimate) 

(See instructions)

(d) 

Date received

$

Schedule B (Form 990, 990-EZ, or 990-PF) (2016)
Schedule B (Form 990, 990-EZ, or 990-PF) (2016) Page 4

Name of organization Employer identification number

Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or 

(10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and 

the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,

contributions of $1,000 or less for the year. (Enter this information once. See instructions.) ▶ $

Use duplicate copies of Part III if additional space is needed.

(a) No. 

from 

Part I

(b) Purpose of gift (c) Use of gift (d) Description of how gift is held

(e) Transfer of gift

Transferee’s name, address, and ZIP + 4 Relationship of transferor to transferee

(a) No. 

from 

Part I

(b) Purpose of gift (c) Use of gift (d) Description of how gift is held

(e) Transfer of gift

Transferee’s name, address, and ZIP + 4 Relationship of transferor to transferee

(a) No. 

from 

Part I

(b) Purpose of gift (c) Use of gift (d) Description of how gift is held

(e) Transfer of gift

Transferee’s name, address, and ZIP + 4 Relationship of transferor to transferee

(a) No. 

from 

Part I

(b) Purpose of gift (c) Use of gift (d) Description of how gift is held

(e) Transfer of gift

Transferee’s name, address, and ZIP + 4 Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2016)
Schedule B (Form 990, 990-EZ, or 990-PF) (2016) Page 5

General Instructions

Section references are to the Internal 

Revenue Code unless otherwise noted.

Future developments. For the latest 

information about developments related 

to Schedule B (Form 990, 990-EZ, or 

990-PF), such as legislation enacted 

after the schedule and its instructions 

were published, go to 

www.irs.gov/form990.

Note: Terms in bold are defined in the

Glossary of the Instructions for Form

990. 

Purpose of Schedule

Schedule B (Form 990, 990-EZ, or 

990-PF) is used to provide information 

on contributions the organization 

reported on:

• Form 990, Return of Organization 

Exempt from Income Tax, Part VIII, 

Statement of Revenue, line 1; 

• Form 990-EZ, Short Form Return of 

Organization Exempt from Income Tax, 

Part I, line 1; or

• Form 990-PF, Return of Private 

Foundation, Part I, line 1.

Who Must File

Every organization must complete and 

attach Schedule B to its Form 990, 

990-EZ, or 990-PF, unless it certifies that 

it doesn't meet the filing requirements of 

this schedule by taking the following 

action:

• Answering “No” on Form 990, Part IV, 

Checklist of Required Schedules, line 2, 

or

• Checking the box on

• Form 990-EZ, line H, or

• Form 990-PF, Part I, Analysis of 

Revenue and Expenses, line 2.

See the separate instructions for these 

lines on those forms.

If an organization isn't required to file 

Form 990, 990-EZ, or 990-PF but 

chooses to do so, it must file a complete 

return and provide all of the information 

requested, including the required 

schedules.

Accounting Method

When completing Schedule B (Form 990, 

990-EZ, or 990-PF), the organization 

must use the same accounting method it 

checked on Form 990, Part XII, Financial

Statements and Reporting, line 1; Form 

990-EZ, line G; or Form 990-PF, line J.

Public Inspection

Note: Don't include social security 

numbers of contributors as this 

information may be made public.

• Schedule B is open to public 

inspection for an organization that files 

Form 990-PF.

• Schedule B is open to public inspection 

for a section 527 political organization 

that files Form 990 or 990-EZ.

• For all other organizations that file 

Form 990 or 990-EZ, the names and 

addresses of contributors aren't required 

to be made available for public 

inspection. All other information, 

including the amount of contributions, 

the description of noncash 

contributions, and any other 

information, is required to be made 

available for public inspection unless it 

clearly identifies the contributor. 

If an organization files a copy of Form 

990 or 990-EZ, and attachments, with 

any state, it shouldn't include its 

Schedule B (Form 990, 990-EZ, or 

990-PF) in the attachments for the state, 

unless a schedule of contributors is 

specifically required by the state. States 

that don't require the information might 

inadvertently make the schedule 

available for public inspection along with 

the rest of the Form 990 or 990-EZ.

See the Instructions for Form 990, 

990-EZ, or 990-PF for information on 

telephone assistance and the public 

inspection rules for these forms and their 

attachments.

Contributors to be 

Listed on Part I

A contributor (person) includes 

individuals, fiduciaries, partnerships, 

corporations, associations, trusts, and 

exempt organizations. In addition, 

section 509(a)(2), 170(b)(1)(A)(iv), and 

170(b)(1)(A)(vi) organizations must also 

report governmental units as 

contributors.

Contributions

Contributions reportable on Schedule B

(Form 990, 990-EZ, or 990-PF) are

contributions, grants, bequests, devises,

and gifts of money or property, whether

or not for charitable purposes. For

example, political contributions to

section 527 political organizations are

included. Contributions don't include

fees for the performance of services. See 

the instructions for Form 990, Part VIII, 

line 1, for more detailed information on 

contributions.

General Rule

Unless the organization is covered by 

one of the Special Rules below, it must 

list in Part I every contributor who, during 

the year, gave the organization, directly 

or indirectly, money, securities, or any 

other type of property that total $5,000 

or more for the organization’s tax year. 

In determining the total amount, 

separate and independent gifts of less 

than $1,000 can be disregarded.

Include each contribution included on 

Form 990, Part VIII, line 1, in calculating 

a contributor's total contributions and 

determining whether that contributor 

must be reported on Schedule B under 

this General Rule (or one of the following 

Special Rules, if applicable). For 

example, if an organization that uses the 

accrual method of accounting reports a 

pledge of noncash property in Part VIII, 

line 1, it must include the value of that 

contribution in calculating whether the 

contributor meets the General Rule (or 

one of the Special Rules, if applicable), 

even if the organization didn't receive the 

property during the tax year. 

Special Rules

Section 501(c)(3) organizations that 

file Form 990 or 990-EZ. For an

organization described in section

501(c)(3) that meets the 331/3% support

test of the regulations under sections

509(a)(1) and 170(b)(1)(A)(vi), and not just

the 10% support test (whether or not the

organization is otherwise described in

section 170(b)(1)(A)), list in Part I only

those contributors whose contribution of

$5,000 or more during the tax year is

greater than 2% of the amount reported

on Form 990, Part VIII, line 1h(A), or 

Form 990-EZ, line 1. An organization that 

claims the benefit of this special rule 

must either (1) establish on Schedule A 

(Form 990 or 990-EZ), Part II, that it met 

the 331/3% support test for the current 

year or prior year, or (2) check the box on 

Schedule A (Form 990 or 990-EZ), Part I, 

line 7 or 8, and the box on Schedule A, 

Part II, line 13, as a section 170(b)(1)(A)

(vi) organization in its first five years.

Example. A section 501(c)(3)

organization, of the type described

above, reported $700,000 in total

contributions, gifts, grants, and similar

amounts received on Form 990, Part VIII,

line 1h. The organization is only required

to list in Parts I and II of its Schedule B

each person who contributed more than

the greater of $5,000 or 2% of $700,000

($14,000) during the tax year. Thus, a

contributor who gave a total of $11,000

wouldn't be reported in Parts I and II for 

this section 501(c)(3) organization. Even 

though the $11,000 contribution to the 

organization was greater than $5,000, it 

didn't exceed $14,000.

Section 501(c)(7), (8), or (10) 

organizations. For contributions to

these social and recreational clubs,

fraternal beneficiary and domestic

fraternal societies, orders, or

associations that weren't for an

exclusively religious, charitable, etc.,

purpose, list in Part I each contributor

who contributed $5,000 or more during

the tax year, as described under 

General Rule, earlier.
Schedule B (Form 990, 990-EZ, or 990-PF) (2016) Page 6

For contributions to a section 501(c)(7), 

(8), or (10) organization received for use 

exclusively for religious, charitable, 

scientific, literary, or educational 

purposes, or for the prevention of cruelty 

to children or animals (sections 170(c)(4), 

2055(a)(3), or 2522(a)(3)), list in Part I 

each contributor whose aggregate 

contributions for an exclusively religious, 

charitable, etc., purpose were more than 

$1,000 during the tax year. To determine 

the more-than-$1,000 amount, total all of 

a contributor’s gifts for the tax year 

(regardless of amount). For a noncash 

contribution, complete Part II.

All section 501(c)(7), (8), or (10) 

organizations that listed an exclusively 

religious, charitable, etc., contribution in 

Part I or II must also complete Part III to 

provide further information on such 

contributions of more than $1,000 during 

the tax year and show the total amount 

received from such contributions that 

were for $1,000 or less during the tax 

year.

However, if a section 501(c)(7), (8), or 

(10) organization didn't receive total 

contributions of more than $1,000 from a 

single contributor during the tax year for 

exclusively religious, charitable, etc., 

purposes and consequently wasn't 

required to complete Parts I through III 

with respect to these contributions, it 

need only check the third Special Rules 

box on the front of Schedule B and 

enter, in the space provided, the total 

contributions it received during the tax 

year for an exclusively religious, 

charitable, etc., purpose.

Specific Instructions

▲!

CAUTION

Don't attach substitutes for 

Schedule B or attachments to 

Schedule B with information 

on contributors. Parts I, II, 

and III of Schedule B may be duplicated 

as needed to provide adequate space for 

listing all contributors. Number each 

page of each part (for example, Page 2 

of 5, Part II).

Part I. In column (a), identify the first

contributor listed as No. 1 and the

second contributor as No. 2, etc.

Number consecutively. In column (b),

enter the contributor’s name, address,

and ZIP code. Identify a donor as 

“anonymous” only if the organization 

doesn't know the donor’s identity. In 

column (c), enter the amount of total 

contributions for the tax year for the 

contributor listed.

In column (d), check the type of 

contribution. Check all that apply for the 

contributor listed. If a cash contribution

came directly from a contributor (other 

than through payroll deduction), check 

the “Person” box. A cash contribution 

includes contributions paid by cash, 

credit card, check, money order, 

electronic fund or wire transfer, and 

other charges against funds on deposit 

at a financial institution.

If an employee’s cash contribution 

was forwarded by an employer (indirect 

contribution), check the “Payroll” box. If 

an employer withholds contributions 

from employees’ pay and periodically 

gives them to the organization, report 

only the employer’s name and address 

and the total amount given unless you 

know that a particular employee gave 

enough to be listed separately.

Check the “Noncash” box in column 

(d) for any contribution of property other 

than cash during the tax year, and 

complete Part II of this schedule. For 

example, if an organization that uses the 

accrual method of accounting reports a 

pledge of noncash property on Form 

990, Part VIII, line 1g, it must check the 

“Noncash” box and complete Part II 

even if the organization didn't receive the 

property during the tax year.

For a section 527 organization that 

files a Form 8871, Political Organization 

Notice of Section 527 Status, the names 

and addresses of contributors that aren't 

reported on Form 8872, Political 

Organization Report of Contributions 

and Expenditures, don't need to be 

reported in Part I if the organization paid 

the amount specified by section 527(j)(1). 

In this case, enter “Pd. 527(j)(1)” in 

column (b) instead of a name, address, 

and ZIP code; but you must enter the 

amount of contributions in column (c).

Part II. In column (a), show the number

that corresponds to the contributor’s

number in Part I. In column (b), describe

the noncash contribution received by

the organization during the tax year, 

regardless of the value of that noncash 

contribution. Note the public inspection 

rules discussed earlier.

In columns (c) and (d), report property 

with readily determinable market value 

(for example, marked quotations for 

securities) by listing its fair market value 

(FMV). If the organization immediately 

sells securities contributed to the 

organization (including through a broker 

or agent), the contribution still must be 

reported as a gift of property (rather than 

cash) in the amount of the net proceeds 

plus the broker’s fees and expenses. 

See the instructions for Form 990, Part 

VIII, line 1g, which provide an example to 

illustrate this point. If the property isn't 

immediately sold, measure market value 

of marketable securities registered and 

listed on a recognized securities 

exchange by the average of the highest 

and lowest quoted selling prices (or the 

average between the bona fide bid and

asked prices) on the contribution date. 

See Regulations section 20.2031-2 to 

determine the value of contributed 

stocks and bonds. When FMV can't be 

readily determined, use an appraised or 

estimated value. To determine the 

amount of a noncash contribution 

subject to an outstanding debt, subtract 

the debt from the property’s FMV. Enter 

the date the property was received by 

the organization, but only if the donor 

has fully given up use and enjoyment of 

the property at that time.

The organization must report the value 

of any qualified conservation 

contributions and contributions of 

conservation easements listed in Part II 

consistently with how it reports revenue 

from such contributions in its books, 

records, and financial statements and in 

Form 990, Part VIII, Statement of 

Revenue.

For more information on noncash 

contributions, see the instructions for 

Schedule M (Form 990), Noncash 

Contributions.

If the organization received a partially 

completed Form 8283, Noncash 

Charitable Contributions, from a donor, 

complete it and return it so the donor 

can get a charitable contribution 

deduction. Keep a copy for your records.

Original (first) and successor donee 

(recipient) organizations must file Form 

8282, Donee Information Return, if they 

sell, exchange, consume, or otherwise 

dispose of (with or without 

consideration) charitable deduction 

property (property other than money or 

certain publicly traded securities) within 

3 years after the date the original donee 

received the property.

Part III. Section 501(c)(7), (8), or (10)

organizations that received contributions

for use exclusively for religious,

charitable, etc., purposes during the tax

year must complete Parts I through III for 

each person whose gifts totaled more 

than $1,000 during the tax year. Show 

also, in the heading of Part III, the total of 

gifts to these organizations that were 

$1,000 or less for the tax year and were 

for exclusively religious, charitable, etc., 

purposes. Complete this information 

only on the first Part III page if you use 

duplicate copies of Part III.

If an amount is set aside for an 

exclusively religious, charitable, etc., 

purpose, show in column (d) how the 

amount is held (for example, whether it is 

commingled with amounts held for other 

purposes). If the organization transferred 

the gift to another organization, show the 

name and address of the transferee 

organization in column (e) and explain 

the relationship between the two 

organizations.