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SCHEDULE G
(Form 990)
(Rev. December 2024)
Department of the Treasury
Internal Revenue Service
Name of the organization
Part I
Supplemental Information Regarding Fundraising or Gaming Activities
Complete if the organization answered “Yes” on Form 990, Part IV, line 17, 18, or 19; or if the
organization entered more than $15,000 on Form 990-EZ, line 6a.
Attach to Form 990 or Form 990-EZ.
Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
Open to Public
Inspection
Employer identification number
Fundraising Activities. Complete if the organization answered “Yes” on Form 990, Part IV, line 17.
Form 990-EZ filers are not required to complete this part.
TREASURY/IRS
AND OMB USE
ONLY DRAFT
November 19, 2024
DO NOT FILE
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a
Mail solicitations
e
Solicitation of nongovernment grants
b
f
Internet and email solicitations
Solicitation of government grants
Phone solicitations
Special fundraising events
c
g
d
In-person solicitations
2a Did the organization have a written or oral agreement with any individual (including officers, directors, trustees,
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
Yes
No
b If “Yes,” list the 10 highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is to be
compensated at least $5,000 by the organization.
(i) Name and address of individual
or entity (fundraiser)
(ii) Activity
(iii) Did fundraiser have
custody or control of
contributions?
Yes
(iv) Gross receipts
from activity
(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i)
(vi) Amount paid to
(or retained by)
organization
No
1
2
3
4
5
6
7
8
9
10
Total
. . . . . . . . . . . . . . . . . . . . . .
3
List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from
registration or licensing.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50083H
Schedule G (Form 990) (Rev. 12-2024)
Page 2
Schedule G (Form 990) (Rev. 12-2024)
Part II
Fundraising Events. Complete if the organization answered “Yes” on Form 990, Part IV, line 18, or reported more
than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with
gross receipts greater than $5,000.
(a) Event #1
(b) Event #2
(c) Other events
(event type)
(event type)
(total number)
(d) Total events
(add col. (a) through
col. (c))
Direct Expenses
Revenue
TREASURY/IRS
AND OMB USE
ONLY DRAFT
November 19, 2024
DO NOT FILE
1
Gross receipts .
.
.
2
3
Less: Contributions .
Gross income (line 1
minus line 2)
. . .
.
.
4
Cash prizes .
5
Noncash prizes
.
.
.
.
.
.
6
Rent/facility costs .
.
.
7
Food and beverages .
.
8
Entertainment .
.
.
9
Other direct expenses
.
10
11
Revenue
Part III
.
.
.
Direct expense summary. Add lines 4 through 9 in column (d)
Net income summary. Subtract line 10 from line 3, column (d)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
Gaming. Complete if the organization answered “Yes” on Form 990, Part IV, line 19, or reported more than
$15,000 on Form 990-EZ, line 6a.
(b) Pull tabs/instant
bingo/progressive bingo
(a) Bingo
(d) Total gaming (add
col. (a) through col. (c))
(c) Other gaming
Gross revenue .
.
.
.
2
Cash prizes .
.
.
.
3
Noncash prizes
.
.
.
4
Rent/facility costs .
.
.
5
Other direct expenses
.
6
Volunteer labor .
.
7
Direct expense summary. Add lines 2 through 5 in column (d)
.
.
.
.
.
.
.
.
.
8
Net gaming income summary. Subtract line 7 from line 1, column (d) .
.
.
.
.
.
.
.
.
Enter the state(s) in which the organization conducts gaming activities:
a Is the organization licensed to conduct gaming activities in each of these states? .
b If “No,” explain:
.
.
.
.
.
Direct Expenses
1
.
.
.
Yes
No
%
Yes
No
Yes
No
%
.
.
%
9
.
.
Yes
No
10a Were any of the organization’s gaming licenses revoked, suspended, or terminated during the tax year?
b If “Yes,” explain:
.
Yes
No
.
Schedule G (Form 990) (Rev. 12-2024)
Page 3
Schedule G (Form 990) (Rev. 12-2024)
11
12
Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . . . .
Is the organization a grantor, beneficiary, or trustee of a trust; or a member of a partnership or other entity
formed to administer charitable gaming? . . . . . . . . . . . . . . . . . . . . . .
Yes
No
Yes
No
13
Indicate the percentage of gaming activity conducted in:
13a
a The organization’s facility . . . . . . . . . . . . . . . . . . . . . . . . .
13b
b An outside facility . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14
Enter the name and address of the person who prepares the organization’s gaming/special events books and
records:
%
%
TREASURY/IRS
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November 19, 2024
DO NOT FILE
Name
Address
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b If “Yes,” enter the amount of gaming revenue received by the organization $
amount of gaming revenue retained by the third party $
c If “Yes,” enter the name and address of the third party:
Yes
No
Yes
No
and the
Name
Address
16
Gaming manager information:
Name
Gaming manager compensation $
Description of services provided
Director/officer
17
Employee
Independent contractor
Mandatory distributions:
Is the organization required under state law to make charitable distributions
retain the state gaming license? . . . . . . . . . . . . . . .
b Enter the amount of distributions required under state law to be distributed to
spent in the organization’s own exempt activities during the tax year . . .
a
Part IV
from the gaming proceeds to
. . . . . . . . . .
other exempt organizations or
. .
$
Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and
Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information.
See instructions.
Schedule G (Form 990) (Rev. 12-2024)
File Type | application/pdf |
File Title | Schedule G (Form 990) (Rev. December 2024) |
Subject | Fillable |
Author | C:DC:TS:CAR:MP |
File Modified | 2024-11-19 |
File Created | 2024-11-07 |