Form CT-12
For Oregon Charities
For Accounting Periods Beginning in:
2016
Charitable Activities Section
Oregon Department of Justice
100 SW Market Street VOICE (971) 673-1880
Portland, OR 97201-5702 FAX (971) 673-1882
Email: charitable.activities@doj.state.or.us
Website: http://www.doj.state.or.us
You can now file reports and
pay by credit card using our
online form at
https://justice.oregon.gov/
paymentportal/Account/Login
Section I. General Information
1.
Cross Through Incorrect Items and Correct Here:
(See instructions for change of name or accounting period.)
Registration #:
Organization Name:
Address:
City, State, Zip:
Phone: Fax: Amended
Email: Report?
Period Beginning: / / Period Ending: / /
2.
Yes No
3.
Yes No
4.
Yes No
5.
Yes No
6.
Yes No
7.
Provide contact information for the person responsible for retaining the organization’s records.
Name
Position
Phone
Mailing Address & Email Address
8.
List of Officers, Directors, Trustees and Key Employees List each person who held one of these positions at any time during the year even if they did
not receive compensation. Attach additional sheets if necessary. If an attached IRS form includes substantially the same compensation information,
the phrase “See IRS Form” may be entered in lieu of completing that section. (Oregon law requires a minimum of three directors for nonprofit
corporations.)
(A) Name, mailing address, daytime phone number
and email address
(B) Title &
average weekly
hours devoted to
position
(C)
Compensation
(enter $0 if
position unpaid)
Name:
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
(_ _ _)_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Address:
Phone:
Email:
Name:
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
(_ _ _)_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Address:
Phone:
Email:
Name:
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
(_ _ _)_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Address:
Phone:
Email:
Print
Reset
Section II. Fee Calculation
9.
Total Revenue ...........................................................................................................................
(From Line 12 (current year) on Form 990; Line 9 on Form 990-EZ; Part I, Line 12a on Form 990-PF; Line 9 on Form 1041;
or see the CT-12 instructions if no federal tax return was prepared or a Form 990-N was filed. Attach explanation if Total
Revenue is $0.)
9.
10.
Revenue Fee ............................................................................................................................................................................
(See chart below. Minimum fee is $20, even if total revenue is a negative amount.)
10.
Amount on Line 9 Revenue Fee
$0 - $24,999 $20
$25,000 - $49,999 $50
$50,000 - $99,999 $90
$100,000 - $249,999 $150
$250,000 - $499,999 $200
$500,000 - $1,000,000 $300
$1,000,000 or more $400
11.
Net Assets or Fund Balances at End of the Reporting Period ......
(From Line 22 (end of year) on Form 990, Line 21 on Form 990-EZ, or Part III, Line
6 on Form 990-PF; or see the CT-12 instructions to calculate.)
11.
12.
Net Fixed Assets Used to Conduct Charitable Activities ...........
12.
13.
Amount Subject to Net Assets or Fund Balances Fee ..............................................................
(Line 11 minus Line 12. If Line 11 minus Line 12 is less than $50,000, write $0.)
13.
14.
Net Assets or Fund Balances Fee ...........................................................................................................................................
(Line 13 multiplied by .0001. If the fee is less than $5, enter $0. Not to exceed $2,000. Round cents to the nearest whole dollar.)
14.
15.
Are you filing this report late? Yes No.................................................................................................................
(If yes, the late fee is a minimum of $20. You may owe more depending on how late the report is. See Instruction 15 for additional information or contact the
Charitable Activities Section at (971) 673-1880 to obtain late fee amount.)
15.
16.
Total Amount Due ...................................................................................................................................................................
(Add Lines 10, 14, and 15. Make check payable to the Oregon Department of Justice.)
16.
17.
Attach a copy of the organization’s federal 990 or other return and all supporting schedules and attachments that were filed with the IRS, except that
Form 990 & 990EZ filers do not need to attach a copy of their Schedule B. Also, if the organization did not file with the IRS or filed a 990-N, but had
Total Revenue of $50,000 or more, or Net Assets or Fund Balances of $100,000 or more, see the instructions as the organization may be required to
complete certain IRS forms for Oregon purposes only. If the attached return was not filed with the IRS, then mark any such return as “For Oregon
Purposes Only." If your organization files IRS Form 990-N (e-Postcard) please attach a copy or confirmation of its filing.
Please
Sign
Here
Under penalties of perjury, I declare that I have examined this return, including all accompanying forms, schedules, and attachments, and
to the best of my knowledge and belief, it is true, correct, and complete.
_______________________________________ _____________________ _________________________
Signature of officer Date Title
_______________________________________ _______________________________________________________
Officer’s name (printed) Address
_______________________________________________________
Phone
Paid
Preparer’s
Use Only
_______________________________________ _____________________ _________________________
Preparer’s signature Date Phone
_______________________________________ _______________________________________________________
Preparer’s name (printed) Address
(Generally, from Part X, Line 10c on Form 990, Line 23B on Form 990-EZ or Part
II, Line 14b on Form 990-PF; or see the CT-12 instructions to calculate. See the
Ct-12 instructions if organization owns income-producing assets.)
Charitable Activities Section, Oregon Department of Justice
2016 Form CT-12 Instructions
General
Instructions
Purpose
Oregon law charges the Attorney General with
the duty and responsibility to represent the
public’s interest in connection with assets held
for charitable purposes. The Attorney General
carries out this responsibility by requiring
organizations holding such assets to register and
file periodic financial reports.
Once submitted, this Form and all attachments
become a part of the public record. Any
interested person may examine or obtain a copy
of an annual report of a charitable organization
by contacting the Charitable Activities Section.
Reports can also be viewed on our website at
https://justice.oregon.gov/Charities.
Who Must File
All organizations registered with the Charitable
Activities Section of the Oregon Department of
Justice must annually file Form CT-12, CT-12F,
or CT-12S unless the Attorney General has
specifically exempted the organization from the
reporting requirements.
What Form to File
File Form CT-12 if the organization is
incorporated or organized in Oregon.
File Form CT-12F if the organization is
incorporated or organized outside of Oregon.
The Charitable Activities Section does not
accept multi-state annual report forms in lieu of
a completed Form CT-12F.
File Form CT-12S if the organization is a split-
interest trust that holds assets for the benefit of
both charitable and non-charitable beneficiaries.
If the organization does not fit within any of the
above categories, file Form CT-12.
The Form year should match the starting
year of the fiscal period covered by the
report.
Due Date
The Form, all required attachments and
schedules, and payment of fees are due in the
Charitable Activities Section’s office no later
than 4 months and 15 days after the end of the
organization’s fiscal year. If the due date falls on
a weekend or legal holiday, the due date is the
next business day.
The Charitable Activities Section does not use
the postmark date to determine whether an
organization has filed timely. Instead, filings are
considered timely if they are physically received
within 5 business days after the due date. All
filings received more than 5 business days after
the due date will be assessed a late charge. See
Instruction 15 Late Fees.
Extensions for Filing and
Paying Fees
An organization may apply for an extension of
time to file. Extension requests must be received
on or before the due date of the report to avoid a
late fee. The maximum available extension
period is 180 days. An extension to file is also
an extension to pay any associated fees.
Therefore, estimated payments should not be
included with extension requests.
Extensions may be requested through the
Department of Justice website at
https://justice.oregon.gov/Charities/Extensions.
Follow the instructions carefully to ensure that
the Charitable Activities Section receives your
request. Please contact our office if you have
any questions or are experiencing difficulties
with your online request.
The organization may also submit a written
request or a copy of the organization’s federal
extension request (IRS Form 8868) so long as
the Charitable Activities Section receives the
request or copy before the due date of the
report. The organization’s 4 or 5-digit
registration number should be noted on the top
of all extension requests. If you would like
acknowledgement that your extension request
has been received, you should enclose an
additional copy of the request and a self-
addressed, stamped envelope.
The Charitable Activities Section will not
provide formal notice that the organization’s
extension request has been approved. Instead,
the organization should assume that its extension
request has been granted unless you hear
otherwise from our office. In the event your
request is denied, to avoid a late fee, the annual
report must be submitted by the later of the due
date or within 10 days after the organization
receives notice of denial of the requested
extension.
Important NoteAn extension request filed
with the IRS or the Oregon Department of
Revenue does NOT act as an extension with
the Charitable Activities Section unless a copy
is submitted to the Charitable Activities
Section by the due date.
Record Keeping
Please retain a copy of this report and all
supporting documentation for at least five years
after the due date.
Rounding and Blank Lines
Round all amounts on the report to the nearest
whole dollar. Drop amounts under 50 cents and
increase amounts from 50 to 99 cents to the next
whole dollar. If the amount is zero write “$0.”
Do not leave any line blank.
Important Reminders
Don’t lose your tax-exempt status. Most tax-
exempt organizations other than churches must
file a yearly return with the IRS. Very small
organizations are required to file IRS Form 990-
N, also known as the e-Postcard. The IRS is
required by law to revoke the tax-exempt status
of any organization that has failed to file a
required return for three consecutive years.
Please refer to http://www.irs.gov/eo for more
information about these requirements.
Important information regarding Social
Security numbers (SSNs) Forms submitted
to this office become a public record. In
order to protect the privacy of named
individuals, you should redact any SSNs (if
used) from copies of any IRS forms
submitted. Although we endeavor to redact
social security numbers from any forms we
receive, we request your assistance in
safeguarding this information by not
including it in your submission.
How to Contact the
Charitable Activities
Section
To obtain blank forms, technical assistance or
information about a charitable organization,
contact the Charitable Activities Section or visit
our website at:
Charitable Activities Section
Oregon Department of Justice
100 SW Market Street
Portland, OR 97201-5702
Phone: (971)673-1880
TTY: (800)735-2900
Fax: (971)673-1882
Email: charitable.activities@doj.state.or.us
Website: http://www.doj.state.or.us
Where to File
Send completed forms and corresponding fees to
the above address. The Charitable Activities
Section does not accept reports by Fax, Email, or
electronic submission at this time.
Line Instructions
Section I.
General Information
1. Missing or Incorrect
Information
The Charitable Activities Section sends a form
preprinted with name, address, contact
information and registration number to all
registered organizations. If the organization has
received one of these preprinted forms, provide
any missing or corrected information. If the
organization is completing a blank form, provide
the requested information in this section.
Name Changes
If applicable, write the organization’s new legal
name. Attach a copy of the filed amended
articles of incorporation or trust document that
changed the organization’s name.
Address and Phone Number
Changes
If applicable, write the new address where mail
for the organization should be directed in the
future. If applicable, write the new daytime
phone number, fax number and email address
for the organization.
Accounting Year Changes
If applicable, write the organization’s new or
short reporting period. Preprinted forms are
based upon the accounting period we have on
record for the organization. If the organization
has changed its fiscal year or is filing a final
report for a period less than 12 months, the
shortened period covered by the report must be
noted here. For final reports also see
instructions for line 6.
Short Year ReportIf the organization is
filing a shortened report due to a change in fiscal
year, see the instructions for line 13 for
calculation of prorated Net Assets or Fund
Balances fee.
Amended Reports
If amending previously submitted information
for the same accounting period, check the
amended report box. Either complete a blank
form that includes the amended information or
provide a copy of the previously submitted form
that clearly shows what information is being
amended. Submit any additional fee due with the
amended report.
2. Independent Audit
Check yes if the organization had an
independent audit of its financial records
performed by a certified public accountant.
Attach a copy of the auditor’s report, the
financial statements, the accompanying notes,
schedules, or other documents supplementing
the report or financial statements. Do not
submit copies that are professionally bound.
3. Professional / Commercial
Fund-Raising
Check yes if the organization entered into a
contract with a for-profit company or a mutual
benefit nonprofit company to conduct in-person,
advertising, vending machine, or telephone
solicitations on its behalf. Write the name(s) of
the fund-raising firm(s) in the space provided.
4. Disclosure of Legal Action
Check yes if the organization or any of its
officers, directors, trustees or key employees
ever signed a voluntary agreement with any
government agency, such as a state attorney
general, secretary of state, or local district
attorney, or been a party to legal action in any
court or administrative agency regarding
charitable solicitation, administration,
management, or fiduciary practices. This
includes assurances of voluntary compliance or
discontinuance involving the organization or any
other proceeding in which the organization or
any current officer, director, trustee, or key
employee is subject to any injunction, order, or
pending action relating to the solicitation of
contributions, or administration of charitable
assets. Attach a written explanation of each
such action or agreement, including the
agency involved and the allegations. Also,
attach a copy of any agreements or actions
that occurred in the current reporting period.
5. Amendments to Articles of
Incorporation, Bylaws, Trust
Documents, or Tax-Exempt
Status
Check yes if during the reporting period the
organization amended its articles, bylaws, or
trust documents, or if the IRS issued a new tax-
exempt status ruling for the organization,
including revocation.
Important NoteAttach copies of
amendments to articles of incorporation bearing
the Secretary of State’s file stamp, signed and
dated copies of amended bylaws, amended trust
documents, and/or IRS determination letters.
6. Final Report
Check yes if this is the final report for the
organization.
If the organization is dissolving, the Charitable
Activities Section must be notified in writing 20
days prior to the dissolution or the distribution of
the organization’s assets. This notification may
be done either through a letter or submission of a
completed Closing Form which can be obtained
by contacting the Charitable Activities Section
or from our website. Notification must include
the disposition of assets including the name,
address, phone number, and contact person of
each organization that will receive any
remaining assets and the amount of the assets
involved or a copy of the minutes of the board
meeting that approved the dissolution containing
the same information.
If the organization is filing a final report for a
reason other than a dissolution, such as the
discontinuance of soliciting contributions,
holding assets or conducting charitable activities
in Oregon, there are similar notification
requirements.
If the organization is a trust and is filing a final
report for any reason, the Charitable Activities
Section should be contacted for specific
instructions and requirements related to closing
procedures.
A final report must reflect the financial
transactions of the charitable organization from
the day after the close of its last accounting
period to the date of the disposition of all
remaining assets.
Important NoteDissolving corporations
must submit a copy of any articles of dissolution
filed with the Corporation Division in addition to
the information required above. If articles of
dissolution have not been filed, then the
anticipated date of dissolution must be provided.
Important NoteThe organization must
submit this information even if the distribution
of assets has already occurred.
7. Who Keeps the Books?
Indicate the person to be contacted if the
organization's books need to be accessed for
information or review. Either a business or
personal phone number and mailing address are
acceptable.
8. Officers, Directors,
Trustees, and Other Key
Employees
List each person who was an officer, director,
trustee, or key employee (defined below) of the
organization at any time during the year even if
they are a volunteer and do not receive any
compensation from the organization. Give the
daytime phone number and preferred mailing
address at which officers, etc., want the
Charitable Activities Section to contact them.
Use an attachment if there are more persons to
list than there are lines available.
A failure to fully complete this part can subject
the organization to penalties for filing an
incomplete Form.
If the organization is an Oregon public benefit
corporation, it must have a minimum of three
individuals serving on its board of directors.
A "key employee" is any person having
responsibilities or powers similar to those of
officers, directors, or trustees. The term includes
the chief management and administrative
officials of an organization (such as executive
director) but does not include the heads of
separate departments or smaller units within an
organization.
A chief financial officer and the officer in charge
of administration or program operations are both
key employees if they have the authority to
control the organization's activities, it's finances,
or both. The "heads of separate departments"
reference applies to persons such as the head of
the radiology department or coronary care unit
of a hospital or the head of the chemistry or
history or English department at a college. These
persons are managers within their specific areas
but not for the organization as a whole and,
therefore, are not key employees.
Column (C)
If an IRS form is attached that includes complete
and accurate compensation information the
phrase “See IRS Form” may be entered in lieu of
completing this section.
Otherwise, for each person listed, report the total
amount of compensation paid or deferred for
payment to a later date, including salary, fees,
bonuses, benefits, taxable allowances or
reimbursements, the value of noncash
compensation, and severance payments.
Enter a zero in column (C) if the person was a
volunteer and was not paid or did not accrue any
compensation during the reporting year.
The organization may provide an attachment to
explain the entire compensation package for any
person listed in this part, including whether the
compensation includes the payment of amounts
previously deferred.
Section II.
9. Total Revenue
The Charitable Activities Section has adopted
the definition for “Total Revenue” used by the
Internal Revenue Service. If the organization
completed one of the following IRS Forms for
this reporting period, the Total Revenue figure
should come from the line number listed:
IRS Form 990, Part I, line 12 (current
year)
IRS Form 990-EZ, Part I, line 9
IRS Form 990-PF, Part I, line 12a
IRS Form 1041, line 9
If the organization was not required to complete
one of these IRS Forms, or filed an IRS Form
990-N, a summary of what constitutes Total
Revenue is provided within these instructions. A
more detailed definition can be found in the IRS
instructions for the forms listed above.
“Total Revenue” includes such items as:
contributions
gifts
grants
donated real property
donated thrift items
membership dues & assessments
program service revenue
government fees & contracts
interest income
dividend income
net rental gain or loss as determined by
gross rental income less rental expense
other investment income
gain or loss on sales of assets other than
inventory as calculated by gross sale
price less cost or other basis
gain or loss from special events &
activities which may include bingo
games, raffle events, Monte Carlo events,
dinners, and door-to-door sales of
merchandise as calculated by gross
proceeds minus direct expenses
gain or loss on sale of inventory as
calculated by sales price less returns &
allowances and the cost of goods sold
all other sources of revenue.
include amounts obtained from both
Oregon and out of state sources.
To report contributions received in a form other
than cash, use the market value as of the date of
the contribution. When market value cannot be
readily determined, use an appraised or
estimated value.
To determine the amount of any noncash
contribution that is subject to an outstanding
debt, subtract the debt from the property’s fair
market value in assigning a value to the revenue
received.
“Fair market value” is the amount a reasonable
person would pay for the item at the time it was
donated to the organization.
Important NoteDo not include the value of
services donated to the organization, or items
such as the free use of materials, equipment, or
facilities in reporting Total Revenue.
Important NoteIf Total Revenue is zero,
attach an explanation of why Total Revenue is
zero and indicate whether the organization plans
to continue operations. See the instructions for
line 6 if this is the organization’s final report.
10. Revenue Fee
Use the Total Revenue figure from line 9 to
calculate the revenue fee according to the
following schedule.
Revenue Fee Schedule
Amount on Line 9
Revenue Fee
$ 0
-
$ 24,999
$ 20
25,000
-
49,999
50
50,000
-
99,999
90
100,000
-
249,999
150
250,000
-
499,999
200
500,000
-
1,000,000
300
1,000,000
or
more
400
The maximum amount subject to a revenue fee is
$1,000,000. The maximum revenue fee is $400.
The minimum revenue fee is $20, even if total
revenue is zero or a negative amount.
11. Net Assets or Fund
Balances at the End of the
Reporting Period
The Charitable Activities Section has adopted
the definitions for “Net Assets” and “Fund
Balances” used by the Internal Revenue Service.
If the organization completed one of the
following IRS forms for this reporting period,
the Net Assets or Fund Balances figure should
come from the line number listed:
IRS Form 990, Part I, line 22 (end of
year)
IRS Form 990-EZ, Part I, line 21
IRS Form 990-PF, Part III, line 6,
If the organization was not required to complete
one of these IRS forms, or filed an IRS Form
900-N, a summary of what constitutes Net
Assets or Fund Balances is provided within these
instructions. A more detailed definition can be
found in the IRS instructions for the forms listed
above.
Net Assets and Fund Balances refer to the
organization’s assets minus liabilities.
“Assets” are items of value to the organization,
such as cash, receivables less any allowance for
doubtful accounts, inventory, prepaid expenses,
investments, land, buildings & equipment less
any accumulated depreciation if the organization
records depreciation.
“Liabilities” are the amount of debts and
obligations owed by the organization, such as
accounts payable, accrued expenses, deferred
revenue, loans, and mortgages.
12. Net Fixed Assets Used to
Conduct Charitable Activities
Enter the amount of the organization’s Net Fixed
Assets that were held for use in the operation of
charitable activities at the end of the reporting
period.
Important NoteYou should not include any
cash, bank accounts, stock holdings,
investment accounts, or other liquid assets in
Line 12. Line 12 should only include fixed
assets that are used for charitable purposes, such
as land, buildings, or equipment.
The following instructions provide guidance on
how to calculate Net Fixed Assets, where the
amount may be located on the organization’s
IRS return, and whether that amount should be
adjusted to include only those fixed assets used
for charitable purposes.
The Charitable Activities Section defines “Net
Fixed Assets” as the organization’s book value
(cost or other basis less any accumulated
depreciation) of all owned land, buildings, or
equipment, that are used directly for
charitable purposes. For example, if the
charity owns and operates a museum, the
building that houses the museum is a net fixed
asset. However, undeveloped land, a building
owned and used for rental income, or any other
fixed asset used for investment purposes should
not be included in Line 12. Accordingly, the net
fixed assets used for charitable purposes on Line
12 may be less than the organization’s total net
fixed assets.
If the organization completed one of the
following IRS Forms for this reporting period
and all its Net Fixed Assets are held for use in
conducting charitable activities, the figure
should come from the line number listed:
IRS Form 990, Part X, line 10c
IRS Form 990-EZ, Part II, line 23B
IRS Form 990-PF, Part II, line 14b
If the organization was not required to complete
one of these IRS Forms, or filed an IRS Form
990-N, this figure will need to be calculated
from the organization’s accounting records.
13. Amount Subject to Net
Assets or Fund Balances Fee
Subtract line 12 from line 11. If the result is less
than $50,000 enter $0 on line 13. If the result is
more than $20,000,000 enter $20,000,000.
Example #1
line 11
$ 100,000
line 12
(25,000)
75,000
line 13
$ 75,000
Example #2
line 11
$ 100,000
line 12
(80,000)
20,000
line 13
$ 0
Important NoteIf the organization is filing a
short report of less than one year due to a change
in accounting periods, the amount entered on
line 13 should be prorated by the number of
months covered by the report. To determine the
prorated amount, divide the amount determined
above by 12 and multiply by the number of
months covered by the short report. No similar
proration should be made if the short report is
due to the initial or final reporting period.
14. Net Assets or Fund
Balances Fee
Multiply the amount subject to a Net Assets or
Fund Balances fee from line 13 by .0001 and
enter this figure on line 14. Round to the nearest
whole dollar. If the result is less than $5 enter
$0. If the amount is more than $2,000 enter
$2,000.
15. Late Fees
If the report is not filed or the fee is not paid by
the due date (or the extended due date), an initial
late fee of $20 will be due. If the report or
payment remains outstanding more than 13
months past the end of the fiscal year covered by
the report, the late fee will increase to $50. If
the delinquency is not corrected within 16
months of the end of the fiscal year covered by
the report, the late fee increases to $100.
Late Fee Schedule
Fiscal
Year
End
Dates
Late
Report
Received
Before
This
Date
Late
Report
Received
Between
These
Dates
Late
Report
Received
After This
Date
Late
Fee:
$20
$50
$100
12/31/16
2/1/18
2/1/18-
4/30/18
4/30/18
1/31/17
3/1/18
3/1/18
5/31/18
5/31/18
2/28/17
4/1/18
4/1/18-
6/30/18
6/30/18
3/31/17
5/1/18
5/1/18-
7/31/18
7/31/18
4/30/17
6/1/18
6/1/18-
8/31/18
8/31/18
5/31/17
7/1/18
7/1/18-
9/30/18
9/30/18
6/30/17
8/1/18
8/1/18-
10/31/18
10/31/18
7/31/17
9/1/18
9/1/18-
11/30/18
11/30/18
8/31/17
10/1/18
10/1/18-
12/31/18
12/31/18
9/30/17
11/1/18
11/1/18-
1/31/19
1/31/19
10/31/17
12/1/18
12/1/18-
2/28/19
2/28/19
11/30/17
1/1/19
1/1/19-
3/31/19
3/31/19
The above late fees apply automatically and
cannot be waived. The Department has the
authority to obtain additional civil penalties
against the organization and its officers and
directors or take other administrative action in
connection with the failure to file timely reports.
16. Total Amount Due
Add lines 10, 14, and 15. This is the total
amount due. Make check or money order
payable to the “Oregon Department of Justice”.
The Department does not accept payment by
credit card. Do not send cash. Mail payment
together with the report to:
Charitable Activities Section
Oregon Department of Justice
100 SW Market Street
Portland, Oregon 97201-5702
Important NoteIndicate on the check the
organization’s 4 or 5-digit Oregon Department
of Justice registration number. The registration
number is located on line 1 of the preprinted
Form CT-12 or can be obtained by contacting
the Charitable Activities Section or looking up
the charity on our website at
https://justice.oregon.gov/Charities.
17. IRS Forms, Schedules,
and Attachments
All organizations must attach a complete copy
of all forms, supporting schedules, and
attachments filed with the IRS, except
publicly-supported charities are not required
to attach Schedule B, Listing of Contributors.
Even if your organization is not required to file a
Form 990, 990-EZ, or 990-PF with the IRS, if
the organization’s revenues or net assets exceed
certain thresholds, it may be required to
complete one of these forms for Oregon
purposes to meet the Charitable Activities
Section’s filing requirements.
In general, if your organization’s total revenues
are at least $50,000, or its assets are more than
$100,000, you may be asked to complete a 990-
EZ or 990 for Oregon purposes only. If the
organization has not filed the form with the IRS,
it should note on the form that it is for Oregon
purposes only.
Additional instructions are provided below for
990-N filers and for organizations that do not file
any type of 990 with the IRS.
For 990-N FilersIf your organization does
not complete an IRS Form 990 or 990-EZ
because it files an IRS form 990-N, the
Charitable Activities Section will consider
suspending the requirement to file a Form 990 or
990-EZ for Oregon purposes.
If the organization files an IRS Form 990-N
because its gross receipts are normally $50,000
or less, but its assets are more than $100,000,
please contact this office in writing if you would
like the Charitable Activities Section to consider
suspending the requirement to file an IRS Form
990 or 990-EZ for Oregon purposes. The
amount of assets in excess of $100,000 is
material to consideration of suspension requests.
Please include a balance sheet or similar
statement listing your assets to expedite review
of your request.
For organizations that do not file a
990/990EZ/990-N with the IRS. Please
attach to your CT-12 a copy of your Form 1120
or 1120-A or other return your organization has
filed with the IRS for the reporting period. We
will contact you if this office determines that a
990-EZ or 990 is required for Oregon purposes.
Important NoteOrganizations which file
Form 990 or 990-EZ with the IRS are not
required to attach any schedule of contributors to
filings with the Charitable Activities Section.
Therefore, there is no requirement to attach
Schedule B. However, if voluntarily submitted,
this information may be made available for
public inspection.
This exclusion does not apply to Form 990-PF
filers who must submit their schedule of
contributors.
Important Note for CPAs/Paid
Preparers/Beneficiaries Forms submitted
to this office become a public record. In order to
protect the privacy of named individuals, you
should redact Social Security Numbers (if used)
from the copy of the IRS Form 990/990-EZ/990-
PF/5227/1041-A (Schedule K) submitted to this
office. Although we endeavor to redact social
security numbers from any forms we receive, we
request your assistance in safeguarding this
information by not including it in your
submission.
Signature Block
To make the return complete, an authorized
officer must sign in the space provided. For a
corporation or association, this officer may be
the president, vice president, treasurer, assistant
treasurer, chief financial officer, or other
corporate officer, such as tax officer. A trustee,
receiver, or assignee must sign any return he or
she files for a trust. Signature stamps and labels
are not acceptable. Power of Attorney signature
is not accepted.
In the paid preparer’s information section,
include the name, daytime phone number, and
address of any person who was paid by the
organization to complete this report.
Contact the Following Agencies for Assistance
Charitable Activities
Section
Oregon Department of Justice
100 SW Market Street
Portland, Oregon 97201-5702
Phone: (971)673-1880
TTY: (800)735-2900
Fax: (971)673-1882
Email: charitable.activities@doj.state.or.us
Website: http://www.doj.state.or.us
Issues
Questions about annual reports for
charitable organizations-Forms CT-12,
CT-12F, and CT-12S
Registration of charitable organizations
and trusts
Merging nonprofit organizations
Dissolving nonprofit organizations
Reporting illegal activity by nonprofit
organizations
Serving as a board member of a nonprofit
organization
Information about charitable
organizations and copies of annual
reports
Questions about raffles and other
charitable gaming
Forms
RF-C, Registration Form for Charitable
Organizations
RF-T, Registration Form for Trusts
CT-12, Annual Report Form for Oregon
Charities
CT-12F, Annual Report Form for Foreign
Charities
CT-12S, Annual Report Form for Split-
Interest Trusts
Closing Form
Publications
Oregon Wise Giving Guide
A Guide to Non-Profit Board Service in
Oregon
Oregon Revised Statutes
Chapter #65, Nonprofit Corporations
Chapter #128, Trusts; Charitable
Activities
Chapter #130, Uniform Trust Code
Chapter #464, Charitable Gaming
Chapter #646, Trade Practices &
Antitrust Regulation
Oregon Administrative Rules
Chapter #137-010-0005 et seq.
Internal Revenue Service
Phone: (877)829-5500
Website: http://www.irs.gov
Issues
Obtaining federal tax identification
number or federal tax-exempt status
Completing federal tax forms
Forms
990, Return of Organization Exempt
From Income Tax
990-EZ, Short Form - Return of
Organization Exempt From Income Tax
Schedule A, for Form 990 and 990-EZ
990-PF, Return of Private Foundation
990-T, Exempt Organization Business
Income Tax Return
1023, Application for Recognition of
Exemption Under §501(c)(3)
1024, Application for Recognition of
Exemption Under §501(a)
1041, U.S. Income Tax Return for
Estates and Trusts
1041-A, U.S. Information Return - Trust
Accumulation of Charitable Amounts
1128, Application to Adopt, Change, or
Retain a Tax Year
4720, Return of Certain Excise Taxes on
Charities and Other Persons
5227, Split-Interest Trust Return
5768, Election/Revocation of Election by
an Eligible Section 501(c)(3)
Organization to Make Expenditures to
Influence Legislation
8822, Change of Address
8868, Application for Extension of Time
to File an Exempt Organization Return
Publications
Pub. 526, Charitable Contributions
Pub. 538, Accounting Periods and
Methods
Pub. 557, Tax-Exempt Status for Your
Organization
Pub. 583 Starting a Business and
Keeping Records
Pub. 598 Tax on Unrelated Business
Income of Exempt Organizations
Pub. 3079 Gaming Publication for
Tax-Exempt Organizations
Veterans’ Services
If you are or know a veteran and would like
more information about benefits, please see DOJ
Veterans Resources available through the
Department of Justice’s website at:
http://www.doj.state.or.us
Oregon Secretary of State
Corporation Division
Public Service Building
255 Capitol Street NE, Suite 151
Salem, OR 97310-1327
Phone: (503)986-2200
Website:
http://sos.oregon.gov/business/Pages/default.aspx
Issues
Forming a new corporation
Merging nonprofit corporations
Dissolving nonprofit corporations
Amending articles of incorporation
Obtaining copies of filed articles of
incorporation and amendments
Forms
Articles of Incorporation
Assumed Business Name Registration
Articles of Amendment
Restated Articles
Articles of Dissolution
Revocation of Dissolution
Publications
Oregon Business Guide
Oregon Department
of Revenue
Revenue Building
955 Center St. NE
Salem, OR 97301-2555
Phone: (503)378-4988 and (800)356-4222
Website: http://www.oregon.gov/DOR
Issues
State taxation and filing requirements
Forms
20, Oregon Corporation Excise Tax
Return
41, Oregon Fiduciary Income Tax Return
State of Oregon
Website: http://www.oregon.gov
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