ALP 2

Form 990 (2012) Page 6
LjM Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any uestion in this Part V . ❑
Yes
No
1a Enter the number reported in Box 3 of Form 1096. Enter -0- If not applicable . . . . 1a
b Enter the number of Forms W -2G included in line 1a. Enter -0- if not applicable . . . . 1b
c Did the organization comply with backup withholding rules for reportable payments to vendors and
reportable gaming (gambling) winnings to prize winners? . . . . . . . . . . . . . . .
is
2a Enter the number of employees reported on Form W -3, Transmittal of Wage and Tax
I
Statements, filed for the calendar year ending with or within the year covered by this return 2a
b If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
2b
Note. If the sum of lines la and 2a is greater than 250, you maybe required to a -file (see Instructions)
3a Did the organization have unrelated business gross income of $1,000 or more during the year? . . . .
3a
b If "Yes," has it filed a Form 990 -T for this year? If "No," provide an explanation in Schedule O . . . . .
3b
4a At any time during the calendar year, did the organization have an interest in, or a signature or other authority
over, a financial account in a foreign country (such as a bank account, securities account, or other financial
account)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4a
b If "Yes," enter the name of the foreign country: ►
_ _ _
See instructions for filing requirements for Form TD F 90 -22.1, Report of Foreign Bank and Financial Accounts.
5a Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? . . .
5a
5b
b Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5c
c If "Yes" to line 5a or 5b, did the organization file Form 8886 -T? . . . . . . . . . . . . . . .
6a Does the organization have annual gross receipts that are normally greater than $100,000, and did the
organization solicit any contributions that were not tax deductible as charitable contributions? . . . . .
6a
b If "Yes," did the organization include with every solicitation an express statement that such contributions or
gifts were not tax deductible? . . . . . . . . . . . . . . . . . . . . . . . . . .
6b
7 Organizations that may receive deductible contributions under section 170(c).
a Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods
and services provided to the payor? . . . . . . . . . . . . . . . . . . . . . . . .
7a
7b
b If "Yes," did the organization notify the donor of the value of the goods or services provided? . . . . .
c Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was
required to file Form 8282? . . . . . . . . . . . . . . . . . . . . . . . . . . .
7c
d If "Yes," indicate the number of Forms 8282 filed during the year . . . . . . . 7d
e Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
f Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? .
7f
7
g If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?
h If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098 -C?
7h
8 Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting
organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring
organization, have excess business holdings at any time during the year? . . . . . . . . . . .
8
9 Sponsoring organizations maintaining donor advised funds.
a Did the organization make any taxable distributions under section 4966? . . . . . . . . . . . .
9e
9b
b Did the organization make a distribution to a donor, donor advisor, or related person? . . . . . . .
10 Section 501(c)(7) organizations. Enter:
a Initiation fees and capital contributions included on Part VIII, line 12 . . . . . . 10a
b Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities 1110bj
11 Section 501(c)(12) organizations. Enter:
a Gross Income from members or shareholders . . . . . . . . 11a
b Gross income from other sources (Do not net amounts due or paid to other sources
against amounts due or received from them.) . . . . . . . . . . . . . . 11b
12a Section 4947(a)(1) non - exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
b If "Yes," enter the amount of tax- exempt Interest received or accrued during the year, I12bI
13 Section 501(c)(29) qualified nonprofit health insurance issuers.
13a
a Is the organization licensed to issue qualified health plans in more than one state? . . . . . . . .
Note. See the instructions for additional information the organization must report on Schedule O.
b Enter the amount of reserves the organization is required to maintain by the states in which
the organization is licensed to issue qualified health plans . . . . . . . . . 13b
c Enter the amount of reserves on hand . . . . . . . . . . . . . . . . 13c
14a Did the organization receive any payments for indoor tanning services during the tax year? . . . . . .
14a
14b
b If "Yes," has it filed a Form 720 to report these eats? !f "No " provW an axp&mtlon in Schedule O
Form (2012)