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Form 990 OMB No. 1545-0047 Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)
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O. Box 102936, Cincinnati, OH 45202 Telephone: Toll-free: FAX: Return of organization Exempt From Income Tax Under section 501(a), 527, or 4947 of The Internal Revenue Code (except black lung benefit trust or private foundation) The organization provides income to a member or individual. , 2009, and ending Please C Name of corporation Domestic Corporation C-Corp (as defined by the Internal Revenue Code) Other (specify) C Corp Internal Revenue Code Exemption 6(d)(2) Income from property (other than from a rental or royalty stream) The corporation's net income from its property as a percentage of its net income from all other sources is exempt from taxation under section 6(d)(2). The section also permits tax-exempt corporations to allocate income to different classes of shares or to different classes of property. If you have questions about determining your corporation's percentage of tax-exempt income, please visit. , 2009, and ending Please C Type of shares Preferred stock, common stock, certificate of stock and/or stock options; or Other (specify) Preferred stock, common stock, certificate of stock and/or stock options; or Other (specify) I am providing a copy to: The Internal Revenue Service Cincinnati Center P.O.

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