CIFT-401W (1/23)

                                  Unrelated Business Income Worksheet for                          Attach completed worksheet
                                  IRC 401(a) and 501 Organizations                                  to your 2022 CIFT-620

                                  Enter your LA Revenue Account Number here. _________________________

Name as shown on CIFT-620                                     Income Taxable Period Covered

Louisiana Revised Statute 47:287.501 provides that an organization described in Internal Revenue Code Sections 401(a) or 501 shall 
be exempt from income taxation to the extent the organization is exempt from income taxation under federal law, unless the contrary is 
expressly provided. Accordingly, an exempt organization that has income from an unrelated trade or business and files a Federal Form 
990-T with the Internal Revenue Service is subject to file and report its Louisiana-sourced unrelated business income to Louisiana. 
Louisiana Administrative Code 61:I.1140 and Revenue Information Bulletin 09-009 have been published providing guidance whereby 
these organizations are not exempt from taxation on the Louisiana-sourced unrelated business income or income not included under 
I.R.C. Sections 401(a) or 501, and they are required to file a Form CIFT-620 reporting such income.
This worksheet will serve as a guide in determining the amount of Louisiana-sourced unrelated business income that the organization 
must report and the amount of federal income tax that is allowed as a deduction. When completing this worksheet and Form CIFT-620, 
include only items of income and expense related to the production of unrelated business income. Also note that franchise tax 
computations on both forms are not required to be completed if these organizations are not subject to the Louisiana Franchise Tax. If not 
subject to Franchise Tax, use code 5 on Form CIFT-620, Line 7.

                                  Unrelated Business Income
  To determine the amount of unrelated business income that should be reported to Louisiana, complete Lines 1 and 2 below.
  Federal net unrelated business income – Enter the amount from Federal Form 990-T, Part I, Line 
1                                                                                                  1
  5, here and on Form CIFT-620, Schedule F, Line 1.
If the unrelated business income is from business done only within Louisiana:
Complete Form CIFT-620, Schedule F. Enter the amount from Form CIFT-620, Schedule F, Line 4 on Form CIFT-620, Line 1A. 
Proceed to Line 2. 
If the unrelated business income is from business within and outside of Louisiana:
Complete Form CIFT-620, Schedules D and F, and, if applicable, complete Schedules B and C. Enter the amount from Form CIFT-
620, Schedule D, Line 30 on Form CIFT-620, Line 1A. Proceed to Line 2. 
  Louisiana net unrelated business income before federal income tax deduction – Complete Form 
2 CIFT-620, Lines 1B through 1C1. Subtract Lines 1B and 1C1 from Line 1A and enter the result here 2
  and on Form CIFT-620, Line 1D.  
                                                   Tax Calculation
  Louisiana income tax – Follow the instructions for Form CIFT-620 Schedule J. Enter the amount 
3                                                                                                  3
  from Schedule J, Line 4 here and on Form CIFT-620, Line 2.

                   After completing Line 3 above, follow the instructions to complete Form CIFT-620.
                                  Attach this worksheet and applicable schedules to the  
                                  completed Form CIFT-620 when filing the return.

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