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                                                 Charitable Activities Section 
   Form                                                                                                         You can now file reports and 
        CT-12F                                Oregon Department of Justice                                      pay by credit card using our 
   For Foreign Charities                                                                                                     online form at 
   For Accounting Periods Beginning in: 100 SW Market Street                      VOICE      (971) 673-1880 
                                        Portland, OR 97201-5702                        TTY   (800) 735-2900     https://justice.oregon.gov/ 
                                        Email: charitable@doj.state.or.us           FAX      (971) 673-1882     paymentportal/Account/Login
                                        Website: https://www.doj.state.or.us 
         2021                           Line-by-line instructions for completing the annual 
                                        report form can be found on our website. 
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. Did a certified public accountant audit your financial records? - If yes, attach a copy of the auditor’s report, financial statements,
   accompanying notes, schedules, or other documents supplementing the report or financial statements.                                           Yes      No

3. Is the organization a party to a contract with a fundraising firm that relates to solicitations in Oregon? If yes, check the type of
   solicitations;   in-person; direct mail; advertising;  vending machine;  telephone; or  other solicitations.                            Yes      No
   If yes, also write the name of the fundraising firm(s) here: __________________________________________  (If you checked
   “other solicitations”, attach an explanation.)
4. Has the organization or any of its officers, directors, trustees, or key employees ever signed a voluntary agreement with any
   government agency or been a party to legal action in any court or administrative agency regarding charitable solicitation,
   administration, management, or fiduciary practices? If yes, attach explanation of each such agreement or action.  See                         Yes      No
   instructions.
5. During this reporting period, did the organization amend its articles of incorporation, bylaws, or trust documents, OR did the
   organization receive a determination or revocation letter from the Internal Revenue Service relating to its tax-exempt status?                Yes      No
   If yes, attach a copy of the amended document or letter.
6. Is the organization ceasing operations in Oregon and is this the final report?  (If yes, see instructions on how to close your                Yes      No 
   registration.)
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 this section.
                         (A) Name, mailing address, daytime phone number                                        (B) Title &              (C) 
                                                  and email address                                             average weekly           Compensation 
                                                                                                                hours devoted to         (enter $0 if 
                                                                                                                position                 position unpaid) 
   Name: 
                 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 
   Address: 
                 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 
   Phone: 
                 (_ _ _) _ _ _ _ _ _ _ _ _ Email:_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 
   Name: 
                 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _  
   Address:      _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 
   Phone: 
                 (_ _ _) _ _ _ _ _ _ _ _ _ Email: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 
   Name: 
                 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _  
   Address: 
                 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 
   Phone: 
                 (_ _ _) _ _ _ _ _ _ _ _ _ Email: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 
                                                 Form Continued on Reverse Side 



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 Section II.  Fee Calculation 
                                                                                                                                                                                                      
 9.   Total Oregon Revenue .............................................................................................................  9. 
       (If Oregon revenue is unknown or cannot be reasonably estimated, write the total revenue from Part I, Line 12 (current 
      year) on Form 990; Line 9 on Form 990-EZ; or Part I, Line 12a on Form 990-PF.)  (If estimated, or if organization 
      claims no Oregon revenue, attach explanation.) 
                                                                                                                                                                                                      
      Revenue   Fee ...........................................................................................................................................................................       
 10.  (See chart below.  Minimum fee is $20, even if total revenue is a $0 or negative amount.)  The revenue fee is determined by the amount on line 9.                                          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  -      $999,999         $300 
      $1,000,000  or   more             $400 
                                                                                                                                                                                                      
 11.  Oregon Net Assets or Fund Balances at the End of the                                           
      Reporting Period ...........................................................................  11. 
      (If the Oregon amount is unknown, write the total net assets or fund balances from 
      Part I, Line 22 (end of year) on Form 990; Line 21 on Form 990-EZ; or Part III, Line 6 
      on Form 990-PF.) 
                                                                                                                                                                                                      
 12.  Oregon Net Fixed Assets Used to Conduct Charitable Activities .                               12. 
      (If the Oregon amount is unknown, write $0.) 
                                                                                                                                                                                                      
 13.  Amount Subject to Net Assets or Fund Balances Fee...............................................................   13. 
      (Line 11 minus line 12.  If Line 11 minus Line 12 is less than $50,000, write $0.) 
                                                                                                                                                                                                      
 14.  Net Assets or Fund Balances Fee ...........................................................................................................................................                14. 
      (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.) 
      Are you filing this report late?              Yes      No ..................................................................................................................                    
 15.  (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                            15. 
      Charitable Activities Section at (971) 673-1880 to obtain late fee amount.) 
                                                                                                                                                                                                      
 16.  Total Amount Due  ...................................................................................................................................................................      16. 
      (Add Lines 10, 14, and 15.  Make check payable to the Oregon Department of Justice.) 
       
 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.  Such organizations 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 if available. 
       
                Under penalties of perjury, I declare that I am an officer/director of the organization.  I have examined this return, including all 
 Please         accompanying forms, schedules, and attachments, and to the best of my knowledge and belief, it is true, correct, and complete. 
 Sign Here                  _______________________________________                 _____________________                  _________________________ 
                      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 
 
Line-by-line instructions for completing the annual report form can be found at https://www.doj.state.or.us/charitable-
activities/annual-reporting-for-charities/file-your-annual-report.  If you click the appropriate link for this year’s form, the 
instructions are included in that document.  If you would like us to send a copy of the instructions, please call us at 971-673-
1880 or send an email to charitable@doj.state.or.us.   



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Charitable Activities Section, Oregon Department of Justice  
 
2021 Form CT-12F Instructions 
                                                                                                                                                
    You can now complete and file reports online at https://justice.oregon.gov/paymentportal/Account/Login 
 
                                                    than 4 months and 15 days after the end of the       the organization receives notice of denial of the 
                                                    organization’s fiscal year. If the due date falls on requested extension. 
General                                             a weekend or legal holiday, the due date is the       
                                                    next business day.                                   Important NoteAn extension request filed 
Instructions                                                                                             with the IRS  or the Oregon Department of 
                                                    The Charitable  Activities Section does not use      Revenue does  NOT act as an extension with 
                                                    the postmark  date to determine  whether an          the Charitable Activities Section unless a copy 
Purpose                                             organization has filed timely. Instead, filings are  is submitted to the Charitable Activities 
Oregon law charges the  Attorney General with       considered timely if they are physically received    Section by the due date. 
the duty and  responsibility to represent  the      within 5 business days after the due date. All        
public’s interest in charitable organizations and   filings received more than 5 business days after 
in assets held or received for charitable purposes. the due date will be assessed a late charge.  See    Record Keeping 
The Attorney General carries  out this              Instruction 15 Late Fees.                            Please retain  a copy  of this  report and all 
responsibility     by requiring        charitable                                                        supporting documentation for at least five years 
organizations  to register  and file periodic                                                            after the due date. 
financial reports.                                  Extensions for Filing  
                                                    An organization may  apply for an extension of 
Once submitted, this Form and  all  attachments     time to file.  Extension requests must be received   Rounding and Blank Lines 
become a part of the public record. Any             on or before the due date of the report to avoid a   Round  all amounts on the report  to the  nearest 
interested person may examine or obtain a copy      late fee.   The maximum  available extension         whole dollar. Drop amounts under 50 cents and 
of an annual report of a charitable organization    period is 180 days.   An extension to file is also   increase amounts from 50 to 99 cents to the next 
by contacting the Charitable Activities Section.    an extension to  pay any associated  fees.           whole dollar. If the amount is zero write “$0.” 
Reports  can  also be viewed on our website at      Therefore, estimated payments should not be           
https://justice.oregon.gov/Charities.               included with extension requests.                    Do not leave any line blank.  Your report may 
                                                                                                         be treated as incomplete if you leave blank lines. 
                                                    Please do not submit an incomplete CT-12/CT-
Who Must File                                       12F/CT-12S if you intend to later supplement or 
All organizations registered with the Charitable    amend your report  with  a  copy  of  your IRS       Important Reminders 
Activities Section of the Oregon Department of      return. Instead, file an extension request so that   Don’t lose your tax-exempt status.   Most tax-
Justice must annually file Form CT-12, CT-12F,      you can  submit  a complete  report  by the          exempt organizations other  than churches must 
or CT-12S unless  the  office  has specifically     extended due date with a copy of the appropriate     file a yearly return with the IRS.  Very small 
exempted the organization  from the reporting       IRS form attached.                                   organizations are required to file IRS Form 990-
requirements.                                                                                            N, also known  as the  e-Postcard.  The IRS is 
                                                    Extensions  may be requested through the             required by law to revoke the tax-exempt status 
                                                    Department   of        Justice    website at         of any organization  that has failed to file  a 
What Form to File                                   https://justice.oregon.gov/Charities/Extensions.     required return for three consecutive years. 
File Form CT-12 if the  organization is  either     Follow the instructions  carefully to ensure that     
incorporated,  organized, or  headquartered  in     we  receive  your request.   Please contact  our     Please refer to https://www.irs.gov/charities-and-
Oregon.                                             office if you  have any questions  or  difficulties  nonprofits  for  more information about these 
                                                    with your online request.                            requirements. 
File Form CT-12F if the  organization is                                                                  
organized and headquartered outside of Oregon.      You should print and retain a copy of the online     Important  information regarding  Social 
The Charitable Activities Section does not          Confirmation of Extension Request.  You should       Security numbers (SSNs) Forms submitted 
accept multi-state annual report forms in lieu of   also expect to receive a confirmation of receipt     to this office  become a public record.   In 
a completed Form CT-12F.                            of your online request.                              order to protect the privacy of named 
                                                                                                         individuals, you should redact any SSNs (if 
File Form CT-12S if the organization is a split-    You may also submit a written request or a copy      used) from  copies of any IRS forms 
interest trust that holds assets for the benefit of of the organization’s federal extension request      submitted.   Although we  endeavor  to redact 
both charitable and non-charitable beneficiaries.   (IRS Form 8868)    so long  as  the  Charitable      SSNs from any forms we receive, we request 
                                                    Activities Section receives the request or copy      your assistance      in  safeguarding        this
If the organization does not fit within any of the  before the due date of the report.   The             information by not including it  in your 
above categories, file Form CT-12.                  organization’s 4 or 5-digit registration number      submission. 
                                                    should be noted on the  top  of all extension         
The form year should match the starting year        requests.   If you would like acknowledgement         
of the fiscal period covered by the report.         that your extension  request has been received,       
                                                    you should enclose an  additional copy of the 
                                                    request and a self-addressed, stamped envelope.       
Due Date                                                                                                  
The  form, all required attachments and             In the  event your  request  is denied,  to avoid a 
schedules, and  payment of fees are due in the      late fee, the annual report must be submitted by 
Charitable Activities Section’s office no later     the later of the due date or within 10 days after 



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Online Filing Option                                Accounting Year Changes                               any  current officer, director,  trustee, or key 
                                                                                                          employee is subject to any injunction, order, or 
The Department has  an  online filing  option if    If applicable, write the organization’s new or        pending action  relating to the solicitation of 
you would like to complete and file your report     short reporting period. Preprinted  forms are         contributions, or administration of charitable 
electronically  and pay via  credit card.  For      based upon the accounting period we have on           assets.  Attach  a written  explanation of each 
additional          information,            visit   record for the organization.  If the organization     such action or agreement, including the 
https://www.doj.state.or.us/charitable-             has changed  its fiscal year or  is filing a final    agency involved and the allegations.   Also, 
activities/annual-reporting-for-charities/file-     report for a period  less than 12  months, the        attach a  copy  of any agreements or actions 
your-annual-report/                                 shortened period covered by the report must be        that occurred in the current reporting period. 
                                                    noted here.  If the  organization is filing a final 
                                                    report, also see the  instructions for line 6 for 
How to Contact the                                  closing requirements. 
                                                                                                          5.  Amendments to Articles of 
Charitable Activities                               Short  Year  Report—If the  organization is           Incorporation, Bylaws, or Tax-
Section                                             filing a shortened report due to a change in fiscal   Exempt Status 
To obtain blank forms,  mailed instructions,        year,  see the instructions for line 13  for 
                                                                                                          Check yes if during the reporting period the 
technical  assistance  or  information about a      calculation  of prorated  Net Assets  or Fund 
                                                                                                          organization amended its articles or bylaws, or if 
charitable organization,  contact the Charitable    Balances fee. 
                                                                                                          the IRS issued a new tax-exempt status ruling for 
Activities Section or visit our website at:                                                               the organization, including revocation.  
                                                    Amended Reports                                        
       Charitable Activities Section                If amending previously submitted information          Important     Note—Attach  copies         of
       Oregon Department of Justice                 for the same  accounting period, check the            amendments to articles of incorporation bearing 
       100 SW Market Street                         amended report box. Either  complete a blank          the Secretary of State’s file stamp, signed and 
       Portland, OR 97201-5702                      form that includes  the amended information or        dated copies of amended bylaws, and/or IRS 
       Phone:  (971)673-1880                        provide a copy of the previously submitted form       determination letters. 
       TTY:    (800)735-2900                        that clearly shows what information is being 
       Fax:      (971)673-1882                      amended. Submit any additional fee due with the 
       Email: charitable@doj.state.or.us            amended report.                                       6.  Final Report 
       Website: https://www.doj.state.or.us 
                                                                                                          Check yes  if this is  the final report for  the 
                                                                                                          organization. 
Where to File                                       2.  Independent Audit                                  
Send completed forms and corresponding fees to      Check yes if the organization had  an                 If  the  foreign organization is dissolving, 
the above address. Do not send cash.                independent audit  of its financial records           discontinuing solicitations of Oregon residents, 
                                                    performed by  a certified public accountant.          no longer receiving other payments from persons 
                                                    Attach a copy of the auditor’s report, the            in  Oregon, or  no  longer holding  assets or 
                                                    financial statements, the accompanying notes,         conducting charitable activities  in Oregon and 
Line Instructions                                   schedules, or other documents supplementing           would like to  close  its registration file, the 
                                                    the report or  financial statements.      Do not      organization must provide written notice to this 
                                                    submit copies that are professionally bound.  If      office in  addition  to a final report.  The  notice 
              Section I.                            the audit  has not  been completed  prior to the      may be provided through a letter, but the letter 
                                                    report due date,  please note that  and the           must  confirm that the organization does not 
 General Information                                estimated completion date on the CT-12F.              intend to  conduct further solicitations or 
                                                                                                          activities  in Oregon, or receive  other payments 
                                                                                                          from persons in Oregon and holds no assets in 
1.  Missing or Incorrect                            3.  Fundraising Contracts                             the state. 
                                                                                                           
Information                                         Check  yes if the  organization entered into  a       Organizations  are required to file reports 
The  Charitable Activities Section sends a  form    contract with  a  fundraising firm  that  relates  to covering  all fiscal periods  in which the 
preprinted with      name,     address      contact solicitations  in Oregon,  including  in-person,      organization was registered.   Accordingly, a 
information and  registration number to  all        direct mail, advertising, vending machine,            final report must cover the fiscal period in which 
registered organizations. If the  organization  is  telephone, or other solicitations made in Oregon.     the written notice requesting  closure of the 
returning one of these preprinted forms, provide    Check  the type(s) of campaign to  which the          registration was received. 
any  missing or corrected information. If the       contract(s)  relates and  write  the name(s) of the    
organization is completing a blank form, provide    fundraising firm(s) in the space provided. If you     Important Note—Foreign organizations which 
the requested information in this section.          checked  “other  solicitations”  as  the  type of     intermittently conduct solicitations or charitable 
                                                    campaign, attach an explanation.                      activities  in Oregon may  wish to remain 
                                                                                                          registered during periods of inactivity.  
Name Changes 
If applicable, write the organization’s new legal   4.  Disclosure of Legal Action 
name. Attach  a  copy of  the filed amended         Check yes if  the organization or  any of its         7.  Who Keeps the Books? 
articles of incorporation that changed the          officers, directors,  trustees  or key employees      Indicate the person to be contacted if the 
organization’s name.                                ever signed  a  voluntary agreement  with any         organization’s books  need to be accessed for 
                                                    government agency, such  as a  state attorney         information or review.  Either a business or 
Address, Email and Phone                            general, secretary of state, or local district        personal phone number,  email,  and mailing 
                                                    attorney, or been a party to  legal action  in any    address  are acceptable.   If the person  does  not 
Number Changes                                      court  or  administrative agency regarding            have an email  address, please note  that on the 
If applicable, write the new address where mail     charitable    solicitation,        administration,    form. 
for  the organization should be directed in the     management, or fiduciary practices.   This 
future. If  applicable, write the new daytime       includes assurances  of voluntary compliance or 
phone number, fax number and email address for      discontinuance involving the organization or any 
the organization.                                   other proceeding in which the organization or 



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                                                                                                         Important Note—Do not include the value of 
8.  Officers, Directors, and                                       Section II.                           services donated to  the organization, or items 
                                                                                                         such as the free use of materials, equipment, or 
Other Key Employees                                                                                      facilities in reporting Total Revenue. 
                                                                 Fee Calculation
List  each person who was an  officer, director,                                                          
trustee, or key employee (defined below) of the                                                          Important  Note—If  Oregon  Revenue is zero, 
organization at any time during the year even if                                                         attach an explanation of why Oregon Revenue is 
they are  a volunteer and do  not receive any         9.  Total Oregon Revenue 
compensation  from the  organization. Give the        Enter the Total Revenue earned from persons or     zero and indicate whether the organization plans 
daytime  phone number  and preferred mailing          businesses located in Oregon. If the organization  to continue operations in Oregon. See the 
address  at which officers, etc., want  the           does not have a  method for identifying or         instructions for line 6 if this is the organization’s 
Charitable Activities Section to contact them.        reasonably estimating the Oregon portion, enter    final report. 
Use an attachment if there are more persons to        the organization’s Total Revenue.  If the Oregon 
list than there are lines available.                  portion reported was calculated using  a 
                                                      reasonable  estimate, note on  the Form  that an   10.  Revenue Fee 
A failure to fully complete this part can subject     estimate was used and identify the method that     Use the total Oregon revenue figure from line 9 
the organization to late fees or civil penalties for  was used.  Do not use an estimate if the amount    to calculate the  revenue  fee according  to the 
filing an incomplete form.                            of Total Oregon Revenue is known or readily        following schedule. 
                                                      available.                                          
Officers include  those officers required by                                                                             Revenue Fee Schedule 
applicable state law, such as president, secretary,   The Charitable  Activities Section has adopted                          
or  treasurer, and also  includes  the  person(s)     the definition  for “Total  Revenue” used by the      Amount on Line 9           Revenue Fee 
elected or appointed to implement the decisions       Internal Revenue Service. If  the organization     $             0 -  $   24,999          $   20 
                                                                                                           25,000        -   49,999                  50 
of  the governing  body or  for supervising  the      completed an IRS Form for this reporting period,     50,000        -   99,999                  90 
management, administration, or operation of the       the Total Revenue figure should come from the       100,000        -   249,999               150 
organization, regardless of title or the amount of    line number listed:                                 250,000        -   499,999               200 
compensation received.  The CEO or  Executive          •     IRS Form 990, Part I, line 12 (current       500,000        -   999,999               300 
Director is an officer for purposes of this form.            year)                                        1,000,000      or  more                  400 
The top financial official may also be an officer      •     IRS Form 990-EZ, Part I, line 9              
if they are responsible for  managing the              •     IRS Form 990-PF, Part I, line 12a           The maximum amount subject to a revenue fee is 
organization’s finances.                                                                                 $1,000,000. The maximum revenue fee is $400. 
                                                      If the organization was not required to            The minimum revenue fee is $20, even if total 
                                                                                                         revenue is a zero or negative amount. 
A "key employee" is any person, other than an         complete one of these IRS  Forms, or filed an 
officer, director,   or    trustee,  who  has         IRS Form 990-N, a summary of what constitutes 
responsibilities  over the organization  that  are    Total Revenue is provided within these 
similar to those  of  its officers, directors, or     instructions.  A more detailed definition can  be  11.  Oregon Net Assets or 
trustees.  If  the  organization  attaches a  990  or found in the IRS instructions for  forms listed    Fund Balances at the End of 
990EZ, it may rely on the IRS definition of key       above.                                             the Reporting Period 
employee in the corresponding IRS instructions         
for purposes of this form.                            “Total Revenue” includes such items as:            Enter the  amount of Net Assets or Fund 
                                                       •     Contributions, gifts, grants                Balances at the end of the reporting period which 
                                                                                                         were held in Oregon. If the organization does not 
                Column (C)                             •     donated real property 
                                                                                                         have a  method for identifying or reasonably 
                                                       •     donated thrift items                        estimating Oregon Net Assets or Fund Balances 
If an IRS form is attached that includes complete      •     membership dues & assessments               at end of year, enter the organization’s total Net 
and  accurate compensation information,  the           •     program service revenue                     Assets or Fund Balances.  If the Oregon portion 
phrase “See IRS Form” may be entered in lieu of 
completing this section.                               •     government fees & contracts                 reported was  calculated using a reasonable 
                                                       •     interest or dividend income                 estimate, note on the form that an estimate was 
Otherwise, for each person listed, report the total    •     gross rental income less rental expense     used and identify the method that was used. 
amount of  compensation paid  or deferred for          •     other investment income                      
payment to a later date, including  salary, fees,      •     gain or loss on sales of assets other than  The Charitable  Activities Section has adopted 
bonuses,  benefits, taxable  allowances  or                  inventory                                   the definitions for “Net Assets”  and  “Fund 
reimbursements,    the    value      of noncash        •     gain or loss from special events &          Balances” used by the Internal Revenue Service. 
compensation, and severance payments.                        activities which may include bingo,         If the organization  completed one of the 
                                                             raffles, and Monte Carlo events             following  IRS  forms for this  reporting period, 
Enter a zero in column (C) if the person was a         •     gain or loss on sale of inventory           the Net Assets  or  Fund Balances figure should 
volunteer and was not paid or did not accrue any       •     all other sources of revenue.               come from the line number listed: 
compensation during the reporting year.                                                                   • IRS Form 990, Part I, line 22 (end of 
                                                      To report contributions received in a form other      year) 
The organization may provide an attachment to         than cash, use the market value as of the date of   • IRS Form 990-EZ, Part I, line 21 
explain the entire compensation package for any       the contribution. When market value  cannot be      • IRS Form 990-PF, Part III, line 6 
person listed in this part, including whether the     readily determined, use  an appraised or            
compensation includes the payment of amounts          estimated value.                                   If the organization was not required to complete 
previously deferred.                                                                                     one of these IRS forms, or filed an IRS Form 
                                                      To determine  the amount of  any noncash           990-N, a summary of what constitutes Net 
                                                      contribution  that is subject to an outstanding    Assets or Fund Balances is provided below. A 
                                                      debt, subtract  the debt from  the property’s fair more detailed definition can be found in the IRS 
                                                      market value in assigning a value to the revenue   instructions for the forms listed above. 
                                                      received.   “Fair  market value”  is the amount a   
                                                      reasonable person would pay for the item at the    Net  Assets and Fund Balances refer  to the 
                                                      time it was donated to the organization.           organization’s assets minus liabilities. 
                                                       



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“Assets” are items of value to the organization,                                                            6/30/22  8/1/23      8/1/23-         10/31/23 
such as cash, receivables less any allowance for     13.  Amount Subject to Net                                                  10/31/23 
                                                                                                            7/31/22  9/1/23      9/1/23-         11/30/23 
doubtful  accounts, inventory,  prepaid expenses,    Assets or Fund Balances Fee                                                 11/30/23 
investments, land, buildings  &  equipment less 
any accumulated depreciation if the organization     Subtract line 12 from line 11. If the result is less   8/31/22  10/1/23     10/1/23-        12/31/23 
records depreciation.                                than $50,000 enter $0 on line 13. If the result is                          12/31/23 
                                                     more than $20,000,000 enter $20,000,000.               9/30/22  11/1/23     11/1/23-        1/31/24 
“Liabilities”  are the amount  of  debts and                                                                                     1/31/24 
obligations owed by the organization, such as                                                               10/31/22 12/1/23     12/1/23-        2/28/24 
accounts  payable, accrued expenses,  deferred       Example #1  line 11 $ 100,000                                               2/28/24 
                                                                 line 12      (25,000)                      11/30/22 1/1/24      1/1/24-         3/31/24 
revenue, loans, and mortgages.                                                75,000                                             3/31/24 
                                                                 line 13                $ 75,000            
                                                                                                           The above  late fees apply automatically  and 
12.  Oregon Net Fixed Assets                         Example #2  line 11 $ 100,000                         cannot be waived.   The Department has  the 
                                                                 line 12      (80,000)                     authority to  obtain additional  civil penalties 
Used to Conduct Charitable                                                    20,000                       against the  organization and  its officers and 
Activities                                                       line 13                $         0        directors or  take other  administrative  action in 
                                                      
Enter the amount of the organization’s Net Fixed                                                           connection with the failure to  file  timely  and 
Assets that were held  in Oregon for use in the      Important Note—If the organization          is filing complete reports.  
                                                     a short report  of less than one year due to  a 
operation of charitable activities at the end of the 
                                                     change in  accounting periods, the amount 
reporting period. If  the organization does  not 
                                                     entered on line 13 should be  prorated by the 
have a method for identifying Oregon net fixed                                                             16.  Total Amount Due 
                                                     number  of  months covered by the report. To 
assets used to conduct charitable activities, enter                                                        Add lines 10, 14 and 15. This is the total amount 
                                                     determine the prorated amount,  divide the 
$0.                                                                                                        due. Make check or money order payable to the 
                                                     amount determined above by 12 and multiply by 
                                                                                                           “Oregon Department of Justice”. Do not send 
                                                     the number of months covered by the short 
Important NoteYou should not include                                                                      cash.  Mail payment together with the report to: 
                                                     report. No similar proration should be  made  if 
any cash, bank accounts,  stock holdings,                                                                   
                                                     the short report is due  to  the initial or  final 
investment accounts, or other liquid assets in                                                                     Charitable Activities Section 
                                                     reporting period. 
Line 12.   Line 12 should only include  fixed                                                                      Oregon Department of Justice  
assets that are used for charitable purposes, such                                                                 100 SW Market Street 
as land, buildings, or equipment  that are used                                                                    Portland, Oregon 97201-5702 
directly for charitable purposes.                    14.  Net Assets or Fund                                
                                                     Balances Fee                                          Important Note—Indicate on the  check the 
The following instructions provide guidance on       Multiply the amount subject to a Net Assets or        organization’s  4 or 5-digit Oregon Department 
how to calculate Net Fixed Assets and where the      Fund  Balances  fee from  line 13 by .0001 and        of Justice  registration  number. The registration 
amount may be located on the organization’s tax      enter this figure on line 14. Round to the nearest    number is  located on line 1 of the preprinted 
return.                                              whole dollar. If the result is less than $5 enter     Form CT-12F or can be obtained by contacting 
                                                     $0.  If the  result is more  than  $2,000 enter       the  Charitable Activities Section or looking up 
The Charitable Activities Section defines “Net       $2,000.                                               the charity        on our      website        at
Fixed Assets”  as the  organization’s book value                                                           https://justice.oregon.gov/Charities. 
(cost   or other      basis  less accumulated
depreciation) of all owned land, buildings, or               Late Fees 
equipment that are used directly for charitable      15.                                                         IRS Forms, Schedules, 
purposes.  For example, if the charity owns and      If the report is not filed or the fee is not paid by  17.
operates a museum, the building that houses the      the due date (or the extended due date), an initial   and Attachments 
museum  is a net fixed asset.  However,              late fee of $20 will be due.   If the report or       All organizations must attach a complete copy 
undeveloped land, a building owned and used for      payment remains outstanding more than 13              of all forms, supporting schedules, and 
rental income, or any other fixed asset used for     months past the end of the fiscal year covered by     attachments filed with the IRS, except 
investment purposes should not  be  included in      the report, the late fee will increase to  $50.   If  publicly supported charities are not required 
Line 12.  Accordingly, the net fixed assets used     the  delinquency is not corrected within 16           to attach  the Schedule  B, Listing of 
for charitable purposes on Line 12 may be less       months of the end of the fiscal year covered by       Contributors. 
than the organization’s total net fixed assets.      the report, the late fee increases to $100.            
                                                                                                           Even if your organization is not required to file a 
If the organization  completed one of the                        Late Fee Schedule                         Form 990, 990-EZ, or 990-PF  with the IRS, if 
following IRS  Forms for this reporting  period       Fiscal    Late     Late          Late                the organization’s revenues or net assets exceed 
                                                      Year      Report   Report        Report              certain  thresholds,  it may  be required to 
and all its Net Fixed Assets are held for use in      End       Received Received      Received            complete  one of these forms for Oregon 
conducting  charitable activities, the figure         Dates     Before   Between       After This          purposes to meet the Charitable  Activities 
should come from the line number listed:                        This     These         Date 
 •      IRS Form 990, Part X, line 10c                          Date     Dates                             Section’s filing requirements. 
 •      IRS Form 990-EZ, Part II, line 23B            Late                                                  
        and/or 24B to the extent 24B includes         Fee:      $20      $50           $100                In general, if your organization’s total revenues 
        equipment or similar assets used for          12/31/21  2/1/23   2/1/23-       4/30/23             are at least $50,000, or its assets are more than 
        charitable programs.                                             4/30/23                           $100,000, you  may be  asked to complete  a 
                                                      1/31/22   3/1/23   3/1/23        5/31/23             990EZ or 990 for Oregon purposes only.  If the 
 •      IRS Form 990-PF, Part II, line 14b                               5/31/23                           organization has not filed the form with the IRS, 
                                                      2/28/22   4/1/23   4/1/23-       6/30/23             it should note on the form that it is for Oregon 
If the organization was not required to complete                         6/30/23                           purposes only. 
one of these IRS Forms, or filed an IRS Form          3/31/22   5/1/23   5/1/23-       7/31/23              
990-N, this figure will need to be calculated                            7/31/23 
from the organization’s accounting records, but       4/30/22   6/1/23   6/1/23-       8/31/23             Additional  instructions are provided below for 
the 990/990EZ can be used as worksheets to                               8/31/23                           990-N filers and for organizations that do not file 
determine the amount to report.                       5/31/22   7/1/23   7/1/23-       9/30/23             any type of 990 with the IRS.  
                                                                         9/30/23                            



- 7 -
For 990-N Filers—If your organization does          address of any person who  was paid by  the 
not complete an IRS Form 990 or 990-EZ              organization to complete this report. 
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 upon request. 
 
If the organization filed an IRS Form 990-N 
because its gross receipts are normally $50,000 
or less and the organization’s assets are less than 
$100,000 the organization may submit a copy of 
its Form 990-N. 
 
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 
990/990-EZ/990-N  with  the  IRS.   Please 
attach to your CT-12F a copy of your Form 1120 
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 Note—Organizations that file Form 
990 or 990-EZ with the IRS are not required to 
attach the Schedule B listing of contributors to 
filings with  the Charitable Activities Section. 
However, if voluntarily submitted, the schedule 
of contributors 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  this officer may  be the president, 
vice president, treasurer, chief executive officer, 
executive  director,  chief financial officer, or 
other corporate  officer, such as tax officer. 
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 



- 8 -
       Contact the Following Agencies for Assistance 
 
   Charitable Activities                          Internal Revenue Service                   Oregon Secretary of State 
                                                 
             Section                            Phone:  (877)829-5500                            Corporation Division 
Oregon Department of Justice                    Website: https://www.irs.gov/charities-and-  
100 SW Market Street                            nonprofits                                  Public Service Building 
Portland, Oregon 97201-5702                                                                 255 Capitol Street NE, Suite 151 
Phone:  (971)673-1880                                                                       Salem, OR 97310-1327 
TTY:       (800)735-2900                        Issues                                      Phone:  (503)986-2200 
Fax:     (971)673-1882                           • Obtaining federal tax identification     Fax:     (503)378-4381 
Email:   charitable@doj.state.or.us                number or federal tax-exempt status      Website:  https://sos.oregon.gov/business/ 
Website: https://www.doj.state.or.us             • Completing federal tax forms             Pages/default.aspx 

Issues                                          Forms                                       Issues 
 •     Questions about annual reports for        • 990, Return of Organization Exempt        •   Forming a new corporation 
       charitable organizations-Forms CT-12,       From Income Tax                           •   Merging nonprofit corporations 
       CT-12F, and CT-12S                        • 990-EZ, Short Form - Return of            •   Dissolving nonprofit corporations 
 •     Registration of charitable organizations    Organization Exempt From Income Tax       •   Amending articles of incorporation 
       and trusts                                • 990-PF, Return of Private Foundation      •   Obtaining copies of filed articles of 
 •     Merging nonprofit organizations           • 990-T, Exempt Organization Business           incorporation and amendments 
 •     Dissolving nonprofit organizations          Income Tax Return 
 •     Reporting illegal activity by nonprofit   • 990-W, Estimated Tax on Unrelated        Forms 
       organizations                               Business Taxable Income for Tax-          •   Articles of Incorporation 
 •     Serving as a board member of a nonprofit    Exempt Organizations                      •   Assumed Business Name Registration 
       organization                              • 1023/1023-EZ, Application for             •   Articles of Amendment 
 •     Information about charitable                Recognition of Exemption Under 
       organizations and copies of annual          §501(c)(3)                                •   Restated Articles 
       reports                                   • 1024, Application for Recognition of      •   Articles of Dissolution 
 •     Questions about raffles and other           Exemption Under §501(a)                   •   Revocation of Dissolution 
       charitable gaming                         • 1041, U.S. Income Tax Return for 
                                                   Estates and Trusts                       Publications Forms                                              1041-A, U.S. Information Return - Trust   •   Oregon Business Guide 
                                                   Accumulation of Charitable Amounts             
 •     RF-C, Registration Form for Charitable    • 1128, Application to Adopt, Change, or 
       Organizations                               Retain a Tax Year                             Oregon Department 
 •     RF-T, Registration Form for Trusts        • 4720, Return of Certain Excise Taxes on 
 •     CT-12, Annual Report Form for  Oregon       Charities and Other Persons                        of Revenue 
                                                                                             
       Charities                                 • 5227, Split-Interest Trust Return        Revenue Building 
 •     CT-12F, Annual Report Form for            • 5768, Election/Revocation of Election by 955 Center St. NE 
       Foreign Charities                           an Eligible Section 501(c)(3)            Salem, OR 97301 
 •     CT-12S, Annual Report Form for Split-       Organization to Make Expenditures to     Phone:  (503)378-4988 and (800)356-4222 
       Interest Trusts                             Influence Legislation                    TTY:     (800) 886-7204 
 •     Closing Form                              • 8822, Change of Address                  Website:  https://www.oregon.gov/DOR 
                                                 • 8868, Application for Extension of Time 
Publications                                       to File an Exempt Organization Return 
 •     Oregon Wise Giving Guide                    8976, Notice of Intent to Operate Under  Issues 
                                                 •
                                                   Section 501(c)(4)                         •   State taxation and filing requirements 
 •     A Guide to Non-Profit Board Service in 
       Oregon 
                                                Publications                                Forms 
Oregon Revised Statutes                          • Pub. 526, Charitable Contributions        •   20, Oregon Corporation Excise Tax 
 •     Chapter #65, Nonprofit Corporations         Pub. 538, Accounting Periods and              Return 
                                                 •
                                                   Methods                                   •   41, Oregon Fiduciary Income Tax Return 
 •     Chapter #128, Trusts; Charitable          • Pub. 557, Tax-Exempt Status for Your      
       Activities 
                                                   Organization 
                                                                                                     State of Oregon  
 •     Chapter #130, Uniform Trust Code          • Pub. 583, Starting a Business and         
 •     Chapter #464, Charitable Gaming 
                                                   Keeping Records                          Website:  https://www.oregon.gov 
 •     Chapter #646, Trade Practices &           • Pub. 598, Tax on Unrelated Business 
       Antitrust Regulation 
                                                   Income of Exempt Organizations 
                                                 • Pub. 3079, Gaming Publication for Tax-
Oregon Administrative Rules                        Exempt Organizations 
 •     Chapter #137-010-0005 et seq.             • Pub. 4220, Applying for 501(c)(3) Tax-
                                                   Exempt Status 
                                                 • Pub. 4221, Compliance Guide for 
                                                   501(c)(3) Organizations 
                                                  






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