California Exempt Organization Annual Information Return

Exempt Organization Annual Information Return
2023 Form 199 California Exempt Organization Annual Information Return
TAXABLE YEAR

2023

California Exempt Organization
Annual Information Return

Calendar Year 2023 or fiscal year beginning (mm/dd/yyyy)	
Corporation/Organization name

FORM

Additional information. See instructions.

PMB no.

City

State

Foreign country name

Foreign province/state/county

A First return. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

E
F
G
H

ZIP code
Foreign postal code

□ Yes □ No I

Did the organization have any changes to its guidelines
not reported to the FTB? See instructions.. . . . . . . . . . . . . . . □ Yes
J If exempt under R&TC Section 23701d, has the organization
IRC Section 4947(a)(1) trust. . . . . . . . . . . . . . . . . . . . . . . . . .  □ Yes □ No engaged in political activities? See instructions.. . . . . . . . . . □ Yes
Final information return?
K Is the organization exempt under R&TC Section 23701g?. . . □ Yes
□ Dissolved  □ Surrendered (Withdrawn) □ Merged/Reorganized
If “Yes,” enter the gross receipts from nonmember sources. . . $
Enter date: (mm/dd/yyyy)  ____ / _____ / _______
L Is the organization a limited liability company?. . . . . . . . . . . □ Yes
Check accounting method:  (1) □ Cash  (2) □ Accrual  (3) □ Other
M Did the organization file Form 100 or Form 109 to report
Federal return filed? (1)   □ 990T (2)   □ 990PF (3)  □Sch H (990) taxable income?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  □ Yes
(4) □Other 990 series
N Is the organization under audit by the IRS or has the IRS
Is this a group filing? See instructions. . . . . . . . . . . . . . . . . . □ Yes □ No audited in a prior year?.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . □ Yes
Is this organization in a group exemption . . . . . . . . . . . . . . . .  □ Yes □ No O Is federal Form 1023/1024 pending?. . . . . . . . . . . . . . . . . . . .  □ Yes
If “Yes,” what is the parent’s name?
Date filed with IRS

B Amended return. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
D

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Part I	

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Complete Part I unless not required to file this form. See General Information B and C.

Receipts
and
Revenues

5
6
7
8
Expenses 9
10
11
12
13
Payments 14
15
16
Sign
Here

• □ Yes □ No

•

1
2
3
4

.

FEIN

Street address (suite or room)

C

199

, and ending (mm/dd/yyyy)	
California corporation number

□ No

•
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□ No
□ No

•

□ No

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□ No
□ No
□ No

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1
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3

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00

7
8
9
10
11
12
13
14
15
16

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Gross sales or receipts from other sources. From Side 2, Part II, line 8  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Gross dues and assessments from members and affiliates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Gross contributions, gifts, grants, and similar amounts received  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Total gross receipts for filing requirement test. Add line 1 through line 3.
This line must be completed. If the result is less than $50,000, see General Information B  . . . . . . . . . . . . . . . 
5
00
Cost of goods sold . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
6
00
Cost or other basis, and sales expenses of assets sold . . . . . . . . . . . . . . . . . . . 
Total costs. Add line 5 and line 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total gross income. Subtract line 7 from line 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Total expenses and disbursements. From Side 2, Part II, line 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Excess of receipts over expenses and disbursements. Subtract line 9 from line 8  . . . . . . . . . . . . . . . . . . . . . . . 
Total payments	 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Use tax. See General Information K  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Payments balance. If line 11 is more than line 12, subtract line 12 from line 11 . . . . . . . . . . . . . . . . . . . . . . . . . 
Use tax balance. If line 12 is more than line 11, subtract line 11 from line 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Penalties and interest. See General Information J . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Balance due. Add line 12 and line 15. Then subtract line 11 from the result  . . . . . . . . . . . . . . . . . . . . . . . . . . . •

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Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is
true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.

Signature
of officer 
Preparer’s
signature 

Title

▶

Date

Date

• Telephone

Check if self-

• PTIN

employed ▶ □

▶

Paid
Preparer’s Firm’s name (or yours,
▶
Use Only if self-employed)    

• Firm’s FEIN

and address

• Telephone

May the FTB discuss this return with the preparer shown above? See instructions . . . . . . . . . . . . . . . . . . . .

• □ Yes □ No

For Privacy Notice, get FTB 1131 EN-SP.

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Form 199  2023  Side 1

Part II	

Organizations with gross receipts of more than $50,000 and private foundations
regardless of amount of gross receipts — complete Part II or furnish substitute information.

1
2
3
Receipts
from
4
Other
5
Sources
6
7
8
9
10
11
12
Expenses 13
and
14
Disburse- 15
ments
16
17
18

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Gross sales or receipts from all business activities. See instructions  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Dividends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Gross rents  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Gross royalties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Gross amount received from sale of assets (See instructions)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Other income. Attach schedule  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Total gross sales or receipts from other sources. Add line 1 through line 7. Enter here and on Side 1, Part I, line 1 . . . 
Contributions, gifts, grants, and similar amounts paid. Attach schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Disbursements to or for members . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Compensation of officers, directors, and trustees. Attach schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Other salaries and wages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Rents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Depreciation and depletion (See instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Other expenses and disbursements. Attach schedule  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Total expenses and disbursements. Add line 9 through line 17. Enter here and on Side 1, Part I, line 9 . . . . . . . . . 

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Schedule L  Balance Sheet

Beginning of taxable year

Assets

(a)

(b)

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18

End of taxable year

(c)

1	 Cash  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2	 Net accounts receivable  . . . . . . . . . . . . . . . . . . . . . . .
3	 Net notes receivable  . . . . . . . . . . . . . . . . . . . . . . . . . .
4	 Inventories  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5	 Federal and state government obligations . . . . . . . . . .
6	 Investments in other bonds . . . . . . . . . . . . . . . . . . . . .
7	 Investments in stock . . . . . . . . . . . . . . . . . . . . . . . . . .
8	 Mortgage loans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9	 Other investments. Attach schedule  . . . . . . . . . . . . . .
10	a	Depreciable assets  . . . . . . . . . . . . . . . . . . . . . . . . .
b	 Less accumulated depreciation . . . . . . . . . . . . . . . .
11	 Land  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12	 Other assets. Attach schedule . . . . . . . . . . . . . . . . . . .
13	 Total assets  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Liabilities and net worth
14	 Accounts payable  . . . . . . . . . . . . . . . . . . . . . . . . . . . .
15	 Contributions, gifts, or grants payable  . . . . . . . . . . . .
16	 Bonds and notes payable  . . . . . . . . . . . . . . . . . . . . . . .
17	 Mortgages payable . . . . . . . . . . . . . . . . . . . . . . . . . . .
18	 Other liabilities. Attach schedule . . . . . . . . . . . . . . . . .
19	 Capital stock or principal fund . . . . . . . . . . . . . . . . . . .
20	 Paid-in or capital surplus. Attach reconciliation  . . . . .
21	 Retained earnings or income fund  . . . . . . . . . . . . . . .
22	 Total liabilities and net worth  . . . . . . . . . . . . . . . . . .
Schedule M-1	
Reconciliation of income per books with income per return
Do not complete this schedule if the amount on Schedule L, line 13, column (d), is less than $50,000.
1	 Net income per books . . . . . . . . . . . . . . . . . . . . . . . . .
2	 Federal income tax  . . . . . . . . . . . . . . . . . . . . . . . . . . .
3	 Excess of capital losses over capital gains  . . . . . . . . .
4	 Income not recorded on books this year.
	 Attach schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5	 Expenses recorded on books this year not
	 deducted in this return. Attach schedule . . . . . . . . . . .
6	 Total. Add line 1 through line 5 . . . . . . . . . . . . . . . . . .

Side 2  Form 199  2023

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7	 Income recorded on books this year
not included in this return. Attach schedule  . .

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8	 Deductions in this return not charged
against book income this year.

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Attach schedule . . . . . . . . . . . . . . . . . . . . . . . .
9	 Total. Add line 7 and line 8  . . . . . . . . . . . . . . .
10	 Net income per return.
Subtract line 9 from line 6 . . . . . . . . . . . . . . . .

3652233

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(d)