Print Reset Form For Accounting Periods Charitable Activities Section Beginning in: Oregon Department of Justice 100 SW Market Street VOICE (971) 673-1880 CT-12S Portland, OR 97201-5702 TTY (800) 735-2900 For Split-Interest Trusts Email: charitable@doj.state.or.us FAX (971) 673-1882 Website: https://www.doj.state.or.us Line-by-line instructions for completing the annual 2022 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. Has the trust 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. 3. During this reporting period, did the trust amend any trust documents OR did the trust receive a determination or ruling from the Internal Revenue Service relating to its status? If yes, attach a copy of the amended document or IRS communication. Yes No 4. Is the trust ceasing operations and is this the final report? (If yes, see instructions on how to close your registration.) Yes No 5. Provide contact information for the person responsible for retaining the trust’s records. Name Position Phone Mailing Address & Email Address 6. 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 Compensation weekly hours (enter $0 if devoted to position unpaid) position Name: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Address: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Phone: (_ _ _)_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Email: Name: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Address: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Phone: (_ _ _)_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Email: Name: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Address: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Phone: (_ _ _)_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Email: Form Continued on Reverse Side |
Section II. Fee Calculation 7. Charitable Distribution .............................................................................................................. 7. (If no charitable distributions were made during the report year write $0. Otherwise, write the total of Part III, Lines 2 a, b and c, plus Line 3, plus Line 9 from Form 5227, or the total of Line 18 plus Line 24 from Form 1041-A) 8. Charitable Distribution Fee ..................................................................................................................................................... 8. (See chart below. Minimum fee is $20.) Amount on Line 8 Charitable Distribution 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 9. Net Assets at the End of the Reporting Period .......................................................................... 9. (Part IV, Line 22b on Form 5227 or Line 45b on Form 1041-A) 10. Net Assets Fee ....................................................................................................................................................................... 10. (Line 9 multiplied by .0001. If the fee is less than $5, write $0. Not to exceed $2,000. Round cents to the nearest whole dollar.) Are you filing this report late? Yes No ................................................................................................................. 11. (If yes, the late fee is a minimum of $20. You may owe more depending on how late the report is. See Instruction 11 for additional information or contact the 11. Charitable Activities Section at (971) 673-1880 to obtain late fee amount.) 12. Total Amount Due .................................................................................................................................................................. 12. (Add Lines 8, 10, and 11. Make check payable to the Oregon Department of Justice.) 13. Attach a copy of the trust’s federal returns and all supporting schedules and attachments. Under penalties of perjury, I declare that I have examined this return, including all accompanying forms, schedules, and attachments, Please 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. |
Charitable Activities Section, Oregon Department of Justice 2022 Form CT-12S Instructions organization’s fiscal year. If the due date falls on the later of the due date or within 10 days after a weekend or legal holiday, the due date is the the trust receives notice of denial of the General next business day. requested extension. Instructions The Charitable Activities Section does not use the postmark date to determine whether an Record Keeping organization has filed timely. Instead, reports Please retain a copy of this report and all Purpose must be physically received by the due date to supporting documentation for at least five years Oregon law charges the Attorney General with not be considered late. See Instruction 15 Late after the due date. the duty and responsibility to represent the Fees. public’s interest in charitable organizations and in assets held or received for charitable purposes. Rounding and Blank Lines The Attorney General carries out this Extensions for Filing Round all amounts on the report to the nearest responsibility by requiring charitable Important Note—An extension request filed whole dollar. Drop amounts under 50 cents and organizations to register and file periodic with the IRS or the Oregon Department of increase amounts from 50 to 99 cents to the next financial reports. Revenue does NOT act as an extension with whole dollar. If the amount is zero write “$0.” the Charitable Activities Section unless a copy Once submitted, this Form and all attachments is submitted to the Charitable Activities Do not leave any line blank. Your report may become a part of the public record excluding Section by the due date. be treated as incomplete if you leave blank lines. social security numbers and similar confidential information. Any interested person may examine A trust may apply for an extension of time to or obtain a copy of an annual report of a file. Extension requests must be received on or Important Reminders charitable organization by contacting the before the due date of the report to avoid a late Important information regarding Social Charitable Activities Section. fee. The maximum available extension period is Security numbers (SSNs) –Forms submitted 180 days. An extension to file is also an to this office become a public record. To extension to pay any associated fees. Therefore, protect the privacy of named individuals, you estimated payments should not be included with should redact any SSNs (if used) from copies Who Must File extension requests. of any IRS forms submitted. Although we All organizations registered with the Charitable endeavor to redact SSNs from any forms we Activities Section of the Oregon Department of Please do not submit an incomplete CT-12S if receive, we request your assistance in Justice must annually file Form CT-12, CT-12F, you intend to later supplement or amend your safeguarding this information by not or CT-12S unless the Attorney General has report with a copy of your IRS return. Instead, including it in your submission. specifically exempted the organization from the file an extension request so that you can submit a reporting requirements. complete report by the extended due date with a copy of the appropriate IRS form attached. How to Contact the Charitable Activities What Form to File Extensions may be requested through the File Form CT-12 if the organization is either Department of Justice website at Section incorporated, organized, or headquartered in https://justice.oregon.gov/Charities/Extensions. To obtain blank forms, mailed instructions, Oregon. Follow the instructions carefully to ensure that technical assistance or information about a we receive your request. Please contact our charitable organization, contact the Charitable File Form CT-12F if the organization is office if you have any questions or difficulties Activities Section or visit our website at: organized and headquartered outside of Oregon. with your online request. The Charitable Activities Section does not Charitable Activities Section accept multi-state annual report forms in lieu of You should print and retain a copy of the online Oregon Department of Justice a completed Form CT-12F. Confirmation of Extension Request. You should 100 SW Market Street also expect to receive a confirmation of receipt Portland, OR 97201-5702 File Form CT-12S if the organization is a split- of your online request. Phone: (971)673-1880 interest trust that holds assets for the benefit of TTY: (800)735-2900 both charitable and non-charitable beneficiaries. You may also submit a written request or a copy Fax: (971)673-1882 of the trust’s federal extension request (IRS Email: charitable@doj.state.or.us If the organization does not fit within any of the Form 8868) so long as the Charitable Website: https://www.doj.state.or.us above categories, file Form CT-12. Activities Section receives the request or copy before the due date of the report. The trust’s The form year should match the starting year 4 or 5-digit registration number should be noted Where to File of the fiscal period covered by the report. on the top of all extension requests. If you Send completed forms and corresponding fees to would like acknowledgement that your extension the above address. Do not send cash. The request has been received, you should enclose an Charitable Activities Section does not accept Due Date additional copy of the request and a self- CT-12S reports via electronic submission at this The form, all required attachments and addressed, stamped envelope. time. schedules, and payment of fees are due in the In the event your request is denied, to avoid a Charitable Activities Section’s office no later late fee, the annual report must be submitted by than 4 months and 15 days after the end of the |
secretary of state, or local district attorney, or been a party to legal action in any court or Officers include those officers required by Line Instructions administrative agency regarding charitable applicable state law, such as president, secretary, solicitation, administration, management, or or treasurer, and also includes the person(s) fiduciary practices. This includes assurances of elected or appointed to implement the decisions Section I. voluntary compliance or discontinuance of the governing body or for supervising the involving the trust or any other proceeding in management, administration, or operation of the which the trust or any current officer, director, organization, regardless of title or the amount of General Information trustee, or key employee is subject to any compensation received. The CEO or Executive injunction, order, or pending action relating to Director is an officer for purposes of this form. the solicitation of contributions, or The top financial official may also be an officer 1. Missing or Incorrect administration of charitable assets. Attach a if they are responsible for managing the Information written explanation of each such action or organization’s finances. agreement, including the agency involved and The Charitable Activities Section sends a form Column (C) the allegations. Also, attach a copy of any preprinted with name, address, contact agreements or actions that occurred in the information and registration number to all If an IRS form is attached that includes complete current reporting period. registered trusts. If the trust is returning one of and accurate compensation information, the these preprinted forms, provide any missing or phrase “See IRS Form” may be entered in lieu of corrected information. If the trust is completing a completing this section. blank form, provide the requested information in 3. Amendments to Trust this section. Documents Otherwise, for each person listed, report the total Check yes if during the reporting period the trust amount of compensation paid or deferred for Name Changes amended the documents that created the trust or payment to a later date, including salary, fees, if the trust received a determination or ruling bonuses, benefits, taxable allowances or If applicable, write the trust’s new legal name. from the IRS relating to its status. reimbursements, the value of noncash Attach a copy of the trust document that changed compensation, and severance payments. Important Note the trust’s name. —Attach signed and dated copies of amended trust documents and/or IRS Enter a zero in column (C) if the person was a Address, Email, and Phone communication. volunteer and was not paid or did not accrue any Number Changes compensation during the reporting year. If applicable, write the new address where mail for the trust should be directed in the future. If 4. Final Report The trust may provide an attachment to explain applicable, write the new daytime phone Check yes if this is the final report for the trust. the entire compensation package for any person number, fax number and email address for the The trust should contact the Charitable Activities listed in this part, including whether the trust. Section for specific instructions and compensation includes the payment of amounts requirements relating to closing procedures. previously deferred. Accounting Year Changes A final report must reflect the financial If applicable, write the trust’s new or short transactions of the trust from the day after the reporting period. Preprinted forms are based close of its last accounting period to the date of upon the accounting period we have on record the disposition of all remaining assets. for the trust. If the trust has changed its fiscal Section II. year or is filing a final report for a period less than 12 months, the shortened period covered by 5. Who Keeps the Books? Fee Calculation the report must be noted here. If the trust is Indicate the person to be contacted if the trust's filing a final report, see the instructions for line 4 books need to be accessed for information or for closing requirements. review. Either a business or personal phone 7. Charitable Distribution number, email, and mailing address are The charitable distribution represents the total Short Year Report—If the trust is filing a acceptable. If the person does not have an email amount paid to charitable organizations. For shortened report due to a change in fiscal year, address, please note that on the form. Charitable Remainder trusts there will generally see the instructions for line 10 for calculation of be no charitable distributions until the final year prorated Net Assets fee. when the trust terminates. If no charitable 6. Officers, Directors, distributions were made during the report year, Amended Reports enter zero on line 7. Otherwise, if IRS Form Trustees, and Other Key If amending previously submitted information 5227 was filed, add the amounts on Part III, for the same accounting period, check the Employees Lines 2 a, b and c, plus Line 3, plus Line 9. If amended report box. Either complete a blank List each person who was an officer, director, IRS Form 1041-A was filed, add the amounts on form that includes the amended information or trustee, or key employee (defined below) of the lines 18 and 24. provide a copy of the previously submitted form trust at any time during the year even if they are that clearly shows what information is being a volunteer and do not receive any compensation amended. Submit any additional fee due with the from the organization. Give the daytime phone amended report. number and preferred mailing address at which officers, etc., want the Charitable Activities 8. Charitable Distribution Fee Section to contact them. Use an attachment if Use the charitable distribution figure from line 7 2. Disclosure of Legal Action there are more persons to list than there are lines to calculate the charitable distribution fee available. according to the following schedule. Check yes if the trust or any of its officers, directors, trustees or key employees ever signed A failure to fully complete this part can subject Charitable Distribution Fee Schedule a voluntary agreement with any government the trust to late fees or civil penalties for filing agency, such as a state attorney general, an incomplete form. |
Charitable should be made if the short report is due to the located on line 1 of the preprinted Form CT-12S Amount on Line 8 Distribution Fee initial or final reporting period. or can be obtained by contacting the Charitable $ 0 - $ 24,999 $ 20 Activities Section. 25,000 - 49,999 50 50,000 - 99,999 90 100,000 - 249,999 150 11. Late Fees 250,000 - 499,999 200 If the report is not filed or the fee is not paid by 13. IRS Forms, Schedules, 500,000 - 999,999 300 the due date (or the extended due date), an initial and Attachments 1,000,000 or more 400 late fee of $20 will be due. If the report or All trusts must attach a complete copy of all payment remains outstanding more than 13 forms, supporting schedules, and attachments The maximum amount subject to the charitable months past the end of the fiscal year covered by filed with the IRS. This may include IRS Form distribution fee is $1,000,000. The maximum the report, the late fee will increase to $50. If 1041-A and/or IRS Form 5227. charitable distribution fee is $400. The minimum the delinquency is not corrected within 16 charitable distribution fee is $20. months of the end of the fiscal year covered by Important Note for CPAs/Paid the report, the late fee increases to $100. Preparers/Beneficiaries— Forms submitted to this office become a public record. To protect 9. Net Assets at the End of Late Fee Schedule the privacy of named individuals, you should the Reporting Period Fiscal Late Late Late Year End Report Report Report redact Social Security Numbers (if used) from The Charitable Activities Section has adopted Dates Receive Received Received the copy of the IRS Form 990/990-EZ/990- the definition for “Net Assets” used by the d Before Between After This PF/5227/1041-A (Schedule K) submitted to this Internal Revenue Service. If the trust completed This These Date office. Although we endeavor to redact social one of the following IRS Forms for this Date Dates security numbers from any forms we receive, we reporting period, the Net Assets figure should Late $20 $50 $100 request your assistance in safeguarding this come from the line number listed: Fee: information by not including it in your • IRS Form 1041-A, Part IV, line 45b 12/31/22 2/1/24 2/1/24- 4/30/24 submission. 4/30/24 • IRS Form 5227, Part IV, line 22b 1/31/23 3/1/24 3/1/24 5/31/24 5/31/24 Signature Block If the trust was not required to complete one of 2/28/23 4/1/24 4/1/24- 6/30/24 these IRS Forms, a summary of what constitutes 6/30/24 To make the return complete, a trustee, receiver Net Assets is provided within these instructions. 3/31/23 5/1/24 5/1/24- 7/31/24 or assignee must sign any return he or she files A more detailed definition can be found in the 7/31/24 for the trust. Signature stamps and labels are not IRS instructions for forms listed above. 4/30/23 6/1/24 6/1/24- 8/31/24 acceptable. Power of Attorney signature is not 8/31/24 accepted. Net Assets refer to the trust’s assets minus 5/31/23 7/1/24 7/1/24- 9/30/24 liabilities. 9/30/24 In the paid preparer’s information section, 6/30/23 8/1/24 8/1/24- 10/31/24 include the name, daytime phone number, and 10/31/24 “Assets” are items of value to the trust, such as 7/31/23 9/1/24 9/1/24- 11/30/24 address of any person who was paid by the trust cash, receivables less any allowance for doubtful 11/30/24 to complete this report. accounts, inventory, prepaid expenses, 8/31/23 10/1/24 10/1/24- 12/31/24 investments, land, buildings & equipment less 12/31/24 any accumulated depreciation if the trust records 9/30/23 11/1/24 11/1/24- 1/31/25 depreciation. 1/31/25 10/31/23 12/1/24 12/1/24- 2/28/25 “Liabilities” are the amount of debts and 2/28/25 obligations owed by the trust, such as accounts 11/30/23 1/1/25 1/1/25- 3/31/25 payable, accrued expenses, deferred revenue, 3/31/25 loans, and mortgages. The above late fees apply automatically and Important Note— If the trust disposed of all or cannot be waived. The Department has the substantially all of the trust’s assets during this authority to obtain additional civil penalties reporting period, attach a letter listing a against the organization and its officers and description of the asset and the name, address, directors or take other administrative action in phone number, and contact person of each entity connection with the failure to file timely and which received the trust’s assets. complete reports. 10. Net Assets Fee 12. Total Amount Due Multiply the amount subject to a Net Assets fee Add lines 8, 10, and 11. This is the total amount from line 9 by .0001 and enter this figure on line due. Make check or money order payable to the 10. Round to the nearest whole dollar. If the “Oregon Department of Justice”. The result is less than $5 enter $0. If the result is Department does not accept payment by credit more than $2,000 enter $2,000. card. Do not send cash. Mail payment together with the report to: Important Note—If the trust is filing a short report of less than one year due to a change in Charitable Activities Section Oregon Department of Justice accounting periods, the amount entered on line 100 SW Market Street 11 should be prorated by the number of months Portland, Oregon 97201-5702 covered by the report. To determine the prorated amount, divide the amount determined above by Important Note—Indicate on the check the 12 and multiply by the number of months trust’s 4 or 5-digit Oregon Department of Justice covered by the short report. No similar proration registration number. The registration number is |
Contact the Following Agencies for Assistance Charitable Activities Internal Revenue Service 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 Website: Email: charitable@doj.state.or.us number or federal tax-exempt status https://sos.oregon.gov/business/Pages/ Website: https://www.doj.state.or.us • Completing federal tax forms 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 • 1023/1023-EZ, Application for Forms organizations Recognition of Exemption Under • Articles of Incorporation • Serving as a board member of a §501(c)(3) • Assumed Business Name Registration nonprofit organization • 1024, Application for Recognition of • Articles of Amendment • Information about charitable Exemption Under §501(a) • Restated Articles organizations and copies of annual • 1041, U.S. Income Tax Return for • reports Estates and Trusts Articles of Dissolution • • Questions about raffles and other • 1041-A, U.S. Information Return - Revocation of Dissolution charitable gaming Trust Accumulation of Charitable • Application for Authority to Transact Amounts Business • Forms 1128, Application to Adopt, Change, or Retain a Tax Year Publications • RF-C, Registration Form for Charitable • 4720, Return of Certain Excise Taxes • Oregon Business Guide Organizations on Charities and Other Persons • RF-T, Registration Form for Trusts • 5227, Split-Interest Trust Return • CT-12, Annual Report Form for • 5768, Election/Revocation of Election Oregon Department Oregon Charities by an Eligible Section 501(c)(3) • CT-12F, Annual Report Form for Organization to Make Expenditures to of Revenue Foreign Charities Influence Legislation • CT-12S, Annual Report Form for Split- • 8822, Change of Address Revenue Building Interest Trusts • 8868, Application for Extension of 955 Center St. NE • Closing Form Time to File an Exempt Organization Salem, OR 97301-2555 Return Phone: (503)378-4988 and (800)356-4222 Publications • 8976, Notice of Intent to Operate Under Website: https://www.oregon.gov/DOR Section 501(c)(4) • Oregon Wise Giving Guide • A Guide to Non-Profit Board Service in Issues Oregon Publications • State taxation and filing requirements • Pub. 526, Charitable Contributions Oregon Revised Statutes • Pub. 538, Accounting Periods and Forms Methods • Chapter #65, Nonprofit Corporations • 20, Oregon Corporation Excise Tax • Pub. 557, Tax-Exempt Status for Your • Chapter #128, Trusts; Charitable Return Organization Activities • 41, Oregon Fiduciary Income Tax • • Chapter #130, Uniform Trust Code Pub. 583, Starting a Business and Return Keeping Records • Chapter #464, Charitable Gaming • Pub. 598, Tax on Unrelated Business • Chapter #646, Trade Practices & Income of Exempt Organizations State of Oregon Antitrust Regulations • Pub. 3079, Gaming Publication for Tax-Exempt Organizations Website: https://www.oregon.gov Oregon Administrative Rules • Pub. 4220, Applying for 501(c)(3) Tax- • Chapter #137-010-0005 et seq. Exempt Status • Pub. 4221, Compliance Guide for 501(c)(3) Organizations |