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Form

Department of the Treasury


Internal Revenue SerVIce

OMB No 1545-0687
Exempt Organization Business Income Tax Return
(and proxy tax under section 6033(e))
Fer calendar year 2013 or other tax year beginning
, and ending
2013
D Information about Form 990-T and its instructions is available at WW "5 gov/formggm.
0 en to Public inspection for
5 1(cx3) Organizations Only
D Do not enter SSN numbers on this form as it may be made public it your organization is a 501(c)(3).
ogpglggfgggffsg um
Name 01 organization ( 1:] Check box 11 name changed and see Instructions.)

71:] Check box It


address changed
B Exempt under section

Print

CHURCH OF so I ENTOLOGY FLAG


SERVICE ORGANI ZATION , INC .

501(C )( 3 )
[34mm [:|220(e)

r
""9

Number, street, and room or sude no. It a P.0. box, see instructions.
2 1 0 s. FORT HARRI SON AVE.

Instructions)
59-2143308
E,gg;::;?uggj'::,ss WW ng

[:14OBA D530(a)
City or town, state or provmce, country, and ZIP or foreign postal code
1:1529(a)
CLEARWATER, FL
337565109
721110
Book value of all assets
F Group exemption number (See instructions.)
P
at end of year
2 l 8 1 5 4 3 1 9 . G Check organization type P
LXJ 501(c) corporation
LJ 501(c) trust
|_| 401(a) trust
L] Other trust
SEE STATEMENT 1
H Describe the organizations primary unrelated busmess actIVIty. b
l During the tax year, was the corporation a subSIdIary in an affiliated group or a parent-subsndlary controlled group?
D Ll Yes
No
If 'Yes, enter the name and identifying number of the parent corporation. P
J The books are in care of P GLEN STILO , SECRETARY
Telephone number F 727467-5000
Wart l | Unrelated Trade or Business Income
(A) Income
(B) Expenses
(0) Ne!
154 , 927 .
1a Gross receipts or sales
b Less returns and allowances
c Balance
b
1c
154 , 927 .
46 , 440 .
2
2 Cost of goods sold (Schedule A, Ilne 7)
1O8 , 487
108 , 487 .
3
3 Gross profit. Subtract line 2 from line 1c
4a Capltal galn net Income (attach Form 8949 and Schedule D)
4a
"
4b
b Net galn (loss) (Form 4797, Part II, line 17) (attach Form 4797)
c Capital loss deduction for trusts
4c
5 Income (loss) from partnerships and S corporations (attach statement)
5
6 Rent income (Schedule C)
6
7 Unrelated debt-financed income (Schedule E)
7
8
8 Interest, annurties, royalties, and rents from controlled organlzatlons (Sch. F)
9 Investment income of a section 501(c)(7), (9), or (17) organization (Schedule G) 9
10 Explaited exempt activ1ty income (Schedule |)
10
11 Advertismg income (Schedule J)
11
12 Other Income (See instructions; attach schedule.)
12
~
108 , 487 .
13
13 Total. Combine llnesathroughlz
I Part II I Deductions Not Taken Elsewhere (See instnrctions for limitations on deductions.)
(Except for contributions, deductions must be directly connected With the unrelated busmess income.)
14
15
16
17
18
19
20
21
22
23
(131%in
330
17102
1; 24
25
26
27
28
29
30
31
32
33
34

Compensation of officers, directors, and trustees (Schedule K)


14
Salaries and wages
15
16
_,
Repairs and maintenance
Bad debts
__
\
17
Interest (attach schedule)
3: \ klli,
18
Taxes and licenses
7 ' ' J
\(Q
19
Charitable contributions (See Instructionstor limitation rules.)
Mr,
q ll.
20
DepreCIation (attach Form 4562)
2' w L
21).
18 , l 1 0 . __
Less depreciation claimed on Schedule A and elsewhere on return
._\
__,,.4 :22a
'1
22b
Depletion
\ y
\1 1 ,
23
Contributions to deferred compensation plans
,
1;
"J
HT
24
Employee benefit programs
25
Excess exempt expenses (Schedule I)
26
Excess readership costs (Schedule J)
_
27
Other deductions (attach schedule)
SEE STATEMENT 3
28
Total deductions. Add lines 14 through 28
29
Unrelated busmess taxable income before net operatmg loss deduction. Subtract line 29 from lIne 13
30
Net operating loss deduction (limtted to the amount on line 30)
31
Unrelated busmess taxable Income before specific deduction. Subtract Ime 31 from line 30
32
Specific deduction (Generally $1,000, but see instructlons for exceptions.)
,
_ _
33
Unrelated business taxable income. Subtract lIne 331roml1ne 32.ll|1ne 33 is greater than line 32, enter the smaller of zero 0r
line32
34
m3 LHA For Paperwork Reduction Act Notice, see instructions.

E
l
i
.

108 , 487 .

l7 , 928 .
3 , 920 .

4 , 56 0 .

18 , l10 .

8l , 778 .
126 , 296 .
<1 7 , 8 0 9 . >
<1 7 , 8 0 9 . >
l , 000 .
<17,809.>
Form 990-T (2013)

Form990-Tl2013)

CHURCH OF SCIENTOLOGY FLAG


SERVICE ORGANIZATION, INC.

592143308

Page 2

I Part III | Tax Computation


\
35 Organizations Taxable as Corporations. See Instructions for tax computation.
Controlled group members (sections 1561 and 1563) check here > E] See instructions and:
a Enter your share of the $50,000, $25,000, and $9,925,000 taxable income brackets (in that order):
I
(3) Is
I
(2) Is
I
(1) |$
b Enter organization's share or. (1) Additional 5% tax (not more than $11,750)
|$
|
(2) Additional 3% tax (not more than $100,000)
|$
I
35c
c Income tax on the amount on line 34
36 Trusts Taxable at Trust Rates. See instructions for tax computation. Income tax on the amount on line 34 from:
36
b
[:1 Tax rate schedule or Cl Schedule D (Form 1041)
37 Proxy tax. See instructions
P
37
38
38 Alternative minimum tax
39
39 Total. Add linesgz and 38 to line 35c or 36, whichever applies
n IvlJTax and Payments
40a Foreign tax credit (corporations attach Form 1118; trusts attach Form 1116)
40a
40b
b Other credits (see instructions)
400
c General busmess credit Attach Form 3800
__.__
40d
11 Credit tor prior year minimum tax (attach Form 8801 or 8827)
40c
e Total credits. Add lines 40a through 40d
41
41 Subtract line 40e from line 39
42
42 Other taxes Check it from: [:1 Form 4255 |:l Form 8611 [:1 Form 8697 |:I Form 8866 [:1 Other (attach schedule)
43
43 Total tax. Add lines 41 and 42
5 , 000 .
44a
44 a Payments: A 2012 overpayment credited to 2013
5 , 229 .
44b
b 2013 estimated tax payments

0 .

0 .
0 .

0
0
e
1
9
45
46
47
48
49
[part
1

Tax depOSited With Form 8868


44c
44d
Foreign organizations: Tax paid or Withheld at source (see instructions)
44a
Backup Withholding (see instructions)
Credit for small employer health insurance premiums (Attach Form 8941)
441
[:1 Form 2439
Other credits and payments:
44g
Total p
C] Other
El Form 4136
Total payments Add lines 44a through 44g
Estimated tax penalty (see instructions). Check 11 Form 2220 is attached b E]
Tax due. ll line 45 is less than the total of lines 43 and 46, enter amount owed
_
Overpayment. ll line 45 is larger than the total of lines 43 and 46, enter amount overpaid
l 0 , 2 2 9 .I Relunded
Enter the amount of line 48 you want Credited to 2014 estimated tax b
v I Statements Regarding Certain Activities and Other Information (see Instmctlons)

0 .

l0 , 229 .

45
46
47
48
49

b
b
b

10 , 229 .
0 .

At any time during the 2013 calendar year, did the organization have an interest in or a Signature or other authority over a financial account (bank,
securities, or other) In a loreign country? If YES, the organization may have to file Form TD F 90-221, Report 01 Foreign Bank and Financ1al
UNITED KINGDOM AND AUSTRALIA
Accounts. ll YES, enter the name of the foreign country here >

2 Wt? :22 8:533:08: $3338.?2312':In?233?.I%2%$321"25%! "


0 .
3 Enter the amoun_t ol tax-exempt interes_t received or accrued during the tax year > $
Schedule A - Cost of Goods Sold. Enter method of inventory valuation b ALLOCATED
6 Inventory at end of year
0 o
1
1 Inventory at beginning ol year
7 Cost 01 goods sold. Subtract line 6
4 6 , 44 0 .
2
2 Purchases
from line 5. Enter here and in Part I, line 2
3
3 Cost ol labor
4 a Additional section 263A costs (an schedule)
4a
8 Do the rules 01 section 263A (With respect to
property produced or acqu1red for
4b
b Other costs (attach schedule)
A 0.5 A
the organization?
46 , 440 .
5
5 Tota|.Add lines 1 througle
S.
were?.amusemeezaizeeeemesses:gammadare: $91.
9. 1
ign <
Here
lam/m. 5
O
80
Date
(
Print/Type preparers name

Preparer's signature
0 D Date
Paid
WI LLIAM
Preparer WILLIAM D. ESENSTEN ESENSTEN
11/17/14
use only Firm's name DNSBN LLP
9454 WILSHIRE BLVD. , 4TH FLOOR
Flrm'SaddreSS b BEVERLY HILLS, CA 90212-2907
323711 12-12-13

Yes

No

X
X
I

6
"_
AJ

0 .
46 , 440 .
Yes No
C ___ ___l
X
w

mstrucuons)? [X] Yes E] No


PTIN i

Check I il
selt- employed
Firm's EIN b
Phoneno.

P00535334
95-2399533

(310)2732501
Form 990-T(2o13)

CHURCH OF SCIENTOLOGY FLAG


Form 990-T (2013) SERVICE ORGANIZATION, INC .
59 2143308
Page 3
Schedule C - Rent lncomejFrom Real Property and Personal Property Leased With Real Property)(898 INSUUCIIOHS)
(

1. Description of property
(1)
(2)
(3)
(4)

2, Rent received or accrued


a From personal property (it the percentage of
I) From real and personal property (it the percentage
( ) rent for personal property is more than
( of rent for personal property exceeds 50% or I(
10% but not more than 50%)
the rent is based on prot or income)

(1)
C2)
(3)
45L
Total

0 .

Total

3(a)Deductions directly connected With the income in


celumns 2(a) and 2(bHaHBCh scnwum)

0 .

(c) Total income. Add totals of columns 2(a) and 2(b). Enter
here and on page 1, Part I, line 6, column (A)
p
Schedule E - Unrelated Bebt-Financed Income (see instructions)

0 .

0 .

3, Deductions directly connected With or allocable


to debt-nanced property
(a) sum ght line depreCIation
( b(anach
)Other schedum
deductions
(anach schedule)

2_ Gross Income from


or allocable to debtfinanced property

1. Description of debt _ nanced property

(b) Tm deductwnsEnter here and on page 1,


Part I, line a, column (a)
p

(1)
(2)
(3)
(4)
4 _ Amount 0 i average acqursition
debt on or allocable to debt-nanced
property (attach schedule)

5 _ A verage a d luste d b a5is


of or allocable to
debtnanced property
(attach schedule)

6 _ c olumn 4 diVided
by column 5

(1)
42)
L3)
(4)

7 . G ross income
reportable (column
2 x column 5)

8 , Alloca bl e d ed uctions
(column 6 x total 01 columns
3(a) and 3(1)

%
%
%
0/o
Enter here and on page 1,
Pan I, line 7, column (A)

Enter here and on page 1.


Pan I, line 7, column (B)

Totals
b
0.
Total dividends-received deductions Included in column 8
b
Schedule F - Interest, Annuities, Royalties, and Rents From Controlled Organizations (see Instructlons)
Exempt Controlled Organizations
1. Name of controlled organization

2.
Employer identication
number

(1)
(2)
(3)
(4)
Nonexempt Controlled Organizations
7, Taxable Income
8_ Net unrelated income (loss)
(see instructions)

3.
Net unrelated income
(loss) (see instructions)

4.
Total of speCIed
payments made

9, Total of specied payments


made

5. Pan of column 4 that is


included in the controlling
organization's gross income

0 .
0 .

6. Deductions directly
connected With income
in column 5

10, Pan of column 9 that is included


in the controlling organization's
gross income

11, Deductions directly connected


With income in column 10

Add columns 5 and 10


Enter here and on page 1, Part I.
into 8. column (A)

Add columns 6 and 11


Enter here and on page 1, Pan I.
line 8, column (B)

(1)
(2)
(3)
(4)

Totals
323721 12-12-13

0 .

0 .
Form SSO-T (2013)

CHURCH OF SCIENTOLOGY FLAG


Form 990-T(2013) SERVICE ORGANIZATION, INC.

(1)
(2)
(3)
(4)

4. Sel'aSIdBS
(attach schedule)

5. Total deductlons
and set-aSIdes
(col 3 plus col 4)

Enter here and on page 1.


Part I. ma 9. column (A)

Enter here and on page 1,


Pan l, km 9. column (B)

0 ,

0 ,

Totals

Page 4

592143308

Schedule G - Investment Income of a Section 501(c)(7), (9), or (17) Organization


\
(see Instmctlons)
3. Deductions
1, Descnpuon 01 Income
2_ Amount 01 Income
dIrectIy connected
(attach schedule)

Schedule I - Exploited Exempt Activity Income, Other Than Advertising Income


(see InstructIons)
1. Description ol
exploited actIVIty

2. Gross
unrelated busrness
Income from
trade or bustness

dlrgu$x:$ed
mm roducuon
of :melated
busmess Income

Enter here and on


page 1. Part 1.
lIne 10, col (A)

Enter here and on


page 1, Part I.
lIne 10. col (B)

(1)
(2)
(3)
(4)

4. Net Income (loss)


from unrelated trade or
ousmess (column 2
mInus column 3) If a
gain, crogggefols 5

5. Gross Income
from activity that
Is not unrelated
busmess Income

5,x ~ ,

6 Expenses
atibumbla 0
column 5

, 334;;
,

ngizzzsgip
6 minus column 5
but not mow man
column 4)

Enter here and


on page 1,
Part II, lIne 26
0 .

0 .
0 .
b
Totals
Schedule J - Advertising Income (see ll'tStrUCthllS)
I part | | Income From PerIodIcaIs Reported on a ConsoIIdated BaSIs

2. Gross
advmlsm
mme g

- Name 0' DHIOdlca'

3. DIrect
advertIsrng costs

4. Advemsmg gain
or (loss) (col 2 mmus
col 3) lf a 93m. compute
cols 5 through 7

5. CIrculatIon
Income

6. Readership
costs

7. Excess readership
costs (column 6 mInus
column 5, but not more
than column 4)

<1)
(2)
(3)
(4)
Tota|s(carrylo Part II, km (5))
> _
0 .
0 .
l part || | Income From Periodicals Reported on a Separate Basis (For each perlodlcal lIsted In Part II, fIlI In
columns 2 through 7 on a lIne-by-llne baSIS)
2. Gross
advemsm
Income 9

1- Name 0' Dlodlcal


(1)
(2)
(3)
(4)
Totals from Partl

O .
Enter here and on
page 1. Part I.
line 11. cal (A).

3. DIrect
advertising costs

4. Advemsmg 9am
or (loss) (col 2 rnInus
col 3) II a gain, compute
col: 5 through 7

5. CIrcuIatIon
Income

6. Readershlp
costs

0 .

7. Excess readershlp
costs (column 6 mInus
column 5. but not more
than column 4)

0 .

0 .
Enter here and on
page 1. Part I.
um 11. col (B)

Enter here and


on page 1.
Part II. lIne 27

Totals, Part II (lInes 1-5)


F
0 .
0 .
Schedule K - Compensation of OfTicers, Directors, and Trustees (see Instructions)
1 . Name

Total. Enter here and on


323731
12-1243

2' ne

m9busmess
downed to

0 .
4. Compensation annbutable
to unrelated busrness

1 Panl line 14
Form 990-T (2013)

CHURCH OF

FORM

592143308

SCIENTOLOGY FLAG SERVICE ORGAN

990-T

DESCRIPTION OF ORGANIZATION'S PRIMARY UNRELATED


BUSINESS ACTIVITY

LIMITED USE OF FACILITIES FOR MEETINGS THAT MAY NOT BE


RELATED TO THEIR TAX EXEMPT PURPOSES.
TO FORM 990-T,

PAGE

STATEMENT

SUBSTANTIALLY

FOOTNOTES

ELECTION TO WAIVE THE NET OPERATING LOSS

STATEMENT

CARRYBACK PERIOD

CHURCH OF SCIENTOLOGY FLAG SERVICE ORGANIZATION INC.


ELECTS, PURSUANT TO SEC. 172(B)(3) OF THE INTERNAL REVENUE
CODE, TO RELINGQUISH THE ENTIRE CARRYBACK PERIOD WITH
RESPECT TO THE NET OPERATING LOSS INCURRED FOR THE TAX YEAR
ENDED DECEMBER 31, 2013, AND WILL HAVE SUCH LOSS AVAILABLE
FOR CARRYFORWARD ONLY.

STATEMENT(S)

l,

CHURCH OF

SCIENTOLOGY FLAG SERVICE ORGAN

OTHER DEDUCTIONS

FORM 990-T

STATEMENT

AMOUNT

DESCRIPTION

3,327.
2,601.

CLEANING & LAUNDRY


EQUIPMENT RENTAL
PROPERTY INSURANCE
STAFF WELFARE
TRANSPORTATION EXPENSE
UTILITIES EXPENSE
WORKERS COMPENSATION INSURANCE
SUPPLIES FOR USE OF FACILITIES
EVENTS EXPENSE
OFFICE EXPENSE
ACCOUNTING FEES
TOTAL TO FORM

59-2143308

990-T,

PAGE

1,

LINE

8,457.
31,067.
2,571.
7,161.
6,366.
7,992.
7,068.
32.
5,136.
28

81,778.

STATEMENT(S)

/
5~ . 31,29,0.3627.09.

23,0.312.

34,13.
469.
482.397.

50,703.
14,1,127965.519.27.

50,12
708.
14,1,97619.85.27,

:146,512718.17,9.0L6, 18694,9. 86.

5
iii 4 713,8106.1L,8709,8090.
an A

1 60,3150,8.15,s,2153,4e.4a.

g?
57,50.041.

Excl
Depreciation
Expense
41X

4-

~,M

04"A93
~K

W
newee

Basns
0r
De%
Basus
A179
Sec
xpense
c pud0rmuecultiaoetidnon
SectUnaBus
ReCurBegiYear
179
BaSI
In
For
EndidLiucdrjinuoteisniontnSetndgNECost
00:)

Dat

LPE.OTHER SANDCASFEQUI<ITNETS.3

FOSEQUIITNCE-OSLPA.
6
{$312601
111017
07/7.00
SL
FCTR.
I0T1/NE9S9l

DAND
2013
AREPORT
EMPORECTIAZTION

A33
Ammfed
DeMetLife
scrhipodtion
990-1
FORM
PAGE
990TT

. .1_,42_4.

.1161,
'965,1
90
TOTHER
167,90-OTAL
0.
47127.745.27.37.

FURNIEa
QTUUREIP-MENTS
11
07.00
43,SL
16
7043.FCTR,
/I0T1N7/7E016.S115-

13
07/57,SD
16
5.00
EV0E1/0NT41.1S

14
C0E16
5.O1
1SL
1,V7M0.
/EP019.
-NU01T/E0RS19.01

*23,15
F07/E5.00
16
UsL
&
QRUNI0PTM11/UER0N2?T2S

16
C07/5.00
16
O10,5L
M0.
10,P0U1/T9E09R30.230.

BUILDINGS

41'49651
,'PG
1B59oT9U50me1I7.Lt6Dl7.,LI6N0936G0,645 6.
MML7
4452135g
7a
07/B39.FORT
HSL
UAIRL0DI1/SN0OG0N09

105
B07/FORT
34,39.HUSL
MM16
AILRD0I1/SN30OG197.N0

'91
TPG
M90-OTAL
ACHINETRY EE
QUIPMENT

FFORT
ITNES
MAE&
QCUHIPNMEREYNT HEUIP.
07/79
7.00
20003
7
0CTR.
FH1/IATRN0IES9OSN

990-1
TPG
OTAL-T

BUILDINGS pBLDG.
IaM's-f
P1R9OV3E. 07/11631588.
31.11311?
81.
SA0ND1/C5A9S0T2LE
F1
320m (D)
0Asset
diSalI5Bonus.
CGO
DeR"-oe0TC,
Zone
svm1uposed
d-tme1-avucl3uage,zractnlioanln,

73R?5%.1.5. .
%
NuTW

Deprpremuaonanon
DeExcl
Expense

0r
Cost
ENo
DeBaSI
179
%
cxpense
pudrmuecltuaioSetndlon
SUnaeudcnueLmeodcnulmsFYo1eorn7al9mnr dASec
CBaysRBus
Cunenl
Bewnnmg
Endmg
UO:>

DI

32117
10,1,20.St.
S43A7N1,/D034,3C1A.04LS/,'1I0L3E4130.3, 03 .

pBLDG.
IoMmP-R1O9 V3E.

2002
IMPROVE.
BLDG.
01a
M'39.4SL
v,21n92s6,7uous9wM06a0.4Lnl,78s790-4r1,.m9 1.

DREPORT
A2013
AND
EMPORETCIZATION

Acqifed
AW:
DeLIfe
Metscrhlpoduon
990-1
9PAGE
FORM90TT

026.'57981
BTpg
,468U90-OTAL
427IL4.0D,62I7N01T.,G261S.
29,654,20
0.
39.07/8L
MM17
SA0N91/D02C32.A037.0S2TLE

24
39.07/SBSL
1,MMl
0.
25.
AUNIDL90CDA1/0IS42.NT70LG0E3

'0921
T99
6.5790-OTAL8,469427.041,62701,.261 .

BUILDINGS

2,2,0H2117
20.56FORT
HBs0
4.7UA40,28,/RIL60-D741I.S028N/,O6G4067.2Na16,27.

BUILDING
m

033,,7'831
97B2TPG
,U82,3790-9OTALI87L.23D,37I8N97.2T9G,37S.

'9o33,1
T,PG
7.8390T
OTAL
72,382,79-e7.z3,37897.29,379. '990-1
TOTALT 18,172,3521papa
GRAND
PG
2973418065982.10.1032.

._1W4~-,

8281 1 GO
-RCdl0A'eo5TC,
SalI(0)
DeBonus.
Zone
vms-dusset0tmepuca1vl-osz1age,rat3CiloIaenld.

OMB No 1545-0172
Fm.
Department of the Treasury
lntemal Revenue Serv-ce (99)
Name(5) Show" 0" return

Depreciation and Amortization 990-T


(Including Information on Listed Property)
b Attach to your tax return.
> See separate instructions.
Busmess or actrvrty to which this form relates

Attachment
Sequence No 179
Identrfyrng number

CHURCH OF SC IENTOLOGY FLAG


592143308
FORM 990T PAGE 1
SERVICE ORGANIZATION, INC.
I Part u Election To Expense Certain Property Under Section 179 Note: If you have any lrsted property, complete Part Vbefore you complete Part I.
Maxrmum amount (see Instructions)
Total cost of sectIon 179 property placed In servrce (see InstructIons)
Threshold cost of sectIon 179 property before reductIon In IImItatIon
ReductIon In IImItatIon. Subtract lIne 3 from lIne 2 It zero or less, enter 0Dollar IImItatIon for tax year Subtract lIne 4 from me 1 ll zero or less, enter -0- I1 mamed tIng separately. see InstructIons _ _
(b) Cost (busrness use only)
(a) Descrlptron of property

1
2
3
4
5
6

500 I 000 o

1
2
3
4
5

2 I 000 I o00 -

(c) Elected cost

l
I
____ __ ~_ ____ ~___I

I 7
7 LIsted property Enter the amount from lIne 29
8 Total elected cost of sectIon 179 property Add amounts In column (0), IInes 6 and 7
_
9 TentatIve deductlon Enter the smaller of lIne 5 or lIne 8
10 Carryover of dIsallowed deductIon from lIne 13 of your 2012 Form 4562
11 Busmess Income lImItatIon Enter the smaller of busmess Income (not less than zero) or lIne 5
12 SectIon 179 expense deductron. Add lInes 9 and 10, but do not enter more than lIne 11
>I 13 I
13 Carryover of dIsallowed deductIon to 2014. Add lInes 9 and 10, less lIne 12
Note: Do not use Part II or Part III below for lIsted property. Instead, use Part V.
[Part II I Special Depreciation Allowance and Other Depreciation (Do not Include |Isted property.)

8
9
10
11
12
v " ,,

14 Specral deprecIatIon allowance for quaIIerd property (other than |Isted property) placed In servrce dunng
the tax year
15 Property subject to sectIon 168(f)(1) electron
16 Other depreCIatIon (IncludInq ACRS)
MACRS Depreciation (Do not Include |Isted property.) (See InstructIons.)
Section A

14
15
16

I. I q, em}; !)

l3 .

18 , 097 17 I
17 MACRS deductrons for assets placed In servrce In tax years begInnIng before 2013
y
if? g
I:I 3
18 It you are electrng to group any assets placed In servrce durrng the tax year Into one or more general asset accounts, check here
Section B - Assets Placed in Service During 2013 Tax Year Using the General Depreciation System
(c) Basrs for deprecratron
(b) Month and
(d) Recovery
(busIness/investment use
(a) ConventIon (1) Method
(9) Deprecratlon deductlon
year placed
(a) Classrcatron of property
perlod
only - see InstructIons)
In servrce

h
i

20a
b
c
I Part

S/L
MM
S/L
Resrdentlal rental property
MM
S/L
MM
S/L
39
Nonresrdentral real property
/
MM
S/L
Section C - Assets Placed in Service During 2013 Tax Year Using the Alternative Depreciation System
Class lIfe
12-year
40-year
IVI Summary (See InstructIons)

12 yrs.
40 yrs.

21 LIsted property. Enter amount from lIne 28


22 Total. Add amounts from lIne 12, lInes 14 through 17, ms 19 and 20 In column (9), and lIne 21.
Enter here and on the appropnate ms of your return. Partnershrps and S corporatIons - see instr.
23 For assets shown above and placed In servrce dunng the current year, enter the
portron of the baSIS attnbutable to sectIon 263A costs
23
3551295313 LHA For Paperwork Reduction Act Notice, see separate instructions.

MM

S/L
S/L
S/L
21
22

18 , 1l0 .

Form 4562 (2013)

CHURCH OF SCIENTOLOGY FLAG


Forrn4562(2013)
SERVICE ORGANIZATION, INC .
592143308 page 2
I Part V I Listed Property (Include automobiles, certain other vehicles, certain computers, and property used for entertainment, recreation, or
amusement)
Note: For any vehicle for which you are usmg the standard mileage rate or deducting lease expense, complete only 24a, 24b, columns (a)
through (c) of Section A, all of Section B, and Section C if applicable.
Section A - Depreciation and Other Information (Caution: See the Instructions for limits for passenger automobiles.)
243 Do you have evrdence to support the busrnessfinvestment use claimed? I
I Yes I
I No 24:, If 'Yes, 13 the ewdence wntten? CI Yes CI No
b)
(e)
(e)
(r)
(9)
(i)
(a)
[(3
(d)
(h)
Type ol property
ate
BUS'MSSI
Cost or
335" '' mam Recovery
Method/
Deprecration
E'eCted
placed
in
investment
(bus-nessrmvestmem
section
(list vehicles first )
sen/me
use percentage
other basrs
use my)
period
Convention
deduction
cost 179
25 SpeCIal deprecration allowance for qualified listed property placed in serv1ce during the tax year and
used more than 50% in a qualified busrness use
_
26 Property used more than 50% in a cualied busrness use:

25

%
%
%
27 Property used 50% or less in a qualied busmess use:
s/L .
%
S/L .
%
%
S/L28 Add amounts in column (h), lines 25 through 27. Enter here and on line 21, page 1
28
29 Add amounts in column (i), line 26 Enter here and on line 7. page 1
I 29
Section B - Information on Use of Vehicles
Complete this section for vehicles used by a sole propnetor, partner, or other 'more than 5% owner, or related person. If you provrded vehicles
to your employees, first answer the questions in Section C to see if you meet an exception to completing this section for those vehicles.

30 Total busmess/investment miles driven during the


year (do not include commuting miles)

(a)
Vehicle

(b)
Vehicle

(C)
Vehicle

(d)
Vehicle

(e)
Vehicle

(f)
Vehicle

31 Total commuting miles driven during the year


32 Total other personal (noncommuting) miles
dnven
33 Total miles driven dunng the year.
Add lines 30 through 32
34 Was the vehicle available for personal use
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
during offduty hours?
35 Was the vehicle used pnmanly by a more
than 5% owner or related person?
36 Is another vehicle available for personal
use?
Section C - Questions for Employers Who Provide Vehicles for Use by Their Employees
Answer these questions to deterrnine if you meet an exception to completing Section B for vehicles used by employees who are not more than 5%
owners or related persons.
37 Do you maintain a written policy statement that prohibits all personal use of vehicles, including commuting, by your
Yes
No
employees?
_
38 Do you maintain a written policy statement that prohibits personal use of vehicles, except commuting, by your
employees? See the instmctions for vehicles used by corporate officers, directors, or 1% or more owners
39 Do you treat all use of vehicles by employees as personal use?
_ _
40 Do you provrde more than five vehicles to your employees. obtain information from your employees about
the use of the vehicles, and retain the information received?
_
41 Do you meet the requirements conceming qualified automobile demonstration use?
Note: If your answer to 37. 38, 39, 40, or 41 is Yes, ' do not complete Section B for the covered vehicles
I Part VI I Amortization
(a)
(b)
(e)
(d)
(e)
(f)
Description of costs
Dar; ammuan
Amoruzable
Code
Amomzanun
Amortization
tieglns
"0"
WW"
penou oi percentage
' ""5 Y!
42 Amortization of costs that
2013 tax

43 Amortization of costs that began before your 2013 tax year


316252 12-19-13

Form 4562 (2013)

go (14
Form 8868
(Rev. January 2014)
watment of the Treaswy
lMondRummwSe~be

Application for Extension of Time To Fi

Exempt Organization Return

7r
V4709

> File a separate application for each return.


D information about Form 8868 and its instructions is at www.lrs.gov/lonn8868.

0 If you are ling for an Automatic 3-Montb Extension. complete only Part I and check this box
.
> El
' 'f YOU are ling for an Additional (Not Automatic) anMenth Extension. complete only Part ii (on page 2 of this form).
Do not complete Pen ll unless you have already been granted an automatic 3-month extenSIon on a prewously led Form 8868
Electronic ling (e-le). You can electronically file Farm 8868 if you need a 8-month automatic extenSion of time to le (6 months for a corporation
required to le Form 990T). or an additional (not automatic) 3-month extension of time. You can electronically le Form 8868 to request an extensiOn
of time to le any of the forms hated in Part I or Part ll with the exception of Form 8870. information Return for Transfers Associated With Certain
Personal Benet Contracts, which must be sent to the IRS in paper format (see instructions). For mere details on the electronic ling of this form,
Visn www.irs v/efile and click on e-le for Charities & Non rots
I Partl I
Automatic 3-Month Extension of Time. Only submit original (no copies needed).
A corporation required to le Form 990T and requesting an automatic 6-month extension - check this box and complete
Part i only
F If]
All other corporations ncluding 1120-0 lers). partnerships. REM/Cs. and trusts must use Form 7004 to request an extension of time
0 "9 "mama tax mm
En
filera identi n n mber
Name of exempt organization or other ler. see instructions.
Type or
Employer identication number (EIN) or
print
CHURCH OF SCI ENTOLOGY FLAG
SERVICE ORGANI ZATION . INC .
F". by m
59 2143308
do. mm, Number. street, and room or surte no. it a P.O. box. see instructions.
Some! security number (SSN)
CjO NSBN LLP - 9454 WILSHIRE BLVD 4TH FLR
my
return
See
instructions City. town Or post ofce. state. and ZIP code. For a foreign address. see Instructions
BEVERLY HILLS, CA 90212
Enter the Return code for the return that this application is for (file a separate application tor each return)
Application

Return

Application
T

Form
4720
Form 990-T
T

GLEN STILO , SECRETARY


0 The books are in the care of > 21 0 S . FORT HARRISON AVE . - CLEARWATER , FL 3 3 7 5 6
Telephone No. >
Fax No b
0 If the organization does not have an ofce or place of business in the United States. check this box
_
D [:l
0 If this is for a Group Return. enter the organization's four digit Group Exemption Number (GEN)
It this is for the whole group, check this
and attach a list With the names and EINs of all members the extension is for.
. If it is far art of the rou check this box
box
| request an automatic 3-month (6 months for a corporation reqwred to le Form 9901) extension of time until
1
NOVEMBER 1 5 . 2 0 1 4 . to le the exempt organization retum for the organization named above. The extension
is for the organization's return forD BU calendar year 2 0 1 3 or
b [:3 tax year beginning
. and ending
C3 Final retum
[:1 initial return
if the tax year entered in line 1 is for less than 12 months. check reason:
C] Change in accounting period
as If this application is for Forms QQGBL. 990-PF. 990T. 4720. or 6069. enter the tentative tax. less any
nonrefundable credits. See instnictions.
3a
L
L 186 .
b If this application is for Forms 990-PF, 990T. 4720. or 6069. enter any refundable credits and
estimated texpamients made. include any prMear overpayment allowed as a credit.
3b $
5 L000 .
c Balance due. Subtract line 3b from line 3a Include your payment With this form. if reqmred.
by using EFiPS (Electronic Federal Tax Pament System). See instructions.
L 5
O .
Caution. if you are going to make an electronic funds withdrawal (direct debit) wnh this Form 8868, see Form 8453-EO and Form 8879EO for payment
instmcttone.
2

LHA

For Privacy Act and Paperwork Reduction Act Notice. see instructions.

Form 8888 (Rev 1-2014)