TY 2022 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(1) JENNIFER EDMONDSON...................................................................... DIRECTOR & O	37.00 .................	X	X	47,509
(2) CINDY CHAPMAN...................................................................... PRESIDENT	10.00 .................	X	X	0
(3) MARCIA HARTMAN...................................................................... VICE-PRESIDE	10.00 .................	X	X	0
(4) KATHERINE WINGFIELD...................................................................... SECRETARY	4.00 .................	X	X	0
(5) BECKY EDMONDSON...................................................................... TREASURER	10.00 .................	X	X	0
(6) LAUREN FIGARD...................................................................... DIRECTOR	1.00 .................	X		0
(7) TONY ROBERT...................................................................... DIRECTOR	1.00 .................	X		0
(8) MAT FUNK...................................................................... DIRECTOR	1.00 .................	X		0
(9) SUSAN BROCK...................................................................... DIRECTOR	1.00 .................	X		0
(10) SANTIAGO CARABALLO...................................................................... DIRECTOR	1.00 .................	X		0
(11) LINDSEY POLLOCK...................................................................... DIRECTOR	1.00 .................	X		0
(12) JEFF BENAVIDES...................................................................... DIRECTOR	1.00 .................	X		0
(13) JONATHAN HANSEN...................................................................... DIRECTOR	1.00 .................	X		0
(14) EUGENE SIRLS...................................................................... DIRECTOR	1.00 .................	X		0
(15) DONNA STROM...................................................................... DIRECTOR ->0	1.00 .................	X		0
(16) ANGIE FURNARI...................................................................... DIRECTOR ->0	1.00 .................	X		0
(17) MAGGIE DONOVAN...................................................................... DIRECTOR	1.00 .................	X		0

(A)
Name and title

(B)
Average hours per week (list any hours for related organizations below dotted line)

(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)

(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)

(F)
Estimated amount of other compensation from the organization and related organizations

(1) JENNIFER EDMONDSON......................................................................
DIRECTOR & O

37.00
.................

47,509

(2) CINDY CHAPMAN......................................................................
PRESIDENT

10.00
.................

(3) MARCIA HARTMAN......................................................................
VICE-PRESIDE

10.00
.................

(4) KATHERINE WINGFIELD......................................................................
SECRETARY

4.00
.................

(5) BECKY EDMONDSON......................................................................
TREASURER

10.00
.................

(6) LAUREN FIGARD......................................................................
DIRECTOR

1.00
.................

(7) TONY ROBERT......................................................................
DIRECTOR

1.00
.................

(8) MAT FUNK......................................................................
DIRECTOR

1.00
.................

(9) SUSAN BROCK......................................................................
DIRECTOR

1.00
.................

(10) SANTIAGO CARABALLO......................................................................
DIRECTOR

1.00
.................

(11) LINDSEY POLLOCK......................................................................
DIRECTOR

1.00
.................

(12) JEFF BENAVIDES......................................................................
DIRECTOR

1.00
.................

(13) JONATHAN HANSEN......................................................................
DIRECTOR

1.00
.................

(14) EUGENE SIRLS......................................................................
DIRECTOR

1.00
.................

(15) DONNA STROM......................................................................
DIRECTOR ->0

1.00
.................

(16) ANGIE FURNARI......................................................................
DIRECTOR ->0

1.00
.................

(17) MAGGIE DONOVAN......................................................................
DIRECTOR

1.00
.................

(A)
Name and title

(B)
Average hours per week (list any hours for related organizations below dotted line)

(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)

(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)

(F)
Estimated amount of other compensation from the organization and related organizations

(18) ALAN HIRSCHMAN........................................................................
DIRECTOR

1.00
.......................

(19) MARTHA KINN........................................................................
DIRECTOR 09/

1.00
.......................

(20) BECKY PATE........................................................................
DIRECTOR 09/

1.00
.......................

(21) ANDREW JEFFERSON........................................................................
DIRECTOR 09/

1.00
.......................

(22) BOB DROUBI........................................................................
DIRECTOR 09/

1.00
.......................

(A)
Name and business address

(B)
Description of services

Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet

Return Reference	Explanation
SCHEDULE C, PART IV	THERE WERE NO LOBBYING AND POLITICAL ACTIVITY EXPENSES DURING THE CURRENT YEAR.

- TIN:

SCHEDULE O
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

THE WESTBURY CIVIC CLUB INC

Employer identification number

74-1381479

Return Reference	Explanation
FORM 990, PAGE 1, PART I, LINE 6	VOLUNTEERS SERVE ON THE BOARD OF DIRECTORS, COMMITTEES, AND ON PROJECTS UNDERTAKEN BY THE BOARD TO IMPROVE THE COMMUNITY. THESE PROJECTS INCLUDE BLOCK PARTIES, PARK CLEAN-UPS AND PLANTINGS, THE COMMUNITY WHITE ELEPHANT SALE, AND INTERACTION WITH CITY AND COUNTY AGENCIES. THESE AGENCIES INCLUDE NEIGHBORHOOD PROTECTION, HARRIS COUNTY FLOOD CONTROL, HOUSTON POLICE DEPT, CITY OF HOUSTON SOLID WASTE, HARRIS COUNTY PRECINCT 1, SUPER NEIGHBORHOOD ALLIANCE, CITY COUNCIL, OUR STATE REPRESENTATIVES AND OUR FEDERAL REPRESENTATIVES. VOLUNTEERS ALSO SERVICE ON MANY OF THE LOCAL NONPROFIT BOARDS SUCH AS THE WESTBURY AREA IMPROVEMENT CORPORATION, THE WILLOW WATERHOLE GREENSPACE CONSERVANCY, LEVITT PAVILION HOUSTON AND MORE.
FORM 990, PART III	CONTINUED FROM LINE 4C WCC ALSO EMPHASIZES THAT EACH HOMEOWNER PLAYS A VALUABLE ROLE IN KEEPING A CLEAN AND BEAUTIFUL COMMUNITY. THIS NOT ONLY ENHANCES THE QUALITY OF LIFE FOR EVERYONE, BUT IT IS AN IMPORTANT FACTOR IN KEEPING HOME VALUES AT A HIGH LEVEL. ONE SUCH EVENT IS THE YARD OF THE MONTH CONTEST. HUNDREDS OF VOLUNTEERS WORKED ON THESE PROJECTS DURING 2022. BOARD MEMBERS HELD MONTHLY DRIVE-THRU EVENTS FOR RESIDENTS WHO WANTED TO TALK TO THEM OUTSIDE AND PAY THEIR DUES. NATIONAL NIGHT OUT WAS ALSO HELD AS A DRIVE-THRU EVENT. ANOTHER VERY IMPORTANT PART OF WCC'S ACTIVITIES INVOLVES ADVOCACY AT THE CITY, COUNTY AND STATE LEVEL. VOLUNTEERS OF THE WCC HAVE ADVOCATED FOR MORE FLOOD RELIEF FOR MANY YEARS AS HOMES, INCLUDING ABOUT 700 DURING HURRICANE HARVEY, HAVE REPETITIVELY FLOODED ALONG THE WILLOW WATERHOLE BAYOU. THE CITY OF HOUSTON PURCHASED A 35 ACRE TRACT, A 4 ACRE TRACT AND SEVERAL RESIDENTIAL LOTS TO USE FOR DETENTION AND FLOOD MITIGATION. THE WCC HAS BEEN ADVOCATING FOR A NEW LIBRARY AFTER THE ONE IN THE AREA CLOSED SEVERAL YEARS AGO. VOLUNTEER WCC MEMBERS IDENTIFIED A SITE AND GROUND BREAKING TOOK PLACE IN NOVEMBER OF 2022. ADDITIONALLY, THE OFFICE MANAGER PARTICIPATED AS A CO-RESEARCHER IN A GRANT WITH UNIVERSITY OF HOUSTON AND TSU, "CIVIC ENGAGEMENT POST HARVEY."
FORM 990, PAGE 6, PART VI, LINE 2	BECKY EDMONDSON JENNIFER EDMONDSON TREASURER BOARD MEMBER FAMILY RELATIONSHIP
FORM 990, PAGE 6, PART VI, LINE 6	MEMBERSHIP OF THE ORGANIZATION IS OPEN TO ALL RESIDENTS OF THE WESTBURY COMMUNITY.
FORM 990, PAGE 6, PART VI, LINE 7A	MEMBERS IN GOOD STANDING ARE THOSE WHO ARE THE OWNER OF RECORD OF PROPERTY IN WESTBURY.
FORM 990, PAGE 6, PART VI, LINE 7B	MEMBERS IN GOOD STANDING HAVE THE RIGHTS AND PRIVILEGES OF MEMBERSHIP INCLUDING THE RIGHT TO INITIATE RESOLUTIONS, PLANS, POLICIES, AND PROJECTS. THEY ALSO HAVE THE RIGHT TO VOTE AND TO HOLD OFFICE.
FORM 990, PAGE 6, PART VI, LINE 11B	THE 990 IS PREPARED BY A CPA WHO IS FAMILIAR WITH NON-PROFITS AND THEN REVIEWED BY THE ORGANIZATION'S BOARD. THE BOARD WILL ADDRESS ANY QUESTIONS WITH THE PREPARER IN ORDER TO BETTER UNDERSTAND THE REPORTS AND SUGGEST CHANGES AS NEEDED. ONCE ANY CHANGES HAVE BEEN MADE AND APPROVED, THE 990 WILL BE FILED. ONCE THE 990 HAS BEEN ACCEPTED BY THE IRS, A FINAL COPY IS SENT TO THE BOARD.
FORM 990, PAGE 6, PART VI, LINE 15B	COMPENSATION OF THE OFFICE MANAGER WAS DETERMINED BY A SUB-COMMITTEE OF THE BOARD USING DATA FROM COMPARABLE ORGANIZATIONS.
FORM 990, PAGE 6, PART VI, LINE 19	FORM 990 AND ALL FINANCIAL RECORDS OF THE CIVIC CLUB ARE KEPT AT THE OFFICES AND AVAILABLE ON REQUEST.
FORM 990, PART XI	ADJUSTMENTS WERE MADE THAT AFFECTED INCOME AND EXPENSES FOR PRIOR YEARS.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO IMPROVE THE APPEARANCE OF THE WESTBURY COMMUNITY AND TO PROMOTE THE CIVIC, CULTURAL, EDUCATIONAL, HEALTH, AND GENERAL WELFARE OF THE RESIDENTS OF THE WESTBURY AND PARKWAY SUBDIVISIONS IN HARRIS COUNTY, TEXAS.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	20
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	19
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	1
6	Total number of volunteers (estimate if necessary) .............	6	28
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	14,872
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........		0
9	Program service revenue (Part VIII, line 2g) .........	327,570	314,584
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	27	32
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)		0
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	327,597	314,616
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...		0
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	49,164	49,482
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	374,569	358,050
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	423,733	407,532
19	Revenue less expenses. Subtract line 18 from line 12.......	-96,136	-92,916
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	223,602	174,225
21	Total liabilities (Part X, line 26).............		21,367
22	Net assets or fund balances. Subtract line 21 from line 20.....	223,602	152,858

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 277,318 including grants of $ ) (Revenue $ 155,255 )
	PROVIDE A CONTRACT CONSTABLE PATROL PROGRAM, WESTBURY AREA PATROL (WAP), TO ENHANCE COMMUNITY SECURITY. THE CONSTABLE PATROL CONSISTS OF 3 OFFICERS WHO PATROL THE NEIGHBORHOOD REGULARLY. FOR RESIDENTS WHO PAY THE WAP DUES, A SPECIAL VACATION WATCH CAN BE REQUESTED FOR ANY TIME DURING WHICH THE HOUSE WILL BE LEFT VACANT (VACATION, DURING REMODELING, ETC). FREE HOME SAFETY INSPECTIONS ARE ALSO AVAILABLE TO THESE RESIDENTS. THERE IS A SILVER WATCH PROGRAM WHERE SENIORS CAN REGISTER TO BE CHECKED ON REGULARLY BY THE DEPUTIES. ALL OF THE 5,000 HOUSEHOLDS AND OVER 10,000 RESIDENTS BENEFIT FROM HAVING THIS EXTRA SECURITY.

4b	(Code: ) (Expenses $ 64,640 including grants of $ ) (Revenue $ 14,873 )
	PRINTING AND DISTRIBUTION OF THE COMMUNITY NEWSLETTER (WESTBURY CRIER) TO ALL 5,000 HOMES. THE NEWSLETTER IS A MONTHLY PUBLICATION THAT HIGHLIGHTS EVENTS IN THE WESTBURY AREA AND INFORMS HOMEOWNERS ABOUT VARIOUS MEETINGS, EVENTS, AND OTHER OPPORTUNITIES BEING HELD IN THEIR NEIGHBORHOOD. THESE INCLUDE ALL OF THE WCC SPONSORED ACTIVITIES AND ACCOMPLISHMENTS AS DESCRIBED BELOW AND ON SCHEDULE O. THE CRIER ALSO PROVIDES INFORMATION ON HOW HOMEOWNER DUES ARE BEING USED TO BENEFIT THE AREA. THE COST OF THE NEWSLETTER IS PARTIALLY OFFSET BY ADVERTISING REVENUE.

4c	(Code: ) (Expenses $ 36,116 including grants of $ ) (Revenue $ 720 )
	ENSURE THE UPKEEP OF THE NEIGHBORHOOD GREENSPACE, PROVIDE FUN AND ENGAGING COMMUNITY ACTIVITIES, AND IMPROVE THE OVERALL QUALITY OF LIFE FOR RESIDENTS. SOME OF THE ACTIVITIES REGULARLY PROMOTED BY WCC INCLUDE AN ANNUAL WHITE ELEPHANT SALE AND OTHER SEASONAL EVENTS SUCH AS KEEP WESTBURY BEAUTIFUL DAY IN APRIL AND MONTHLY "WOW, WORKING ON WESTBURY" DAYS WHERE VOLUNTEERS COME TOGETHER TO CLEAN UP AREAS AROUND WESTBURY. A VERY IMPORTANT PART OF WCC'S ACTIVITIES INVOLVES PROJECTS TO MAINTAIN AND BEAUTIFY THE ESPLANADES AND GREENSPACES IN THE AREA, INCLUDING MOWING, SEASONAL PLANTINGS, AND WATERING. MANY HOMEOWNERS ARE INVOLVED REGULARLY IN THESE PROJECTS. SEE ADDITIONAL INFORMATION ON SCHEDULE O.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses378,074

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	47,509

(A) Name and business address	(B) Description of services	(C) Compensation





2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization

1a	Federated campaigns..	1a
b	Membership dues..	1b
c	Fundraising events..	1c
d	Related organizations	1d
e	Government grants (contributions)	1e

f	All other contributions, gifts, grants, and similar amounts not included above	1f

g	Noncash contributions included in lines 1a - 1f:$	1g

h Total. Add lines 1a-1f.......

		Business Code
2a	CONSTABLE PATROL SERVICE	812900	155,255	155,255
b	CIVIC CLUB DUES	812900	89,588	89,588
c	TRANSFER & REFINANCE FEES	812900	54,149	54,149
d	NEWSLETTER ADVERTISING	511110	14,872		14,872
e	OTHER PROGRAM SERVICE REVENUE	812900	720	720
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		314,584

3 Investment income (including dividends, interest, and othersimilar amounts) ......			32	32
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents			6a
b	Less: rental expenses			6b
c	Rental income or (loss)			6c
d	Net rental income or (loss).......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory			7a
b	Less: cost or other basis and sales expenses			7b
c	Gain or (loss)			7c
d	Net gain or (loss).........
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......
12	Total revenue. See instructions.....			314,616	299,744	14,872

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	45,911	32,138	13,773
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....
9	Other employee benefits .......
10	Payroll taxes ...........	3,571	2,500	1,071
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	2,068	1,448	620
c	Accounting ...........	3,431		3,431
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)
12	Advertising and promotion ....
13	Office expenses .......	11,059	7,741	3,318
14	Information technology ......	3,514	2,460	1,054
15	Royalties ..
16	Occupancy ...........	18,155	12,708	5,447
17	Travel ............
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..
23	Insurance ...	2,480	1,736	744
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	WESTBURY AREA PATROL	266,028	266,028
b	CRIER PRINTING & EXPENSE	50,760	50,760
c	COMMUNITY GARAGE SALE	517	517
d	PROGRAMS & HOSPITALITY	38	38
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	407,532	378,074	29,458	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........		60,442	1	11,027
2	Savings and temporary cash investments .........		163,160	2	163,198
3	Pledges and grants receivable, net ......			3
4	Accounts receivable, net .............			4
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
				6
7	Notes and loans receivable, net ...........			7
8	Inventories for sale or use ............			8
9	Prepaid expenses and deferred charges ......			9
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a
b	Less: accumulated depreciation	10b		10c
11	Investments—publicly traded securities .			11
12	Investments—other securities. See Part IV, line 11 .....			12
13	Investments—program-related. See Part IV, line 11 ..			13
14	Intangible assets ...............			14
15	Other assets. See Part IV, line 11 ...........			15
16	Total assets. Add lines 1 through 15 (must equal line 33)...		223,602	16	174,225

17	Accounts payable and accrued expenses .....		17	21,367
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D		25
26	Total liabilities. Add lines 17 through 25..	0	26	21,367

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	223,602	27	152,858
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	223,602	32	152,858
33	Total liabilities and net assets/fund balances ........	223,602	33	174,225

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................
d	Other exempt purpose expenditures ...............................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
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