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) CHAD ELLIS...................................................................... CHAIR (AS OF 05/23)	1.00 ................. 0.00	X	X
(2) MIKE WILLIAMS...................................................................... CHAIR ELECT (AS OF 05/23)	1.00 ................. 0.00	X	X
(3) PAULA ALEXANDER...................................................................... DIRECTOR	1.00 ................. 0.00	X
(4) HUGH ALJOE...................................................................... DIRECTOR (AS OF 05/23)	1.00 ................. 0.00	X
(5) BRETT BASEL...................................................................... DIRECTOR (THRU 01/23)	1.00 ................. 0.00	X
(6) ROB CANNELL...................................................................... DIRECTOR (AS OF 05/23)	1.00 ................. 0.00	X
(7) MATTHEW CLEVELAND...................................................................... DIRECTOR (THRU 05/23)	1.00 ................. 0.00	X
(8) CAITLIN COLEGROVE...................................................................... DIRECTOR (THRU 05/23)	1.00 ................. 0.00	X
(9) BRUCE DALEY...................................................................... DIRECTOR	1.00 ................. 0.00	X
(10) BROOKE DAVIS...................................................................... DIRECTOR (AS OF 05/23)	1.00 ................. 0.00	X
(11) JESSICA FINCK...................................................................... DIRECTOR (THRU 05/23)	1.00 ................. 0.00	X
(12) TIM HARDMAN...................................................................... DIRECTOR (AS OF 05/23)	1.00 ................. 0.00	X
(13) CLAYTON HUSEMAN...................................................................... DIRECTOR (AS OF 05/23)	1.00 ................. 0.00	X
(14) JAMEE KRUG...................................................................... DIRECTOR (AS OF 05/23)	1.00 ................. 0.00	X
(15) NANCY LABBE...................................................................... DIRECTOR	1.00 ................. 0.00	X
(16) JESSICA LANGLEY...................................................................... DIRECTOR (THRU 05/23)	1.00 ................. 0.00	X
(17) KENDRA LEVINE...................................................................... DIRECTOR	1.00 ................. 0.00	X

(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) CHAD ELLIS......................................................................
CHAIR (AS OF 05/23)

1.00
.................
0.00

(2) MIKE WILLIAMS......................................................................
CHAIR ELECT (AS OF 05/23)

1.00
.................
0.00

(3) PAULA ALEXANDER......................................................................
DIRECTOR

1.00
.................
0.00

(4) HUGH ALJOE......................................................................
DIRECTOR (AS OF 05/23)

1.00
.................
0.00

(5) BRETT BASEL......................................................................
DIRECTOR (THRU 01/23)

1.00
.................
0.00

(6) ROB CANNELL......................................................................
DIRECTOR (AS OF 05/23)

1.00
.................
0.00

(7) MATTHEW CLEVELAND......................................................................
DIRECTOR (THRU 05/23)

1.00
.................
0.00

(8) CAITLIN COLEGROVE......................................................................
DIRECTOR (THRU 05/23)

1.00
.................
0.00

(9) BRUCE DALEY......................................................................
DIRECTOR

1.00
.................
0.00

(10) BROOKE DAVIS......................................................................
DIRECTOR (AS OF 05/23)

1.00
.................
0.00

(11) JESSICA FINCK......................................................................
DIRECTOR (THRU 05/23)

1.00
.................
0.00

(12) TIM HARDMAN......................................................................
DIRECTOR (AS OF 05/23)

1.00
.................
0.00

(13) CLAYTON HUSEMAN......................................................................
DIRECTOR (AS OF 05/23)

1.00
.................
0.00

(14) JAMEE KRUG......................................................................
DIRECTOR (AS OF 05/23)

1.00
.................
0.00

(15) NANCY LABBE......................................................................
DIRECTOR

1.00
.................
0.00

(16) JESSICA LANGLEY......................................................................
DIRECTOR (THRU 05/23)

1.00
.................
0.00

(17) KENDRA LEVINE......................................................................
DIRECTOR

1.00
.................
0.00

(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)
(18) GENE LOLLIS........................................................................ DIRECTOR	1.00 .......................0.00	X
(19) KRISTIE MACZKO........................................................................ DIRECTOR (THRU 05/23)	1.00 .......................0.00	X
(20) ROB MANES........................................................................ DIRECTOR	1.00 .......................0.00	X
(21) MICHAEL MCCARTY........................................................................ DIRECTOR (THRU 05/23)	1.00 .......................0.00	X
(22) TOM MCDONALD........................................................................ DIRECTOR	1.00 .......................0.00	X
(23) WAYNE MORGAN........................................................................ DIRECTOR (AS OF 01/23)	1.00 .......................0.00	X
(24) NIKKI RICHARDSON........................................................................ DIRECTOR (THRU 05/23)	1.00 .......................0.00	X
(25) BELINDA RICHARDSON........................................................................ DIRECTOR (AS OF 05/23)	1.00 .......................0.00	X
(26) KEVIN SIMS........................................................................ DIRECTOR (THRU 05/23)	1.00 .......................0.00	X
(27) BILL THONI........................................................................ DIRECTOR	1.00 .......................0.00	X
(28) JESSICA WILLINGHAM........................................................................ DIRECTOR (AS OF 05/23)	1.00 .......................0.00	X
(29) LANCE ZIMMERMAN........................................................................ DIRECTOR (AS OF 05/23)	1.00 .......................0.00	X
(30) DEBBIE LYONS-BLYTHE........................................................................ PAST CHAIR (NON-VOTING AS OF 05/23)	1.00 .......................0.00		X
(31) SCOTT ANDERSON........................................................................ SECRETARY/TREASURER	1.00 .......................0.00		X

(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) GENE LOLLIS........................................................................
DIRECTOR

1.00
.......................0.00

(19) KRISTIE MACZKO........................................................................
DIRECTOR (THRU 05/23)

1.00
.......................0.00

(20) ROB MANES........................................................................
DIRECTOR

1.00
.......................0.00

(21) MICHAEL MCCARTY........................................................................
DIRECTOR (THRU 05/23)

1.00
.......................0.00

(22) TOM MCDONALD........................................................................
DIRECTOR

1.00
.......................0.00

(23) WAYNE MORGAN........................................................................
DIRECTOR (AS OF 01/23)

1.00
.......................0.00

(24) NIKKI RICHARDSON........................................................................
DIRECTOR (THRU 05/23)

1.00
.......................0.00

(25) BELINDA RICHARDSON........................................................................
DIRECTOR (AS OF 05/23)

1.00
.......................0.00

(26) KEVIN SIMS........................................................................
DIRECTOR (THRU 05/23)

1.00
.......................0.00

(27) BILL THONI........................................................................
DIRECTOR

1.00
.......................0.00

(28) JESSICA WILLINGHAM........................................................................
DIRECTOR (AS OF 05/23)

1.00
.......................0.00

(29) LANCE ZIMMERMAN........................................................................
DIRECTOR (AS OF 05/23)

1.00
.......................0.00

(30) DEBBIE LYONS-BLYTHE........................................................................
PAST CHAIR (NON-VOTING AS OF 05/23)

1.00
.......................0.00

(31) SCOTT ANDERSON........................................................................
SECRETARY/TREASURER

1.00
.......................0.00

(A)
Name and business address

(B)
Description of services

NATIONAL CATTLEMEN'S BEEF ASSOCIATION

9110 E NICHOLS AVE
CENTENNIAL,CO80112

ADMINISTRATION

375,243

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

- 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

US ROUNDTABLE FOR SUSTAINABLE BEEF
INC

Employer identification number

81-4414776

Return Reference	Explanation
FORM 990, PART III, LINE 4A, DESCRIPTION OF PROGRAM SERVICE:	TO ADVANCE, SUPPORT AND COMMUNICATE CONTINUOUS IMPROVEMENT IN THE SUSTAINABILITY OF U.S. BEEF PRODUCTION BY EDUCATING AND ENGAGING THE BEEF VALUE-CHAIN THROUGH A COLLABORATIVE MULTI-STAKEHOLDER EFFORT. AS A TRANSPARENT EFFORT FOCUSED ON SHAPING THE SUSTAINABILITY FRAMEWORK FOR THE U.S. BEEF VALUE CHAIN, THE USRSB WILL ENCOURAGE AND PROMOTE CONTINUOUS IMPROVEMENT THROUGH SEVERAL ACTIONS, INCLUDING: - IDENTIFYING SUSTAINABILITY INDICATORS - RECOGNIZING VERIFICATION METHODOLOGIES - GENERATING FIELD PROJECT DATE TO TEST SUSTAINABILITY CONCEPTS - PROVIDING A FORUM FOR OPEN DISCUSSION, INFORMATION EXCHANGE AND PROGRAM DEVELOPMENT - OFFERING STAKEHOLDERS AN EQUAL OPPORTUNITY THROUGH MEMBERSHIP PARTICIPATION
FORM 990, PART VI, SECTION A, LINE 1A	DELEGATION OF AUTHORITY PER THE ORGANIZATION'S BYLAWS THE OFFICERS OF THE CORPORATION SHALL HAVE AUTHORITY AND SHALL EXERCISE SUCH POWERS AND PERFORM THE DUTIES PER THE BYLAWS AND AS MAY BE ADDITIONALLY SPECIFIED BY THE CHAIR, BOARD OF DIRECTORS, OR BYLAWS, EXCEPT THAT IN ANY EVENT EACH OFFICER SHALL EXERCISE SUCH POWERS AND PERFORM SUCH DUTIES AS MAY BE REQUIRED BY LAW.
FORM 990, PART VI, SECTION A, LINE 6	MEMBERS OR STOCKHOLDERS THE ORGANIZATION HAS FIVE CLASSES OF MEMBERSHIP: PRODUCERS, ALLIED INDUSTRY MEMBERS, PROCESSORS, RETAIL MEMBERS AND CIVIL SOCIETY MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7A	MEMBERS OR STOCKHOLDERS WHO MAY ELECT THE ASSOCIATION MEMBERS AND REGISTRANTS SHALL ELECT THE CHAIR AND A VICE CHAIR (ALSO REFERRED TO AS THE "CHAIR-ELECT") AT THE STAKEHOLDERS CONGRESS. EACH CONSTITUENCY GROUP (I.E. CLASS OF MEMBERSHIP) ELECTS 2 PRIMARY DIRECTORS TO THE BOARD OF DIRECTORS PRIOR TO THE ANNUAL GENERAL ASSEMBLY MEETING. PRIMARY DIRECTORS APPOINT ONE ALTERNATIVE DIRECTOR.
FORM 990, PART VI, SECTION A, LINE 7B	DECISIONS SUBJECT TO APPROVAL DECISIONS OF THE WORKING GROUPS AND COMMITTEES ARE SUBJECT TO APPROVAL BY THE BOARD OF DIRECTORS. AMENDMENTS TO REPEAL THE BYLAWS REQUIRES APPROVAL FROM BOTH THE BOARD OF DIRECTORS AND THEN A MAJORITY VOTE OF THE FULL MEMBERSHIP.
FORM 990, PART VI, SECTION B, LINE 11B	FORM 990 REVIEW PROCESS THE FORM 990 IS PREPARED BY THE ORGANIZATION'S PROFESSIONAL TAX PREPARER AND REVIEWED IN DETAIL BY THE ORGANIZATION'S TREASURER, CONTRACTED ADMINISTRATOR AND CONTRACTED CONTROLLER. A COMPLETE COPY OF THE FORM 990 IS PROVIDED TO THE GOVERNING BODY BEFORE IT IS FILED.
FORM 990, PART VI, SECTION B, LINE 12C	CONFLICT OF INTEREST POLICY & WHISTLEBLOWER POLICY THE ORGANIZATION REQUIRES THAT THE BOARD OF DIRECTORS AGREE TO UPHOLD THE ORGANIZATION POLICIES AND PROCEDURES, WHICH INCLUDES THE CONFLICT OF INTEREST POLICY. THE BOARD OF DIRECTORS, WHEN ENCOUNTERING POTENTIAL CONFLICTS OF INTEREST, SHALL IDENTIFY THE POTENTIAL CONFLICT AND, AS REQUIRED, REMOVE THEMSELVES FROM ALL DISCUSSION AND VOTING ON THE MATTERS.
FORM 990, PART VI, SECTION C, LINE 19	HOW DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC THE ORGANIZATION MAKES ITS FORM 990 AVAILABLE UPON REQUEST. ADDITIONALLY, IT MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC, UPON REQUEST, AS REQUIRED BY LAW.
FORM 990, PART IX, LINE 11G	PROFESSIONAL SERVICES: TOTAL EXPENSES 262,474.

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 ADVANCE, SUPPORT AND COMMUNICATE CONTINUOUS IMPROVEMENT (SEE SCHDEULE O)IN THE SUSTAINABILITY OF U.S. BEEF PRODUCTION BY EDUCATING AND ENGAGING THE BEEF VALUE-CHAIN THROUGH A COLLABORATIVE MULTI-STAKEHOLDER EFFORT
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	20
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	31
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	0	0
9	Program service revenue (Part VIII, line 2g) .........	717,335	966,255
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	1,983	14,913
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	0	0
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	719,318	981,168
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	0	0
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	698,497	797,560
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	698,497	797,560
19	Revenue less expenses. Subtract line 18 from line 12.......	20,821	183,608
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	514,767	698,375
21	Total liabilities (Part X, line 26).............	0	0
22	Net assets or fund balances. Subtract line 21 from line 20.....	514,767	698,375

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )
	SEE SCHEDULE O.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












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

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	0	0	0

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	MEMBERSHIP DUES	900099	688,400	688,400
b	SPONSORSHIPS	900099	201,730	201,730
c	MEETING REGISTRATION	900099	76,125	76,125
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		966,255

3 Investment income (including dividends, interest, and othersimilar amounts) ......			14,913			14,913
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.....			981,168	966,255	0	14,913

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 ...........
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 ...........
11	Fees for services (non-employees):
a	Management ......	331,145
b	Legal .........	172
c	Accounting ...........	1,993
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)	262,474
12	Advertising and promotion ....
13	Office expenses .......	18,903
14	Information technology ......	958
15	Royalties ..
16	Occupancy ...........
17	Travel ............	59,643
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	122,272
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..
23	Insurance ...
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
b
c
d
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	797,560
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 ........				1
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			514,767	4	698,375
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 ......			0	9	0
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	0
b	Less: accumulated depreciation	10b	0	0	10c	0
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....			0	12	0
13	Investments—program-related. See Part IV, line 11 ..			0	13	0
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			0	15	0
16	Total assets. Add lines 1 through 15 (must equal line 33)...			514,767	16	698,375

17	Accounts payable and accrued expenses .....		17
18	Grants payable ...		18
19	Deferred revenue .........	0	19	0
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	0	25	0
26	Total liabilities. Add lines 17 through 25..	0	26	0

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	514,767	27	698,375
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 ...........	514,767	32	698,375
33	Total liabilities and net assets/fund balances ........	514,767	33	698,375

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-.
1
2
3
4
5
6