..
REGISTRATION/RENEWAL
IN
MAIL TO:
Registry of Charitable Trusts
P.o. Box 903447
Sacramento, CA 94203-4470
Telephone: (916) 445-2021
FEE REPORT
TO ATTORNEY GENERAL OF CALIFORNIA
Sections 12586 and 12587, California Government Code
11 CCR Sections 311 and 312
Failure to submit this report annually no later than four months and fifteen days after the
end of the organization's accountin? ~eriod may result in the loss of tax exemption and
~~ed~~~~:J~e~~~~~n:::~n~;n~:c.~~e~ti08~M~~~1i~terest, andlor fines or filing penalties
WEBSITE ADDRESS:
[Link]
IRS FORM 990 EXTENSIONS WILL BE HONORED. PLEASE SUBMIT WITH RRF1 ALL
IRS EXTENSION REQUESTS AND, WHERE APPLICABLE, IRS EXTENSION APPROVALS.
State Charity Registration Number
oo
~~~~--~~\7~----------------51138
Check if:
Change of address
Amended report
Theatre
t-:P:-7.-;-O_.::-:B;;,..0'7x~2~2~2-,-073..:;,5
---i Corporate or Organization No.
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-I
Address (Number and Street)
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--l Federal Employer ID No.
--:::.,---=:::-::---:-State ZIP Code
City or Town
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PART A - ACTIVITIES
Yes
Note:
If the answer is yes, you are required by Title 11 of the California Code of Regulations, Sections 311 and 312, to attach a check in
the amount of $25.00 to this report. Make check payable to Department of Justice.
1/01/04
For your most recent full accounting period (beginning
Gross receipts $
1,088,699.
Totalassets
PART B - STATEMENTS
Note:
REGARDING
12/31/04)
list:
DURING THE PERIOD OF THIS REPORT
If you answer 'yes' to any of the questions below, you must attach a separate sheet providing an explanation and details for each
'yes' response. Please review RRF-1 instructions for information required.
During this reporting period, were there any contracts, loans, leases or other financial transactions between the
organization and any officer, director or trustee thereof either directly or with an entity in which any such officer,
director or trustee had an financial interest?
See
Statement
2
No
1,324,037.
ORGANIZATION
ending
-1
Yes
No
During this reporting period, was there any theft, embezzlement, diversion or misuse of the organization's charitable
ro ert or funds?
3
4
During this reporting period, were any organization funds used to pay any penalty, fine or judgment? If you filed a
Form 4720 with the Internal Revenue Service, attach a co .
During this reporting period, were the services of a professional fundraiser or fundraising counsel used? If 'yes,' provide
an attachment listing the name, address, and tele hone number of the service rovider.
During this reporting period, did the organization receive any governmental funding? If so, provide an attachment listing
the name of the a enc ,mailin address, contact erson, and tele hone number.
During this reporting period, did the organization hold a raffle for charitable purposes? If 'yes,' provide an attachment
indicating the number of raffles and the date(s the occurred.
Does the organization conduct a vehicle donation program? If 'yes,' provide an attachment indicating whether the program is
o erated b the charlt or whether the organization contracts with a commercialfundraiser.
OrganizaUon's area code and telephone number
_(~8::..:3::..:1=-)~~6=2=2-'-....:0....:7....:0::..:0~
Organization's e-mail address
CAVA980lL
01118/05
RRF-1 (52004)
-------
-----------------------
2004
California Statements
Pacific Repertory Theatre
77-0026957
Statement 1
Form RRF -1, Part B, line 1
Financial Transactions
Name of Officer involved:
Nature of transaction:
Date of Transaction:
Loan from Executive
10/15/04.
Purpose of Transaction:
Loan Amount:
Repayment
Stephen Moorer, Executive
Working capital.
$15,000.
Terms: fully payable
Balance Due: $15,000.
in 6 months.
Page 1
Director.
Director to the organization.
Form 8868
Pa e 2
If you are filing for an Additional (not automatic) 3-Month Extension, complete only Part II and check this box.
Note. Only complete Part II if you have already been granted an automatic 3month extension on a previously filed Form 8868.
If
"
3-Month
Type or
print
File by the
extended
due date for
filing the
return. See
instructions.
ZiP code. For a foreign address. see Instructions.
Carmel
Check
= type of return to be filed (File a separate
,.... application for each return):
Form 990
_ Form 990T (section 401(a) or 408(a) trust)
Form 990BL
Form 990T (trust other than above)
I- Form [Link]
- Form 1041.A
r!
Form 5227
Form 6069
Form 8870
- Form 4720
Form 990PF
STOP: Do not complete Part lilt you were not already granted an automatic 3-month extension on a previously filed Form 8868.
The books are in care of ~ J>2i_f.!_R~[Link]'.!-Q.r'y_
'Kh_e2tr_e
_
Telephone No. ~ _(.~lJ_.2..f.:Q.1_0~
.
FAX No. ~
_
If the organization does not have an office or place of business in the United States, check this box. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ~
If this is for a Group Return, enter the organizations four digit Group Exemption Number (GEN). . . . .
. If this is for the
whole group, check this box. ..
members the extension is for.
0 .If it is part of the group, check this box..
4 I request an additional 3month extension of time until 11/15
5 For calendar year 2004 ,or other tax year beginning- - - - - - - - -
TI i;;itialr;t;:;;';
If this tax year is fo;:-I;S; ihan 12 months, check reason: State in detail why you need the extension .. __ T2~ay~r_
0 and attach a list with the names and EINs of all
, 20 _O~.
,20
, and ending
OFinal
return
TI Ch;~e-i;
,20
~counti;:;-g-period
~~s..P~'U',g!.~_!:.~~s_t_a..9.Q.!,'I;:.i.Q!lC!..l_
tlm~_'I;:.o
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8a
if this
.
_
application is for Form-990:-BL,-990:-PF,990:=r;-4720,-or606;-enter the tentative tax,lessany- - - - - - - - - - - - - - - - -nonrefundable credits. See instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. $
.--
b If this application is for Form 990PF, 990T, 4720, or 6069, enter any refundable credits and estimated tax
r: ~~:~~~~~~~~
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~~~.~~i~~
.~II.~~~~.~~.~ .c.r~~.it.
~~.d.~~~.~~~~~~ .~~i~.~~~~i~.U.S.I~
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c Balance Due. Subtract line 8b from line 8a. Include your payment with this form, or, if required, deposit with
FTC coupon or, if required, by using EFTPS (Electronic Federal Tax Payment System). See instructions. . . . . . ..
Signature and Verification
rm, including accompanying schedules and statements, and to the best of my knowledge and belief. it is tr e,
form.
fJ.
Notice t9 Apylicant - To be Completed by the IRS
We have approve
is application. Please ~
this form to the organization's return.
We have not app
d this application. However, we have granted a 10day grace period from the later of the date shown below or the
due date of the organization's return (including any prior extensions). This grace period is considered to be a valid extension of time for
elections otherwise required to be made on a timely filed return. Please attach this form to the organization's return.
We have not approved this application. After considering the reasons stated in item 7, we cannot grant your request for an extension of
time to file. We are not granllng a 10day grace period.
We cannot consider this application because it was filed after the extended due date of the return for which an extension was requested.
Other:
By:
Director
Date
Alternate Mailing Address - Enter the address if you want the copy of this application for an additional 3'month extension returned to an
address different than the one entered above.
Name
Type or
print
Slade, Gertz & Assoc.,CPAs
PO Box 222539
City or town, province or stete, and country (including
Carmel,
BAA
LLP
Number and street (include suite, room, or epartment number) or a P.O. box number
postal or ZIP code)
CA 93922
FIFZ0502L
01104105
Form 8868 (Rev 122004)