8

03 90509 2949334229010

OMB No

Return of Organization Exempt From Income Tax

(*",. 990

Under section 501(c ), 527, or 4947( a)(1) of the Internal Revenue Code (except private foundations)
n
^ Do not enter social security numbers on this form as it may be made public .
Department of the Treasury
Internal Revenue Service
^ Go to www.irs . aov/Form990 for instructions and the latest information .
and ending
A For the 2017 calendar year, or tax year beginning
B check if

1545-0047

2017
Open to Public
Inspection

D Employer identification number

C Name of organization

applicable

Address

CSG ACTION
Dom business as

Da,ange
Initial
return
=Final
return/
terminated
= Amended
return

0 ttion
pending

2 7=4`'&4$5&6'

Number and street (or P.O. box if mail is not delivered to street address )

Room/suite

5850 SAN FELIPE

585

540-441-7227
22,630.

City or town, state or province, country, and ZIP or foreign postal code

G Gross receipts $

HOUSTON,

H(a) Is this a group return

TX

77057

F Name and address of principal officer MARK

MECKLER

SAME AS C ABOVE

=Yes 0 No
0 Yes = No
4947(a)(1) or t_LJ 27
If "No," attach a list. (see instructions)
H(c) Grou p exem ption number ^
Other ^
L Year of formation : 2 011 M State of legal domicile: TX
for subordinates?

H( b) Are all subordinates included9

4
),4 (insert no.)
I Tax-exem pt status L-J 501(c)(3) LXJ 501(c) (
J Website : ^ N/A
K Form of organization . X Corporation L_J Trust L_J Association

Part I

E Telephone number

Summary
Briefly describe the organization's mission or most significant activities TO

1

EMPOWER

ORDINARY

CITIZENS

TO

HAVE AN IMPACT ON COMMUNITY LIFE BY PROVIDING OPPORTUNITIES FOR
i
0

.5
Q

e)c

Check this box ^
if the organization discontinued its operations or disposed of more than 25% of its net assets.
3
4
Number of voting members of the governing body (Part VI, line 1 a)
3
4
Number of independent voting members of the governing body (Part VI, line 1 b)
1
t1
Total number of individuals employed in calendar year 2017 (Part V, line 2a)
^
5
0
Total number of volunteers (estimate if necessary)
6
0
7a
0
Total unrelated business revenue from Part VIII, column (C), line 12
7b
0
b Net unrelated business taxable income from Form 990-T, line 34
'or Year
Current Year
, 144 , 000 .
X60
20,000.
8 Contributions and grants (Part VIII, line 1 h)
0 .
0 .
9 Program service revenue (Part VIII, line 2g)
0.
0.
10 Investment Income (Part VIII, column (A), lines 3, 4, and 7d)
2 , 630 .
0.
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 1 Oc, and 11 e)
22 , 630 .
2,144,000.
12 Total revenue - add lines 8 throu g h 11 (must eq ual Part VIII, column (A) , line 12
0.
0 .
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)
2
3
4
5
6
7a

0

15

X
W

16a
b
17
18
19

Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10)
Professional fundraising fees (Part IX, column (A), line 11e)
Total fundraising expenses (Part IX, column (D), line 25)
00,
Other expenses (Part IX, column (A), lines 11 a-11 d, 11 f-24e)
Total expenses. Add lines 13.17 (must equal Part IX, column (A), line 25)
Revenue less expenses Subtract line 18 from line 12

8^

31,139.

30 , 900 .

0.

0.

0
228

1,806,314.

259,519.

337,686.
Beginning of Current Year

443,947.

20 Total assets (Part X, line 16)
21
=if 22

Total liabilities (Part X, line 26)
Net assets or fund balances. Subtract line 21 from line 20

Part ll

,619.

1,775,175.

22,183. 1

421 , 764 .

-236 , 889
End of Year

192,667.
7,792.

184,875.

sig n atu re tbl O CK

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is
true, correct, and complete. De
rep
other than officer) is based on all information of which preparer has any knowledge.
Sign

Here

Paid
Preparer
Use Only

Sign

o

I MARK M CKLER ,
ype or print name and title

CEO

Print/Type preparer's name
Preparer's slg
T MURP
T MURPHY
Firm's name III, CLIFTONLARSONALLEN LLP
Firm's address p, 9365 COUNSELORS ROW, ST
INDIANAPOLIS,

IN

46240

May the IRS discuss this return with the re parer shown above? see Inst
732001 11-28-17
LHA For Paperwork Reduction Act Notice, see the se

SEE SCHEDULE 0 FOR ORGANIZATION M

 CSG ACTION
Forn 990 2017
Part III Statement of Program Service Accomplishments
1

27-4648506

Pag e 2

Check If Schedule 0 contains a response or note to any line in this Part III
Bneely describe the organization's mission

0

TO EMPOWER ORDINARY CITIZENS TO HAVE AN IMPACT ON COMMUNITY LIFE BY
PROVIDING OPPORTUNITIES FOR CITIZENS TO RECEIVE INFORMATION AND
TRAINING ON CIVIC ENGAGEMENT, AND TO ENGAGE IN LOBBYING ACTIVITIES IN
ORDER TO INFLUENCE LEGISLATION FOR THE BENEFIT OF THE COMMUNITY.
2

3
4

4a

Did the organization undertake any significant program services during the year which were not listed on the
prior Form 990 or 990 -EZ?
[::]Yes 0 No
If "Yes," describe these new services on Schedule 0.
Did the organization cease conducting , or make significant changes in how it conducts, any program services'
[::]Yes 0 No
If "Yes," describe these changes on Schedule 0
Describe the organization's program service accomplishments for each of its three largest program services, as measured by expenses
Section 501 (c)(3) and 501 (c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and
revenue, if any, for each program service reported
(Code

) (Expenses $

236,0 99

.

including grants of $

)

(Revenue $

TO EMPOWER ORDINARY CITIZENS TO HAVE AN IMPACT ON COMMUNITY LIFE BY
PROVIDING OPPORTUNITIES FOR CITIZENS TO RECEIVE INFORMATION AND
TRAINING ON CIVIC ENGAGEMENT , AND TO ENGAGE IN LOBBYING ACTIVITIES IN
ORDER TO INFLUENCE LEGISLATION FOR THE BENEFIT OF THE COMMUNITY.

4b

(Code

) (Expenses $

including grants of $

)

4C

(Code

) (Expenses $

including grants of $

) (Revenue $

4d

Other program services (Describe in Schedule 0.)

4e

Total program service expenses ^

(Expenses $

including grants of $

(Revenue $

) (Revenue $

236,099.

Form 990 (2017)
732002 11-28-17

 orrr3990 (201 7)

CSG ACTION

27-4648506

Pa e3

Part IV Checklist of Required Schedules
Yes
1
2
3
4
5
6
7
8
9

10
11

Is the organization described in section 501 (c)(3) or 4947(a)(1) (other than a private foundation)'?
If "Yes, " complete Schedule A
Is the organization required to complete Schedule B, Schedule of Contributor9
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for
public office? If "Yes, " complete Schedule C, Part 1
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect
during the tax year? If "Yes," complete Schedule C, Part 11
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or
similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part 111
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to
provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes,' complete Schedule D, Part 1
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part 11
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If 'Yes,' complete
Schedule D, Part 111
Did the organization report an amount in Part X, line 21, for escrow or custodial account liability, serve as a custodian for
amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services?
If "Yes, " complete Schedule D, Part IV
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent
endowments, or quasi-endowments? If "Yes," complete Schedule D, Part V
If the organization's answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X
as applicable.
a Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes,' complete Schedule D,
Part VI
b Did the organization report an amount for investments - other securities in Part X, line 12 that is 5% or more of its total
assets reported in Part X, line 16? If "Yes,' complete Schedule D, Part VII

c Did the organization report an amount for investments - program related in Part X, line 13 that is 5% or more of its total
assets reported in Part X, line 16' If "Yes," complete Schedule D, Part VIII
d Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in
Part X, line 16' If 'Yes,' complete Schedule D, Part IX
e Did the organization report an amount for other liabilities in Part X, line 25' If "Yes," complete Schedule D, Part X
f Did the organization's separate or consolidated financial statements for the tax year include a footnote that addresses
the organization's liability for uncertain tax positions under FIN 48 (ASC 740) If "Yes," complete Schedule D, Part X
12a Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts Xl and XII
b Was the organization included in consolidated, independent audited financial statements for the tax year?
If 'Yes,' and if the organization answered "No' to line 12a, then completing Schedule D, Parts XI and XII is optional
13 Is the organization a school described in section 170(b)(1)(A)(ii)' If 'Yes, ° complete Schedule E
14a Did the organization maintain an office, employees, or agents outside of the United States?
b Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business,
investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000
or more? If "Yes,' complete Schedule F, Parts 1 and IV
15
16
17
18
19

Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any
foreign organization? If "Yes," complete Schedule F, Parts 11 and IV
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to
or for foreign individuals? If "Yes," complete Schedule F, Parts III and IV
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX,
column (A), lines 6 and 11 e' If "Yes,' complete Schedule G, Part 1
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines
1 c and 8a? If 'Yes,' complete Schedule G, Part 11
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a' If "Yes,"
complete Schedule G, Part 111

732003 11-28-17

1
2
3

No
X

X
X

4
5

X

6

X

7

X

8

X

9

X

10

X

11a

X

11b

X

11c

X

11d
11e

X
X

11f

X

12a

X

12b
13

X
X

14a

- X

14b

X

15

X

16

X

17

X

18

X

119
X
Form 990 (2017)

 CSG ACTION

27-4648506

Page4

(continued)
Yes
20a Did'the organization operate one or more hospital facilities? If "Yes," complete Schedule H
b If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or
domestic government on Part IX, column (A), line 12 If 'Yes,' complete Schedule 1, Parts I and 11
22
23

Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on
Part IX, column (A), line 22 If "Yes,' complete Schedule 1, Parts 1 and 111
Did the organization answer 'Yes' to Part VII, Section A, line 3, 4, or 5 about compensation of the organization's current
and former officers, directors, trustees, key employees, and highest compensated employees' If "Yes," complete
Schedule J

24a Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the
last day of the year, that was issued after December 31, 2002 If "Yes, ° answer lines 24b through 24d and complete
Schedule K If "No", go to line 25a
b Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?
c Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease
any tax-exempt bonds'
d Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year's
25a Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit
transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I
b Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and
that the transaction has not been reported on any of the organization's prior Forms 990 or 990-EZ' If "Yes," complete
Schedule L, Part

No
X

?Oa
?0b
21

X

22

X

9^

X

24a
24b

X

24c
24d
25a

X

25b

X

26

Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or
former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons' If "Yes,"
complete Schedule L, Part II

26

X

27

Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial
contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member
of any of these persons? If 'Yes,' complete Schedule L, Part 111

27

X

28a
28b

X
X

28c
29

X
X

28 Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV
instructions for applicable filing thresholds, conditions, and exceptions)A
current or former officer, director, trustee, or key employee? If "Yes, ° complete Schedule L, Part IV
a
A
family member of a current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV
b
An
entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer,
c
director, trustee, or direct or indirect owner? If 'Yes,' complete Schedule L, Part IV
29 Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M
30 Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation
contributions' If 'Yes,' complete Schedule M

.qn

X

31

Did the organization liquidate, terminate, or dissolve and cease operations?
If "Yes," complete Schedule N, Part/

31

X

32

Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets'lf "Yes," complete
Schedule N, Part 11

32

X

33

Did the organization own 100% of an entity disregarded as separate from the organization under Regulations
sections 301.7701-2 and 301.7701-32 If "Yes," complete Schedule R, Part I
Was the organization related to any tax-exempt or taxable entity? If "Yes,' complete Schedule R, Part 11, 111, or IV, and
Part V, line l

33

X

34

35a Did the organization have a controlled entity within the meaning of section 512(b)(13)'
b If "Yes" to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity
within the meaning of section 512(b)(13)' If 'Yes,' complete Schedule R, Part V, line 2
Section
501(c)(3) organizations. Did the organization make any transfers to an exempt non-chantable related organization?
36
If 'Yes, " complete Schedule R, Part V, line 2
37
38

Did the organization conduct more than 5% of its activities through an entity that is not a related organization
and that is treated as a partnership for federal income tax purposes? If 'Yes," complete Schedule R, Part VI
Did the organization complete Schedule 0 and provide explanations in Schedule 0 for Part VI, lines 11 b and 19'
Note. All Form 990 filers are reawred to complete Schedule 0

34

X

35a

X

35b
36

371

1X

381XI
Form 990 (2017)

732004 11-28-17

 CSG ACTION
Form 990 (2017)
}Party
Statements Regarding Other IRS Filings and Tax Compliance

27-4648506

Pa e5

Check if Schedule 0 contains a response or note to any line in this Part V

E

'
la Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable
la
b Enter the number of Forms W-2G included in line 1 a. Enter -0- if not applicable
lb
c Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming
(gambling) winnings to prize winners?
i
2a Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements,
filed for the calendar year ending with or within the year covered by this return
2a
b If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note . If the sum of lines 1 a and 2a is greater than 250, you may be required to e-file (see instructions)

Yes
0 ''
X

1c
0

ti.
2b

3a Did the organization have unrelated business gross income of $1,000 or more during the year?
3a
b If "Yes," has it filed a Form 990-T for this year? If "No," to line 3b, provide an explanation in Schedule 0
3b
4a At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a
financial account in a foreign country (such as a bank account, securities account, or other financial account)?
4a
b If "Yes," enter'the name of the foreign country. 0'
See instructions for filing requirements for FinCEN Form 114, Report of Foreign, Bank and Financial Accounts (FBAR).
am * ,
5a Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?
5a
b' Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
c If "Yes," to line 5a or 5b, did the organization file Form 8886-T?
5c
6a Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit
any contributions that were not tax deductible as charitable contributions?
6a
X
b If Yes,' did the organization include with every solicitation an express statement that such contributions or gifts
were not tax deductible?
' 6b
X
7 Organizations that may receive deductible contributions under section 170(c).
a Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor' 7a
b If "Yes," did th e organization notify the donor of the value of the goods or services provided?
7b
c

No

X

X
.
IN
X
X,•

r
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required

to file Form 8282'
7c
If Yes,' indicate the number of Forms 8282 filed during the year
7d
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
7f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?
7g
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C'
7h
8 Sponsoring organizations maintaining donor advised funds . Did a donor advised fund maintained by the
sponsoring organization have excess business holdings at any time during the year?
8
9 Sponsoring organizations maintaining donor advised funds .
a bid the sponsoring organization make any taxable distributions under section 4966
9a
b Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?
9b
10 Section 501(c)( 7) organizations . Enter:
y
10a
a Initiation fees and capital contributions included on Part Vffl, line 12
b Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
11
Section 501(c)( 12) organizations . Enter .
11a
a Gross income from members or shareholders
d
e
f
g
h

b
12a
b
13
a
b

Gross income from other sources (Do not net amounts due or paid to other sources against
amounts due or received from them.)
11b
Section 4947(a)(1) non -exempt charitable trusts . Is the organization filing Form 990 in lieu of Form 1041?
If "Yes," enter the amount of tax-exempt interest received or accrued during the year
12b
Section 501(c)(29) qualified nonprofit health insurance issuers.
r
Is the organization licensed to issue qualified health plans in more than one state'?
Note. See the instructions for additional information the organization must report on Schedule O.
Enter the amount of reserves the organization is required to maintain by the states in which the

organization is licensed to issue qualified health plans
13b
13c
c Enter the amount of reserves on hand
14a Did the organization receive any payments for indoor tanning services during the tax year?
b If Yes." has it filed a Form 720 to report these Davments? If "No," provide an explanation in Schedule 0

ti732005 11-28-17

-

ri `

, • et

12a
3
13a

14a
X
14b
Form 990 (2017)

, .

 Forn 990 (2017)
Part VII

CSG ACTION

27-4648506

Page 6

Governance , Management , and Disclosure For each "Yes" response to lines 2 through 7b below, and fora " No" response
to hne 8a, 8b, or 1Ob below, describe the circumstances , processes , or changes in Schedule 0 See instructions
OX

Check if Schedule 0 contains a response or note to any line in this Part VI

Section A. Governing Body and Management
Yes
la Enter the number of voting members of the governing body at the end of the tax year
If there are material differences in voting rights among members of the governing body, or if the governing
body delegated broad authority to an executive committee or similar committee , explain in Schedule 0.

la

lb
b Enter the number of voting members included in line 1 a, above , who are independent
2 Did any officer , director, trustee , or key employee have a family relationship or a business relationship with any other
officer , director , trustee , or key employee?
3 Did the organization delegate control over management duties customarily performed by or under the direct supervision
of officers , directors , or trustees , or key employees to a management company or other person?
4 Did the organization make any significant changes to its governing documents since the prior Form 990 was filed'
5 Did the organization become aware during the year of a significant diversion of the organization ' s assets?
6 Did the organization have members or stockholders'?
7a Did the organization have members, stockholders , or other persons who had the power to elect or appoint one or
more members of the governing body?
b Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or
persons other than the governing body?
8 Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:

3
2
3
4
5
6

X
X
X
X
X

7a

X

7b

X

a The governing body?
b Each committee with authority to act on behalf of the governing body?
9 Is there any officer , director , trustee , or key employee listed in Part VII, Section A, who cannot be reached at the
organization ' s mailin g address? If "Yes," provide the names and addresses in Schedule 0
Section B . Policies (This Section B requests information about policies not required by the Internal Revenue Code)

8a
8b

10a Did the organization have local chapters, branches , or affiliates?
b If "Yes ," did the organization have written policies and procedures governing the activities of such chapters, affiliates,
and branches to ensure their operations are consistent with the organization 's exempt purposes'
1la Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form'?
b Describe in Schedule 0 the process , if any, used by the organization to review this Form 990.
12a Did the organization have a wntten conflict of interest policy'? If 'No," go to line 13
b Were officers , directors, or trustees , and key employees required to disclose annually interests that could give rise to conflicts?
c Did the organization regularly and consistently monitor and enforce compliance with the policy? If 'Yes," describe
in Schedule 0 how this was done

10a

X
X
X

9
Yes

13
14

Did the organization have a wntten whistleblower policy?
Did the organization have a written document retention and destruction policy?
15 Did the process for determining compensation of the followi ng persons include a review and approval by independent
persons , comparability data , and contemporaneous substantiation of the deliberation and decision?
a The organization 's CEO, Executive Director , or top management official
b Other officers or key employees of the organization
If 'Yes" to line 15a or 15b, describe the process in Schedule 0 (see instructions).
16a Did the organization invest in, contribute assets to , or participate in a joint venture or similar arrangement with a
taxable entity during the year?
b If "Yes ," did the organization follow a written policy or procedure requiring the organization to evaluate its participation
in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization's
exem pt status with res pect to such arrangements?

No

4

10b
11a

No
X

X

12a
12b

X

12c
13
14

X

X

X
X

15a
15b

X
X

16a

X

16b

Section C. Disclosure

19

NONE
List the states with which a copy of this Form 990 is required to be filed ^
organization
to
make
its
Forms
1023
1024
if
applicable),
990, and 990 -T (Section 501 (c)(3)s only) available
Section 6104 requires an
(or
how
you
made
available
Check
all
that
apply.
for public inspection . Indicate
these
.
0 Upon request
0 Other (explain in Schedule 0)
= Own website
0 Another's website
organization
governing
Describe in Schedule 0 whether (and if so, how) the
made its
documents , conflict of interest policy , and financial

20

statements available to the public during the tax year.
State the name , address , and telephone number of the person who possesses the organization's books and records 00,

17
18

CLIFTONLARSONALLEN -

3175749100

9365 COUNSELORS ROW,

STE

732006 11 - 28-17

200,

INDIANAPOLIS,

IN

46240
Form 990 (2017)

 27-4648506
CSG ACTION
Form 990 2017
Part VII Compensation of Officers, Directors , Trustees , Key Employees, Highest Compensated

Page 7

Employees , and Independent Contractors
Check if Schedule 0 contains a response or note to any line in this Part VII
Section A. Officers, Directors , Trustees , Key Employees , and Highest Compensated Employees
la Complete this table for all persons required to be listed Report compensation for the calendar year ending with or within the organization's tax year.
• List all of the organization' s current officers, directors, trustees (whether individuals or organizations), regardless of amount of compensation
Enter -0- in columns (D), (E), and (F) if no compensation was paid
• List all of the organization' s current key employees, if any. See instructions for definition of "key employee."
• List the organization' s five current highest compensated employees (other than an officer, director, trustee, or key employee) who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the organization and any related organizations
• List all of the organization's former officers, key employees, and highest compensated employees who received more than $100,000 of
reportable compensation from the organization and any related organizations.
• List all of the organization 's former directors or trustees that received, in the capacity as a former director or trustee of the organization,
more than $10,000 of reportable compensation from the organization and any related organizations.
List persons in the following order individual trustees or directors, institutional trustees, officers; key employees; highest compensated employees,
and former such persons.
= Check this box if neither the organization nor any related organization compensated any current officer, director. or trustee
(B)
(C)
(D)
(E)
(A)
Position
Average
Reportable
Reportable
Name and Title
(do not check more than one
hours per box, unless person is both an
compensation
compensation
officer and a director/trustee)
week
from
from related
(list any
the
organizations
(W-2/1099-MISC)
hours for
organization
'2
'Ll
(W-2/1099-MISC)
related
organizations a . o
below
s = o
=E E
line)
g
:2
(1)

MARK MECKLER

PRESIDENT
(2)

ERIC O'KEEFE

4. 0 0

40.00

TIM DUNN

SECRETARY
(6) TIMOTHY MURPHY
CFO

732007 11-28-17

0.

223,588.

22,221.

X

0 .

0 .

0 .

X

0 .

0 .

0 .

X

0 .

0 .

0 .

X

0.

100,800.

X

0.

0.

1.00

DIRECTOR
(5) MICHAEL RUTHENBERG

X

1.00

DIRECTOR

(4) MARK ROLLINS

X

1.00

DIRECTOR
(3)

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

1. 00
40.00

25

,749

.

1.00
0.

Form 990 (2017)

 CSG ACTION
27- 4648506
Form 990 2017
Part VII Section A. Officers, Directors , Trustees , Ke y Em to ees, and Hi ghest Com p ensated Em p loyees (continued)
(A)
Name and title

(C)
(B)
Position
Average
(do not check more than one
hours per
box, unless person is both an
officer and a director/trustee )
week
(list any
hours for
f
5i
related
organizations
o
below
E
line)
s - o
E

(D)
Re p ortable
compensation
from
the
organization
(W-2/1099-MISC)

0.

(E)
Re p ortable
compensation
from related
organizations
(W-2/1099-MISC)

Page8

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

324,388.

47,970.

0.
0.
^
c Total from continuation sheets to Part VII , Section A
0.
324,388.
^
d Total (add lines lb and 1c
2 Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable

47,970.

^

1b Sub -total

0.

No
3
4

Did the organization list any former officer, director, or trustee, key employee, or highest compensated employee on
line 1 a? If "Yes," complete Schedule J for such individual
For any individual listed on line 1 a, is the sum of reportable compensation and other compensation from the organization
and related organizations greater than $150,0009 If "Yes,' complete Schedule J for such individual

Did any person listed on line 1 a receive or accrue compensation from any unrelated organization or individual for services
rendered to the oraanlzatlon9 If "Yes, " complete Schedule J for such person
Section B. Independent Contractors

3
4

X
X

5

1

--X

Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from
the org anization. Report com pensation for the calendar year endin g with or within the org anization's tax year.
(A)
Name and business address

COALITION PARTNERS, N7130 NORTH LOST LAKE
RD, RANDOLPH, WI 53956

2

5

(B)
Description of services

AD VOCACY SERVICES

(C)
Compensation

192,000.

Total number of independent contractors (including but not limited to those listed above) who received more than
1
$100 ,000 of com pensation from the or anization jo,
Form 990 (2017)

732008 11-28-17

 27-4648506

CSG ACTION
Form 990 (2017)
P4QW!11^ Statement of Revenue
Check if Schedule 0 contains a res ponse or note to any line in this Part VIII

0
Related or
exempt function
revenue

Total revenue

9 a Gross income from gaming activities. See
a
Part IV, line 19
b
b Less direct expenses
c Net income or (Ioss) from gaming activities
10 a Gross sales of inventory, less returns
a
and allowances
b
b Less cost of goods sold
c Net income or oss from sales of invento ry

Miscellaneous Revenue
11 a MISC INCOME
b
c
d All other revenue
e Total . Add lines 11a-11d
Total revenue . See instructions.
12
732009 11-28-17

^

Page9

Unrelated
business
revenue

Revenu excluded
from tax under
sections
512 - 514

r ..

B usiness Cod

^
^

22,630.

2,630.
rr

V .

Form 990 (2017)

 CSG ACTION
Form 990 2017
,A tiXr Statement of Functional Expenses

27-4648506 ' Pa a 10
-

Section 501(c)(3) and 501(c)(4) organizations must complete all columns All other organizations must complete column (A)
X

Check If Schedule 0 contains a resoonse or note to any line In this Part IX

Do not include amounts reported on lines 6b,
7b , 8b , 9b , and 10b of Part Vlll .

Total expenses

1

Grants and other assistance to domestic organizations
and domestic governments . See Part IV, line 21

2

G rants and other assistance to domestic
Individuals See Part IV, line 22
Grants and other assistance to foreig n
organizations , foreign governments , and foreign
Individuals. See Part IV , lines 15 and 16

3

4

Program service
expenses

Management and
general expenses
N
4

wl

6

'K
s N I

O;

.
z

i

;`

M"a

Benefits paid to or for members
Compensation of current officers, directors,
trustees , and key employees
Compensation not included above, to disqualified
persons ( as defined under section 4958 (f)(1)) and

5

Fundraising
expenses
r. a . u

N,

1

a=M

persons described in section 4958 ( c)(3)(B)
7
8

Other salaries and wages
Pension plan accruals and contributions ( include
section 401 ( k) and 403 ( b) employer contributions)

9

Other employee benefits

10
11

Payroll taxes

26,56 7-.

19,9 25.

6,642.

2,392 .
1,941.

1,794.
1,456.

598.
485.

Fees for services (non-employees)
a Management
b Legal

6,856.

6,856.

c Accounting

7,713.

7,713.

d
e
f
g

Lobbying
Professional fundraisin g

See Part IV, line 17

-x a

f%`f

'''

"

'7'

*^ EW

Investment management fees
Other. ( If line 11g amount exceeds 10 % of line 25,

column (A) amount, list line ldg expenses on Sch 0.)
12

Advertising and promotion

13

Office expenses

14
15
16

Information technology
Royalties
Occupancy

17

Travel

18

Payments of travel or entertainment expenses
for any federal , state, or local public officials
Conferences , conventions , and meetings
Interest
Payments to affiliates
Depreciation, depletion , and amortization

19
20
21
22
23
24

-

212,924.

212,924.

1,113.

1,113.

13.

13.

Insurance
Other expenses . Itemize expenses not covered
a b ove. ( L is t misce ll aneous expenses in l ine 24 e. If l ine

24e amount exceeds 10% of line 25 , column (A)
amount, list line 24e expenses on Schedule 0.)

' K ?.

:•

.,

.

a
b

C

-

d
e All other expenses
25 Total functional expenses. Add lines 1 through 24e
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 he Boo-

732010 11-28-17

259,519.

236,099.

23,420.

0.

O if following SOP 98-2 (ASC 958-720 )

Form 990 (2017)

 CSG ACTION

27-4648506

Paaell

Check if Schedule 0 contains a response or note to any line in this Part X

LJ
(A)
Beginning of year

Cash - non-interest-bearing
Savings and temporary cash investments
Pledges and grants receivable, net
Accounts receivable, net
Loans and other receivables from current and former officers, directors,
5
trustees, key employees, and highest compensated employees. Complete
Part II of Schedule L
6
Loans and other receivables from other disqualified persons (as defined under
section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing
employers and sponsoring organizations of section 501(c)(9) voluntary
employees' beneficiary organizations (see instr) Complete Part II of Sch L
7
Notes and loans receivable, net
8
Inventories for sale or use
9
Prepaid expenses and deferred charges
10a Land, buildings, and equipment cost or other
10a
basis. Complete Part VI of Schedule D
lob
b Less accumulated depreciation
Investments - publicly traded securities
11
Investments - other securities. See Part IV, line 11
12
13
Investments - program-related. See Part IV, line 11
14
Intangible assets
15 Other assets. See Part IV, line 11
16 Total assets. Add lines 1 throug h 15 (must eq ual line 34
17
Accounts payable and accrued expenses
18 Grants payable
19
Deferred revenue
20 Tax-exempt bond liabilities
Escrow or custodial account liability. Complete Part IV of Schedule D
21
Loans and other payables to current and former officers, directors, trustees,
22
key employees, highest compensated employees, and disqualified persons.
Complete Part II of Schedule L
23 Secured mortgages and notes payable to unrelated third parties
24
Unsecured notes and loans payable to unrelated third parties
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
26 Total liabilities . Add lines 17 throu g h 25
Organizations that follow SFAS 117 (ASC 958), check here-100.
X and
complete lines 27 through 29, and lines 33 and 34.

443,947.

1
2
3
4

Y
N

.LD

•M
"j

'Fi
M
v

1

192,667.

2
3
4
3"

w^ J

k
5
R
f
r.^

'&s j
,
off

^,_
6
7

^^y,ry

8
9

,,tv

y^,

,C

f
Mf r

;
` ^ 4

K

u'
`

10c
11
12
13
14
15

44 3 , 9 4 7 .

16

19 2 , 6 6 7 .

22,183.

17

7,792.

18
19
20
21
.:
'01",101
1

ry
22
23
24

22,183.

25
26

7,792.
a1^}h

49 , 719.

sa

27

Unrestncted net assets

27

3,343.

28
29

372 , 045. 28

181,532.

32

Temporarily restricted net assets
Permanently restricted net assets
Organizations that do not follow SFAS 117 (ASC 958), check here op- 0
and complete lines 30 through 34.
Capital stock or trust principal, or current funds
Paid-in or capital surplus, or land, building, or equipment fund
Retained earnings, endowment, accumulated income, or other funds

33
34

Total net assets or fund balances
Total liabilities and net assets/fund balances

421,764. 1 33

0
30
31
Z

(B)
End of year

29
""

01''

-6

30
31
32

443,947. 1 34

184,875.

192,667.
Form 990 (2017)

732011

11-28-17

 CSG ACTION
Form 990 201
Fart XI Reconciliation of Net Assets
Check if Schedule 0 contains a res ponse or note to any line in this Part XI
Total revenue (must equal Part VIII, column (A), line 12)
Total expenses (must equal Part IX, column (A), line 25)
Revenue less expenses . Subtract line 2 from line 1
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A))
Net unrealized gains posses) on investments
Donated services and use of facilities

1
2
3
4
5
6
7

Investment expenses
Prior period adjustments
Other changes in net assets or fund balances (explain in Schedule 0)
Net assets or fund balances at end of year Combine lines 3 through 9 (must equal Part X , line 33,
column (13))

8
9
10

27-4648506

Pa e12

1

22,630.

2
3

259,519.
-236,889.

4

421,764.

5
6
7
8
9

10

0

184,875.

Part XII Financial Statements and Reporting
Check if Schedule 0 contains a response or note to an y line in this Part XII
Yes
1
2a

b

c

3a
b

Cash
0 Accrual
Accounting method used to prepare the Form 990
= Other
If the organization changed its method of accounting from a prior year or checked "Other," explain in Schedule O.
Were the organization ' s financial statements compiled or reviewed by an independent accountant?
If "Yes,' check a box below to indicate whether the financial statements for the year were compiled or reviewed on a
separate basis, consolidated basis , or both
Both consolidated and separate basis
Separate basis
Consolidated basis
Were the organization ' s financial statements audited by an independent accountant'?
If "Yes," check a box below to indicate whether the financial statements for the year were audited on a separate basis,
consolidated basis , or both
Both consolidated and separate basis
= Separate basis
0 Consolidated basis
If "Yes* to line 2a or 2b , does the organization have a committee that assumes responsibility for oversight of the audit,
review , or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year , explain in Schedule O.
As a result of a federal award , was the organization required to undergo an audit or audits as set forth in the Single Audit
Act and OMB Circular A- 133
If "Yes ,' did the organization undergo the required audit or audits? If the organization did not undergo the required audit

2a

No

^^ll
X

2b

2c

3a

!r
S
^^.. JJ!
X

Form 990 (2017)

732012 11-28-17

 Compensation Information

SCHEDULE J

(Form 990)
Department of the Treasury

O

-

For certain Officers , Directors, Trustees , Key Employees, and Highest
Compensated Employees

2017

loo. Complete if the organization answered " Yes" on Form 990, Part IV, line 23 .
No- Attach to Form 990.

internal Revenue Serv ice'

n^-,^ ,
emto Publtcr
` p ns pect or
M

Poo Go to www. irs. g ov/Form990 for instructions and the latest information .

Name of the organization
CSG ACTION

MB No 1545-0047

V4

Employer identification number
27-4648506

Paftjll_l Questions Regarding Compensation
N
la Check the appropriate box(es) if the organization provided any of the following to or for a person listed on Form 990,
Part VII, Section A, line 1a . Complete Part III to provide any relevant information regarding these items.
0 Housing allowance or residence for personal use
First-class or charter travel
0 Payments for business use of personal residence
0 Travel for companions
Tax indemnification and gross -up payments
0 Health or social club dues or initiation fees
= Personal services (such as , maid, chauffeur, chef)
0 Discretionary spending account
r
b If any of the boxes on line la are checked , did the organization follow a written policy regarding payment or

reimbursement or provision of all of the expenses described above-? If "No," complete Part III to explain
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all directors,
trustees , and officers , including the CEO/Executive Director , regarding the items checked on line 1a'

2

3

Indicate which , if any, of the following the filing organization used to establish the compensation of the organization's
CEO/Executive Director . Check all that apply . Do not check any boxes for methods used by a related organization to
establish compensation of the CEO/Executive Director , but explain in Part III
0 Written employment contract
Compensation committee
0 Compensation survey or study
0 Independent compensation consultant'
Form 990 of other organizations '
El Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1 a, with respect to the filing
organization or a related organization
a Receive a severance payment or change-of-control payment?
b Participate in, or receive payment from, a supplemental nonqualified retirement plan?
c Participate in, or receive payment from, an equity-based compensation arrangement?
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

4

5
a
b
6
a
b
7
8
9

Only section 501(c)(3), 501(c)(4), and 501(c)( 29) organizations must complete lines 5-9.
For persons listed on Form 990, Part VII, Section A, line 1 a, did the organization pay or accrue any compensation
.
contingent on the revenues of
The organization?
Any related organization?
If 'Yes' on line 5a or 5b, describe in Part III.
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any compensation
contingent on the net earnings of
The organization?
Any related organization?
If 'Yes' on line 6a or 6b, describe in Part III.
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfix`ed payments
not described on lines 5 and 6? If "Yes," describe in Part III
Were any amounts reported on Form 990, Part VII, paid or accrued pursuant to a contract that was subject to the
initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe in Part III
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in

LHA For Paperwork Reduction Act Notice , see the Instructions for Form 990.
J

732111

10-17-17

X
X
X

X

X

Schedule J (Form 990) 2017

 CS G ACTION
27-4648506
Schedule J (Form 990) 2017
Part II Officers , Directors , Trustees , Key Employees , and Highest Compensated Employees . Use duplicate copies if additional space is needed.

Pa g e 2-

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row () and from related organizations, described in the instructions, on row (ii)
Do not list any individuals that aren't listed on Form 990, Part VII.
Note : The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1 a, applicable column (D) and (E) amounts for that individual
(B) Breakdown of W-2 and/or 1099-MISC compensation
(I) Base
compensation

(A) Name and Title

(1) MARK MECKLER

(I)

PRESIDENT

(ii) Bonus &
incentive
compensation

(III) Other
reportable
compensation

(C) Retirement and
o th er d e f erre d
compensation

(D) Nontaxable
b ene f i t s

(E) Total of columns
( B )( i ) - ( D )

(F) Compensation
in co l umn ( B )
reported as deferred
on prior Form 990

0 .

0 .

0 .

0 .

0 .

0 .

0 .

223,588.

0.

0.

0.

22,221.

245,809.

0.

(I)
11

)
(1)
11
(I)
11
(I)

(i)

(I)

(I)

(1)

11 )
(I)

(1)

(I)

(I)

Schedule J (Form 990) 2017
732112 10-17-17

 Schedule J ( Form 990) 2017
'Part III Supplemental Information

C SG ACTION

27-4648506

Pa g e 3-

Provide the information, explanation, or descriptions required for Part I, lines 1 a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Schedule J (Form 990) 2017
732113 10-17-17

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

(Form 990 or 990 - EZ)

Employer identification number
27-4648506

Name of the organization
CSG ACTION
PART

I,

LINE

TO RECEIVE

CITIZENS
TO ENGAGE

2017
Opento Public?
Inspection

1110- Attach to Form 990 or 990-EZ.
Go to www.irs. g ov/Form990 for the latest information .

Department of the Treasury
Internal Revenue Service

FORM 990,

OMB No 1545-0047

Supplemental Information to Form 990 or 990-EZ

SCHEDULE 0

1,.DESCRIPTION OF ORGANIZATION MISSION:

INFORMATION AND TRAINING ON CIVIC ENGAGEMENT,

IN LOBBYING ACTIVITIES

IN ORDER TO

AND

INFLUENCE LEGISLATION FOR

THE BENEFIT OF THE COMMUNITY.

FORM 990,

PART VI,

SECTION A,

LINE

3:

THE ORGANIZATION CONTRACTS WITH CITIZENS

FORM 990,

PART VI,

SECTION B,

LINE

FOR SELF GOVERNANCE

FOR PERSONNEL.

11B:

THE DRAFT RETURN WAS DISTRIBUTED TO ALL BOARD MEMBERS BEFORE FILING SUCH
THAT MEMBERS HAVE THE OPPORTUNITY TO REVIEW AND COMMENT PRIOR TO THE RETURN
BEING FILED.

FORM 990,

PART VI,

SECTION B,

LINE

12C:

OFFICERS AND DIRECTORS ARE REQUIRED TO DISCLOSE ANY POTENTIAL CONFLICTS
INTEREST AT THE ANNUAL BOARD MEETING.
ORGANIZATIONAL EXPENSES

OF

LEGAL COUNSEL ROUTINELY MONITORS

FOR POSSIBLE CONFLICTS OF INTEREST AND DIRECTS

SUCH

CONFLICTS-TO THE ATTENTION OF THE BOARD FOR RESOLUTION IN ACCORDANCE WITH
THE CONFLICT OF

FORM 990,

INTEREST POLICY.

PART VI,

SECTION C,

LINE

19:

ANNUAL FINANCIAL STATEMENTS AND FORM 990 ARE AVAILABLE UPON REQUEST.

FORM 990 ,

PART

IX,

LINE

11G,

OTHER FEES:

PROGRAM CONSULTING:
PROGRAM

SERVICE

EXPENSES

LHA For Paperwork Reduction Act Notice , see the Instructions for Form 990 or 990 - EZ.
732211 09-07-17

212,924.
Schedule 0 (Form 990 or 990-EZ) (2017)

 Schedule 0 (Form 990 or 990 -EZ) (2017)
Name of the organization
CSG ACTION

Pag e 2
Em ployer identification number
27-4648506

MANAGEMENT AND GENERAL EXPENSES

0.

FUNDRAISING EXPENSES

0.
212,924.

TOTAL EXPENSES
TOTAL OTHER FEES ON FORM

732212 09-07-17

990,

PART

IX,

LINE

11G,

COL A

212,924.

Schedule 0 (Form 990 or 990-EZ) (2017)

 OMB No 1545-0047

Related Organizations and Unrelated Partnerships

SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service

^ Go to www.irs.aov/Form990 for instructions and the latest information.

Employer identification number
27-4648506
"

Nameof the organization
CSG ACTION
Part I

Identification of Disregarded Entities . Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(b)
Primary activity

(a)
Name, address, and EIN (if applicable)
of disregarded entity

Part IIj

2017-

^ Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
0- Attach to Form 990.

(c)
Legal domicile (state or
foreign country)

(d)
Total Income

(e)
End-of-year assets

(f)
Direct controlling
entity

Identification of Related Tax-Exempt Organizations . Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related tax-exempt
organizations during the tax year.
(a)

(b)

(c)

(d )

(e)

Name, address, and EIN
of related organization

Primary activity

Legal domicile (state or

Exempt Code
section

Public charity
status (if section

foreign country)

501(c)(3))

(f)
Direct controlling
entity

section(5{2(bx13)
controlled
entity?

Yes

No

CITIZENS FOR SELF GOVERNANCE - 27-1657203
5850 SAN FELIPE #575A
HOUSTON,

TX

CHARITABLE ORGANIZATION

77057

EXAS

01(C)(3)

L INE 7

DVOCACY

EXAS

01(C)(4)

X

DVOCACY

ISSOURI

01(C)(4)

X

X

CONVENTION OF STATES ACTION - 47-2245708
5850 SAN FELIPE #580A
HOUSTON , TX

77057

DEFENDING LIBERTY,

INC - 81-2322002

1464 MORENA BLVD
SAN DIEGO,

CA

92110

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
732161 09 -11-17

LHA

Schedule R (Form 990) 2017

 Schedule R (Form 990) 2017

27-4648506

C SG ACTION

Page 2

Identification of Related Organizations Taxable as a Partnership . Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related
organizations treated as a partnership during the tax year

Pt III

(a)
Name, address, and EIN
of related organization

(b)
Primary activity

(c)
Legal
domicile
(state or

(d)
Direct controllin g
entity

foreign
country)

^t ^^
Pay

(e)
Predominant Income
(related, unrelated,
excluded from tax under
sections 512-514)

(f)
Share of total
income

(g)
Share of
end-of-year
asse t s

(h )
Dlspropoi onale

auowuons)
Yes

No

(k)
(i)
0)
General
or
V-UBI
Code
Percenta g e
amount in box managing ownership
20 of Schedule p artner?
K-1 (Form 1065) a No

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related
organizations treated as a corporation or trust during the tax year.
(a)
Name , address, and EIN
of related organization

732162 09-11-17

(b)
Primary activity

(c)
Legal domicile

(state or
foreign
country)

(d)
Direct controlling
entity

(e)
Type of entity
(C corp, S corp,
or trust)

(f)
Share of total
income

(g)
Share of
end-of-year
assets

(h)
Percentage
ownership

(1)
Section
512(bx13)
controlled
entity?
Yes

No

Schedule R (Form 990) 2017

 Schedule R (Form 990) 2017

C SG ACTION

27-4648506

Page 3 _

Part V1 Transactions With Related Organizations . Complete if the organization answered "Yes° on Form 990, Part IV, line 34, 35b, or 36.
Note : Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule .
1
During the tax year, did the organization engage in any of the following transactions with one or more related organizations listed in Parts II-IV"
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity
b Gift, grant, or capital contribution to related organization(s)
c Gift, grant, or capital contribution from related organization(s)
d Loans or loan guarantees to or for related organization(s)

Yes

f
g
h
i
j

X

la
lb

e Loans or loan guarantees by related organization(s)
Dividends from related organization(s)
Sale of assets to related organization(s)
Purchase of assets from related organization(s)
Exchange of assets with related organization(s)
Lease of facilities, equipment, or other assets to related organization(s)

No

1c
1d
le

X
X
X
X

if
1
1h

X
X
X

1i
1'

X
X

1k

k Lease of facilities, equipment, or other assets from related organization(s)
I Performance of services or membership or fundraising solicitations for related organization(s)
m Performance of services or membership or fundraising solicitations by related organization(s)
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s)

11
1m
in

X
X
X
X

o Sharing of paid employees with related organization(s)

10

X

p Reimbursement paid to related organization(s) for expenses
q Reimbursement paid by related organization(s) for expenses

1
1

r Other transfer of cash or property to related organization(s)
s Other transfer of cash or property from related organization(s)
2 If the answer to an y of the above is "Yes," see the instructions for information on who must com p lete t his line, includin g covered relationshi ps and transaction thresholds.
(a)
Name of related organization

( 1 ) CITIZENS FOR SELF GOVERNANCE

(b)
Transaction
type (a-s)

P

(c)
Amount involved

1r
1s

X
X
X
^ Xx
-

(d)
Method of determining amount involved

32,026. ACTUAL COSTS INCURRED

(2)
(3)
(4)
(5)
(6)
732163 09-11-17

Schedule R (Form 990) 2017

 Schedule R (Form 990) 2017
art;V,I

27-4648506

CSG ACTION

Pane 4

Unrelated Organizations Taxable as a Partnership . Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue)
that was not a related organization. See instructions regarding exclusion for certain investment partnerships
(a)
Name, address, and EIN
of entity

(b)
Primary activity

(c)
Legal domicile
(state or foreign

country)

(d)
(e)
Are all
Predominant income artners sec
501(5)i3)
(related, unrelated,
excluded from tax under

sections 512-514)

es No

(f)
Share of
total

(g)
Share of
end-of-year

income

assets

G)
(k)
General or Percentage
amount in box 20 pat 9 ownership
allocation s7 of Schedule K-1
(h )

(1)

Dispropor-

Code V-UBI

es No

(Form 1065)

Yes No

Schedule R (Form 990) 2017
732164 09-11-17

 CSG ACTION
Schedule R Form 990 2017
Party
I1
;
Supplemental
Information.
I

27-46 48506

Pa e 5

Provide additional information for responses to questions on Schedule R. See instructions

732165 09-11-17

Schedule R (Form 990) 2017