Financial data.

Financial data, whether budgets or actual, should be consistent with other information presented in your requested determination. Budgeted financial data should be prepared based on your current plans. We recognize that your actual financial results may vary from the budgeted amounts.

Past, present, and planned activities.

Many items on Form 8940 are written in the present tense; however, base your answers on your past, present, and planned activities.

Language and currency requirements.

Complete Form 8940 and attachments in English. Provide an English translation if your organizational document, bylaws, or any other attachments are in any other language.

Report financial information in U.S. dollars (specify the conversion rate used). Combine amounts from within and outside the United States and report the totals on the financial statements.

Organizations described in section 501(a).

Organizations exempt under section 501(a) file Form 8940 for miscellaneous determinations under sections 507, 509(a), 4940, 4942, 4945, and 6033. Canadian registered charities file Form 8940 to request inclusion in TEOS (Pub. 78 data) or request public charity status. Government entities requesting voluntary termination of exempt status under section 501(c)(3) file Form 8940. See the specific instructions below for more information about each type of request.

Nonexempt charitable trusts.

Nonexempt charitable trusts may also file this form for an initial determination of foundation classification under section 509(a)(3).

Form 2848.

Upload a completed Form 2848 if you want to authorize a representative to represent you regarding your request. An individual authorized by Form 2848 may not sign Form 8940 unless that person is also an officer, director, trustee, or other official who is authorized to sign the form.

Form 8821.

Upload a completed Form 8821 if you want to authorize us to discuss your request with the person you have appointed on that form.

Form 8821 doesn’t authorize your appointee to advocate your position with respect to federal tax laws; to execute waivers, consents, or closing agreements; or to otherwise represent you before the IRS. If you want to authorize an individual to represent you, use Form 2848.

No additional information needed.

If our review shows that you meet the requirements for your requested miscellaneous determination, we’ll send you a determination letter stating that your request was approved.

Additional information needed.

If we can’t make a determination without more information, we’ll write or call you. Examples of the types of questions you may be asked are available at Application for Exemption or Misc. Determination: Sample Questions. If the additional information you provide shows that you meet the requirements for your request, we’ll send you a letter approving your request. If we determine that you don’t meet the requirements for your request, we’ll send you a letter that explains our position and your appeal rights (if applicable).

Information available for public inspection.

If your requested miscellaneous determination is among those disclosable to the public, the information that will be open for public inspection includes the following.

Information not available for public inspection.

The following items won’t be open for public inspection.

Making documents available for public inspection.

Both you and the IRS must make the information that is subject to disclosure available for public inspection. The public may request a copy of the information available for public inspection from us by submitting Form 4506-B. The public may also request inspection of the information or a copy of the information directly from you.

You may post the documents required to be available for public inspection on your own website. Information returns and your exemption application materials must be posted exactly as filed with the IRS. You may only delete the information that isn't open for public inspection.

If you post the documents on your website, you can give any person requesting copies the website where the documents may be found, but you don’t need to provide copies of the information. However, even if these documents are posted on your website, you must still allow public inspection without charge at your main office during regular business hours.

Documents aren't considered available for public inspection on a website if the otherwise disclosable information is edited or subject to editing by a third party when posted. To date, the IRS hasn’t approved any third-party websites for posting.

See Pub. 557 for additional information on public inspection requirements.

Line 1. Full name of applicant.

Enter your complete name exactly as it appears in your organizing document, including amendments.

Line 2.

If you have an “in care of” name, enter it here; otherwise, leave this space blank.

Lines 3–9. Mailing address.

Enter your complete address where all correspondence will be sent. If mail isn't delivered to your street address and you have a P.O. box, list your P.O. box information instead of your street address. For a foreign address, enter your province or state and foreign postal code where indicated.

Line 10. Employer identification number (EIN).

You must have your own EIN. Enter the 9-digit EIN the IRS assigned to you. If you don't have an EIN, you must apply for one before submitting your request. You can find out how to apply for an EIN by visiting IRS.gov and searching for “apply for an EIN.” You may apply for an EIN online or by fax or mail. International applicants may call 267-941-1099 (toll call).

Don't apply for an EIN more than once. If you’re unsure of your EIN or whether you have one, call 877-829-5500 for assistance.

Don’t use the EIN of a related or other organization.

Line 11. Month tax year ends.

Select the month your tax year (annual accounting period) ends. Your tax year is the 12-month period on which your annual financial records are based.

Check your bylaws or other rules of operation for consistency with the tax year you enter here.

Line 12. Person to contact.

Enter the name and title of the person you want us to contact if we need more information. The person to contact may be an officer, director, trustee, or other individual who is permitted to speak with us according to your bylaws or other rules of operation. Your person to contact may also be an authorized representative, such as an attorney, certified public accountant, or enrolled agent, for whom you’re submitting a completed Form 2848 with Form 8940.

Line 13.

Provide a daytime telephone number for the contact listed on line 12.

Line 14.

You may provide a fax number for the contact listed on line 12.

Line 15.

Pay.gov will populate this field with the current user fee for filing Form 8940.

Line 16.

If you have a website, enter the complete web address. Also, list any websites maintained on your behalf. The information on your website should be consistent with the information in your Form 8940.

Line 17. Officers, directors, and trustees.

Enter the full names, titles, and mailing addresses of your officers, directors, and/or trustees. You may use the organization's address for mailing. If you have more than five entries, check the box provided to add more officer, director, and/or trustee information.

The person who is signing Form 8940 must be listed within the first five entries of line 17.

Line 1.

Select the item that best describes your request. Submit a separate request for each type of request set forth in Part II. For additional information on any of the determination issues covered by Form 8940, visit our website at IRS.gov/EO.

Advance approval of certain set-asides described in section 4942(g)(2).

Check this box if you are (1) a private foundation requesting approval of a set-aside as described in section 4942(g)(2), or (2) a non-functionally integrated supporting organization requesting approval of a set-aside as described in Regulations section 1.509(a)-4(i)(6)(v). Complete Form 8940, Schedule A.

Advance approval of voter registration activities described in section 4945(f).

Check this box if you are requesting advance approval of voter registration activities described in section 4945(f). Complete Form 8940, Schedule B.

Advance approval of individual grant procedures.

Check this box if you are a private foundation and are requesting advance approval of your individual grant-making procedures under section 4945(g). Complete Form 8940, Schedule C.

Exception from Form 990 filing requirements.

Check this box if you are requesting an exception from filing Form 990, Return of Organization Exempt From Income Tax; Form 990-EZ, Short Form of Organization Exempt From Income Tax; or Form 990-N (e-Postcard). Complete Form 8940, Schedule D.

If you believe you should be exempt from Form 990 filing requirements because you are affiliated with a church or a convention or association of churches, please review Regulations sections 1.6033-2(g) and (h) and Rev. Proc. 96-10, 1996-1 C.B. 577.

If you are claiming an exception from Form 990 filing requirements as a state institution (other than a section 509(a)(3) supporting organization) whose income is excluded from gross income under section 115, at the end of this form, upload a copy of the ruling letter from the IRS stating that your income, derived from activities constituting the basis for your exemption under section 501(c), is excluded from gross income under section 115.

If you believe you should be exempt from filing Form 990 or 990-EZ because you are a governmental unit or affiliated with a governmental unit, please review Rev. Proc. 95-48, 1995-2 C.B. 418.

If you are claiming an exception from Form 990 filing requirements as an organization described in section 501(c)(1), at the end of this form, upload a copy of your determination letter or other documentation from the IRS that indicates whether you are described in section 501(c)(1).

Advance approval that a potential grant or contribution is an “unusual grant.”

Check this box if you are requesting advance approval that a grant (including a contribution or bequest for this purpose) is an “unusual grant.” Complete Form 8940, Schedule E.

If you are described in sections 509(a)(1) and 170(b)(1)(A)(vi) or section 509(a)(2), you may request a determination that a grant you received be classified as an “unusual grant” under Regulations section 1.170A-9(f)(6)(ii) or 1.509(a)-3(c)(3).

Regulations sections 1.170A-9(f)(6)(iii) and 1.509(a)-3(c)(4) set forth the criteria for an unusual grant. Grants are considered unusual if each of the following three requirements is met.

In determining whether a particular grant may be excluded as an unusual grant, all pertinent facts and circumstances will be taken into consideration. No single factor will necessarily be determinative.

Change in type (or initial determination of type) for 509(a)(3) organizations.

Check this box if you are a 509(a)(3) supporting organization requesting a change in Type or initial determination of Type. Complete Form 8940, Schedule F.

Reclassification of foundation status.

Check this box if you are requesting a reclassification of foundation status. These instructions supplement the procedures set forth in Rev. Proc. 2022-5, 2022-1 I.R.B. 256 (updated annually). Complete Form 8940, Schedule G.

Also check this box if:

A private foundation that wishes to become a public charity does not check this box but instead must terminate its private foundation status. See Termination of private foundation status under section 507(b)(1)(B) below.

Required attachments.

Termination of private foundation status under section 507(b)(1)(B)—advance ruling request.

Check this box if you are requesting an advance ruling on termination of your private foundation status under section 507(b)(1)(B). Complete Form 8940, Schedule H.

An organization may terminate its private foundation status under section 507(b)(1)(B) if it meets the requirements of section 509(a)(1), (2), or (3)) for a continuous 60-month period beginning with the first day of any tax year, and notifies the IRS before beginning the 60-month period that it is terminating its private foundation status.

An organization that seeks an advance ruling and files Form 8940 will be required to complete and submit Form 872-B agreeing to extend the statute of limitations for paying the section 4940 excise tax on net investment income until after the end of the 60-month period. You must also establish immediately after the end of the 60-month period that you have met the requirements of section 509(a)(1), (2), or (3).

Notice Only – Termination of private foundation status under section 507(b)(1)(B).

Check this box if you are providing notice only on termination of your private foundation status under section 507(b)(1)(B). Complete Form 8940, Schedule I.

An organization may terminate its private foundation status under section 507(b)(1)(B) if it meets the requirements of section 509(a)(1), (2), or (3) for a continuous 60-month period beginning with the first day of any tax year, and notifies the IRS before beginning the 60-month period that it is terminating its private foundation status.

Form 872-B is optional for organizations not requesting an advance ruling but, if the organization chooses not to submit the form, it must pay the taxes on its investment income during the period. The organization must also establish immediately after the end of the 60-month period that it has met the requirements of section 509(a)(1), (2), or (3).

Termination of private foundation status under section 507(b)(1)(B)—60-month period ended.

Check this box if you have completed the 60-month termination of foundation status period. Complete Form 8940, Schedule J.

Voluntary termination of section 501(c)(3) recognition by a government entity.

In Part III, describe how you are a government entity not subject to federal income tax (without regard to section 501(a)), and provide a statement that you are requesting to voluntarily terminate your recognition under section 501(c)(3).

Canadian registered charities: listing on Pub. 78 Data and/or public charity classification.

A Canadian charity registered by the Canada Revenue Agency (CRA) is automatically recognized as tax exempt under the United States–Canada Income Tax Convention (Treaty). Check this box if you are a Canadian charity and want to be listed as an organization described in section 501(c)(3) on IRS.gov or request classification as a public charity rather than a private foundation. Complete Form 8940, Schedule K.

Line 1.

Describe completely and in detail your request for miscellaneous determination. Your description should include the nature of the request as well as the reason(s) for making the request.

For more information on what to include, see the instructions for your specific request in the appropriate schedule(s) in these instructions.

Signature requirements.

An officer, director, trustee, or other official who is authorized to sign for the organization must sign Form 8940. The signature must be accompanied by the title or authority of the signer and the date.

The person signing Form 8940 must be listed as an officer, director, or trustee within the first five entries of Part I, line 17.

Documents to upload.

Check the boxes to indicate which documents are included in the file you upload with your form.

Line 1. Suitability test set-aside.

If the requirements of section 4942(g)(2) and Regulations section 53.4942(a)-3(b) are met, a private foundation may treat an amount set aside for a specific charitable project as a qualifying distribution in the year of the set-aside rather than in the year in which the amount is actually disbursed. A set-aside under the suitability test requires advance approval. Similar rules apply to a non-functionally integrated (NFI Type III) supporting organization under Regulations section 1.509(a)-4(i)(6)(v).

Requests must be submitted before the end of the tax year in which the amount is set aside.

Contingent set-aside.

If a private foundation is involved in litigation and cannot distribute assets or income because of a court order, the foundation may request approval of a set-aside of amounts held pursuant to the court order that otherwise would be distributed as qualifying distributions, known as a contingent set-aside. See Regulations section 53.4942(a)-3(b)(9). If you are requesting approval of a contingent set-aside, at the end of this form, upload a copy of the court order restricting you from distributing assets or income.

Line 1a.

State the amount of the set-aside.

Line 1b.

Check “Yes” if the amount set aside will be paid by the last day of your tax year after your tax year in which the litigation is terminated. If “No,” explain.

Line 2.

Describe the nature and purposes of the project and the amount of the set-aside.

Line 3.

Describe the amounts and dates of planned additions to the set-aside after its initial establishment, if applicable.

Line 4.

Explain why the project can be better accomplished by a set-aside rather than an immediate payment of funds.

Specific projects that can be better accomplished by the use of a set-aside include, but are not limited to, projects in which relatively long-term grants or expenditures must be made in order to assure the continuity of particular charitable projects or program-related investments (as defined in section 4944(c)) or where grants are made as part of a matching-grant program. Such projects include, for example, a plan to erect a building to house the direct charitable, educational, or other similar exempt activity of the private foundation (such as a museum building in which paintings are to be hung), even though the exact location and architectural plans have not been finalized; a plan to purchase an additional group of paintings offered for sale only as a unit that requires an expenditure of more than one year's income; or a plan to fund a specific research program that is of such magnitude as to require an accumulation of funds before beginning the research, even though not all of the details of the program have been finalized.

Line 5.

Describe the project, including estimated costs, sources of any future funds expected to be used to complete the project, and location of any physical facilities to be acquired or constructed as part of the project.

Line 6.

Answer “Yes” if the amounts to be set aside will actually be paid within a specified period of time that ends not more than 60 months after the date of the first set-aside.

Line 6a.

State the extension of time required.

Line 6b.

Explain why the proposed project could not be divided into two or more projects covering periods of no more than 60 months each.

Line 7.

Answer “Yes” if you are described under section 509(a)(3) as a non-functionally integrated Type III supporting organization.

Line 7a.

Answer “Yes” if you have obtained a written statement from each supported organization whose exempt purpose the specific project accomplishes, signed under penalty of perjury by one of their principal officers, stating that they approve the project as one that accomplishes one or more of their exempt purposes and also approves their determination that the project is one that can be better accomplished by such a set-aside than by the immediate payment of funds.

Line 7b.

Provide an explanation of how you meet the responsiveness test under Regulations section 1.509(a)-4(i)(3) with respect to a supported organization whose exempt purposes are accomplished by the specific project.

Line 1.

Answer “Yes” if you are described in section 501(c)(3) and exempt from taxation under section 501(a). If “No,” stop and do not submit Form 8940 to request advance approval of voter registration activities under section 4945(f).

Line 2.

Describe how your voter registration activities are conducted in a nonpartisan manner.

Line 3.

Answer “Yes” if your voter registration activities are confined to one specific election period.

Line 4.

Answer “Yes” if your voter registration activities are carried out in five or more states.

Line 5.

Answer “Yes” if you spend at least 85% of your income directly for the active conduct of activities constituting the purpose or function for which you are organized and operated rather than to make grants to fund the activities of other organizations.

Line 6.

Answer “Yes” if you receive at least 85% of your support (other than gross investment income) from exempt organizations, the general public, governmental units, or any combination of those.

Line 7.

Answer “Yes” if you receive more than 25% of your support (other than gross investment income) from any one exempt organization.

Line 8.

Answer “Yes” if you receive more than 50% of your support from gross investment income.

Line 9.

Answer “Yes” if any contributions to you for voter registration drives are subject to conditions that they may be used only in specified states or other localities of the United States, or that they may be used in only one specific election period and explain.

Line 1.

Check the appropriate box(es) indicating under which section(s) you want your grant-making procedures to be considered.

Check the box for section “4945(g)(1)” if the purpose of your award is to provide a scholarship or fellowship grant that is awarded on an objective and nondiscriminatory basis and is used for study at a school.

Check the box for section “4945(g)(3)” if the purpose of your award is to achieve a specific objective, produce a report or other similar product, or improve or enhance a literary, artistic, musical, scientific, teaching, or other similar capacity, skill, or talent of the recipient. Include your educational loan program under this section.

You may check more than one box.

If your prizes or awards are not intended to finance a future activity of the recipient and impose no conditions on the recipient as to how they may be spent, you do not have to request advance approval of your grant-making procedures for such prizes or awards because such a prize or award is not a grant for travel, study, or other similar purposes. See Revenue Rulings 77-380, 1977-2 C.B. 419; 76-460, 1976-2 C.B. 371; and 75-393, 1975-2 C.B. 451.

Line 2.

If you conduct more than one grant program, describe each program separately.

If you make educational loans, describe the terms of the loan (for example, the factors you consider in selecting or approving loan recipients, interest rate, duration, forgiveness provision, etc.). Also, describe whether any financial institutions or other lenders are involved in your program.

Explain how you will publicize your program and whether you publicize to the general public or to another group of possible recipients. Include specific information about the geographic area in which your program will be publicized and the means you will use, such as through newspaper advertisements, school district announcements, or community groups.

Line 3.

Organizations that make grants to individuals must maintain adequate records and case histories showing the name and address of each recipient, under Rev. Rul. 56-304, 1956-2 C.B. 306, but don’t provide this information as part of your application.

Line 9.

If “Yes,” what measures do you take to ensure unbiased selections and that awards are not provided to disqualified persons?

Line 10.

Answer “Yes” if you will:

Line 11.

Answer “Yes” if you will maintain all records relating to individual grants, including information obtained to evaluate grantees, identify whether a grantee is a disqualified person, establish the amount and purpose of each grant, and establish that you undertook the supervision and investigation of grants described in line 10.

Line 12.

Answer “Yes” if you award scholarships on a preferential basis because you require, as an initial qualification, that the individual be an employee or be related to an employee of a particular employer, or because you give preference or priority to such persons.

Line 15.

For purposes of this schedule, a program for children of employees of a particular employer includes children and other family members of employees.

Line 1.

Indicate under which exception you are requesting an exemption from filing.

Line 1.

Answer “Yes” if you are described in section 501(c)(3) and under sections 509(a)(1) and 170(b)(1)(A)(vi) or section 509(a)(2).

Line 2.

Answer “Yes” if you were selected for the grant because of your publicly supported nature and explain.

Line 3.

Answer “Yes” if the amount of the grant is unusual or unexpected and explain.

Line 4.

Answer “Yes” if the grant, due to its size, would adversely affect your status as a publicly supported organization and explain.

Line 5.

Provide the name of the grantor, the amount of the grant, when you expect to receive the grant (and whether a single payment or multiple payments over a period of time), and the purpose(s) for which you will use the grant funds.

Line 6.

Section 4946(a)(1) defines the term “disqualified person,” as a person who is:
(A) a substantial contributor, as defined in section 507(d)(2) (generally, a person who has contributed or bequeathed more than 2% of your total contributions and bequests received, if over $5000);
(B) a foundation manager (within the meaning of section 4946(b)(1));
(C) an owner of more than 20% of (i) the total combined voting power of a corporation, (ii) the profits interest of a partnership, or (iii) the beneficial interest of a trust or unincorporated enterprise, which is a substantial contributor to the foundation;
(D) a member of the family (as defined in section 4946(d) (spouse, ancestors, children, grandchildren, great-grandchildren, and spouses of children, grandchildren, and great-grandchildren) of any individual described in subparagraph (A), (B), or (C);
(E) a corporation of which persons described in subparagraph (A), (B), (C), or (D) own more than 35% of the total combined voting power;
(F) a partnership in which persons described in subparagraph (A), (B), (C), or (D) own more than 35% of the profits interest; or
(G) a trust or estate in which persons described in subparagraph (A), (B), (C), or (D) hold more than 35% of the beneficial interest.

Section 4946(b) defines the term “foundation manager,” with respect to any private foundation as an officer, director, or trustee of a foundation (or an individual having powers or responsibilities similar to those of officers, directors, or trustees of the foundation).

Line 7.

If “Yes,” explain how the contributor or any person standing in a relationship to such contributor, which is described in section 4946(a)(1)(C) through (G) (defined above), continues to directly or indirectly exercise control over you.

Line 8.

Indicate whether the contribution was a bequest or an inter vivos transfer. A bequest will ordinarily be given more favorable consideration than an inter vivos transfer.

Line 9.

Describe the type of the expected grant.

Line 10.

Describe any actual program of public solicitation and exempt activities and whether you have been able to attract a significant amount of public support.

Line 11.

Describe how you may reasonably be expected to attract a significant amount of public support subsequent to the particular contribution.

Line 12.

Answer “Yes” if, prior to the contribution, you were able to meet your applicable public support test without the benefit of any exclusions of unusual grants and explain.

Line 13.

If “Yes,” explain how your governing body is made up of public officials, or individuals chosen by public officials acting in their capacity as such; of persons having special knowledge in the particular field or discipline in which you operate; of community leaders, such as elected officials, clergymen, and educators; or, if you are a membership organization, of individuals elected under your governing instrument or bylaws by a broadly based membership.

Line 14.

Regulations section 1.507-2(a)(7) states that whether or not a particular condition or restriction imposed upon a transfer of assets is material must be determined from all of the facts and circumstances of the transfer. Some of the more significant facts and circumstances to be considered in making such a determination are:

Line 1.

Answer “Yes” if you are a nonexempt charitable trust described in section 4947(a)(1) requesting an initial determination that you are described in section 509(a)(3). If “No,” continue to line 2.

Line 1a.

Provide a list of all of the trustees that have served, together with a statement stating whether such trustees were disqualified persons within the meaning of section 4946(a) (other than as foundation managers). At the end of this form, upload a copy of your original trust instrument and all amendments adopted thereafter.

Line 2.

List the name, address, and EIN of each organization you support.

Line 3.

Describe your activities and explain how they are solely engaged in to support or benefit your supported organizations.

Line 4.

Answer “Yes” if each supported organization has a letter from the IRS recognizing it as a public charity under section 509(a)(1) or (2).

Before you file your application, use Tax Exempt Organization Search on IRS.gov to confirm whether each of your supported organizations is currently recognized as exempt and is classified as a public charity.

Line 4a.

Answer “Yes” if any supported organization you listed on line 2 received a letter from the IRS stating that it’s exempt under sections 501(c)(4), (5), or (6) and the supported organization meets the public support test under section 509(a)(2). See Pub. 557 for information on the public support test for section 509(a)(2).

If you answer “No,” describe how each organization you support is a public charity under section 509(a)(1) or (2). For example, if you support a church, a foreign organization, or an organization described in section 501(c)(4), (5), or (6) that meets the public support test in section 509(a)(2) that hasn't received a determination letter recognizing it as an exempt organization, you should describe how this organization qualifies as a public charity under section 509(a)(1) or (2). See Pub. 557 for information on public charities under sections 509(a)(1) and (2).

Line 5. Relationship test.

To qualify under section 509(a)(3), you must show that you meet one of three relationship tests with your supported organization(s). Select the option that best describes your relationship with your supported organization(s).

If you don't meet one of these three relationship tests, you aren't described in section 509(a)(3).

Line 6.

Describe how you are organized to meet the relationship test identified in Line 5. (See Regulations sections 1.509(a)-4(g)–(i) for more information on how to meet each relationship test.)

Type III organizations must also describe how your officers, directors, or trustees maintain a close and continuing relationship with the officers, directors, or trustees of your supported organization(s).

Lines 7–8. Prohibited control by disqualified person.

You can’t be described in section 509(a)(3) if you’re directly or indirectly controlled by disqualified persons. Without proof of independent control (as described in Regulations section 1.509(a)-4(j)(2)), you are controlled if disqualified persons:

Although control is generally demonstrated where disqualified persons have the authority over your governing body to require you to take an action or refrain from taking an action, indirect control by disqualified persons will also disqualify you as a supporting organization.

For a disqualified person, see the instructions for Schedule E, line 6, earlier.

Family includes an individual's spouse, ancestors, children, grandchildren, great-grandchildren, and the spouses of children, grandchildren, and great-grandchildren.

Foundation managers are officers, directors, or trustees, or an individual having powers or responsibilities similar to those of a foundation's officers, directors, or trustees.

Business relationships are employment and contractual relationships, and common ownership of a business where any officers, directors, or trustees, individually or together, possess more than a 35% ownership interest in common. Ownership means voting power in a corporation, profits interest in a partnership, or beneficial interest in a trust.

Line 9. Organizational test.

If you answered “No,” and you are a Type III supporting organization, you must amend your organizing document to specify your supported organization(s) by name; or you won’t meet the organizational test under section 509(a)(3) and need to reconsider your requested public charity classification.

Line 9a.

If you answered “No,” you won’t meet the organizational test under section 509(a)(3) unless you amend your organizing document to specify your supported organization(s) by name, purpose, or class, and need to reconsider your requested public charity classification.

Line 10.

When responding to this question, don’t include organizations described in section 509(a)(1), (2), or (4). A family member for this purpose includes spouse, ancestors, children, grandchildren, great-grandchildren, and spouses of children, grandchildren, and great-grandchildren.

This prohibition on contributions from controlling donors only applies to Type I and Type III supporting organizations.

Line 11. Type III responsiveness test.

Answer “Yes” if, because of your relationship described on line 6, the supported organization(s) has a significant involvement in your investment policies, making and timing of grants, and directing the use of your income and assets, and explain how your supported organization(s) is involved in these matters.

Line 12. Type III notification requirement.

A Type III supporting organization must provide the notice described in this question. If you’re a Type III supporting organization, you’ll be required to answer this question annually on your annual information return (Schedule A (Form 990)).

Lines 13–15. Type III integral part test.

An organization seeking classification as a Type III supporting organization must meet an integral part test, which is satisfied by maintaining significant involvement in the operations of one or more supported organizations and providing support on which the supported organization(s) are dependent. A Type III supporting organization may be functionally integrated (lines 13–14) or non-functionally integrated (lines 15 and 15a–c) depending on the manner in which it meets the integral part test. Functionally integrated Type III supporting organizations are subject to fewer restrictions and requirements than non-functionally integrated Type III supporting organizations.

Line 13.

Answer “Yes” if you’re the parent of all your supported organizations because you:

Line 14.

Answer “Yes” if substantially all of your activities directly further the exempt purposes of one or more supported organizations to which you are responsive and explain.

Holding title to and managing assets that are used (or held for use) directly in carrying out the exempt purposes of your supported organization (exempt-use assets) are activities that directly further the exempt purposes of your supported organization. Conversely, with certain exceptions, fundraising, making grants (whether to the supported organization or to third parties), and investing and managing non-exempt-use assets aren’t activities that directly further the exempt purposes of the supported organization. See Regulations section 1.509(a)-4(i)(4)(ii) for more information.

Line 15.

To satisfy the integral part test as a non-functionally integrated supporting organization, you must annually distribute at least 85% of your adjusted net income or your minimum asset amount for the prior tax year (whichever is greater) to your supported organization(s). A Type III supporting organization must distribute one-third or more of its distributable amount to one or more supported organizations that are attentive to the operations of the supporting organization (within the meaning of Regulations section 1.509(a)-4(i)(5)(iii)(B)). Amounts determined for a given tax year must be distributed by the end of the following tax year, and carryovers of excess distributions are permitted for up to five years. You can use Part V of Schedule A (Form 990) to help determine your answer to this question.

The distributable amount for the first tax year an organization is treated as a non-functionally integrated Type III supporting organization is zero.

In general, “adjusted net income” is the excess of gross income, including gross income from any unrelated trade or business, determined with certain modifications, reduced by total deductions. Gross income doesn’t include gifts, grants, or contributions. Refer to section 4942(f) and Regulations section 53.4942(a)-2(d) for details on adjusted net income.

The minimum asset amount is 3.5% of the fair market value of non-exempt-use assets, decreased by acquisition indebtedness with respect to such assets, and increased by certain amounts received or accrued that were treated as distributed in prior tax years. See Regulations section 1.509(a)-4(i)(5)(ii)(C).

For purposes of this line, “non-exempt-use assets” are all assets of the supporting organization other than:

Line 15a.

List the total amount you distribute(d) annually to each supported organization. Also, indicate how each amount will vary from year to year.

Line 15b.

List the total annual income for each supported organization. If you distribute your income to, or for the use of, a particular department or program of an organization, list the annual revenue of the supported department or program.

Line 15c.

Answer “Yes” if your funds are “earmarked” for a particular program or activity conducted by your supported organization(s).

Required attachments.

Line 1.

Select the foundation classification you are requesting and complete any required information.

Line 1.

Select the foundation classification you are requesting and complete any required information.

Line 2.

Describe your past, current, and proposed activities, and how you intend to become a public charity (in other words, how you will attract the necessary public support and anticipated sources of support or how you will operate to meet the requirements of your intended classification).

Line 3.

Enter the date that corresponds to the first day of the tax year following your request.

Line 1.

Select the foundation classification you are requesting.

Line 2.

Enter the date that corresponds to the first day of the tax year following your request.

Required attachment.

If you are terminating your private foundation status as a public charity described under sections 509(a)(1) and 170(b)(1)(A)(iv), 509(a)(1) and 170(b)(1)(A)(vi), or 509(a)(2), at the end of this form, upload a completed Schedule A (Form 990), Part II or III (as applicable), and your previously filed Form 8940 providing notice or requesting an advance ruling.

Line 1.

Select the foundation classification you are seeking reclassification as and complete any required information.

Line 2.

Provide a complete description of your current operations pertinent to the public charity status, as well as any changes during the 60-month period.

Line 1.

Answer “Yes” if you have received a Notification of Registration from the Canada Revenue Agency. At the end of this form, upload a copy. If “No,” stop here.

Line 1a.

Answer “Yes” if your registration has been revoked and explain.

Line 2.

Answer “Yes” if you have completed Form 8833, Treaty Based Return Position Disclosure Under Section 6114 or 7701(b). At the end of this form, upload a copy.

Line 3.

Answer “Yes” if you are requesting recognition of section 501(c)(3) exemption and listing in Pub. 78 data as an organization eligible to receive tax deductible contributions.

Line 4.

Enter the date you formed.

Line 5.

Select your type of organization.

A corporation generally is an entity organized under a Canadian federal, provincial, or territorial statute.

A limited liability company (LLC) that files its own exemption application is treated as a corporation rather than as a partnership.

An unincorporated association is generally organized under a constitution that is established by two or more individuals.

A trust may be formed by a trust agreement or declaration of trust. A trust may also be formed through a will. Generally, a trust must be funded with property, such as money, real estate, or personal property.

Line 6.

Select the foundation classification you are seeking and complete any required information.

Line 6a.

Answer “Yes” if you are requesting recognition of status as a private operating foundation.

To be a private operating foundation you must engage directly in the active conduct of charitable, religious, educational, and similar activities, as opposed to indirectly carrying out these activities by providing grants to individuals or other organizations.

Line 6b.

Describe how you meet the requirements for private operating foundation status, including how you meet the income test and either the assets test, the endowment test, or the support test. If you’ve been in existence for less than one year, describe how you are likely to satisfy the requirements for private operating foundation status.

Line 1.

Describe your written creed, statement of faith, or summary of beliefs.

Line 2.

Your literature includes any writings about your beliefs, rules, or history.

Line 3.

A “code of doctrine and discipline” refers to a body of laws or rules that govern behavior.

Line 4.

A “religious hierarchy or ecclesiastical government” refers to people or institutions that exercise significant influence or authority over your “church.”

Line 5.

Answer “Yes” if you’re part of a group of churches with similar beliefs and structures, such as a convention, association, or union of churches.

Line 6.

A “form of worship” refers to religious practices that express your devotion to your creed, faith, or beliefs.

Line 7.

Indicate the regular days and times of your religious services. Describe the order of events during your regular worship service and explain how the activities conducted as part of your services further your religious purposes.

Line 7a.

Enter the average number of members and nonmembers who attend your regularly scheduled religious services.

Line 8.

An “established place of worship” is a place where you hold regularly scheduled religious services. It may be a place that you own, rent, or that is provided free for your use.

Line 9.

An “established congregation” or “other religious membership group” includes individuals who regularly attend and take part in the religious services of your organization at an established location. An established congregation generally doesn’t include members of only one family. If you answer “No,” because you don’t have an established congregation or other religious membership, you may be a religious organization that doesn’t qualify as a church.

Line 9a.

Enter the total number of your current members. If you have no members, enter “0.”

Line 9b.

Answer “Yes” if you have a prescribed way to become a member. Answer “Yes” even if you just keep records of who is currently a member. Describe any actions required for individuals to become members.

Line 9c.

Describe any rights and benefits of members. You should include details of any levels of membership and the rights and/or benefits associated with each level.

Line 9d.

If your members may be associated with another denomination or church, describe the circumstances in which your members would be members of your church and another church.

Line 9e.

Family includes an individual's spouse, ancestors, children, grandchildren, great-grandchildren, siblings (whether by whole or half-blood), and the spouses of children, grandchildren, great-grandchildren, and siblings.

Line 10.

Answer “Yes” if you conduct baptisms, weddings, funerals, or other religious rites.

Line 11.

A school for the religious instruction of the young refers to any regularly scheduled religious, educational activities for youth.

Line 12.

A “prescribed course of study” refers to formal or informal training. It doesn’t include self-ordination or paying a fee for an ordination certificate without completing a course of study. Describe the course of study completed by your religious leaders.

Line 15.

Provide any additional information you would like us to consider that would help us classify you as a church.

Line 1.

Answer “Yes” if you normally have a regularly scheduled curriculum, a regular faculty of qualified teachers, a regularly enrolled student body, and facilities where your educational activities are regularly carried on.

Line 2.

Answer “Yes” if the primary function of your school is the presentation of formal instruction. If you answer “No,” you may not meet the requirements for classification as a school and may want to reconsider your foundation classification request.

Line 2a.

Select the best description(s) of your school.

Line 3.

Answer “Yes” if you’re a public school and explain how you’re operated by the state or a subdivision of a state, including if you have a signed contract or agreement with a state or local government under which you operate and receive funding. If you answer “Yes,” stop here.

Line 4.

Answer “Yes” if you were formed or substantially expanded when public schools in your district or county were desegregated by court order.

If you're unsure whether to answer “Yes,” contact an appropriate school official.

Line 5.

Answer “Yes” if a state or federal administrative agency or judicial body ever determined your organization to be racially discriminatory. Identify the parties involved and the forum in which the case was presented. Explain the reason for the action, the decision reached, and provide legal citations (if any) for the decision. Also, explain in detail any changes made in response to the action against your organization or the decision reached.

Line 6.

Answer “Yes” if your right to receive financial aid or assistance from a governmental agency has ever been revoked or suspended and explain.

Establishment of Racially Nondiscriminatory Policy.

Every private school is subject to the provisions of Rev. Proc. 75-50, 1975-2 C.B. 587, modified by Rev. Proc. 2019-22, 2019-22 I.R.B. 1260. See Pub. 557, which sets forth the requirements of Rev. Proc. 75-50 under the section for Private Schools.

Publication of racially nondiscriminatory policy.

An organization described in section 501(c)(3) that is a private school must publish a notice of its racially nondiscriminatory policy as to students as follows. “The M school admits students of any race, color, national origin, and ethnic origin to all the rights, privileges, programs, and activities generally accorded or made available to students at the school. It doesn't discriminate on the basis of race, color, national origin, and ethnic origin in administration of its educational policies, admission policies, scholarship and loan programs, and athletic and other school-administered programs.”

Annual certification.

A private school must certify annually that it meets the requirements of Rev. Proc. 75-50, as modified by Rev. Proc. 2019-22, by filing Schedule A (Form 990), Public Charity Status and Public Support.

Line 7.

Answer “Yes” if your organizing document or bylaws contain a nondiscriminatory statement as to students similar to the one shown above or if you adopted such a policy by resolution of your governing body. State where your policy is located in your organizing document, bylaws, or if it is in an adopted resolution. If you answered “No,” you must adopt a nondiscriminatory policy before submitting this request.

Line 8.

Answer “Yes” if your brochures, application forms, advertisements, and catalogues dealing with student admissions, programs, and scholarships contain a similar statement to the following: “The M school admits students of any race, color, and national or ethnic origin.”

Line 8a.

If you answered “No” to line 8, check the box on line 8a if you agree that all future printed materials, including website content, will contain a statement of nondiscriminatory policy as to students similar to the one provided above.

Line 9.

You must make your nondiscriminatory policy known to all segments of the general community served by the school. One way to meet this requirement is to publish your nondiscriminatory policy annually in a newspaper or over broadcast media. Rev. Proc. 2019-22 now allows this publication requirement to be satisfied by continuously displaying your nondiscrimination statement on your Internet site, as described below.

Check “Yes” if you make your racially nondiscriminatory policy known to all segments of the general community you serve by:

See Rev. Proc. 75-50, as modified by Rev. Proc. 2019-22, for guidance on the format and content of the required notice and whether any exceptions may apply to you.

A notice published in the legal notices section or classified advertisements of your local newspaper generally is not acceptable.

Line 9a.

If you answered “No” to line 9, check the box on line 9a if you agree that you will publicize your nondiscriminatory policy in a way that meets the requirements of Rev. Proc. 75-50, as modified by Rev. Proc. 2019-22.

Line 10.

Answer “Yes” if you (or any department or division of your organization) discriminate in any way on the basis of race with respect to admissions, use of facilities or exercise of student privileges, faculty or administrative staff, or scholarship or loan programs and explain fully.

Line 11.

Enter the racial composition of your student body, faculty, and administrative staff in the spaces provided. Enter actual numbers, rather than percentages, for the current year and projected numbers for the next academic year. If the number is zero, then enter “0.”

If you’re not operational, submit an estimate based on the best information available (such as the racial composition of the community you serve).

Don’t identify students, faculty, and staff by name.

Line 12.

Enter the racial composition of students to whom you award loans and scholarships in the spaces provided. Enter actual numbers, rather than percentages, for the current year and projected numbers for the next academic year. If the number is zero, then enter “0.” If you won’t provide any loans or scholarships, check the box provided.

Don’t identify students by name.

Line 13.

Identify each of your incorporators, founders, board members, donors of land, and donors of buildings by name (whether individuals or organizations).

Line 14.

Answer “Yes” if any individuals or organizations on your list have an objective to keep public or private school education segregated by race and explain how these individuals or organizations promote segregation in public or private schools.

Line 15.

Answer “Yes” if, on a continuing basis, you will maintain for a minimum period of 3 years the following records.

Answer “No” if you don’t maintain records and explain how you meet the recordkeeping requirements under Rev. Proc. 75-50.

Failure to maintain these records or produce them upon the proper request will create a presumption that you haven’t complied with the requirements of Rev. Proc. 75-50.

Line 1.

Answer “Yes” if you’re a medical research organization, as described above.

Line 1a.

As a medical research organization, you must be associated with a hospital described in section 501(c)(3), a federal hospital, or an instrumentality of a government. Provide the name of the hospital(s) you’re associated with and describe the relationship(s).

Line 1b.

List your assets and their fair market value and the portion of your assets directly devoted to medical research and stop here.

Line 2.

Answer “Yes” if you’re a cooperative hospital service organization and describe the services you provide to your member hospitals and the exempt status of your membership and stop here.

Line 3.

Answer “Yes” if all the doctors in your community are eligible for staff privileges at your facility. You must answer “Yes” even if staff privileges at your facilities are limited by capacity, provided that all qualified medical professionals in your community may seek and would be considered for eligibility.

Answer “No” if not all the doctors in your community are eligible for staff privileges at your facility.

If you answer “No,” describe in detail how you limit eligibility for staff privileges at your facility. Include details of your eligibility criteria and selection procedures for your courtesy staff of doctors.

Line 4.

Answer “Yes” if you admit all patients in your community who can pay for themselves or through some form of third-party reimbursement (for example, private health insurance, Medicare, or Medicaid).

Answer “No” if you limit admission for these individuals in any way and describe your admission policy in detail, including how and why you restrict patient admission.

Line 5.

Answer “Yes” if you offer emergency medical or hospital care at your facility on a 24-hour basis, 7 days a week.

Line 5a.

Answer “Yes” if the reason you don’t maintain a full-time emergency room is either because you’re a specialty hospital where emergency care would be inappropriate for the services you provide or another emergency medical care facility that provides such services is located so near to you as to make such services as you might provide duplicative.

Line 6.

Answer “Yes” if you provide free or low-cost medical or hospital care services. If you answer “Yes,” describe your policy and to whom you provide these services. Include details on how these services promote benefits to the community.

Line 7.

Answer “Yes” if you have a formal program of medical training and research. If you answer “Yes,” describe your program, including the programs you offer, the scope of such programs, and affiliation with other hospitals or medical care providers with which you carry on the medical training or research programs.

Line 8.

Answer “Yes” if you have a formal program of community educational programs and describe your programs, including the types of programs offered, the scope of the programs, and affiliation with other hospitals or medical care providers with whom you offer community educational programs.

Line 9.

Answer “Yes” if you have a board of directors that is representative of the community you serve or if an organization described under section 501(c)(3) with a community board exercises rights or powers over you.

Answer “Yes” if you’re subject to a state corporate practice of medicine law that requires your governing board to be composed solely of physicians licensed to practice medicine in the state.

Line 9a.

List each board member by name and describe that person’s relationship to you. Also, for each board member, describe if and how that individual represents the community. Generally, hospital employees and staff physicians aren’t individuals considered to be community representatives. If you operate under a parent organization whose board of directors isn’t comprised of a majority of individuals who are representative of the community you serve, provide the requested information for your parent organization's board of directors as well.

Line 10. Section 501(r).

Answer “Yes” if you operate a facility that is required by a state to be licensed, registered, or similarly recognized as a hospital. Organizations that respond “Yes” to this question are required to meet additional requirements described in section 501(r) to be considered a hospital exempt from taxation by section 501(c).

Line 10a.

A community health needs assessment (CHNA) is an assessment of the significant health needs of the community. To meet the requirements of section 501(r)(3), a CHNA must take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health, and must be made widely available to the public. Each hospital facility must conduct a CHNA at least once every 3 years and adopt an implementation strategy to meet the community health need identified through such CHNA.

Answer “Yes” if the hospital facility conducted a complying CHNA in the current tax year or in either of the 2 immediately preceding tax years or if the hospital facility intends to conduct a CHNA before the end of its first 3-year period.

Line 10b.

A financial assistance policy (FAP), sometimes referred to as a charity care policy, is a policy describing how an organization will provide financial assistance at its hospital(s) and other facilities, if any. Financial assistance includes free or discounted health services provided to persons who meet the organization’s criteria for financial assistance and are unable to pay for all or a portion of the services. Financial assistance doesn’t include:

Answer “Yes” if the hospital facility has adopted a written financial assistance policy and a written policy relating to emergency medical care, as required by section 501(r)(4).

Line 10c.

Under section 501(r)(5), the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care are the amounts generally billed to individuals who have insurance covering such care.

Answer “Yes” if the hospital facility:

The hospital facility may check “Yes” if it charged more than the amounts generally billed to individuals who had insurance covering such care to an individual if:

Line 10d.

Answer “Yes” if the hospital facility has, or will have at the beginning of operation, either a separate written billing and collections policy, or include in a written FAP:

Line 1.

Answer “Yes” if you normally receive a substantial part of your support (excluding income you receive from an activity substantially related to the charitable, educational, or other section 501(c)(3) purpose that’s the basis for your exemption under section 501(a)) from the United States or any state or its political subdivision or from direct or indirect contributions from the general public. If “No,” explain your sources of support.

Line 2.

Answer “Yes” if your bylaws or other organizational documents indicate that you are organized and operated exclusively to receive, hold, invest, and administer property and to make expenditures to or for the benefit of a college or university described in sections 509(a)(1) and 170(b)(1)(A)(ii).

Line 3.

Answer “Yes” if the college or university is an agency or instrumentality of a state or political subdivision thereof, or is it owned or operated by a state or political subdivision thereof, or by an agency or instrumentality of one or more states or political subdivisions. List the name and EIN of the college or university.

Line 1.

Explain in detail how you are operated in conjunction with a land grant college or university or a non-land grant college of agriculture (as defined in section 1404 of the Agricultural Research, Extension, and Teaching Policy Act of 1977).

Line 2.

Explain in detail your agricultural research program and how contributions to such program will be spent.