Financial data.

Financial data, whether budgets or actual, should be consistent with other information presented in your application. 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 1024 are written in the present tense; however, base your answers on your past, present, and planned activities.

Language and currency requirements.

Complete Form 1024 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 United States dollars (specify the conversion rate used). Combine amounts from within and outside the United States and report the totals on the financial statements.

Group exemption.

Don't use Form 1024 to apply for a group exemption. We may issue a group exemption to a central organization recognizing, on a group basis, the exemption of subordinate organizations on whose behalf the central organization has applied. See Pub. 557 for information on how to apply for a group exemption.

Leaving a group exemption.

A subordinate organization under a group exemption can use Form 1024 to leave the group and obtain individual exemption. If you're a subordinate organization and wish to leave a group, you should notify your parent organization of your intent to leave the group ruling before filing Form 1024.

Form 2848.

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

Form 8821.

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

Form 8821 doesn't authorize your appointee to advocate your position with respect to the 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 tax-exempt status, we'll send you a determination letter stating that you're exempt.

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 IRS.gov/charities-non-profits/charitable-organizations/exempt-organization-sample-questions.

If the additional information you provide shows that you meet the requirements for exemption, we'll send you a determination letter stating that you're exempt under either section 501(a) or section 521. If we determine that you don't qualify for exemption, we'll send you a letter that explains our position and your appeal rights.

Information available for public inspection.

If we approve exempt status under section 501(a) or section 521, 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.

When applying for tax-exempt status, you must clearly identify any information that isn't open to public inspection by marking it as “NOT SUBJECT TO PUBLIC INSPECTION” and include an explanation of why you're asking for the information to be withheld. We will decide whether to withhold the identified information from public inspection.

Making documents available for public inspection.

Both the organization 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-A. 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 delete only 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.

Annual returns for foreign organizations.

A foreign organization that obtains exemption must file an information return annually (Form 990 or Form 990-EZ). However, a foreign organization may file Form 990-N (e-Postcard) instead of Form 990 or Form 990-EZ when its gross receipts from U.S. source income are normally $50,000 or less and it hasn't conducted significant activity in the United States. See the Instructions for Form 990 and Form 990-EZ for further information. A foreign organization that is subject to unrelated business income tax must file Form 990-T.

Organizations created in U.S. territories and possessions.

Organizations created in possessions and territories of the United States are generally treated as domestic organizations. If you were created in a U.S. possession or territory, you must complete all required parts of Form 1024 to apply for recognition of exempt status.

Annual filing requirements for an organization created in a U.S. territory or possession are similar to those outlined above for foreign organizations (see Rev. Proc. 2011-15).

Line 1.

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.

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 application. 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..

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.

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 1024.

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 1024.

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 1024.

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, check the box provided to add more officer, director, and/or trustee information.

The person who is signing Form 1024 must be listed within the first five entries of line 17.

Line 1. Type of organization and copy of organizing document.

Select your type of organization and, before submitting the form, upload a copy of your organizing document (including any amendments) as part of the required attachment.

Corporation.

A corporation is an entity organized under a federal or state statute, or a statute of a federally recognized Indian tribal or Alaskan native government.

Copy of organizing document (articles of incorporation and any amendments).

A corporation's organizing document is its articles of incorporation.

If you formed under state statute, your articles of incorporation (and any amendments) must show certification of filing. This means your articles show evidence that on a specific date they were filed with and approved by an appropriate state authority. The document must be an exact copy of what is on file with your state.

If you don't have a copy of your articles of incorporation showing evidence of having been filed and approved by an appropriate state official, you may submit a substitute copy of your articles of incorporation. This substitute copy may be handwritten, typed, printed, or otherwise reproduced. It must be accompanied by a declaration, signed by an officer authorized to sign for you, that it is a complete and correct copy of the articles of incorporation and that it contains all the powers, principles, purposes, functions, and other provisions by which you currently govern yourself.

Limited liability company.

A limited liability company (LLC) that files its own exemption application and is recognized as exempt under either section 501(a) or section 521 is automatically treated as a corporation rather than a partnership.

Copy of organizing document (articles of organization and operating agreement (if adopted) and any amendments).

Instead of articles of incorporation, an LLC's organizing document is its state-approved articles of organization.

If it has adopted an operating agreement, then this document is also part of its organizing document. If you formed under state statute, your articles of organization (and any amendments) must show certification of filing. This means your articles show evidence that on a specific date they were filed with and approved by an appropriate state authority. The document must be an exact copy of what is on file with your state.

If you don't have a copy of your articles of organization showing evidence of having been filed and approved by an appropriate state official, you may submit a substitute copy of your articles of organization. This substitute copy may be handwritten, typed, printed, or otherwise reproduced. It must be accompanied by a declaration, signed by an officer authorized to sign for you, that it is a complete and correct copy of the articles of organization and that it contains all the powers, principles, purposes, functions, and other provisions by which you currently govern yourself.

.If you're an LLC with a tax-exempt organization as its sole member and you want to be treated as a disregarded entity, don't file an exemption application..

Unincorporated association.

An unincorporated association formed under state law must have at least two members who have signed a written document that creates an entity with a specifically defined purpose.

Copy of organizing document (articles of association or constitution and any amendments).

Your organizing document must include the name of the organization, its purpose, the date the document was adopted, and the signatures of at least two individuals.

If your copy doesn’t contain the proper signatures and date of adoption, you may submit a written declaration that states your copy is a complete and accurate copy of the signed and dated original. Your declaration should clearly indicate the original date of adoption.

.Bylaws may be considered an organizing document only if they include the required elements listed above..

Trust.

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.

Copy of organizing document (trust agreement/declaration of trust or will and any amendments).

Your trust agreement (and any amendments) must be signed by at least one trustee.

If your trust agreement copy isn't signed, you may submit a written declaration that states your copy is a complete and accurate copy of the signed and dated original. Your declaration should clearly indicate the original date that it was signed.

For trusts created by a will, include a copy of the death certificate or a statement indicating the date of death, and a copy of the relevant portions of the will.

Line 2. Formation date.

The date you enter should be consistent with your organizing document.

Line 3. State of formation.

Enter the jurisdiction (for instance, the state or the federally recognized tribal government) under the laws of which you were incorporated or otherwise formed. This may not be the place in which you're physically located. For example, if you're physically located in New York, but incorporated under Massachusetts law, enter Massachusetts.

For purposes of completing this application, you're formed under the laws of a foreign country if you aren't formed under the laws of the Unites States, its territories and possessions, federally recognized Indian tribal or Alaska native governments, or the District of Columbia.

Line 4.

Bylaws are generally the internal rules and regulations of an organization. If you have bylaws, upload a current copy (including any amendments). Bylaws don't need to be signed unless they are your organizing document as described in the instructions for line 1 above.

Reminder.

Answer all questions in this part as they pertain to your past, present, and planned activities.

Line 1.

Describe completely and in detail your past, present, and planned activities. Your narrative description of activities should be thorough and accurate because we determine whether you qualify for exempt status based on the information in your application.

For each past, present, or planned activity, include information that answers the following questions:

501(c)(15) - Mutual Insurance Companies or Associations.

If you are applying under section 501(c)(15), provide the following in addition to your narrative description of activities:

501(c)(29) - CO-OP Health Insurance Issuers.

If you are applying under section 501(c)(29) as a qualified nonprofit health insurance issuer (QNHII), provide the following in addition to your narrative description of activities:

Line 2. National Taxonomy of Exempt Entities (NTEE) code.

An NTEE code is a three-character series of letters and numbers that generally describe a type of organization. Enter the code from the list of NTEE codes, located in Appendix A, that best describes you. For more information and more detailed definitions of these codes developed by the National Center for Charitable Statistics (NCCS), visit the Urban Institute, NCCS website at nccs.urba.org.

.NTEE codes are also used for purposes other than identification of organizations described in section 501(a) or section 521. Therefore, all codes in the list don't necessarily correspond to a section 501(a) or section 521 purpose. .

Line 3.

Describe any money or time (whether volunteer or paid) you spent or will spend attempting to influence the selection, nomination, election, or appointment of any person to any federal, state, or local public office or to an office in a political organization.

Line 4.

You are a successor to another organization if you:

Line 4a.

A for-profit organization is one in which persons are permitted to have an ownership or partnership interest, such as corporate stock. It includes sole proprietorships, corporations, and other entities that provide for ownership interests.

Line 5.

Answer “Yes” if you have members and enter the requested information.

Line 6.

Indicate if you distribute, or plan to distribute, any of your property or funds (such as a distribution of profits) to your shareholders or members.

Line 7.

Answer “Yes” if you have or will issue stock as a means of indicating ownership by your members or others. Enter the requested information.

Line 8.

If you should cease operations as a tax-exempt organization, explain to whom your assets will be distributed.

Line 9.

Answer “Yes” if you provide or will provide insurance through a third party or provide the insurance yourself.

Line 10.

Answer “Yes” if you make grants, loans, or other distributions (such as goods) to a foreign organization. A relationship between you and the recipient organization includes the following situations.

Persons who exercise substantial influence over you also exercise substantial influence over the recipient organization.

Lines 10d–10f.

The Office of Foreign Assets Control (OFAC) of the U.S. Department of the Treasury administers and enforces economic and trade sanctions based on U.S. foreign policy and national security goals against certain governments, entities, and individuals, as directed in Executive Orders. As part of the comprehensive and sustained campaign against terrorist financing, all U.S. persons, including U.S.-based charities, are prohibited from dealing with persons (individuals and entities) identified as being associated with terrorism on OFAC's Specially Designated Nationals and Blocked Persons List (OFAC SDN List). Information about OFAC sanction programs and the OFAC SDN List are available at treasury.gov/ofac. If you make grants, loans, distributions, or you provide goods or services to a foreign organization or engage in activities in a foreign country, you are responsible to know whether an OFAC sanctions program applies and whether your activities require a license from OFAC to engage in a transaction that otherwise would be prohibited.

Line 11.

A foreign country is a country other than the United States, its territories and possessions, and the District of Columbia.

Lines 11a–11c.

The Office of Foreign Assets Control (OFAC) of the U.S. Department of the Treasury administers and enforces economic and trade sanctions based on U.S. foreign policy and national security goals against certain governments, entities, and individuals, as directed in Executive Orders. As part of the comprehensive and sustained campaign against terrorist financing, all U.S. persons, including U.S.-based charities, are prohibited from dealing with persons (individuals and entities) identified as being associated with terrorism on OFAC's Specially Designated Nationals and Blocked Persons List (OFAC SDN List). Information about OFAC sanction programs and the OFAC SDN List are available at treasury.gov/ofac. If you make grants, loans, distributions, or you provide goods or services to a foreign organization or engage in activities in a foreign country, you are responsible to know whether an OFAC sanctions program applies and whether your activities require a license from OFAC to engage in a transaction that otherwise would be prohibited.

Line 1.

Answer “Yes” if you pay or will pay compensation to your officers, directors, trustees, employees, members, or independent contractors.

Line 1a.

A conflict of interest arises when a person in a position of authority over an organization, such as a director, officer, or manager, may benefit personally from a decision he or she could make. Adoption of a conflict of interest policy is not required to obtain tax-exempt status. However, by adopting a policy, you will be choosing to put in place procedures that will help you avoid the possibility that those in positions of authority may receive an inappropriate benefit.

Reasonable compensation is the amount that would ordinarily be paid for like services by like organizations under like circumstances as of the date the compensation arrangement is made. Establishing and documenting reasonable compensation is important because excessive compensation may result in excise taxes on both the individual and you. In addition, excessive compensation may jeopardize your tax-exempt status.

Line 1b.

A fixed payment means a payment that is either a set dollar amount or fixed through a specific formula where the amount doesn't depend on discretion. For example, a base salary of $200,000 that is adjusted annually based on the increase in the Consumer Price Index is a fixed payment.

A nonfixed payment means a payment that depends on discretion. For example, a bonus of up to $100,000 that is based on an evaluation of performance by the governing board is a nonfixed payment because the governing body has discretion over whether the bonus is paid and the amount of the bonus.

Line 2.

Don't include purchases or sales of goods and services in your normal course of operations that are available to the general public under similar terms and conditions. Answer “Yes” if any of your officers, directors, or trustees:

An arm's length standard exists where the parties have an adverse (or opposing) interest. For example, a seller wants to sell his goods at the highest possible price, while a buyer wants to buy at the lowest possible price. These are adverse interests.

In negotiating with a person, an adverse interest is assumed if that person is otherwise unrelated to you in the sense of not being in a position to exercise substantial influence over you or your affairs. If the person is in a position to exercise substantial influence over your affairs, then an arm's length standard requires additional precautions to eliminate the effect of the relationship.

Using a conflict of interest policy, information about comparable transactions between unrelated parties, and reliable methods for evaluating the transaction, are examples of precautions that would help make the negotiation process equivalent to one between unrelated persons.

Fair market value is the price at which property or the right to use property would change hands between a willing buyer and a willing seller, neither being under any compulsion to buy, sell, or transfer property or the right to use property, and both having reasonable knowledge of relevant facts.

Line 3.

Answer “Yes” if any of your officers, directors, or trustees:

For example, answer “Yes,” if one of your directors is an officer for a section 501(c)(3) organization with whom you have a lease for office space or if one of your directors owns more than 35% of the voting stock of a corporation to which you made a loan.

Line 4.

Indicate if you perform any services for any other organization or individual for which you receive a fee.

Line 5.

A joint venture is a legal agreement in which the persons jointly undertake a transaction for mutual profit. Generally, each person contributes assets and shares risks. Like a partnership, joint ventures can involve any type of business transaction and the persons involved can be individuals, groups of individuals, companies, or corporations.

Line 1.

Enter the total interest and non- interest-bearing cash in checking and savings accounts, temporary cash investments (money market funds, CDs, treasury bills, or other obligations that mature in less than 1 year), change funds, and petty cash funds.

Line 2.

Enter your total accounts receivable that arose from the sale of goods and/or performance of services, less any reserve for bad debt.

Line 3.

Enter the amount of materials, goods, and supplies you purchased or manufactured and held to be sold or used in some future period.

Line 4.

Enter the total amount of bonds or notes you issued that will be repaid to you. Provide an itemized list on line 19 that shows the name of the borrower (using a letter designation), the borrower's relationship to you, a brief description of the obligation, the rate of return, the due date, and the amount due.

Maintain (but don't submit) a list showing the names of borrowers associated with each letter designation.

Line 5.

Enter the total fair market value of corporate stocks you hold. Provide an itemized list of your corporate stock holdings on line 19.

For stock traded on an organized exchange or in substantial quantities over the counter, the schedule should show the name of the corporation, a description of the stock and the principal exchange on which it is traded, the number of shares held, and their value as carried on the organization's books.

Line 6.

Enter your total amount of loans (personal and mortgage loans) receivable. Provide an itemized list on line 19 that identifies each borrower name (using a letter designation), the borrower's relationship to you, purpose of loan, repayment terms, interest rate, and original amount of loan. Report each loan separately, even if more than one loan was made to the same person.

Maintain (but don't submit) a list showing the names of borrowers associated with each letter designation.

Line 7.

Enter the total book value of your other investments. Include the total book value of governmental securities (federal, state, and municipal), buildings, and equipment held for investment purposes. Provide an itemized list on line 19 identifying and reporting the book value of each building/item of equipment held for investment purposes.

Line 8.

Enter the total book value of buildings and equipment not held for investment purposes. This includes facilities you own and equipment you use in conducting your exempt activities. Provide an itemized listing on line 19 of these assets held at the end of the current tax year/period, including the cost or other basis.

Line 9.

Enter the total book value of land not held for investment purposes.

Line 10.

Enter the total book value of any other category of your assets not reported on lines 1 through 9, for example, patents, copyrights, or other intangible assets. Provide an itemized list of each asset on line 19.

Line 12.

Enter the total of your accounts payable to suppliers and others, such as salaries payable, accrued payroll taxes, and interest payable.

Line 13.

Enter the total unpaid portion of grants and contributions you committed to pay to other organizations or individuals.

Line 14.

Enter the total of your mortgages and other notes payable outstanding at the end of the current year/period. Provide an itemized list on line 19 showing each note separately and the lender's name, purpose of loan, repayment terms, interest rate, and original amount.

Line 15.

Enter the total amount of any other liabilities not reported on lines 12 through 14. Provide an itemized list on line 19 of these liabilities, including the amounts you owe.

If the organization doesn’t use fund accounting, report only the “net assets” account balances, such as capital stock, paid-in capital, and retained earnings or accumulated income.

Line 17.

Under fund accounting, an organization segregates its assets, liabilities, and net assets into separate funds according to restrictions on the use of certain assets. Each fund is like a separate entity in that it has a self-balancing set of accounts showing assets, liabilities, equity (fund balance), income, and expenses. If you don't use fund accounting, report only the net assets account balances, which include capital stock, paid-in capital, retained earnings or accumulated income, and endowment funds.

Line 1.

Answer “Yes” if your exempt status was automatically revoked under section 6033(j)(1) for failure to file required annual returns or notices for 3 consecutive years and you're applying for reinstatement.

Rev. Proc. 2014-11, 2014-3 I.R.B 411, provides procedures for seeking reinstatement of an organization's exempt status depending upon its size, the number of times it's been automatically revoked, and the timeliness of filing for reinstatement. Review the revenue procedure to determine which section applies to you.

Line 1a.

Select the section of Rev. Proc. 2014-11 under which you're applying for reinstatement.

Line 1.

Answer “Yes” if you're claiming you are excepted from filing a Form 990-series return or notice and indicate the reason you believe you're excepted from filing. See Pub. 557 and Instructions for Form 8940, Request for Miscellaneous Determination, for more information on the requirements for the various filing exceptions.

Provide information regarding how you meet your requested exception in your narrative description of activities or as part of an uploaded supplemental response. For example, if you're claiming exception as an affiliate of a governmental unit based on Rev. Proc. 95-48, you must demonstrate that your bylaws or other organizational documents state that your board members were appointed by a governmental unit, an affiliate of a governmental unit, a public official acting in an official capacity, or elected by the public at large, pursuant to local statute or ordinance. Also include information demonstrating that you meet at least two (2) of the affiliation factors listed in Rev. Proc. 95-48, Section 4.03 and how you meet all of the facts and circumstances detailed in Rev. Proc. 95-48, Section 4.04.

Documents to upload.

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

For your application to be complete, you must upload a copy of your organizing document and any amendments to it along with a copy of your bylaws, if adopted. The other documents in the upload checklist are optional unless required for a complete response to a question.

Put your name and EIN on each page of your supplemental response and identify the Part and Line number to which the information relates.

Pay.gov can accommodate only one uploaded file. Consolidate your attachments into a single PDF file not to exceed 15MB.

Line 1.

Provide the requested information on each organization for which you hold title to property. Also indicate the number and types of shares of your stock that are held by each.

Line 2.

Describe the property to which you hold or will hold title.

Line 3.

Answer “Yes” if you turn over the entire amount of your income, less expenses, to your parent organization. The type of distribution is immaterial. It could be termed a dividend on stock or given some other description. What is important is that the income must be distributed to the exempt organization. A mere obligation to use the income for the parent's benefit doesn't satisfy this requirement.

Often, an exempt parent occupies realty that the title-holding company owns. The exempt parent generally doesn't pay rent. In this situation, the statutory requirement that income be paid over to the parent is satisfied if the title-holding company turns over whatever income is available.

If you answer “No,” state the purpose for which the excess is or will be retained.

Line 4.

Answer “Yes” if you engage or will engage in any activities other than holding title to property and collecting income therefrom. Describe the activities in detail.

Line 5.

Check the appropriate box below to indicate the section under which you are applying.

Line 5a.

Answer “Yes” if your shareholders or beneficiaries are permitted to dismiss your investment adviser upon a majority vote.

Line 1.

Select your type of organization from the list.

A labor organization is an association of workers who have combined to protect and promote the interests of their members by bargaining collectively with their employers to secure better working conditions, wages, and similar benefits.

Agricultural and horticultural organizations are connected with raising livestock, cultivating land, raising and harvesting crops or aquatic resources, cultivating useful or ornamental plants, and similar pursuits.

Line 1.

Select your type of organization from the list.

A business league, in general, is an association of persons having some common business interest, the purpose of which is to promote that common interest and not to engage in a regular business of a kind ordinarily carried on for profit. Trade associations and professional associations are considered business leagues.

A chamber of commerce is usually composed of the merchants and traders of a city.

A board of trade often consists of persons engaged in similar lines of business. For example, a nonprofit organization formed to regulate the sale of a specified agricultural commodity to assure equal treatment of producers, warehouse workers, and buyers is a board of trade.

Chambers of commerce and boards of trade usually promote the common economic interests of all the commercial enterprises in a given trade community.

A real estate board consists of members interested in improving the business conditions in the real estate field. It isn't organized for profit and no part of the net earnings inures to the benefit of any private shareholder or individual.

The Internal Revenue Code specifically defines professional football leagues as exempt organizations under section 501(c)(6). They are exempt whether or not they administer a pension fund for football players.

Line 2.

Describe your members' common business interests.

Line 3.

Describe any services you perform or will perform for members or others. You must show that your purpose is the improvement of business conditions. This isn't established by evidence of particular services that provide a convenience or economy to individual members in their businesses, such as advertising that carries the name of members, interest-free loans, assigning exclusive franchise areas, operation of a real estate multiple listing system, or operation of a credit reporting agency.

Line 4.

Answer “Yes” if you restrict or will restrict your membership to individuals, firms, associations, and/or corporations, each representing a different trade, business, occupation, or profession, and organized for the purpose of exchanging information on business prospects. Explain in detail.

Line 5.

Answer “Yes” if you market or will market a specific product(s) and/or brand(s) within an industry. Identify the specific product(s) and/or brand(s) and explain in detail how you market them.

Line 6.

Answer “Yes” if you limit or will limit your activities to users of a specific product within an industry. Explain in detail.

Line 7.

Answer “Yes” if you operate or will operate a listing or referral system. Explain in detail.

Line 1.

Answer “Yes” if personal contact, commingling, and fellowship exist among members. If not, explain.

Line 2.

Answer “Yes” if you conduct activities such as take-out food sales, liquor sales, operation of a gas station, parking garage, barber shop, etc. Describe these activities and indicate the percentage of your time and resources devoted to them.

Line 3.

Answer “Yes” if you have entered or will enter into any contract or agreement for the management or operation of your property and/or activities, such as restaurants, pro shops, lodges. Describe any written or oral arrangements that you made or intend to make, with whom you have or will have such arrangements, how the terms are or will be negotiated at arm's length, and how you determine you pay no more than fair market value or you are paid at least fair market value.

Line 4.

Answer “Yes” if gross receipts from your activities will include amounts paid by non-members for goods and services. Explain in detail.

Line 5.

Answer “Yes” if non-members, other than guests of members, are permitted or will be permitted to use the club facilities or participate in or attend any functions or activities conducted by you. Describe the functions or activities in which there has been or will be non-member participation or admittance.

Line 6.

Enter the figure for the current year and each of the prior tax years.

Line 7.

Enter the figure for the current year and each of the prior tax years.

Line 8.

Answer “Yes” if your charter, bylaws, other governing instrument, or any written policy statement contain any provision that provides for discrimination against any person on the basis of race, color, or religion. Identify where this provision is located; whether or not it will be kept; and if you have such a provision that will be repealed, deleted, or otherwise stricken from your requirements, state when this will be done.

Line 9.

Answer “Yes” if you restrict or will restrict your membership to members of a particular religion. Explain in detail.

Line 9a.

Answer “Yes” if you are an auxiliary of a section 501(c)(8) fraternal beneficiary society. Provide the name and EIN of the organization.

Line 9b.

Answer “Yes” if you, in good faith, limit your membership to the members of a particular religion in order to further the teachings or principles of that religion and not to exclude individuals of a particular race or color.

Line 1.

Operating under the lodge system means carrying on activities under a form of organization that is composed of local branches, chartered by a parent organization, largely self-governing, and called lodges, chapters, or the like.

Line 2.

Answer “Yes” if you operate or will operate for the exclusive benefit of the members of an organization operating under the lodge system. Explain in detail.

Line 3.

Answer “Yes” if you are a subordinate or local lodge, etc. List the name, address, and EIN of your parent organization.

Line 4.

Answer “Yes” if you are a parent or grand lodge. List the name, address, and EIN of each subordinate lodge in active operation.

Line 1.

Describe in detail the benefits you provide or will provide. For each benefit include the account, duration, eligibility requirements, and the circumstances that will entitle a recipient to payment of the benefit.

Line 2.

Answer “Yes” if you provide or will provide deferred compensation benefits, property or malpractice insurance, loans (other than loans at times of disaster or whole life insurance policy loans), savings plans, reimbursement of commuting expenses, or benefits similar to those provided by a pension, stock bonus or profit sharing plan. Describe these benefits in detail.

Line 3.

Provide the requested information for each plan as of the last day of the most recent plan year. If you have more than one plan, at the end of this form, upload a separate schedule.

Line 4.

State the number of persons, if any, other than employees and their dependents (for example, the proprietor of a business whose employees are members of the association) who are entitled to receive benefits.

Line 5.

Answer “Yes” if any employees or classes of employees are entitled to benefits to which other employees or classes of employees are not entitled. Explain in detail.

Line 6.

Answer “Yes” if you are organized under the terms of a collective bargaining agreement. At the end of this form, upload a current copy.

Line 7.

Use the formation date you listed in Part II, line 2, and the date you will submit this electronic form and required user fee payment to determine whether you’re submitting this application within 27 months from the month in which you were formed.

Line 7a.

Generally, if you didn't file Form 1024 within 27 months of formation, the effective date of your exempt status will be the date you filed Form 1024 (submission date). We may grant requests for an earlier effective date when there's evidence to establish you acted reasonably and in good faith, and the grant of relief won't prejudice the interests of the government. See Rev. Proc. 2021-5 (updated annually) for more information.

Select the appropriate box to indicate whether you accept the submission date as the effective date of your exempt status or whether you are requesting an earlier effective date.

Line 7b.

You may be eligible for consideration for relief from the requirement that you file Form 1024 within 27 months of formation if you can establish that you acted reasonably and in good faith, and that granting an extension won’t prejudice the interests of the government

Describe in detail your reasons for filing late, how you discovered your failure to file, any reliance on professional advice or advice from the IRS, and any other information you believe will support your request for relief. Also, you may want to provide a comparison of (1) what your aggregate tax liability would be if you had filed this application within the 27-month period with (2) what your aggregate liability would be if you were exempt as of your formation date.

We may consider the following factors.

Line 1.

Select your type of organization from the list.

A benevolent life insurance association of a purely local character is one that confines its business activities to a particular community, place, or district, irrespective of political subdivisions.

Ditch and irrigation companies, telephone companies, electric companies, and “like organizations” that seek exemption under section 501(c)(12) must be organized and operated as mutual or cooperative organizations.

Line 2.

Answer “Yes” if your business activities will be confined to a particular community, place, or district. If “No,” explain in detail.

Line 3.

List the counties or geographical region from which your members are or will be accepted.

Line 4.

Answer “Yes” if members have democratic control. If “No,” explain in detail.

Democratic Control means you periodically hold democratically conducted meetings with members. Election of officers must be on a one member, one vote basis. Meetings must have a quorum of members in attendance or voting by proxy.

Line 5

Answer “Yes” if the rights and interests of members in your annual savings are determined in proportion to their business with you.

Line 6.

Answer “Yes” if you keep the records necessary to determine at any time each member’s rights and interests in such savings, including assets acquired with the savings.

Line 7.

Answer “Yes” if the rights and interests of members are forfeited upon termination of membership. Explain in detail.

Line 8.

Answer “Yes” if you receive or will receive at least 85% of your income from amounts collected from members for the sole purposes of meeting losses and expenses. If “No,” explain in detail.

Line 1.

Answer “Yes” if you are claiming exemption as a perpetual care fund for an organization described in section 501(c)(13).

Line 1a.

Answer “Yes” if the cemetery organization, for which funds are held, has established exemption under section 501(c)(13). If “No,” explain in detail.

Line 1b.

Answer “Yes” if your funds are devoted exclusively to the perpetual care and maintenance of the non-profit cemetery as a whole. If “No,” explain in detail.

Line 2.

Answer “Yes” if you operate or will operate a mortuary. Explain in detail.

Line 3.

Answer “Yes” if you engage or will engage in land sale agreements, percentage-of-sales land sale agreements, or other similar financial arrangements. Describe in detail any written or oral arrangements that you made or intend to make, with whom you have or will have such arrangements, how the terms are or will be negotiated at arm's length, and how you determine you pay no more than fair market value or you are paid at least fair market value.

Line 4.

Answer “Yes” if you currently, or will, own, operate, or maintain a cemetery for pets. Explain in detail.

Line 1.

Answer “Yes” if you are formed under a state credit union law.

Line 2.

Select the state credit union law under which you are organized and operated from the drop down menu.

Line 3.

Answer “Yes” if you are being operated under uniform bylaws adopted by the state you selected on Line 3a.

If you answer “No,” explain in detail the rules and regulations under which you are operated.

Line 4.

Answer “Yes” if you comply or will comply with the state credit union law requirements, including their purposes, security, and rate of interest charged thereon, in making loans.

If you answer “No,” explain in detail why you do not or will not comply with state credit union law requirements.

Line 5.

Answer “Yes” if you limit or will limit your investments to securities which are legal investments for credit unions under the state credit union law.

If you answer “No,” explain in detail why you do not or will not comply with state credit union law requirements.

Line 6.

Answer “Yes” if you distribute or will distribute dividends on shares, if any, as prescribed by the state credit union law.

If you answer “No,” explain in detail why you do not or will not comply with state credit union law requirements.

Line 7.

Answer “Yes” if you are operated for the mutual benefit of your members.

Line 8.

Answer “Yes” if your members share a common bond such as association, occupation, or residence. Describe the common bond in detail.

Line 9.

Describe how your governing board and officers are selected, including where (if applicable) this information is in your governing document, bylaws, or other internal rules and regulations.

Line 10.

Answer “Yes” if you issue or will issue stock as a means of indicating ownership by your members or others. Describe the provisions for the issuance of stock to shareholders that would take ownership in the corporation and share in the earnings.

Line 11.

Answer “Yes” if you allow or will allow individuals who aren’t members to be shareholders. Explain in detail.

Line 12.

If you answer “No,” explain in detail why you do not or will not ensure that loans to members benefit the borrower and meet their needs.

Line 13.

Answer “Yes” if you make or will make loans to individuals who aren’t members. Explain in detail.

Line 14.

Answer “Yes” if you advertise or will advertise to individuals who aren’t members. Explain in detail.

Line 15.

Answer “Yes” if you are a mutual fund organized before September 1, 1957.

Line 15a.

Answer “Yes” if you provide reserve funds for-- and insurance of shares or deposits in-- a domestic building and loan association, cooperative bank without capital stock organized and operated for mutual purposes and without profit, mutual savings bank not having capital stock represented by shares, or a mutual savings bank described in section 591(b).

Line 15b.

Select the type of organization for which you provide reserve funds and insurance of shares or deposits.

Line 15c.

Provide the name of the organization for which you provide reserve funds and insurance of shares or deposits.

Line 15d.

Answer “Yes” if 85% or more of your income is attributable to providing reserve funds and to investments.

If you answer “No,” specify the percentage of your income that is attributable to providing reserve funds and to investments.

Line 1.

A full description of the supplemental unemployment benefits available to the participants must accompany your application, showing the amount, duration, eligibility requirements, and the circumstances that will entitle a recipient to payment of the benefit.

A copy of your plan documents that describe such benefits and the terms and conditions of eligibility for each benefit should be uploaded at the end of the form.

Line 2.

Answer “Yes” if you provide or will provide benefits for individual proprietors, partners, or self-employed persons under the plan. Explain in detail.

Line 3.

Provide the requested information for each plan as of the last day of the most recent plan year and enter that date in the space provided. If you have more than one plan, at the end of this form, upload a separate schedule.

Line 4.

Answer “Yes” if the creator of the trust or a contributor to the trust; a brother or sister (whole or half-blood), a spouse, an ancestor, or a lineal descendant of such a creator or contributor; or a corporation controlled directly or indirectly by such a creator or contributor has or will (a) borrow or receive any part of the trust’s income or corpus, (b) receive any compensation for personal services, (c) obtain any part of the trust’s services, or (d) sell or purchase any securities or other properties from or to the trust.

Line 5.

Use the formation date you listed in Part II, line 2, and the date you will submit this electronic form and required user fee payment to determine whether you’re submitting this application within 27 months from the month in which you were formed.

Line 5a.

Generally, if you didn’t file Form 1024 within 27 months of formation, the effective date of your exempt status will be the date you filed Form 1024 (submission date). We may grant requests for an earlier effective date when there’s evidence to establish you acted reasonably and in good faith, and the grant of relief won’t prejudice the interests of the government. See Rev. Proc. 2021-5 (updated annually) for more information.

Select the appropriate box to indicate whether you accept the submission date as the effective date of your exempt status or whether you are requesting an earlier effective date.

Line 5b.

You may be eligible for consideration for relief from the requirement that you file Form 1024 within 27 months of formation if you can establish that you acted reasonably and in good faith, and that granting an extension won’t prejudice the interests of the government.

Line 1.

Answer “Yes” if you are a post or organization of past or present members of the Armed Forces of the United States.

Line 1a.

Enter the total number of your members.

Line 1b.

Enter the number of your members that are present or former members of the U.S. Armed forces.

Line 1c.

Enter the total number of your members that are cadets (include students in college or university ROTC programs or at armed services academies only), or spouses, widows, or widowers of cadets or past or present members of the U.S. Armed Forces.

Line 1d.

Answer “Yes” if you have a membership category other than the ones asked about above. Describe other membership categories and state the number of members in each category.

Line 1e.

Answer “Yes” if you wish to apply for a determination that contributions to your organization are deductible by donors.

Line 1f.

Enter the number of your members from line 1b that are war veterans. (A war veteran is a person who served in the Armed Forces of the United States during the following periods of war: April 21, 1898, through July 4, 1902; April 6, 1917, through November 11, 1918; December 7, 1941, through December 31, 1946; June 27, 1950, through January 31, 1955; August 5, 1964, through May 7, 1975; and August 2, 1990, through a future date to be set by law or Presidential Proclamation.)

Line 2.

Answer “Yes” if you are an auxiliary unit or society of a post or organization of past or present members of the Armed Forces of the United States. Enter the name, address, and EIN of the post or organization.

Line 2a.

Answer “Yes” if you are affiliated with and organized according to the bylaws and regulations formulated by such an exempt post or organization. A copy of such bylaws or regulations should be uploaded at the end of this form.

Line 2b.

Enter the total number of your members.

Line 2c.

Enter the number of your members that are themselves past or present members of the Armed Forces of the United States, or are their spouses, or persons related to them within two degrees of blood relationship. (Grandparents, brothers, sisters, and grandchildren are the most distant relationships allowable.)

Line 2d.

Answer “Yes” if all of your members are themselves members of a post or organization, past or present members of the Armed Forces of the United States, spouses of members of such a post or organization, or related to members of such a post or organization within two degrees of blood relationship.

Line 3.

Answer “Yes” if you are a trust or foundation organized for the benefit of an exempt post or organization of past or present members of the Armed Forces of the United States.

Line 3a.

Answer “Yes” if your corpus or income be used solely for the funding of such an exempt organization (including necessary related expenses). If not, answer “No” and explain.

Line 3b.

Answer “Yes” if you are formed for charitable purposes and your organizational document contain a proper dissolution provision as described in section 1.501(c)(3)-1(b)(4) of the Income Tax Regulations.

Line 4.

Answer “Yes” if you currently, or will, (a) rent your facilities to the general public; (b) make your facilities, such as bar and dining facilities, open to the general public; (c) sell liquor and/or food to members and/or the general public for consumption off premises; or (d) conduct gaming activities with the general public. Explain in detail, including the percentage of your time and resources devoted to such activities.

Line 1.

Answer “Yes” if you are organized for the purpose of operating a communal religious community where members live a communal life following your tenets and teachings.

Line 2.

Answer “Yes” if you maintain a common or community treasury.

Line 3.

Answer “Yes” if all your members live in a communal manner.

Line 4.

Answer “Yes” if your members are permitted to own, in their own names, any real or personal property.

Line 5.

Answer “Yes” if your members are required to furnish their own support (food, clothing, and shelter).

Line 6.

State your membership requirements, the method of member admission, members’ right to property owned at the time they’re admitted and terminating members’ rights to share in the organization’s property, or to a return of any property contributed.

Line 1.

Complete the table. Show the number of shares of each class of capital stock currently outstanding, if any, the value of the consideration for which it was issued, and the rate of dividend paid.

Line 2.

Complete the table. Show the number of shares of capital stock (other than non-voting preferred) owned by current and active producers, inactive producers, and non-producers.

The term “producer” means an individual or corporation engaged in farming as a business receiving income based on farm production rather than fixed compensation. For example, a corporation leases its land to a tenant farmer who agrees to pay a rental fee based on a percentage of the farm crops produced. Both the landowner and the tenant farmer qualify as producers.

“Current and active” producers are patrons of a cooperative who market more than 50% of their products or purchase more than 50% of their supplies and equipment through the cooperative during the cooperative's tax year.

Line 3.

Answer “Yes” if you issue or will issue non-voting preferred stock. Explain in detail whether the owners, upon dissolution or liquidation, may share in the profits of the association beyond fixed dividends.

Line 4.

Answer “Yes” if you make or will make any provisions for retiring the voting stock held by a non-producer. Explain in detail.

Line 5.

Enter the legal rate of interest in the state where you are located. If the state in which you are located differs from the state in which you are incorporated, enter the legal rate of interest in the state of your incorporation.

Line 6.

Answer “Yes” if you are required by state law to accumulate and maintain reserves. State the names and purposes of the reserves and specify the amounts of each.

Line 7.

Answer “Yes” if you maintain or will maintain any reserves other than those required by state law. State the names and purposes of the reserves and specify the amounts of each.

Line 8.

Describe who is accorded voting rights in the cooperative and how many votes one person may have. If a person may be entitled to more than one vote, explain in detail how voting rights are acquired.

Line 9.

Answer “Yes” if you are a federated cooperative.

Line 10.

Answer “Yes” if all your member cooperatives are exempt under section 521.

Line 11.

Answer “Yes” if the nonexempt member cooperatives have the same annual accounting period as you. If “No,” describe the method that you use or will use to provide a common or comparable unit of time for analyzing and evaluating your operations and those of your members.

Line 12.

Answer “Yes” if you do business with or will do business with both members and non-members. Explain in detail.

Line 13.

Answer “Yes” if you pay or will pay patronage dividends. Explain in detail whether they will be paid to members and non-members on the same basis.

Line 14.

Answer “Yes” if you allocate or will allocate patronage dividends based on an obligation in existence before you received the amounts allocated. Explain the obligation in detail.

Line 15.

Explain how distribution is or will be made of the proceeds of products marketed for members and non-members. Also, if you operate on a basis of allocated units (i.e., functional, departmental, etc.), explain how losses are or will be treated.

Line 16.

Explain how you charge for supplies and equipment purchased for members and non-members.

Line 17 – 19.

The information requested on lines 17 through 19 must be completed for the current year and each of the 2 immediately preceding years (or for the time you have existed if less than 3 years). The requested information for the current year must cover the period beginning on the first day of your established annual accounting period and ending on any day which is within 60 days of the date of the application. If the date of the application is less than 60 days after the first day of the current accounting period, no information is required for the current year.

Requested information is required for the 2 preceding years regardless of the current year requirement. Please note that if no information is required for the current year, the preceding years information period can end on any day which is within 60 days of the date of the application.

Line 17.

Enter the value of agricultural products marketed or handled for members and non-members below:

Line 17a.

Members – Note: If it is necessary to own one or more shares of stock in order to become a member, include only the amount of business transacted with persons actually owning the required number of shares.

Line 17a.1

List the amount actually produced by members.

Line 17a.2

List the amount not actually produced by members but marketed by them through you

Line 17b.1

Non-members

Line 17b.2

List the amount not actually produced by non-members but marketed by them through you

Line 17c.

List the amount by nonproducers (purchased from nonproducers for marketing by you)

Line 18.

Enter the value of supplies and equipment purchased for or sold to members and non-members below:

Line 18a.

List the amount from members who were producers Note: If it is necessary to own one or more shares of stock in order to become a member, include only the amount of business transacted with persons actually owning the required number of shares.

Line 18b.

List the amount from non-members who were producers

Line 18c.

List the amount from members and non-members who were not producers

Line 19.

List the amount of business done with the United States Government or any of its agencies

Line 20.

Answer “Yes” if all the net earnings (after payment of dividends, if any, on capital stock) for the years shown on lines 17-19 were distributed as patronage dividends. If your net earnings were not distributed as patronage dividends, also indicate whether they were apportioned on the records to all patrons on a patronage basis.