OMB No. 1545-0213 
                              Annual Certification of Racial Nondiscrimination 
Form  5578                                                                                                                                      Open to Public  
(Rev. August 2013)          for a Private School Exempt From Federal Income Tax 
                            ▶ Information about Form 5578 and its instructions is at www.irs.gov/form5578.                                      Inspection 
Department of the Treasury    (For use by organizations that do not file Form 990 or Form 990-EZ)                                               For IRS Use Only  ▶
Internal Revenue Service 
For the period beginning                              ,                                        and ending                                                   ,
1a    Name of organization that operates, supervises, and/or controls school(s).                                                     1b  Employer identification number 

      Address (number and street or P.O. box no., if mail is not delivered to street address) Room/suite 

      City or town, state, and ZIP + 4 (If foreign address, list city or town, state or province, and country. Include postal code.) 

2a    Name of central organization holding group exemption letter covering the school(s). (If same as 1a above, write                2b  Employer identification number 
      “Same” and complete 2c.) If the organization in 1a holds an individual exemption letter, write “Not Applicable.” 

      Address (number and street or P.O. box no., if mail is not delivered to street address) Room/suite                             2c  Group exemption number (see  
                                                                                                                                         instructions under Definitions) 
      City or town, state, and ZIP + 4 (If foreign address, list city or town, state or province, and country. Include postal code.) 

3a    Name of school. (If more than one school, write “See Attached,” and attach a list of the names, complete addresses,            3b  Employer identification number, 
      including postal codes, and employer identification numbers of the schools.) If same as 1a, write “Same.”                          if any 

      Address (number and street or P.O. box no., if mail is not delivered to street address)                                                               Room/suite 

      City or town, state, and ZIP + 4 (If foreign address, list city or town, state or province, and country. Include postal code.) 

Under penalties of perjury, I hereby certify that I am authorized to take official action on behalf of the above school(s) and that to the best of my knowledge and belief the 
school(s) has (have) satisfied the applicable requirements of sections 4.01 through 4.05 of Rev. Proc. 75-50, 1975-2 C.B. 587, for the period covered by this certification. 

                            (Signature)                                                       (Type or print name and title.)                               (Date) 
For Paperwork Reduction Act Notice, see instructions.                                         Cat. No. 42658A                                   Form 5578 (Rev. 8-2013) 

Form 5578 (Rev. 8-2013)                                                                                                                Page 2
                                                A school is an educational organization        Section 4.02, Statement of Policy. Every  
General Instructions                            that normally maintains a regular faculty      school must include a statement of its  
Section references are to the Internal Revenue  and curriculum and normally has a              racially nondiscriminatory policy as to  
Code unless otherwise noted.                    regularly enrolled body of pupils or           students in all its brochures and  
                                                students in attendance at the place where      catalogues dealing with student  
Note. This form is open to public               its educational activities are regularly       admissions, programs, and scholarships. A 
inspection.                                     carried on. The term includes primary,         statement substantially similar to the  
Future Developments                             secondary, preparatory, or high schools        Notice described in paragraph (a) of  
                                                and colleges and universities, whether         subsection 1 of section 4.03, infra, will be 
For the latest information about                operated as a separate legal entity or as      acceptable for this purpose. Further, every  
developments related to Form 5578 and its       an activity of a church or other               school must include a reference to its  
instructions, such as legislation enacted       organization described in section 501(c)(3).   racially nondiscriminatory policy in other  
after they were published, go to                The term also includes preschools and any      written advertising that it uses as a means  
www.irs.gov/form5578.                           other organization that is a school as         of informing prospective students of its  
                                                defined in section 170(b)(1)(A)(ii).           programs. The following references will be  
Purpose of Form                                                                                acceptable: 
                                                A central organization is an organization  
Form 5578 may be used by organizations          that has one or more subordinates under        The (name) school admits students of  
that operate tax-exempt private schools to      its general supervision or control. A          any race, color, and national or ethnic  
provide the Internal Revenue Service with       subordinate is a chapter, local, post, or      origin. 
the annual certification of racial              other unit of a central organization. A        Section 4.03, Publicity. The school must  
nondiscrimination required by Rev. Proc.        central organization may also be a             make its racially nondiscriminatory policy  
75-50 (the relevant part of which is            subordinate, as in the case of a state         known to all segments of the general  
reproduced in these instructions).              organization that has subordinate units and    community served by the school. 
Who Must File                                   is itself affiliated with a national  
                                                organization.                                  1. The school must use one of the  
                                                                                               following two methods to satisfy this  
Every organization that claims exemption        The group exemption number (GEN) is a          requirement: 
from federal income tax under section           four-digit number issued to a central  
501(c)(3) of the Internal Revenue Code and      organization by the IRS. It identifies a       (a) The school may publish a notice of  
that operates, supervises, or controls a        central organization that has received a       its racially nondiscriminatory policy in a  
private school(s) must file a certification of  ruling from the IRS recognizing on a group     newspaper of general circulation that  
racial nondiscrimination. If an organization    basis the exemption from federal income        serves all racial segments of the  
is required to file Form 990, Return of         tax of the central organization and its        community. This publication must be  
Organization Exempt From Income Tax, or         covered subordinates.                          repeated at least once annually during the  
Form 990-EZ, Short Form Return of                                                              period of the school’s solicitation for  
Organization Exempt From Income Tax,            When To File                                   students or, in the absence of a solicitation  
either as a separate return or as part of a                                                    program, during the school’s registration  
group return, the certification must be         Under Rev. Proc. 75-50, a certification of  
made on Schedule E (Form 990 or                 racial nondiscrimination must be filed         period. Where more than one community is 
990-EZ), Schools, rather than on this form.     annually by the 15th day of the 5th month      served by a school, the school may publish 
                                                following the end of the organization’s        its notice in those newspapers that are  
  An authorized official of a central           calendar year or fiscal period.                reasonably likely to be read by all racial  
organization may file one form to certify for                                                  segments of the communities that it 
the school activities of subordinate            Where To File                                  serves. The notice must appear in a  
organizations that would otherwise be                                                          section of the newspaper likely to be read  
required to file on an individual basis, but    Mail Form 5578 to the Department of the        by prospective students and their families  
only if the central organization has enough     Treasury, Internal Revenue Service Center,     and it must occupy at least three column  
control over the schools listed on the form     Ogden, UT 84201-0027.                          inches. It must be captioned in at least 12  
to ensure that the schools maintain a                                                          point boldface type as a notice of  
racially nondiscriminatory policy as to         Certification Requirement                      nondiscriminatory policy as to students,  
students.                                       Section 4.06 of Rev. Proc. 75-50 requires      and its text must be printed in at least 8  
                                                an individual authorized to take official      point type. The following notice will be  
Definitions                                     action on behalf of a school that claims to    acceptable:  
A racially nondiscriminatory policy as to       be racially nondiscriminatory as to  
students means that the school admits the       students to certify annually, under            Notice Of Nondiscriminatory  
students of any race to all the rights,         penalties of perjury, that to the best of his          Policy As To Students 
privileges, programs, and activities            or her knowledge and belief the school has     The (name) school admits students of any  
generally accorded or made available to         satisfied the applicable requirements of       race, color, national and ethnic origin to all  
students at that school and that the school     sections 4.01 through 4.05 of the Revenue      the rights, privileges, programs, and  
does not discriminate on the basis of race      Procedure, reproduced below:                   activities generally accorded or made  
in the administration of its educational                                                       available to students at the school. It does  
policies, admissions policies, scholarship      Rev. Proc. 75-50                               not discriminate on the basis of race, color, 
and loan programs, and athletic and other       Section 4.01, Organizational                   national and ethnic origin in administration  
school-administered programs.                   Requirements. A school must include a          of its educational policies, admissions  
  The IRS considers discrimination on the       statement in its charter, bylaws, or other     policies, scholarship and loan programs,  
basis of race to include discrimination on      governing instrument, or in a resolution of    and athletic and other school-administered  
the basis of color or national or ethnic        its governing body, that it has a racially     programs. 
origin.                                         nondiscriminatory policy as to students  
                                                and therefore does not discriminate against 
                                                applicants and students on the basis of  
                                                race, color, and national or ethnic origin. 

Form 5578 (Rev. 8-2013)                                                                                                                 Page  3
(b) The school may use the broadcast          (b) If a school customarily draws a              The Service encourages schools to 
media to publicize its racially               substantial percentage of its students           satisfy the publicity requirement by the 
nondiscriminatory policy if this use makes    nationwide or world-wide or from a large         methods described in subsection 1 of this 
such nondiscriminatory policy known to all    geographic section or sections of the            section, regardless of whether a school 
segments of the general community the         United States and follows a racially             considers itself within subsection 2, 
school serves. If this method is chosen,      nondiscriminatory policy as to students,         because it believes these methods to be 
the school must provide documentation         the publicity requirement may be satisfied       the most effective to make known a 
that the means by which this policy was       by complying with section 4.02,  supra.          school’s racially nondiscriminatory policy. 
communicated to all segments of the           Such a school may demonstrate that it            In this regard it is each school’s 
general community was reasonably              follows a racially nondiscriminatory policy      responsibility to determine whether 
expected to be effective. In this case,       within the meaning of the preceding              paragraph (a), (b), or (c) of subsection 2 
appropriate documentation would include       sentence either by showing that it currently     applies to it. On audit, a school must be 
copies of the tapes or script used and        enrolls students of racial minority groups in    prepared to demonstrate that the failure to 
records showing that there was an             meaningful numbers or, when minority             publish its racially nondiscriminatory policy 
adequate number of announcements, that        students are not enrolled in meaningful          in accordance with subsection 1 of this  
they were made during hours when the          numbers, that its promotional activities and     section was justified by the application to it 
announcements were likely to be               recruiting efforts in each geographic area       of paragraph (a), (b), or (c) of subsection 2.  
communicated to all segments of the           were reasonably designed to inform               Further, a school must be prepared to  
general community, that they were of          students of all racial segments in the           demonstrate that it has publicly disavowed 
sufficient duration to convey the message     general communities within the area of the       or repudiated any statements purported to 
clearly, and that they were broadcast on      availability of the school. The question         have been made on its behalf (after 
radio or television stations likely to be     whether a school satisfies the preceding         November 6, 1975) that are contrary to its 
listened to by substantial numbers of         sentence will be determined on the basis         publicity of a racially nondiscriminatory 
members of all racial segments of the         of the facts and circumstances of each           policy as to students, to the extent that the 
general community. Announcements must         case.                                            school or its principal official were aware of 
be made during the period of the school’s     (c) If a school customarily draws its            such statements. 
solicitation for students or, in the absence  students from local communities and follows      Section 4.04, Facilities and Programs.  A 
of a solicitation program, during the         a racially nondiscriminatory policy as to        school must be able to show that all of its  
school’s registration period.                 students, the publicity requirement may be       programs and facilities are operated in a  
Communication of a racially                   satisfied by complying with section 4.02,        racially nondiscriminatory manner. 
nondiscriminatory policy as to students by    supra. Such a school may demonstrate that it     Section 4.05, Scholarship and Loan  
a school to leaders of racial groups as the   follows a racially nondiscriminatory policy      Programs. As a general rule, all scholarship 
sole means of publicity generally will not    within the meaning of the preceding sentence     or other comparable benefits procurable for 
be considered effective to make the policy    by showing that it currently enrolls students    use at any given school must be offered on a 
known to all segments of the community.       of racial minority groups in meaningful          racially nondiscriminatory basis. Their 
2. The requirements of subsection 1 of        numbers. The question whether a school           availability on this basis must be known 
this section will not apply when one of the   satisfies the preceding sentence will be         throughout the general community being 
following paragraphs applies:                 determined on the basis of the facts and         served by the school and should be referred 
                                              circumstances of each case. One of the facts     to in the publicity required by this section in 
(a) If for the preceding 3 years the          and circumstances that the Service will          order for that school to be considered racially 
enrollment of a parochial or other            consider is whether the school’s promotional     nondiscriminatory as to students. . . .  
church-related school consists of students    activities and recruiting efforts in each area   scholarships and loans that are made  
at least 75% of whom are members of the       were reasonably designed to inform students      pursuant to financial assistance programs  
sponsoring religious denomination or unit,    of all racial segments in the general            favoring members of one or more racial  
the school may make known its racially        communities within the area of the availability  minority groups that are designed to promote  
nondiscriminatory policy in whatever          of the school. The Service recognizes that the   a school’s racially nondiscriminatory policy 
newspapers or circulars the religious         failure by a school drawing its students from    will not adversely affect the school’s exempt 
denomination or unit utilizes in the          local communities to enroll racial minority      status. Financial assistance programs favoring 
communities from which the students are       group students may not necessarily indicate      members of one or more racial groups that do 
drawn. These newspapers and circulars         the absence of a racially nondiscriminatory      not significantly derogate from the school’s 
may be those distributed by a particular      policy as to students when there are relatively  racially nondiscriminatory policy similarly will 
religious denomination or unit or by an       few or no such students in these                 not adversely affect the school’s exempt 
association that represents a number of       communities. Actual enrollment is, however, a    status.  
religious organizations of the same           meaningful indication of a racially 
denomination. If, however, the school         nondiscriminatory policy in a community in       How To Get Tax Help 
advertises in newspapers of general           which a public school or schools became  
circulation in the community or               subject to a desegregation order of a federal    Internet 
communities from which its students are       court or otherwise expressly became 
drawn and paragraphs (b) and (c) of this      obligated to implement a desegregation plan      You can access the IRS website 24 hours a 
subsection are not applicable to it, then it  under the terms of any written contract or       day, 7 days a week at www.irs.gov/eo to: 
must comply with paragraph (a) of             other commitment to which any federal            • Download forms, including talking tax 
subsection 1 of this section.                 agency was a party.                              forms, instructions, and publications. 

Form 5578 (Rev. 8-2013)                                                                                                               Page  4
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