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                                                                                                               Department of the Treasury
                                                                                                               Internal Revenue Service
Instructions for Form 1023

(Rev. January 2020)
Application for Recognition of Exemption Under Section 501(c)(3) of the Internal 
Revenue Code

Section references are to the Internal Revenue    Contents                                    Page   How To Get Forms and 
Code unless otherwise noted.
                                                  Revenue Code Section                               Publications
Contents                                  Page    508(e) .    . . . . . . . . . . . . . . . . .   27
Future Developments .   . . . . . . . . . . . 1   Appendix C: Glossary of Terms .         . . .   29 Internet. You can access the IRS website 
What's New . . . . . . . . . . . . . . . . . . 1  Appendix D: National Taxonomy of                   24 hours a day, 7 days a week, at IRS.gov 
Overview of Organizations                         Exempt Entities (NTEE)                             to do the following.
Described in Section 501(c)                       Codes  .      . . . . . . . . . . . . . . . .   37 • Download forms, instructions, and 
(3) . . . . . . . . . . . . . . . . . . . . . 1   Index . . . . . . . . . . . . . . . . . . . . . 40 publications.
General Instructions .  . . . . . . . . . . . . 2                                                    • Order IRS products online.
                                                  Note.   Keep a copy of the completed               • Research your tax questions online.
Answers . . . . . . . . . . . . . . . . . . . . 2 Form 1023 for your permanent records.              • Search publications by topic or 
Purpose of Form .   . . . . . . . . . . . . . . 3
                                                                                                     keyword.
What To File . . . . . . . . . . . . . . . . . 3                                                       Use the online Internal Revenue Code, 
                                                                                                     •
When To File . . . . . . . . . . . . . . . . . 4  Future Developments                                regulations, or other official guidance.
Filing Assistance . . . . . . . . . . . . . . . 4 For the latest information about                   • View Internal Revenue Bulletins (IRBs) 
Signature Requirements .    . . . . . . . . . 4   developments related to Form 1023 and              published since 1995.
Authorized Representative .     . . . . . . . 4   its instructions, such as legislation              • Sign up at IRS.gov/Charities-Non-
Public Inspection . . . . . . . . . . . . . . . 4 enacted after they were published, go to           Profits to receive local and national tax 
Foreign Organizations .     . . . . . . . . . . 5 IRS.gov/Form1023.                                  news by email.
Specific Instructions . . . . . . . . . . . . . 6 Reminder                                           Tax forms and publications.  You can 
Part I. Identification of Applicant . . . . . 6                                                      download or print all of the forms and 
Part II. Organizational Structure .   . . . . 6   Don't include social security numbers 
                                                  on publicly disclosed forms. Because               publications you may need at IRS.gov/
Part III. Required Provisions in                  the IRS is required to disclose approved           FormsPubs. Otherwise, you can go to 
Your Organizing Document .            . . . . 7                                                      IRS.gov/OrderForms to place an order 
                                                  exemption applications and information 
Part IV. Your Activities .  . . . . . . . . . . 8 returns, don't include social security             and have forms mailed to you. You should 
Part V. Compensation and Other                    numbers on this form. Documents subject            receive your order within 10 business 
Financial Arrangements  .         . . . . .   10                                                     days.
                                                  to disclosure include supporting 
Part VI. Financial Data .   . . . . . . . . . 11  information filed with the form and 
Part VII. Foundation                              correspondence with the IRS about the 
Classification .    . . . . . . . . . . . .   13  filing.                                            Overview of Organizations 
Part VIII. Effective Date . . . . . . . . . . 15                                                     Described in Section 
Part IX. Annual Filing                            Phone Help
                                                                                                     501(c)(3)
Requirement .       . . . . . . . . . . . .   15  If you have questions and/or need help 
Part X. Signature . . . . . . . . . . . . . . 16  completing Form 1023, please call                  How To Request Recognition of 
Schedule A. Churches .      . . . . . . . . . 16  877-829-5500. This toll-free telephone             Tax-Exempt Status Under 
Schedule B. Schools, Colleges,                    service is available Monday through 
and Universities .      . . . . . . . . . .   17  Friday.                                            Section 501(c)(3)
Schedule C. Hospitals and                                                                            Section 501(c)(3) describes organizations 
Medical Research                                  Email Subscription                                 organized and operated exclusively for 
Organizations .     . . . . . . . . . . . .   18  The IRS provides a subscription-based              religious, charitable, scientific, testing for 
Schedule D. Section 509(a)(3)                     email service for tax professionals and            public safety, literary, or educational 
Supporting Organizations .          . . . .   20  representatives of tax-exempt                      purposes, or to foster national or 
Schedule E. Effective Date .    . . . . . .   21  organizations. We send subscribers                 international amateur sports competition, 
Schedule F. Low-Income                            periodic updates regarding exempt                  or for the prevention of cruelty to children 
Housing .      . . . . . . . . . . . . . . .  22  organization tax law and regulations,              or animals. Unless an exception applies, 
Schedule G. Successors to Other                   available services, and other information.         an organization must file Form 1023 or 
Organizations .     . . . . . . . . . . . .   22  To subscribe, visit IRS.gov/Charities.             Form 1023-EZ (if eligible) to obtain 
Schedule H. Organizations                                                                            recognition of exemption from federal 
Providing Scholarships,                                                                              income tax under section 501(c)(3). You 
Fellowships, Educational                          What's New                                         can find information about eligibility to file 
Loans, or Other Educational 
Grants to Individuals and                         Organizations requesting recognition of            Form 1023-EZ at IRS.gov/Charities.
Private Foundations                               tax-exempt status under section 501(c)(3) 
Requesting Advance                                must complete and submit their Form                  Organizations not required to 
Approval of Individual Grant                      1023 (or Form 1023-EZ, if eligible)                obtain recognition of exemption.        The 
Procedures  .       . . . . . . . . . . . . . 22  applications electronically (including             following types of organizations may be 
Appendix A: Sample Conflict of                    paying the correct user fee) using                 considered tax exempt under section 
Interest Policy .   . . . . . . . . . . . .   25  Pay.gov.                                           501(c)(3) without filing Form 1023 (or 
Appendix B: States With Statutory                                                                    Form 1023-EZ).
Provisions Satisfying the                                                                            • Churches, including synagogues, 
Requirements of Internal                                                                             temples, and mosques.

Feb 03, 2020                                                    Cat. No. 17132z

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• Integrated auxiliaries of churches and     attempting to influence legislation or if it  contribution deductions and attracting 
conventions or associations of churches.     directly or indirectly participates or        grants from private foundations. In order to 
• Any organization that has gross            intervenes in any political campaign on       be classified as a private operating 
receipts in each tax year of normally not    behalf of (or in opposition to) any           foundation, an organization must meet 
more than $5,000. For more information       candidate for elective public office. These   certain support tests. Search for “private 
on gross receipts exceptions, go to          issues are described in more detail in the    operating foundations” at IRS.gov for more 
IRS.gov/Charities.                           instructions for Part IV, lines 5 and 6.      information.
    Even though these organizations aren't                                                 Key distinctions between public chari-
required to seek recognition of exemption,   Public Charities and Private                  ties and private foundations. 
they may choose to file Form 1023 (or        Foundations                                   Foundation classification is important 
Form 1023-EZ, if eligible) to receive a                                                    because different tax rules apply to the 
determination letter stating they are        Every organization described in section       operations of each entity. For more 
recognized as exempt under section           501(c)(3) is classified as a private          information on the different rules, see 
501(c)(3) status. The determination letter   foundation unless it qualifies for one of     IRS.gov/Charities-Non-Profits/EO-
will also state whether an organization      the public charity exceptions. For some       Operational-Requirements-Private-
must file annual information returns or      organizations, the primary distinction        Foundations-and-Public-Charities.
notices and will specify whether             between a public charity and a private 
contributions to that organization are tax   foundation is its sources of financial            Foundation classification has 
deductible.                                  support.                                      TIP nothing to do with the name of the 
                                                                                               organization. Many organizations 
                                             Public charities.       The following section that aren't private foundations include the 
Requirements for Tax-Exempt                  501(c)(3) organizations are classified as     word “foundation” in their names.
Status Under Section 501(c)(3)               public charities.
                                             • Organizations that are public charities 
To qualify for exemption under section       based upon their activities (without regard   State Registration Requirements
501(c)(3), an organization must be           to their sources of support), such as 
organized and operated exclusively for       churches, schools, hospitals, medical         Tax exemption under section 501(c)(3) is 
one or more exempt purposes.                 research organizations, and cooperative       a matter of federal law. After receiving 
Organized.   An organization must be         hospital service organizations and            federal tax exemption, an organization 
organized as a corporation, a limited        agricultural research organizations           may also be required to register with one 
liability company (LLC), an                  (sections 509(a)(1) and 170(b)(1)(A)(i),      or more states where it holds assets or 
unincorporated association, or a trust.      (ii), (iii), and (ix)).                       where it will solicit contributions. The 
Its organizing document (corporate           • Organizations that normally receive         organization may also need to seek 
articles of incorporation, LLC articles of   substantial support from grants,              exemption from state taxes. The National 
organization, articles of association or     governmental units, and/or contributions      Association of State Charity Officials 
constitution of an unincorporated            from the general public (sections 509(a)(1)   (NASCO) maintains a website that 
association, or trust agreement or           and 170(b)(1)(A)(iv) and (vi)).               provides informational links to the various 
declaration of trust) must limit the         • Organizations that normally receive         states for these purposes. It can be 
organization's purpose(s) and                more than one-third of their support from     accessed at www.nasconet.org .
permanently dedicate its assets to exempt    contributions, membership fees, and 
purposes.                                    gross receipts from activities related to     General Instructions
                                             their exempt functions, and not more than 
Operated.   An organization described in     one-third of their support from gross         Social Security number. Don't enter 
section 501(c)(3) must be operated to        investment income and net unrelated           social security numbers on this form or 
further one or more of the exempt            business income (section 509(a)(2)).          any attachments because the IRS is 
purposes stated in its organizing            • Organizations that support other public     required to disclose approved exemption 
document. Certain other activities are       charities (supporting organizations)          applications and information returns. 
prohibited or restricted, including, but not (section 509(a)(3)).                          Documents subject to disclosure include 
limited to, the following activities. A      • Organizations that test for public safety   supporting information filed with the form 
section 501(c)(3) organization must:         (section 509(a)(4)).                          and correspondence with the IRS related 
• Absolutely refrain from participating in                                                 to the application.
the political campaigns of candidates for    Private foundations.    Section 501(c)(3) 
local, state, or federal office;             organizations that don’t fit into any of the  “You” and “us.”    Throughout these 
• Ensure its assets and earnings don’t       foundation classifications above are          instructions and Form 1023, the terms 
unjustly enrich board members, officers,     private foundations. Private foundations      “you” and “your” refer to the organization 
key management employees, or other           are further classified as nonoperating        that is applying for tax-exempt status. The 
insiders;                                    private foundations or private operating      terms “us” and “we” refer to the IRS.
• Not further non-exempt purposes (such      foundations (section 4942(j)(3)).             Definitions. Terms in bold type in Form 
as purposes that benefit private interests)  Nonoperating private foundations.             1023 are defined throughout these 
more than insubstantially;                   Nonoperating private foundations              instructions and in Appendix C.
• Not operate for the primary purpose of     generally accomplish their exempt 
conducting a trade or business that isn’t    purpose by making grants and don’t            Answers
related to its exempt purpose(s);            otherwise engage directly in charitable       Form 1023 asks you to answer a series of 
• Not engage in activities that are illegal  activities.                                   questions and provide information to 
or violate fundamental public policy; and                                                  assist us in determining if you meet the 
• Limit its legislative activities.          Private operating foundations.      A         requirements for tax exemption under 
                                             private operating foundation actively         section 501(c)(3). Answer questions 
Legislative and political campaign in-       conducts exempt programs. Private             completely. If you believe you previously 
tervention.  Section 501(c)(3) denies        operating foundations are subject to more     answered the question, you may refer to 
exemption to an organization if a            favorable rules than other private            your previous answer.
substantial part of its activities is        foundations in terms of charitable 

                                                                     -2-                                Instructions for Form 1023

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Your answers must provide Eligibility Worksheet in the Instructions for User fee amounts are listed in Rev.
! sufficient detail about your past, Form 1023-EZ to determine if you're Proc. 2020-5, updated annually. For the
CAUTION present, and planned activities to eligible to file Form 1023-EZ. You can visit current Form 1023 user fee, go to Rev.
demonstrate that you're described in IRS.gov/Charities for more information on Proc. 2020-5, 2020-1 I.R.B. 241, at
section 501(c)(3). We won't be able to application requirements. IRS.gov/Charities-Non-Profits/User-Fees-
recognize you as tax exempt based on a for-Tax-Exempt-and-Government-Entities-
mission statement (such as providing Leaving a group exemption. A Division. You can also call 877-829-5500.
assistance to the poor) unless you also subordinate organization under a group
describe the activities that further exemption can use Form 1023 to leave the Group Exemption
accomplish your mission. We need to group and obtain individual exemption. If Don't use Form 1023 to apply for a group
understand the specific activities you will you're a subordinate organization and exemption. We may issue to a central
undertake to accomplish your section wish to leave a group, you should notify organization a group exemption that
501(c)(3) exempt purpose(s). your parent organization of your intention recognizes on a group basis the
to leave the group ruling before filing Form exemption of subordinate organizations
Financial data. Financial data, whether 1023. on whose behalf the central organization
budgeted or actual, should be consistent has applied. See Pub. 557 for information
with other information presented in your Application for Reinstatement on how to apply for a group exemption.
application. of Exempt Status and
For example, if you're requesting public Retroactive Reinstatement What To File
charity classification under one of the If your tax-exempt status was All applicants, unless otherwise noted,
public support tests, your financial data automatically revoked for failure to file a must complete Parts I through X of Form
should show contributions from the public return or notice 3 consecutive years, you 1023, plus any required schedules and
or receipts from providing exempt must apply to have your tax-exempt status attachments.
services. Budgeted financial data should reinstated. You must complete and submit The following organizations must
be prepared based upon your current Form 1023, including Schedule E (or, if complete additional schedules to Form
plans. We recognize that your actual eligible, Form 1023-EZ), and pay the 1023.
financial results may vary from the appropriate user fee.
budgeted amounts.
If your application is approved, your THEN you
Past, present, and planned activities. date of reinstatement will generally be the must
Many items on Form 1023 are written in filing date of the application, unless you complete
the present tense; however, base your qualify for reinstatement of exemption IF you’re Schedule
answers on your past, present, and retroactive to your date of automatic
planned activities. revocation. See Rev. Proc. 2014-11, A church . . . . . . . . . . . A
Language and currency requirements. 2014-03 I.R.B. 411 for details, including A school, college, or
Prepare Form 1023 and attachments in additional requirements for retroactive university . . . . . . . . . . B
English. Provide an English translation if reinstatement.
A hospital or medical
the articles of organization, bylaws, or any Requesting Expedited Review research organization . . C
other attachments are in any other
language. We generally review applications for A section 509(a)(3)
exemption in the order we receive them. supporting
Report financial information in U.S. We only expedite processing of an organization . . . . . . . . D
dollars (specify the conversion rate used). application where a written request
Combine amounts from within and outside presents a compelling reason for Filing this application more
the United States and report the total for processing the application ahead of than 27 months from your
each on the financial statements. others. This does not mean your date of formation and/or
application will be immediately approved applying for reinstatement
Purpose of Form or denied. Circumstances generally of tax-exempt status after
warranting expedited processing include being automatically
Completed Form 1023 required to ap- revoked . . . . . . . . . . . E
the following.
ply for recognition of section 501(c)(3)
exemption. Use Form 1023, including • A grant to the applicant is pending and A low-income housing
the failure to secure the grant may have an
the appropriate user fee, to apply for organization . . . . . . . . F
adverse impact on the organization's
recognition of exemption from federal A successor to other
ability to continue operations.
income tax under section 501(c)(3). If organizations . . . . . . . . G
approved, we will issue a determination • The purpose of the newly created
organization is to provide disaster relief to
letter that describes your tax-exempt An organization providing
victims of emergencies such as floods and
status and your qualification to receive scholarships, fellowships,
hurricanes.
tax-deductible charitable contributions. educational loans, or other
The determination letter will also show • An IRS error has caused delays in educational grants to
review of the application.
your specific foundation classification individuals and/or a private
(described earlier) and annual filing User Fee foundation requesting
requirements. The law requires payment of a user fee approval of individual grant
Form 1023-EZ. You may be with each application. You must pay this procedures . . . . . . . . . H
TIP eligible to file Form 1023-EZ, fee through Pay.gov when you file Form
Streamlined Application for 1023.
Recognition of Exemption Under Section Payments can be made directly from
501(c)(3) of the Internal Revenue Code, your bank account or by credit or debit Attachments To Form 1023
which is a streamlined version of Form card. You won't be able to submit Form A complete application will include one or
1023. Complete the Form 1023-EZ 1023 without paying the correct fee. more documents in addition to Form 1023.

Instructions for Form 1023 -3-

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Pay.gov can accommodate only one             • Pub. 526, Charitable Contributions.            Additional information needed.        If we 
uploaded file. Before submitting Form        • Pub. 557, Tax-Exempt Status for Your           can’t make a determination without more 
1023, consolidate your attachments into a    Organization.                                    information, we’ll write or call you. 
single PDF file. Combine your                • Pub. 598, Tax on Unrelated Business            Examples of the types of questions we 
attachments in the following order.          Income of Exempt Organizations.                  may ask you are available at IRS.gov/
• Organizing document (required).            • Pub. 1771, Charitable Contributions            Charities-Non-Profits/Charitable-
• Amendments to your organizing              Substantiation and Disclosure                    Organizations/Exempt-Organization-
document in chronological order (required    Requirements.                                    Sample-Questions. If the additional 
if applicable).                              • Pub. 1828, Tax Guide for Churches and          information you provide shows that you 
• Bylaws or other rules of operation and     Religious Organizations.                         meet the requirements for exemption, we'll 
amendments (if adopted).                     • Pub. 3079, Tax-Exempt Organizations            send you a determination letter stating that 
• Form 2848, Power of Attorney and           and Gaming.                                      you're exempt under section 501(c)(3). If 
Declaration of Representative (if            • Pub. 3833, Disaster Relief: Providing          we determine that you don't qualify for 
applicable).                                 Assistance Through Charitable                    exemption, we will send you a letter that 
• Form 8821, Tax Information                 Organizations.                                   explains our position and your appeal 
Authorization (if applicable).               • Pub. 4220, Applying for 501(c)(3)              rights.
• Supplemental responses (if your            Tax-Exempt Status.
response won't fit in the provided text      • Pub. 4221-PC, Compliance Guide for             Annual Return or Notice While 
field) and any additional information you    501(c)(3) Public Charities.                      Your Application Is Pending
want to provide to support your request      • Pub. 4221-PF, Compliance Guide for             Unless you qualify for an exception from 
(optional).                                  501(c)(3) Private Foundations.                   the requirement to file an annual return or 
• Expedite request (optional).                                                                notice, your filing obligations begin as 
  Put your name and EIN on each page         Signature Requirements                           soon as you were formed. If you have an 
of your supplemental response and            An officer, director, trustee, or other official information return or tax return due while 
identify the part and line number to which   who is authorized to sign for the                your Form 1023 is pending, complete the 
the information relates.                     organization must digitally sign Form 1023       return, mark the “Application Pending” box 
                                             at the end of Part X. The signature must         in the heading, Item B, and submit the 
When To File                                 be accompanied by the title or authority of      return as indicated in those instructions.
                                             the signer and the date.
Generally, if you file Form 1023 within 27                                                      If you’re eligible to file a Form 990-N, 
months after the end of the month in which                                                    e-Postcard, call 877-829-5500 and 
you were legally formed, and we approve      Authorized Representative                        request to be set up to allow filing of Form 
your application, the effective date of your Form 2848.   Upload a completed Form             990-N (note, it takes the IRS up to 6 
exempt status will be your legal date of     2848 if you want to authorize a                  weeks to update its records before you 
formation.                                   representative to represent you regarding        can file your Form 990-N).
  If you don’t file Form 1023 within 27      your application. An individual authorized         You can find information on return filing 
months, the effective date of your exempt    by Form 2848 may not sign the application        requirements and exceptions in Pubs. 557 
status will be the date you filed Form       unless that person is also an officer,           and 598 and in the instructions to the 
1023. For exceptions and special rules,      director, trustee, or other official who is      annual returns listed in Figure 1.
see Part VIII. Effective Date and            authorized to sign the application.
                                                                                                      You may also be required to file 
Schedule E.                                           A Centralized Authorization File        TIP     other returns, such as 
                                                      (CAF) number isn’t required to be 
How to File                                  CAUTION! listed on Form 2848.                            employment tax returns or benefit 
                                                                                              plan returns, which aren't discussed here.
As of January 31, 2020, the IRS requires 
that Form 1023 applications for              Form 8821.   Upload a completed Form                     If a Form 990-series return is due 
recognition of exemption be submitted        8821 if you want to authorize us to discuss        !     while your application is pending, 
electronically online at Pay.gov. The IRS    your application with the person you have        CAUTION complete and submit the return 
will provide a 90-day grace period during    appointed on that form.                          according to Form 990-series form's 
which it will continue to accept paper         Form 8821 doesn’t authorize your               instructions.
versions of Form 1023. To submit Form        appointee to advocate your position with 
1023, you must:                              respect to the federal tax laws; to execute 
  1. Register for an account on              waivers, consents, or closing agreements;        Public Inspection
Pay.gov.                                     or to otherwise represent you before the         Information available for public in-
                                             IRS. If you want to authorize an individual      spection. If we approve exempt status 
  2. Enter "1023" in the search box and      to represent you, use Form 2848.                 under section 501(c)(3), the following 
select Form 1023.
  3. Complete the form.                      After You Submit Form 1023                       information that will be open for public 
                                                                                              inspection includes the following.
                                             Unless we approve a request for                  • Your complete Form 1023 and any 
Filing Assistance                            expedited processing, we will assign and         supporting documents.
For help in completing this form or general  work your application in the order we            • All correspondence between you and 
questions relating to an exempt              received it.                                     the IRS concerning Form 1023, including 
organization, you may access information     No additional information needed.        If      Form 2848.
on our website at IRS.gov/EO.                our review shows that you meet the               • Your determination letter.
  You may find the following publications    requirements for tax-exempt status under         • Annual information returns (Forms 990, 
available on IRS.gov helpful.                section 501(c)(3), we’ll send you a              990-EZ, or 990-PF).
                                             determination letter stating that you’re         • Schedule A, included with Forms 990 or 
• Pub. 517, Social Security and Other        exempt under section 501(c)(3) and               990-EZ.
Information for Members of the Clergy and    identifying your foundation classification.      • Schedule B, included with Forms 990 or 
Religious Workers.                                                                            990-EZ, excluding the names and 

                                                               -4-                                         Instructions for Form 1023

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addresses of contributors and other         Figure 1. 990 Series Forms Filed by Exempt Organizations
identifying information about contributors.
• Schedule B, included with Form 
990-PF, including names, addresses, and     Type of Annual Return                        Who Should File
other identifying information about 
contributors.
• Exempt Organization Business Income       Form 990, Return of Organization             Section 501(c)(3) public charities 
Tax Return (Form 990-T).
                                            Exempt from Income Tax
  Information not available for public 
inspection.  The following items won’t be   Form 990-EZ, Short Form Return of            Section 501(c)(3) public charities whose 
open for public inspection.                 Organization Exempt from Income Tax          gross receipts during the year were less 
• Any information relating to a trade                                                    than $200,000 and total assets at the 
secret, patent, style of work, or apparatus                                              end of the year were less than $500,000 
that, if released, would adversely affect 
you (we must approve withholding this       Form 990-PF, Return of Private               Private foundations, including private 
information).                               Foundation                                   operating foundations, regardless of 
• Any other information that would                                                       financial status
adversely affect national defense (we 
must approve withholding this               Form 990-T, Exempt Organization              Public charities and private foundations 
information).                               Business Income Tax Return                   that have gross unrelated business 
• User fee payment information.                                                          income of $1,000 or more
• Contributors' names and addresses 
and identifying information about           Form 990-N Electronic Notice                 Most small public charities with gross 
contributors included with Forms 990 or     (e-Postcard) for Tax-Exempt                  receipts of $50,000 or less can file a 
990-EZ and the Schedule B filed with        Organizations Not Required to File Form      Form 990-N, if they choose not to file a 
these forms.                                990 or Form 990-EZ                           Form 990 or Form 990–EZ instead.
  When applying for tax-exempt status, 
you must clearly identify any information 
that isn’t open for public inspection by    posted. To date, the IRS hasn’t approved     U.S. sources are normally $50,000 or less 
marking it as “NOT SUBJECT TO PUBLIC        any third-party websites for posting.        and it hasn’t conducted significant activity 
INSPECTION” and include an explanation                                                   in the United States. See the Instructions 
                                            See Pub. 557 for additional information 
of why you’re asking for the information to                                              for Form 990 and Form 990-EZ, and the 
                                            on public inspection requirements.
be withheld. We will decide whether to                                                   Instructions for Form 990-PF for further 
withhold the identified information from                                                 information. A foreign organization that is 
public inspection.                          Foreign Organizations                        subject to unrelated business income tax 
                                            Foreign organizations are those that were    must file Form 990-T.
Making documents available for public       created in countries other than the United 
inspection.  Both you and the IRS must      States, its territories, or its possessions. Canadian Organizations
make the information that is subject to     Foreign organizations may apply for          Canadian organizations that have 
disclosure available for public inspection. tax-exempt status on income earned in the    received a Notification of Registration from 
The public may request a copy of the        United States in the same way that           the Canada Revenue Agency (formerly 
information available for public inspection domestic organizations apply for exempt      Canada Customs and Revenue Agency), 
from us by submitting Form 4506-A. The      status. See Language and currency            and whose registrations haven’t been 
public may also request inspection of the   requirements, above.                         revoked (“Canadian registered charities”), 
information or a copy of the information 
directly from you.                          If you’re a foreign organization applying    are automatically recognized in the U.S. 
  You may post the documents required       for exempt status, you must complete all     as section 501(c)(3) organizations and 
to be available for public inspection on    required parts of Form 1023. However,        aren’t required to file Form 1023. 
your own website. Information returns and   see the special rules below for certain      Canadian registered charities are also 
your exemption application materials must   Canadian organizations.                      presumed to be private foundations. If 
                                                                                         you’re a Canadian registered charity and 
be posted exactly as filed with the IRS.           Contributions by U.S. residents to    want to be listed as a section 501(c)(3) 
You may only delete the information that    TIP    foreign organizations generally       organization on IRS.gov or request 
isn’t open for public inspection.                  aren’t deductible. Tax treaties       classification as a public charity rather 
  If you post the documents on your         between the U.S. and certain foreign         than a private foundation, mail or fax the 
website, you can give any person            countries provide specific limited           information below to:
requesting copies the website where the     exceptions.
documents may be found, but you don’t                                                      Internal Revenue Service
need to provide copies of the information.  Annual returns for foreign organiza-           Exempt Organization Determinations
However, even if these documents are        tions. A foreign organization that obtains     Room 6403
posted on your website, you must still      exemption as a public charity must file an     P.O. Box 2508
allow public inspection without charge at   information return annually (Form 990 or       Cincinnati, OH 45201
your main office during regular business    Form 990-EZ). A foreign organization that      (855) 204-6184
hours.                                      is a private foundation must file Form 
  Documents aren’t considered available     990-PF annually. However, a foreign          No user fee is required.
for public inspection on a website if the   organization, other than a private           • A letter stating the organization’s 
otherwise disclosable information is edited foundation or a section 509(a)(3)            request (listing as a section 501(c)(3) 
or subject to editing by a third party when supporting organization, may file Form       organization on IRS.gov or classification 
                                            990-N (e-Postcard) instead of Form 990 or    as a public charity).
                                            Form 990-EZ when its gross receipts from 

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• The legal name and complete mailing For a foreign address, enter your or trustees, check the box provided to add
address of the organization. province or state and foreign postal code more officer, director, and/or trustee
• The organization’s EIN. where indicated. information.
• The month its tax year ends. The person who is signing Form 1023
Line 2. Employer Identification Num-
• The organization’s date of formation. must be listed within the first five entries of
ber (EIN). You must have your own EIN.
• A contact name and telephone number. line 9.
Enter the 9-digit EIN the IRS assigned to
• The public charity status it is requesting
you. If you don’t have an EIN, you must
(if applicable) and information
apply for one before submitting your
demonstrating how it meets the Part II. Organizational
application. You can find out how to apply
requirements of that status (see Part VII, Structure
for an EIN by visiting IRS.gov and search
line 1, and related questions and You must be a corporation, limited liability
for “apply for an EIN.” You may apply for
schedules). company, unincorporated association, or
an EIN online or by fax or mail.
• This penalty of perjury statement: trust to be tax exempt under section
International applicants may call
I declare under the penalties of perjury 501(c)(3). Sole proprietorships,
267-941-1099 (toll call).
that I have examined this request, partnerships, or loosely affiliated groups of
including the accompanying documents, Don’t apply for an EIN more than individuals aren’t eligible.
and to the best of my knowledge and TIP once. If you’re unsure of your EIN
belief, the request contains all the relevant or whether you have one, call Line 1. Type of organization and copy
facts relating to the request, and such 877-829-5500 for assistance. of organizing document. Select your
type of organization, and before
facts are true, correct, and complete.
• The signature of an officer, director, Don’t use the EIN of a related or submitting the form, upload a copy of your
organizing document (including any
trustee, or other authorized person. ! other organization. amendments) as part of the required
• A copy of the organization’s Notification CAUTION
attachment.
of Registration.
• Form 8833, Treaty-Based Return Line 3. Month tax year ends. Select the Corporation. A corporation is an entity
Position Disclosure Under Section 6114 or month your tax year (annual accounting organized under a federal or state statute,
7701(b). period) ends. Your tax year (annual or a statue of federally recognized Indian
accounting period) is the 12-month period tribal or Alaskan native government.
on which your annual financial records are
Organizations Created in U.S. based. Copy of organizing document
(articles of incorporation and any
Territories and Possessions Check your bylaws or other rules amendments). A corporation’s
Organizations created in possessions and TIP of operation for consistency with organizing document is its “articles of
territories of the U.S. are generally treated the tax year (annual accounting incorporation. ” If you formed under state
as domestic organizations. If you were period) you enter here. statute, your articles of incorporation (and
created in a U.S. possession or territory, any amendments) must show
you must complete all required parts of Line 4. Person to contact. Enter the certification of filing. This means your
Form 1023 to apply for exempt status name and title of the person you want us articles show evidence that on a specific
under section 501(c)(3). to contact if we need more information. date they were filed with and approved by
The person to contact may be an officer, an appropriate state authority. The
Charitable contributions to you are director, trustee, or other individual who is document must be an exact copy of what
deductible by donors if you qualify for permitted to speak with us according to is on file with your state.
exempt status under section 501(c)(3). your bylaws or other rules of operation.
Annual filing requirements for an Your person to contact may also be an If you don’t have a copy of your articles
organization created in a U.S. territory or authorized representative, such as an of incorporation showing evidence of
possession are similar to those outlined attorney, certified public accountant, or having been filed and approved by an
above for foreign organizations (see Rev. enrolled agent, for whom you’re submitting appropriate state official, you may submit
Proc. 2011-15 at IRS.gov/pub/irs-irbs/ a completed Form 2848 with the Form a substitute copy of your articles of
irb11-03.pdf). 1023. incorporation. This substitute copy may be
handwritten, typed, printed, or otherwise
Line 5. Provide a daytime telephone reproduced. It must be accompanied by a
number for the contact listed on line 4. declaration, signed by an officer
Specific Instructions authorized to sign for you, that it is a
Line 6. You may provide a fax number for
Part I. Identification of the contact listed on line 4. complete and correct copy of the articles
of incorporation and that it contains all the
Applicant Line 7. Pay.gov will populate this field powers, principles, purposes, functions,
with the current user fee for filing Form and other provisions by which you
Line 1a. Enter your complete name 1023. currently govern yourself.
exactly as it appears in your organizing
document, including amendments. Line 8. Enter your complete website Limited liability company. A limited
address if you have one. Also, list any liability company (LLC) that files its own
Line 1b. If you have an “in care of” name, websites maintained on your behalf. The exemption application is treated as a
enter it here; otherwise, leave this space information on your website should be corporation rather than a partnership.
blank. consistent with the information in your
Line 1c-i. Enter your complete address Form 1023. Copy of organizing document
(articles of organization and operating
where all correspondence will be sent. If Line 9. Officers, directors, and trust- agreement (if adopted) and any
mail isn’t delivered to your street address ees. Enter the full names, titles, and amendments). Instead of articles of
and you have a P.O. box, list your P.O. mailing addresses of your officers, organization, an LLC’s organizing
box information instead of your street directors, and/or trustees. You may use document is its state-approved “articles
address. the organization’s address for mailing. If of organization.” If it has adopted an
you have more than five officers, directors, “operating agreement,” then this

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document is also part of its organizing accurate copy of the signed and dated • Took over 25% or more of the fair
document. If you formed under state original. Your declaration should clearly market value of the net assets of another
statute, your articles of organization (and indicate the original date that it was organization, or
any amendments) must show certificate signed. For trusts created by a will, include • Were established upon the conversion
of filing. This means your articles show a copy of the death certificate or a of an organization from for-profit to
evidence that on a specific date they were statement indicating the date of death, non-profit status.
filed with and approved by an appropriate and a copy of the relevant portions of the If you’re a successor organization,
state authority. The document must be an will. complete Schedule G, Successors to
exact copy of what is on file with your Other Organizations.
If your trust agreement continues
state. If you don’t have a copy of your
to provide for distributions for
articles of organization showing evidence CAUTION! Your predecessor organization
non-charitable interests, you won’t
of having been filed and approved by an TIP may have been either a
qualify for tax-exempt status.
appropriate state official, you may submit tax-exempt or non-exempt
organization.
a substitute copy of your articles of Line 2. Formation date. The date you
organization. This substitute copy may be enter should be consistent with your
handwritten, typed, printed, or otherwise organizing document. Part III. Required
•
reproduced. It must be accompanied by a If you’re a corporation, enter the date Provisions in Your
declaration, signed by an officer that your articles of incorporation were
authorized to sign for you, that it is a filed and approved by the appropriate Organizing Document
complete and correct copy of the articles authority. Line 1. Purpose clause. Your
•
of organization and that it contains all the If you’re an LLC, enter the date that the organizing document must limit your
powers, principles, purposes, functions, appropriate authority filed your articles of purposes to those described in section
and other provisions by which you organization or other organizing 501(c)(3). Those purposes are charitable,
currently govern yourself. document. religious, educational, scientific, literary,
If you are an LLC and want to be • If you’re an unincorporated association, testing for public safety, fostering national
TIP treated as a disregarded entity by enter the date that your organizing or international amateur sports
a tax-exempt member, don’t file document was adopted by the signatures competition, and preventing cruelty to
an exemption application. of at least two individuals. children or animals.
• If you’re a trust (other than a trust
Unincorporated association. An formed by a will), enter the date your trust The generally accepted legal definition
unincorporated association formed was funded. If your trust agreement of “charitable” includes relief of the poor,
under state law must have at least two provided for any non-charitable interests, the distressed, or the underprivileged;
members who have signed a written enter the date that non-charitable interests advancement of religion; advancement of
document that creates an entity with a expired. If you were formed by a will, enter education or science; erecting or
specifically defined purpose. the date of death or the date any maintaining public buildings, monuments,
non-charitable interests expired. or works; lessening the burdens of
Copy of organizing document government; lessening neighborhood
(articles of association or constitution Line 3. State of formation. Enter the tensions; eliminating prejudice and
and any amendments). Your organizing jurisdiction (for instance, the state or the discrimination; defending human and civil
document must include the name of the federally recognized tribal government) rights secured by law; and combating
organization, its purpose, the date the under the laws of which you were community deterioration and juvenile
document was adopted, and the incorporated or otherwise formed. This delinquency. Therefore, the phrase “relief
signatures of at least two individuals. If may not be the place in which you’re of the poor” in your organizing document
your copy doesn’t contain the proper physically located. For example, if you’re properly limits your purposes.
signatures and date of adoption, you may physically located in New York, but Limiting your purposes by reference to
submit a written declaration that states incorporated under Massachusetts law, section 501(c)(3) generally will be
your copy is a complete and accurate enter Massachusetts. sufficient to meet the organizational test
copy of the signed and dated original. For purposes of completing this under section 501(c)(3). Your organizing
Your declaration should clearly indicate application, you’re formed under the laws document may also sufficiently limit your
the original date of adoption. of a foreign country if you’re not formed purpose by reference to a specific
Bylaws may be considered an under the laws of the United States, its charitable purpose such as “relief of the
TIP organizing document only if they territories and possessions, federally elderly within the meaning of section
include the required elements recognized Indian tribal or Alaska native 501(c)(3).”
listed above. governments, or the District of Columbia. However, purposes listed in your
Line 4. Bylaws“ ” are generally the organizing document broader than those
Trust. A trust may be formed by a trust internal rules and regulations of an listed in section 501(c)(3) may cause you
agreement or declaration of trust. A trust organization. If you have bylaws, upload a to fail the organizational test. In that case,
may also be formed through a will. current copy (including any amendments). you will need to amend your organizing
Generally, a trust must be funded with Bylaws don’t need to be signed unless document before applying. A reference to
property, such as money, real estate, or they are your organizing document as section 501(c)(3) won’t ensure that your
personal property. described in the instructions for line 1 purposes are limited to those described in
Copy of organizing document (trust above. section 501(c)(3) if other provisions
describing your purposes include one or
agreement/declaration of trust or will Line 5. Successor organization. You more non-exempt purposes. The following
and any amendments). Your trust are a “successor” if you: is an example of an acceptable purpose
agreement (and any amendments) must • Took over activities previously clause.
be signed by at least one trustee. If your conducted by another organization,
trust agreement copy isn’t signed, you
may submit a written declaration that
states your copy is a complete and

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The organization is organized Upon the dissolution of this • Where is the activity conducted?
exclusively for charitable, organization, assets shall be • What percentage of your total time is
allocated to the activity? (Combined time
religious, educational, and distributed for one or more percentages should add up to 100%.)
scientific purposes under exempt purposes within the • How is the activity funded (for example,
section 501(c)(3) of the Internal meaning of section 501(c)(3) of donations, fees, etc.) and what
Revenue Code, or the Internal Revenue Code, or percentage of your overall expenses is
corresponding sections of any corresponding section of any allocable to this activity?
future federal tax code. future federal tax code, or shall • How does the activity further your
be distributed to the federal exempt purposes?
government, or to a state or Line 2. National Taxonomy of Exempt
See Pub. 557 for further information local government, for a public Entities (NTEE) code. An NTEE code is
and examples of how to limit your purpose. a three-character series of letters and
purposes.
numbers that generally describes a type of
Line 2. Dissolution clause. Your organization. Enter the code that best
organizing document must provide for See Pub. 557 for further information describes your organization from the list of
the permanent dedication of your assets and examples of acceptable language for NTEE codes, located in Appendix D. For
to a section 501(c)(3) purpose. This dedication of assets in your organizing more information and more detailed
means that if you dissolve your document. definitions of these codes developed by
organization in the future, your assets the National Center for Charitable
must be distributed for an exempt purpose Part IV. Your Activities Statistics (NCCS), visit the Urban Institute
described in section 501(c)(3), or to the NCCS website at www.nccs.urban.org.
federal government, or to a state or local Reminder
government, for a public purpose. In Answer all questions in this part as they NTEE codes are also used for
certain states, you may rely on state law to pertain to your past, present, and future TIP purposes other than identification
establish the permanent dedication of activities. of organizations described in
section 501(c)(3). Therefore, all codes in
assets for exempt purposes. This is based Line 1. Describe completely and in detail the list don't necessarily correspond to a
on Rev. Proc. 82-2, 1982-1 C.B. 367. For your past, present, and planned activities. section 501(c)(3) purpose.
additional information, search “Operation Don’t refer to or repeat the purposes in
of state law” at IRS.gov. your organizing document or speculate Line 3. If programs are limited to specific
Foreign organizations may be able to about potential future programs. Your individuals, describe how you select or
rely upon the applicable laws of their narrative description of activities should be identify those individuals. If programs are
jurisdiction in a similar manner. If relying thorough and accurate because we available only for members, describe
on a foreign law, you must provide a copy determine whether you qualify for section membership criteria, any membership
of the applicable law with an English 501(c)(3) exempt status based on the dues, any different membership levels,
translation. information in your application. You should and the benefit each membership level
Naming a specific organization to describe either actual or planned receives.
receive your assets upon dissolution will activities. For example, if you plan to
be acceptable only if your organizing further educational purposes by operating Line 4. Describe any business or family
document requires that the specific an afterschool homework club, you would relationship between individuals who
organization to be exempt under section describe that activity rather than cite that receive goods, services, or funds through
501(c)(3) at the time your dissolution takes you will further educational purposes. If your programs and any officers, directors,
place and provides for a qualified you were also contemplating offering trustees, or highest compensated
alternative recipient if the named scholarships in the future, but currently employees or independent contractors.
organization isn’t exempt under section have no plans to do so, then the For purposes of this form, “highest
501(c)(3) at that time. scholarship activity would be speculative, compensated” employees or independent
If your organizing document states that and you should not describe it. contractors are persons to whom you pay
your assets would be distributed to Some organizations (such as credit over $100,000 of compensation,
members or private individuals or for any counseling organizations (see Part IV, including compensation from related
purpose other than those provided in line 8), childcare organizations (see Part organizations.
section 501(c)(3), you must amend your IV, line 12), agricultural research Line 5. You participate in a political
organizing document to remove such organizations (see Part VII, line 1), or campaign if you promote or oppose the
statements. cooperative hospital service organizations candidacy of an individual for public office.
The following is an example of an (see Schedule C)) must meet specific Candidate debates and nonpartisan voter
acceptable dissolution clause. operational requirements to qualify for education and registration may be
exemption under section 501(c)(3). If permitted. See Rev. Rul. 2007-41,
you’re such an organization, be certain to 2007-25 I.R.B. 1421 at IRS.gov/irb/
include an explanation in your activity 2007-25_I.R.B. 1421 and Pub. 1828 for
description of how activities you conduct more information and examples.
(or don’t conduct, if the specific
operational requirement limits permissible Organizations described in
activities) satisfy those specific ! section 501(c)(3) are prohibited
operational requirements. CAUTION from supporting or opposing
candidates for public office in any political
For each past, present, or planned campaign. If you answer “Yes,” you aren’t
activity, include information that answers qualified for tax exemption under section
the following questions. 501(c)(3) and should reconsider whether
• What is the activity? the filing of application Form 1023 is
• Who conducts the activity? appropriate for you. See Pub 557 for a

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description of other code sections under             Churches and private foundations     being associated with terrorism on 
which you may qualify.                         !     aren’t eligible to make this section OFAC’s Specially Designed Nationals and 
                                             CAUTION 501(h) election.                     Blocked Persons List (OFAC SDN List). 
Line 6. You are attempting to influence                                                   Information about OFAC sanction 
legislation if you directly contact or urge  Line 7.  Intellectual property includes      programs and the OFAC SDN List are 
the public to contact members of a           the following;                               available at www.treasury.gov/ofac.
legislative body for the purpose of          • Patents (for inventions);
proposing, supporting, or opposing           • Copyrights (for literary and artistic      Line 10.  A “foreign country” is a 
legislation. You are also attempting to      works such as novels, poems, plays, films,   country other than the U.S., its territories 
influence legislation if you advocate the    musical works, drawings, paintings,          and possessions, and the District of 
adoption or rejection of legislation. If you photographs, sculptures, architectural       Columbia.
answer “Yes,” your explanation should        designs, performances, recordings, film,     Line 10a–c.  See instructions for lines 9g–
include the percentage of your total time    and radio or television programs);           i.
and total funds spent on such legislative    • Trade names, trademarks, and service 
activities.                                  marks (for symbols, names, images, and       Line 11.  You are a sponsoring 
Organizations described in section           designs); and                                organization of a donor-advised fund if 
501(c)(3) are prohibited from engaging in    • Formulas, know-how, and trade              you establish separate accounts that you 
a substantial amount of legislative          secrets.                                     own or control for a donor whereby the 
                                                                                          donor or donor-advisor may make 
activities. Whether you’re engaged in        Line 8. These activities involve the         recommendations about the investments 
substantial legislative activities depends   education of the consumer on budgeting,      of or distributions from the account. See 
on all of the facts and circumstances.       personal finance, financial literacy,        Pub. 557 for more information on the 
For this purpose, “legislation” includes     mortgage foreclosure assistance, or other    definitions of sponsoring organizations 
action by Congress, a state legislature, a   consumer credit areas. These activities      and donor-advised funds.
local council, or a similar governing body,  may also involve assisting the consumer 
with respect to acts, bills, resolutions or  in consolidating debt and negotiating                You can't sponsor a 
similar items (such as legislative           between debtors and creditors to lower         !     donor-advised fund if you're a 
confirmation of appointive offices).         interest rates and waive late and over-limit CAUTION private foundation.
Legislation also includes action by the      fees. If you answer “Yes,” you may be 
public in a referendum, ballot initiative,   subject to the requirements of section       Line 12.  A “school” is an educational 
constitutional amendment, or similar         501(q). Search “501(q)” on IRS.gov for       organization whose primary function is the 
procedure. Legislation generally doesn’t     information on these requirements and        presentation of formal instruction and 
include actions by executive, judicial, or   whether they apply to you.                   which normally maintains a regular faculty 
                                                                                          and curriculum and that normally has a 
administrative bodies.                       Line 9. A “relationship” between you         regularly enrolled body of pupils or 
Organizations may involve themselves         and the recipient organization includes the  students in attendance at the place where 
in issues of public policy without being     following situations.                        its educational activities are regularly 
engaged in legislative activity. For         • You control the recipient organization,    carried on. A school may include the 
example, organizations may conduct           or it controls you through common            following.
educational meetings, prepare and            officers, directors, or trustees, or through • Primary, secondary, preparatory, or 
distribute educational materials, or         authority to approve budgets or              high school.
otherwise consider public policy issues.     expenditures.                                • College or university.
Similarly, an organization may appear        • You and the recipient organization were    • Trade or technical school.
before a governmental body at its request    created at approximately the same time       • Nursery or pre-school.
to offer testimony about a decision that     and by the same persons.                     • School that you operate as an activity, 
may affect the organization’s existence.     • You and the recipient organization         such as a school that is operated as an 
        A private foundation isn’t allowed   operated in a coordinated manner with        activity of a museum, historical society, or 
TIP     to engage in any activities to       respect to facilities, programs, employees,  church.
        influence legislation.               or other activities.
                                             • Persons who exercise substantial                   If you're a nursery or pre-school 
Line 6a.  Form 5768. Most public             influence over you also exercise               TIP   that doesn't meet the description 
charities are eligible to elect to make      substantial influence over the recipient             of a school, answer “No,” to 
expenditures to influence legislation by     organization.                                line 12.
filing Form 5768, Election/Revocation of     Line 9b. Answer “Yes,” if you make                   If you’re a nursery, pre-school, or 
Election by an Eligible Section 501(c)(3)    grants, loans, or other distributions (such    TIP   child care organization that 
Organization To Make Expenditures To         as goods) to a foreign organization.                 doesn’t meet the description of a 
Influence Legislation. By filing Form 5768,                                               school, you may still further an educational 
your legislative activities will be measured Line 9g–i. The Office of Foreign Assets      purpose if substantially all the care you 
solely by an expenditure limit under         Control (OFAC) of the U.S. Department of     provide is for the purpose of enabling 
section 501(h) rather than by whether the    the Treasury administers and enforces        individuals to be gainfully employed and 
legislative activity is considered           economic and trade sanctions based on        your services are available to the general 
substantial. Form 5768 describes the         U.S. foreign policy and national security    public (section 501(k)).
types of organizations that are eligible to  goals against certain governments, 
make an election. You must file Form         entities, and individuals, as directed in      If you’re a school, or if you operate a 
5768 by mailing it to the address on the     Executive Orders. As part of the             school as an activity (even if it is a 
form. For a discussion of influencing        comprehensive and sustained campaign         secondary activity), complete Schedule B. 
legislation and the requirements of section  against terrorist financing, all U.S.        See Pub. 557 for additional information.
501(h), see Pub 557.                         persons, including U.S.–based charities, 
                                             are prohibited from dealing with persons     Line 13.   “Hospital” or “medical care” 
                                             (individuals and entities) identified as     includes the treatment of any physical or 

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mental disability or condition, whether as support. Fundraising may be conducted “Yes,” if you will or you do have highest
an inpatient or outpatient. A hospital by your employees or volunteers, through compensated employees or highest
includes the following. an agent, or through an independent compensated independent contractors.
• Hospitals and rehabilitation institutions, contractor. Check all the boxes that apply. For purposes of this form, “highest
outpatient clinics, or community mental For purposes of this application, compensated” employees or independent
health or drug treatment centers if the “bingo” is a game of chance played with contractors are persons to whom you pay
principal purpose or function is the cards that generally are printed with five over $100,000 of compensation,
providing of medical or hospital care or rows of five squares each on which including compensation from related
medical education or research. participants place markers to form a organizations.
• Medical research organizations if the pre-selected pattern to win the game. For information on determining if an
principal purpose or function is the “Other (non-bingo) gaming activities” individual is an employee or an
continuous active conduct of medical include pull-tabs, raffles, keno, independent contractor, see Pub. 15-A,
research in conjunction with a hospital. split-the-pot, and other games of chance. Employer’s Supplemental Tax Guide.
If you provide “hospital or medical
Gaming doesn’t further an
care,” or you’re a medical research Line 1e. Similarly situated “
TIP exempt purpose under section
organization, complete Schedule C. organizations” means tax-exempt or
501(c)(3). Except to the extent
See Pub. 557 for additional that an exception may apply, your revenue taxable organizations of comparable size,
information. from gaming activities will be subject to purpose, and resources. Adjustments due
Line 14. “Low-income housing” refers unrelated business income tax. See to geographic area and other specified
to rental or ownership housing provided to Pub. 3079 for further information about conditions are appropriate, but you should
persons based on financial need. If you gaming. document the adjustments. You should
document the sources(s) of comparable
provide low-income housing, complete compensation data, both taxable and
Schedule F. non-taxable, and retain copies in your
Part V. Compensation and
Line 15. Answer “Yes,” if you pay money permanent records.
to an individual as a scholarship, Other Financial
Line 1g. “Reasonable compensation”
fellowship, or education loan; for travel, Arrangements is the amount that would ordinarily be paid
study, or other similar purposes. Also, Reminder. Answer all questions in this for like services by like organizations
answer “Yes,” if you pay such amounts on part as they pertain to your past, present, under like circumstance as of the date the
behalf of an individual to a school or a and future activities. compensation arrangement is made.
tuition or educational savings program. Establishing and documenting your
Complete Schedule H—Section I. For purposes of Part V, compensation
includes: decisions about compensation is
Travel, study, or other similar purposes Salary or wages; important because excess compensation
include payments made to enhance a • (including cash and other benefits that
literary, artistic, musical, scientific, • Deferred compensation;
teaching or other similar capacity, skill, or • Retirement benefits, whether in the aren’t accounted for as reasonable
form of a qualified or non-qualified compensation for services) may result in
talent of the individual recipient. These employee plan (pensions or annuities); excise taxes on both the individual and
payments include, for example, amounts Fringe benefits (personal vehicle, you, and may jeopardize your tax
paid to: • exemption.
meals, lodging, personal and family
• Vocational high school students to be educational benefits, low-interest loans, Line 2. A conflict of interest arises when a
used to purchase basic tools; payment of personal travel, entertainment, person in a position of authority over an
• Teachers to induce them to teach in a or other expense, athletic or country club organization, such as a director, officer, or
public school system in an economically membership, and personal use of your manager, may benefit personally from a
depressed area; and property); and decision he or she could make. A sample
• A scientific researcher to underwrite Bonuses. Conflict of Interest Policy is included as
that individual’s research project. •
Educational grants don’t include Example. An organization could Appendix A. This sample conflict of
amounts you pay to an individual as compensate a director as follows: interest policy doesn’t prescribe any
specific requirements. Therefore,
compensation, such as payments made to organizations should use a conflict of
a consultant for personal services or to Wages interest policy that best fits their
produce a report for you. Director $2,500 organizations.
Educational grants don’t include Compensation . . . Adoption of a conflict of interest policy
amounts paid to another organization that Salary as Chief Executive isn’t required to obtain tax-exempt status.
distributes your funds as a scholarship to Officer . . . . . . . . . . . . . . . 40,000 However, by adopting the sample policy or
an individual if you have no role in the a similar policy, you will be choosing to put
selection process. Deferred retirement . . . . . . 2,000
in place procedures that will help your
Health insurance policy . . . 5,000
If you're a “private foundation” officers, directors, and trustees recognize
Use of a vehicle . . . . . . . . 5,000 situations that could present potential or
! as described in Part VII, you must Total Compensation $54,500 actual conflicts of interest so that you can
CAUTION obtain advance approval of your
grant-making procedures. You can use take steps to reduce the risk that those in
Schedule H—Section II, to request positions of authority over you may
advance approval as part of this Make sure the information you provide in receive an inappropriate benefit.
application process. You can complete Part V is consistent with the information The sample conflict of interest
Section II when you complete Part VII. you enter in Part VI. Financial Data. TIP policy in Appendix A includes
Foundation Classification. Line 1. Compensation. Check “Yes,” if items marked “Hospital insert–for
you do or you will compensate your hospitals that complete Schedule C” that
Line 16. “Fundraising”includes efforts officers, directors, or trustees. Also, check are intended to be adopted by hospitals.
to raise funds through appeals for financial

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Line 3. A fixed payment means a Line 5. Answer “Yes,” if any of your haven’t existed, for a total of 4 years of
payment that is either a set dollar amount officers, directors, or trustees: financial information. Place financial
or fixed through a specific formula where • Is an officer, director, or trustee in information for the year you’re filing this
the amount doesn’t depend on discretion. another organization (other than a section application in the column marked Current
For example, a salary of $200,000 that is 501(c)(3) organization) that has a lease, tax year.
adjusted annually based on the increase contract, loan, or other agreement with Completed 5 years or more. If
in the Consumer Price Index is a fixed you; or you’ve existed for 5 years or more, provide
payment. • Possesses more than a 35% ownership your actual income and expenses for your
A “non-fixed payment” means a interest in any organization that has a 5 most recently completed tax years.
payment that depends on discretion. For lease, contract, loan, or other agreement Place financial information for your most
example, a bonus of up to $100,000 that is with you. For example, answer “Yes,” if recently completed tax year in the column
based on an evaluation of performance by one of your directors is an officer for a marked Current tax year.
the governing board is a non-fixed section 501(c)(4) organization with whom
payment because the governing body has you have a lease for office space, or if one We may request financial
discretion over whether the bonus is paid of your directors owns more than 35% of ! information for more than 5 years.
and on the amount of the bonus. the voting stock of a corporation to which CAUTION
you made a loan.
Line 4. Don’t include purchases or sales A. Statement of Revenue and
of goods and services in your normal Line 6. “Develop” means the planning, Expenses
course of operations that are available to financing, construction, or provision of
the general public under similar terms and similar services involved in the acquisition Preparing the statement. Prepare the
conditions. of real property, such as land or a building. statement using the method of accounting
For example, you should provide you use in keeping your books and
Answer “Yes,” if any of your officers, information regarding the services of a records.
directors, or trustees: consultant who arranges your acquisition Prepare the statement using the
• Is an officer, director, or trustee of of a facility through the issuance of accounting period entered on Part I, line 3.
another organization (other than a section tax-exempt bonds. Enter “0” if a particular revenue or
501(c)(3) organization) that you will
purchase or sell goods, services, or Line 7. “Manage” means to direct or expense doesn’t apply to you.
assets from or to; or administer. For example, you would Your financial information should reflect
• Possesses more than 35% ownership provide information about an organization your activities described in this
interest in any organization that you will hired to administer a museum gift shop. application.
purchase or sell goods, services, or Line 8. A “joint venture” is a legal Line 1. Enter the total gifts, grants, and
assets from or to. agreement in which the persons jointly contributions you receive (other than
undertake a transaction for mutual profit. membership dues reported on line 2 and
Arm’s length. An arm’s length described below). Include items of value
Generally, each person contributes assets
standard exists where the parties have an that you receive as gifts, grants, or
and shares risks. Like a partnership, joint
adverse (or opposing) interest. For contributions. For example, if one of your
ventures can involve any type of business
example, a seller wants to sell his goods activities is a food drive, include the value
transaction and the persons involved can
at the highest possible price, while a buyer of the donated food on this line. Also
be individuals, groups of individuals,
wants to buy at the lowest possible price. include on this line payments a
companies, or corporations.
These are adverse interests. governmental unit makes to enable you to
In negotiating with a person, an Part VI. Financial Data both accomplish your exempt purpose(s)
adverse interest is assumed if that person and to provide a service or facility directly
is otherwise unrelated to you in the sense Line 1. Select the option that best to the general public.
of not being in a position to exercise describes you to determine the years of See the instructions for line 9 if you’re
substantial influence over you or your revenues and expenses you need to uncertain whether revenue should be
affairs. If the person is in a position to provide. included as a grant on line 1 or as gross
exercise substantial influence over your receipts on line 9. Include unusual
affairs, then an arm’s length standard Completed less than 1 year. If
requires additional precautions to you’ve existed for less than 1 year, grants on line 12 and not on line 1.
eliminate the effect of the relationship. provide projections of your likely income Examples.
and expenses for your current year and
Using a conflict of interest policy, projections of your likely income and 1. A city pays the symphony orchestra
information about comparable expenses for the next 2 years based on a to provide free music programs in the
transactions between unrelated parties, reasonable and good faith estimate of public schools. The programs are open to
and reliable methods for evaluating the your future finances for a total of 3 years of the public. This income received from a
transaction, are examples of precautions financial information. Place financial governmental unit accomplishes the
that would help make the negotiation information for the year you’re filing this orchestra's exempt purpose and directly
process equivalent to one between application in the column marked Current provides a service to the general public.
unrelated persons. tax year. This income is a grant to the symphony
orchestra that should be listed on line 1.
Fair market value. This is the price at Completed more than 1 year, fewer 2. The symphony orchestra sells
which property or the right to use property than 5 years. If you’ve existed for more tickets to the public for its fall season.
would change hands between a willing than 1 year but fewer than 5 years, Such income is gross receipts received
buyer and a willing seller, neither being provide your actual income and expenses from the general public in performance of
under any compulsion to buy, sell, or for each completed year you’ve existed the symphony orchestra’s exempt function
transfer property or the right to use and projections of your likely income and and should be listed on line 9.
property, and both having reasonable expenses based on a reasonable and
knowledge of relevant facts. good faith estimate of your future finances 3. The public school system pays the
for your current year and each year you orchestra to create several musical pieces

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Figure 2. Net Gain or Loss On Sales of Capital Assets Provide an itemized list of your gross
receipts in line 25, describing the sources
Categories and amounts of income. For payments by
a governmental unit, list the payer, the
(A) Real Estate (B) Securities (C) Other purpose of the payment, and the payment
1. Gross sales price of amount.
assets (other than
inventory) by category. Line 10. Lines 8 and 9 will be added for
you.
2. Less: Cost or other
basis and sales Line 11. Enter any net gain or loss on the
expenses. sale of capital assets. Provide an itemized
3. Gain or (loss). Subtract list by asset category (for example, real
line 2 from line 1. estate or securities) showing gross sales,
cost or other basis/sales expenses, and
4. Net gain or (loss) — Add line 3 of columns (A), (B), and (C). Enter here and gain or loss by asset category in line 25.
on Form 1023, Part VI - A. Statement of Revenues and Expenses, line 11. You may use the format in Figure 2.
Line 12. Enter any “unusual grants,”
which generally are any substantial
suitable for the school system’s provided by the governmental unit to the contributions and bequests you received
elementary music curriculum. This public without charge. from disinterested persons that, by their
payment by a governmental unit for the size, adversely affect your classification as
Line 7. Enter your total income from all
music compositions is primarily for the a public charity Unusual grants. “ ” are
sources not reported on lines 1 through 6,
school system’s own use, not for the direct unusual, unexpected, and received from
or lines 9, 11, and 12. Provide an itemized
benefit of the public. Therefore, this an unrelated party. Provide an itemized list
list in line 25, showing each type and
income is gross receipts received from a of any unusual grants, including the
amount of income included, and a brief
governmental unit in performance of the amount in line 25, and explain how it was
description of each type of income.
orchestra’s exempt function that should be unusual, unexpected, and from an
listed on line 9. Line 8. Lines 1 through 7 will be added
unrelated party.
for you.
Line 2. Enter the amount you receive For additional information about
from members to provide support to the Line 9. Enter income from activities that unusual grants and a description of public
organization. Don’t include payments from you conduct to further your exempt charity classifications, see Pub. 557.
members or on behalf of members to purposes (excluding amounts listed on
purchase admissions, merchandise, other lines). Also, include as gross Line 13. Lines 10 through 12 will be
services, or use of facilities. receipts the income from activities added for you.
conducted: Lines 14. Enter the total expenses you
Line 3. Enter your gross income from • Intermittently (not regularly carried on), incur for soliciting gifts, grants, and
dividends, interest, payments received on such as an occasional auction; contributions included on line 1. Include
securities, loans, rents, and royalties you • With substantially all (at least 85%) fees paid to professional fundraisers for
hold for investment purposes. volunteer labor, such as a car wash; soliciting gifts, grants, and contributions.
See Pub. 598 for additional information • For the convenience of members,
regarding royalties treated as unrelated students, patients, officers, or employees, Line 15. Enter the total amount you pay
business income. such as a parking lot for a school’s out to both individuals and organizations.
students and employees; or Provide an itemized list in line 25,
Line 4. Enter your net income from • With substantially all contributed identifying recipients (using letter
unrelated business activities. “Unrelated merchandise, such as a thrift store. designations such as A, B, C, etc.), a brief
business income” generally is income description of the purposes or conditions
from any trade or business activity that is See Pub. 598 for additional information of payments, and the amounts paid.
regularly carried on, and not related to regarding income that isn’t from an
your exempt purpose. Certain exceptions unrelated trade or business. Colleges, universities, and other
educational institutions and agencies
and exclusions may apply. “Gross receipts” also includes subject to the Family Educational Rights
Report on line 9 income from activities payment by a governmental unit that may and Privacy Act (20 U.S.C. 1232g) don’t
that aren’t related to the accomplishment be called a “grant” but is actually payment need to list the names of individuals to
of your exempt purposes, but aren’t for a service or facility for the use of the whom they provided scholarships or other
considered unrelated business activities. government payer, rather than for the financial assistance where such
For example, report income from the sale direct benefit of the public. disclosure would violate the privacy
of merchandise by volunteers that isn’t Example. The state government gives provisions of the law. Instead, group each
treated as an unrelated trade or business a conservation group a grant to study the type of financial aid provided, indicate the
on line 9. effects of a new sewage treatment plant number of individuals who received the
See Pub. 598 for additional information on an ecologically significant woodland aid, and specify the aggregate dollar
regarding unrelated business income. area. Although the payment is called a amount.
grant, it is actually gross receipts that Maintain (but don’t submit) a list
Line 5. Enter amounts any local tax should be included on line 9. The payment showing the names of recipients
authority collects from the public on your is by a governmental unit (state) for a associated with each letter designation.
behalf. study for its own use, not for the direct
Line 6. Enter the value of services or benefit of the general public. A for-profit Line 16. Enter total payments you make
facilities a governmental unit furnishes to consulting company could’ve done the to or for the benefit of your members (not
you. Use the fair market value of the study rather than by the tax-exempt including any amounts listed on line 15).
services or facilities. Don’t include the conservation group. Provide an itemized list in line 25,
value of services or facilities generally identifying recipients (using letter

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designations), a brief description of the Line 4. Enter the total amount of bonds or on lines 1 through 9, for example, patents,
purposes or condition of payments, and notes you issued that will be repaid to you. copyrights, or other intangible assets.
the amounts paid. Provide an itemized list in line 19, that Provide an itemized list of each asset in
Maintain (but don’t submit) a list shows the name of each borrower (using a line 19.
showing the names of recipients letter designation), the borrower’s Line 11. Lines 1 through 10 will be added
associated with each letter designation. relationship to you, a brief description of for you.
the obligation, the rate of return, the due
Line 17. Enter the total amount of Line 12. Enter the total amount of your
date, and the amount due.
compensation you pay to your officers, accounts payable to suppliers and others,
directors, and trustees. Maintain (but don’t submit) a list such as salaries payable, accrued payroll
showing the names of borrowers taxes, and interest payable.
Line 18. Enter the total amount of associated with each letter designation.
salaries and wages you pay to employees Line 13. Enter the total unpaid portion of
(not reported on line 17). Line 5. Enter the total fair market value grants and contributions you committed to
of corporate stocks you hold. Provide an pay to other organizations or individuals.
Line 19. Enter your total interest itemized list of your corporate stock
expenses for the year. Don’t include holdings in line 19. Line 14. Enter the total of your mortgages
mortgage interest treated as an and other notes payable outstanding at
occupancy expense on line 20. For stock of closely held corporations,
list the name or the corporation, a brief the end of the current tax year/period.
Line 20. Enter the amount you pay for the summary of the corporation’s capital Provide an itemized list in line 19 showing
use of office space or other facilities, heat, structure, the number of shares held, and each note separately, including the
light, power and other utilities, outside their value as carried on your books. If lender’s name, purpose of loan,
janitorial services, mortgage interest, real valuation doesn’t reflect current fair market repayment terms, interest rate, and
estate taxes, and similar expenses. value, also include fair market value. original amount.
Line 21. Enter the total depreciation, For stock traded on an organized Line 15. Enter the total amount of any
depletion, and similar expenses you incur. exchange or in substantial quantities over other liabilities not reported on lines 12
the counter, list the name of the through 14. Provide an itemized list in
Line 22. Enter the total professional fees corporation, a description of the stock, line 19 of these liabilities, including the
you pay. Professional fees are amounts and the principal exchange on which it is amounts you owe.
charged by individuals and entities that traded, the number of shares held, their Line 16. Lines 12 through 15 will be
aren’t your employees. They include fees value as carried on your books, and their added for you.
for professional fundraisers (other than fair market value.
fees listed on line 14, earlier), accounting Line 17. Under fund accounting, an
services, legal counsel, consulting Line 6. Enter your total amount of loans organization segregates its assets,
services, contract management, or any (personal and mortgage loans) receivable. liabilities, and net assets into separate
independent contractors. Provide an itemized list in line 19 that funds according to restrictions on the use
identifies each borrower (using a letter of certain assets. Each fund is like a
Line 23. Enter any expenses you didn’t designation), the borrower’s relationship separate entity in that it has a
include in the lines above, such as for to you, purpose of loan, repayment terms, self-balancing set of accounts showing
program services. Provide an itemized list interest rate, and original amount of loan. assets, liabilities, equity (fund balance),
in line 25, showing the type and amount of Report each loan separately, even if more income, and expenses. If you don’t use
each significant expense. than one loan was made to the same fund accounting, report only the “net
Line 24. Lines 14 through 23 will be person. assets” account balances, which include
added for you. Maintain (but don’t submit) a list capital stock, paid-in capital, retained
B. Balance Sheet showing the names of borrowers earnings or accumulated income, and
associated with each letter designation. endowment funds.
Complete the balance sheet for your most
recently completed tax year. If you haven’t Line 7. Enter the total book value of your Line 18. Lines 16 and 17 will be added
completed a full tax year, use the most other investments. Include the total book for you.
current information available. Be sure to value of government securities (federal,
enter the year-end date for the information state, and municipal), and buildings and Part VII. Foundation
provided and not the date you prepare this equipment held for investment purposes.
application. Enter “0” if a particular asset Provide an itemized list in line 19 Classification
or liability doesn’t apply to you. identifying and reporting the book value of Organizations that are exempt under
each building/item of equipment held for section 501(c)(3) are private
Line 1. Enter your total cash in checking investment purposes. foundations unless they are:
and savings accounts, temporary cash • Churches, schools, hospitals,
investments (money market funds, CDs, Line 8. Enter the total book value of governmental units, entities that undertake
treasury bills, or other obligations that buildings and equipment not held for testing for public safety, organizations that
mature in less than 1 year), and petty cash investment purposes. This includes have broad financial support from the
funds. facilities you own and equipment you use general public; or
in conducting your exempt activities. • Organizations that support one or more
Line 2. Enter your total accounts Provide an itemized list in line 19 of these organization(s) that are themselves
receivable that arose from the sale of assets held at the end of the current tax classified as public charities.
goods and/or performance of services, year/period, including the cost or other
less any reserve for bad debt. basis. Section 501(c)(3) organizations
excepted from private foundation
Line 3. Enter the amount of materials, Line 9. Enter the total book value of land classification are public charities. Unless
goods, and supplies you purchased or not held for investment purposes. you meet one of the exceptions above,
manufactured and held to be sold or used
in some future period. Line 10. Enter the total book value of any you’re a private foundation.
other category of your assets not reported

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    You can only select one                   functions, or a combination of these                In Part IV, line 1, include information 
TIP foundation classification.                sources, and not more than one-third of         detailing your agricultural research 
                                              your support from gross investment              program and how you will spend 
                                              income and net unrelated business               contributions to your program, including a 
Line 1.  Select the foundation                income. Typically, you would show a             description of how you’re engaged in the 
classification you’re requesting from the     substantial part of your income on Part         continuous active conduct of agricultural 
list below. The form will then take you to    VI-A. Statement of Revenues and                 research (as defined in Section 1404 of 
additional lines or parts of the application  Expenses, lines 1, 2, and 9.                    the Agricultural Research, Extension, and 
that you must complete based on your                                                          Teaching Policy Act of 1977), information 
response.                                     Under this public charity 
                                              classification, you must meet both the          showing that you’re operated in 
509(a)(1) and 170(b)(1)(A)(vi).     Select    “one-third public support test ” and the        conjunction with a land grant college or 
this classification if you normally receive a “not-more-than-one-third investment             university or a non-land grant college of 
substantial part of your support from         income and net unrelated business               agriculture (as defined in Section 1404 of 
grants from governmental units or from        income test,” lines 1 through 13. See Pub.      the Agricultural Research, Extension, and 
contributions from the general public, or a   557 for additional information about these      Teaching Policy Act of 1977), and 
combination of these sources. Typically,      tests.                                          information discussing the timing of when 
you would show a substantial part of your                                                     you will spend contributions for research.
income on Part VI-A. Statement of             509(a)(1) and 170(b)(1)(A)(i).  Select          509(a)(3). Select this classification if 
Revenue and Expenses, lines 1 and 2.          this classification if your primary purpose     you’re organized and operated to support 
Under this public charity                     is operating a church or convention or          one or more public charities described in 
classification, you must meet the one-third   association of churches. The term               section 509(a)(1) or 509(a)(2) or an 
public support test or 10% facts and          “church” includes mosques, temples,             organization that is tax exempt under 
circumstances test. See Pub. 557 for more     synagogues, etc. If you select this box,        section 501(c)(4), (5), or (6) and meets the 
information.                                  complete Schedule A.                            public support test of section 509(a)(2). 
Public support test. An organization          509(a)(1) and 170(b)(1)(A)(ii).  Select         See the instructions for Schedule D for 
must receive either:                          this classification if your primary purpose     more information about the requirements 
                                              is operating a school. If you select this       for this classification, including the 
1. At least one-third of its total support    box, complete Schedule B.                       required relationship you must have with 
from governmental agencies,                                                                   your supported organization(s). Complete 
contributions from the general public, and    If you operate a school but it isn’t your 
contributions or grants from other public     primary purpose, don’t select this              Schedule D.
charities; or                                 classification. However, you must still         509(a)(4). Select this classification if your 
                                              complete Schedule B. See Part IV, line 12.
2. At least 10% of its total support                                                          primary purpose is to test products to 
from governmental agencies,                   509(a)(1) and 170(b)(1)(A)(iii).   Select       determine their acceptability for use by the 
contributions from the general public, and    this classification if your primary purpose     general public.
contributions or grants from other public     is providing medical or hospital care or            Contributions to organizations of this 
charities; and also satisfy a facts and       medical eduction or research (performed         type aren’t deductible under section 
circumstances test.                           in association with a hospital). If you select  170(c). Also, organizations that primarily 
                                              this box, complete Schedule C.                  test for specific manufacturers don’t 
Facts and circumstances test.       Facts     A hospital includes a rehabilitation            qualify for exemption under section 501(c)
and circumstances include:                    institute, outpatient clinic, community         (3).
1. The amount of support you                  mental health clinic, drug treatment            Select my classification for me.       Select 
received from the general public,             center, or skilled nursing facility. A hospital this option if you believe you’re a public 
governmental units, or public charities;      doesn’t include convalescent homes,             charity but would like the IRS to select the 
2. Whether you have a continuous              homes for children or the aged, or              correct public charity classification (509(a)
and bona fide program for solicitation of     institutions whose principal purpose or         (1) and 170(b)(1)(A)(vi) or 509(a)(2)) for 
funds from the general public,                function is to train handicapped individuals    you.
governmental units, or public charities, or   to pursue some vocation.
                                                                                              Private foundation. Select this 
carry on activities designed to attract       Cooperative hospital service                    classification if you don’t meet one of the 
support from organizations or other           organizations described in section              exceptions listed above.
governmental units, and                       501(e) should also check this box and 
3. All other facts and circumstances,         complete Schedule C.                            Line 1a. Section 508(e) provides that a 
                                                                                              private foundation isn’t tax exempt unless 
including the public nature of your           509(a)(1) and 170(b)(1)(A)(iv).    Select       its organizing document contains 
governing board, the extent to which your     this classification if you’re organized and     specific provisions. These specific 
facilities or programs are publicly           operated exclusively to benefit a college       provisions require that you operate to 
available, the extent to which nature your    or university owned or operated by a            avoid liability for excise taxes under 
dues encourage membership, and                governmental unit. You must also normally       sections 4941(d), 4942, 4943(c), 4944, 
whether your activities are likely to appeal  receive a substantial part of your support      and 4945(d). You can also meet these 
to persons having a broad common              from a governmental unit or from                provisions by reliance on state law.
interest or purpose. For additional           contributions from the general public.
information about the 10% facts and                                                               See Pub. 557 for samples of provisions 
circumstances test, see Pub. 557 and          509(a)(1) and 170(b)(1)(A)(ix).    Select       that will meet section 508(e). Also, see 
Reg. 1.170A-9(f)(3).                          this classification if you’re an agricultural   Appendix B for a list of states that have 
                                              research organization described in section      enacted statutory provisions that satisfy 
509(a)(2). Select this classification if you  170(b)(1)(A)(ix) operated in conjunction        the requirement of section 508(e), subject 
normally receive more than one-third of       with a land grant college or university or a    to notations. Appendix B is based on Rev. 
your support from contributions,              non-land grant college of agriculture.          Rul. 75-38, 1975-1 C.B. 161.
membership fees, and gross receipts 
from activities related to your exempt 

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Line 1c. Some private foundations are         Line 2a(i). 509(a)(2). Check “Yes,” if you     amount contributed must also be more 
private operating foundations. Private        received amounts listed on lines 1, 2, and     than 2% of all the contributions you 
operating foundations make qualifying         9 of Part VI-A, Statement of Revenue and       received. A creator of a trust is treated as 
distributions directly for the active conduct Expenses, from any disqualified                a substantial contributor regardless of the 
of their educational, charitable, and         persons and identify those disqualified        amount contributed. For more information 
religious purposes. “Directly for the active  persons by letter (A, B, C, etc.) and list the regarding substantial contributors, go to 
conduct” means that you use the               amounts contributed by each. Keep, but         IRS.gov/Charities-Non-Profits/Private-
distributions yourself to carry out the       don’t submit, a list of the names of your      Foundations/Substantial-Contributor-
programs for which you’re organized and       donors with the associated letter              Private-Foundation.
operated. Grants made to assist other         designations.
                                                                                             Family members.    A “member of the 
organizations or individuals are normally 
                                              Line 2a(ii). Check “Yes,” if you received      family” includes the spouse, ancestors, 
considered indirect.
                                              amounts paid by an individual or               children, grandchildren, 
Line 1d.  If you have existed for 1 year or   organization greater than the larger of 1%     great-grandchildren, and their spouses.
more, you must provide information that       of line 10, of Part VI-A, Statement of           For additional information concerning 
demonstrates you meet the requirements        Revenues and Expenses, or $5,000 for           members of the family, go to IRS.gov/
to be classified as a private operating       any completed tax year, and identify those     Charities-Non-Profits/Charitable-
foundation, including the income test and     individuals or organizations by letter and     Organizations/Member-of-the-Family.
either the endowment test, the assets test,   list the amount(s) received from each. 
or the support test. If you have existed for  Keep, but don’t submit, a list of the names      Further information about disqualified 
less than 1 year, you must sufficiently       of your donors with the associated letter      persons, can be obtained at IRS.gov/
describe how you’re likely to meet these      designations.                                  Charities-Non-Profits/IRC-Setion-4946-
requirements and tests. You may also                                                         Definition-of-Disqualified-Person.
submit an affidavit or opinion of counsel             Don’t include disqualified persons 
                                                                                             Line 2a(iii). Use Schedule A (Form 990 
giving enough facts about your operations      !      in this list. Disqualified persons     or 990-EZ), Public Charity Status and 
and support to enable us to determine that    CAUTION should be listed in line 2(a)(i). For 
you’re likely to meet these requirements.     purposes of this application, a                Public Support, Part III, Support Schedule 
                                              “disqualified person” is any individual or     for Organizations Described in Section 
See Pub. 557 for additional information                                                      509(a)(2), and its instructions to determine 
                                              organization that is any of the following.
about private operating foundations.                                                         if you meet the public support test for your 
                                               1. A “substantial contributor” to you         most recent 5-year period.
Line 2. Confirmation of public support        (defined below).
status. If you have been in existence for 
more than 5 years, and you requested           2. An officer, director, trustee, or any 
classification as a public charity described  other individual who has similar powers or     Part VIII. Effective Date
in sections 509(a)(1) and 170(b)(1)(A)(vi),   responsibilities.                              Line 1. Use the formation date you listed 
you must confirm that you meet the public      3. An individual who owns more than           in Part II, line 2, and the date you will 
support test.                                 20% of the total combined voting power of      submit this electronic form and required 
To show that you meet the required            a corporation that is a substantial            user fee payment to determine whether 
public charity support test, complete lines   contributor.                                   you’re submitting this application within 27 
                                                                                             months from the month in which you were 
2(i) and 2(ii). Calculate your public support  4. An individual who owns more than           formed. If you’re not submitting this 
based on the accounting method you used       20% of the profits interest of a partnership   application within 27 months from your 
to complete Part VI-A, Statement of           that is a substantial contributor.             formation, complete Schedule E.
Revenues and Expenses.                         5. An individual who owns more than 
Line 2(i). 509(a)(1) and 170(b)(1)(A)         20% of the beneficiary interest of a trust or  Part IX. Annual Filing 
(vi). Check “Yes,” if you received            estate that is a substantial contributor.
                                                                                             Requirement
contributions from any person, company,        6. A member of the family of any 
or organization (other than a governmental    individual described in 1, 2, 3, 4, or 5       Most organizations must file an annual 
unit described in section 170(c)(1) or a      above.                                         return (Form 990, 990-EZ, or Form 
                                                                                             990-PF) or notice (Form 990-N, Electronic 
publicly supported organization under          7. A corporation in which any                 Notice (e-Postcard)). Exceptions to this 
section 170(b)(1)(A)(vi)), whose gifts        individuals described 1, 2, 3, 4, 5, or 6      rule include churches, certain church 
totaled more than 2% of the amount on the     above hold more than 35% of the total          affiliated organizations, and certain 
total of amounts entered on line 8 of Part    combined voting power.                         affiliates of a governmental unit. You can 
VI-A, Statement of Revenue and 
Expenses, and identify those contributors      8. A trust or estate in which any             find more detailed information about filing 
by letter (A, B, C, etc.) and list the        individuals described in 1, 2, 3, 4, 5, or 6   requirements and exceptions from the 
amount(s) contributed by each. Keep, but      above hold more than 35% of the                requirement to file in the Instructions for 
don’t submit, a list of the names of your     beneficial interests.                          Form 990.
donors with the associated letter              9. A partnership in which any                   The following are some general rules.
designations.                                 individuals described in 1, 2, 3, 4, 5, or 6   • A private foundation must file Form 
                                              above hold more than 35% of the profits        990-PF annually, regardless of its gross 
Line 2(ii). Use Schedule A (Form 990 or       interest.                                      receipts.
990-EZ) Public Charity Status and Public 
Support, Part II, Support Schedule for                                                       • Unless specifically required to file Form 
Organizations Described in Sections           Substantial contributor. A substantial         990 or Form 990-EZ (see the Instructions 
170(b)(1)(A)(iv) and 170(b)(1)(A)(vi), and    contributor is any individual or               for Form 990), most public charities that 
its instructions to determine if you met the  organization that gave more than $5,000        normally have gross receipts of $50,000 or 
public support test for your most recent      to you from the date you were formed or        less may satisfy their filing obligation with 
5-year period.                                other date that your exemption would be        Form 990-N, Electronic Notice 
                                              effective, to the end of the year in which     (e-Postcard).
                                              the contributions were received. This total 

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If you fail to file a required The characteristics generally attributed to activities conducted as part of your
! information return or notice for 3 churches are: services further your religious purposes.
CAUTION consecutive years, your exempt • A distinct legal existence,
Line 7a. Enter the average number of
status will be automatically revoked. • A recognized creed and form of
members and non-members who attend
worship,
your regularly scheduled religious
Line 1. Check “Yes,” if you’re claiming • A definite and distinct ecclesiastical
services.
you are excepted from filing a Form government,
990-series return or notice and indicate • A formal code of doctrine and Line 8. An “established place of worship”
the reason you believe you’re excepted discipline, is a place where you hold regularly
from filing. See Pub. 557 and the • A distinct religious history, scheduled religious services. It may be a
Instructions for Form 8940, Request for • A membership not associated with any place that you own, rent, or that is
Miscellaneous Determination, for more other church or denomination, provided free for your use.
information on the requirements for the • Ordained ministers ministering to the Line 9. An “established congregation” or
various filing exceptions. Provide congregation, “other religious membership group”
information regarding how you meet your • Ordained ministers selected after includes individuals who regularly attend
requested exception in your narrative completing prescribed courses of study, and take part in the religious services of
description of activities or as part of an • A literature of its own, your organization at an established
uploaded supplemental response. • Established places of worship, location. An established congregation
• Regular congregations, generally doesn’t include members of only
Part X. Signature • Regular religious services, one family. If you answer “No,” because
• Sunday schools for the religious you don’t have an established
Signature requirements. An officer, instruction of the young, and congregation or other religious
director, trustee, or other official who is • Schools for the preparation of ministers. membership, you may be a religious
authorized to sign for the organization
must sign Form 1023. The signature must Although you don’t need to meet each of organization that doesn’t qualify as a
be accompanied by the title or authority of the above criteria to be classified as a church. If you don’t qualify as a church,
the signer and the date. church, you’re generally required to have you will need to go back to Part VII, line 1,
a congregation or other religious to reconsider your public charity
membership group. For purposes of classification.
The person signing Form 1023 foundation classification under section
TIP must be listed as an officer, 509(a)(1) and 170(b)(1)(A)(i), the term You may request classification as
director, or trustee within the first “church” includes, without limitation, TIP a church at a later date after you
five entries of Part I, line 9. mosques, temples, and synagogues, and establish a congregation or other
certain other forms of religious religious membership group. For
Upload Checklist organizations. For more information, see information about this option, see Form
Documents to upload. Check the boxes Pub. 1828. 8940, Request for Miscellaneous
Determination Under Section 507, 509(a),
to indicate which documents are included The practices and rituals associated with 4940, 4942, 4945, and 6033 of the Internal
in the file you upload with your application. your religious beliefs or creed must not be Revenue Code, or contact our customer
You must upload a copy of your illegal or contrary to public policy. account service representatives at
organizing document and any 877-829-5500 (toll-free).
amendments to it along with a copy of
your bylaws, if adopted. The other listed Line 9a. Enter the total number of your
documents are not required. Specific Line Items current members. If you have no
Put your name and EIN on each page Line 1. Describe your written creed, members, enter zero (0).
of your supplemental response and statement of faith, or summary of beliefs. Line 9b. Answer “Yes,” if you have a
identify the part and line number to which Line 2. Your literature includes any prescribed way to become a member.
the information relates. writings about your beliefs, rules, or Answer “Yes,” even if you just keep
Pay.gov can accommodate only one history. records of who is currently a member.
Describe any actions required for
uploaded file. Consolidate your Line 3. A “code of doctrine and discipline” individuals to become members.
attachments into a single PDF file, which refers to a body of laws or rules that
cannot exceed 15MB. govern behavior. Line 9c. Describe any rights and benefits
If your PDF file exceeds the 15MB limit, of members. You should include details of
remove any items over the limit and Line 4. A “religious hierarchy or any levels of membership and the rights
contact IRS Customer Accounts Services ecclesiastical government” refers to and/or benefits associated with each level.
at 877-829-5500 for assistance on how to people or institutions that exercise
submit the removed items. significant influence or authority over your Line 9d. If your members may be
church. associated with another denomination or
Schedule A. Churches church, describe the circumstances in
Line 5. Answer “Yes,” if you’re part of a which your members would be members
There is no single definition of the word group of churches with similar beliefs and of your church and another church.
“church” for tax purposes. When structures, such as a convention,
determining whether a section 501(c)(3) association, or union of churches. Line 9e. See Appendix C for a
religious organization is described as a description of the word “family.”
church (described in section 509(a)(1) and Line 6. A “form of worship” refers to
170(b)(1)(A)(i)), we will consider religious practices that express your Line 10. Answer “Yes,” if you conduct
characteristics generally attributed to devotion to your creed, faith, or beliefs. baptisms, weddings, funerals, or other
religious rites.
churches and the facts and circumstances Line 7. Indicate the regular days and
of each organization applying for public times of your religious services. Describe Line 11. A school for the religious
charity classification as a “church.” the order of events during your regular instruction of the young refers to any
worship service and explain how the

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regularly scheduled religious, educational • Certification by the appropriate state nondiscriminatory policy as to students as
activities for youth. authority or successful completion of follows.
required training for qualified teachers;
Line 12. A “prescribed course of study” The M school admits students
refers to formal or informal training. It • Records of regular attendance by
students at your facility; and
doesn’t include self-ordination or paying a of any race, color, national
fee for an ordination certificate without • A lease agreement or deed for your origin, and ethnic origin to all the
facility.
completing a course of study. Describe rights, privileges, programs, and
the course of study completed by your If you answer “No,” you may not meet activities generally accorded or
religious leaders. the requirements of a school and you may made available to students at
Line 15. Provide any additional need to go back to Part VII, line 1, to the school. It doesn't
information you would like us to consider reconsider your foundation classification if discriminate on the basis of
that would help us classify you as a you requested classification as a school race, color, national origin, and
church. under sections 509(a)(1) and 170(b)(1)(A) ethnic origin in administration of
(ii). its educational policies,
admission policies, scholarship
Schedule B. Schools, Line 2. Answer “Yes,” if your primary and loan programs, and athletic
Colleges, and Universities function of the school is the presentation and other school-administered
of formal instruction. If you answer “No,”
An organization qualifies as a school (for you may not meet the requirements for programs.
purposes of classification under sections classification as a school and may want to
509(a)(1) and 170(b)(1)(A)(ii)) if all the go back to Part VII, line 1, to reconsider
following applies. It: your foundation classification if you Annual certification. A private school
requested classification as a school under must certify annually that it meets the
• Presents formal instruction as its sections 509(a)(1) and 170(b)(1)(A)(ii). requirements of Rev. Proc. 75-50, as
primary function, modified by Rev. Proc. 2019-22, by filing
• Has a regularly scheduled curriculum, Line 3. Answer “Yes,” if you’re a public Schedule A (Form 990, or Form 990-EZ)
• Has a regular faculty of qualified school and explain how you’re operated Organization Exempt Under Section
teachers, by the state or a subdivision of a state, 501(c)(3).
• Has a regularly enrolled student body, including if you have a signed contract or
and agreement with a state or local Schools that don’t file Form 990 or
• Has a place where educational government under which you operate and 990-EZ must make the certification by
activities are regularly carried on. receive funding. If you answer “Yes,” don’t filing Form 5578, Annual Certification of
complete the remainder of Schedule B. Racial Nondiscrimination for a Private
The term “school” includes primary, School Exempt From Federal Income Tax.
secondary, preparatory, high schools, Line 4. Answer “Yes,” if you were formed
colleges, and universities. An organization or substantially expanded when public Line 7. Answer “Yes,” if your organizing
won’t be described as a school under schools in your district or county were document or bylaws contain a
sections 509(a)(1) and 170(b)(1)(A)(ii) if it desegregated by court order. nondiscriminatory statement as to
students similar to the one shown above
engages in both educational and If you're unsure whether to answer
or if you adopted such a policy by
non-educational activities, unless the latter ! “Yes,”contact an appropriate resolution of your governing body. State
are merely incidental to the educational CAUTION school official.
activities. Non-traditional schools such as where your policy is located in your
an outdoor survival school or a yoga Line 5. Answer “Yes,” if a state or federal organizing document, bylaws, or if it is in
school may qualify. However, an administrative agency or judicial body ever an adopted resolution. If you answered
organization may further an educational determined your organization to be racially “No,” you must adopt a nondiscriminatory
purpose without satisfying all the discriminatory. Identify the parties involved policy before submitting this application.
conditions listed above that describe a and the forum in which the case was Line 8. Answer “Yes,” if your brochures,
school. Such organizations may qualify as presented. Explain the reason for the application forms, advertisements, and
public charities based upon their sources action, the decision reached, and provide catalogues dealing with student
of support as organizations described in legal citations (if any) for the decision. admissions, programs, and scholarships
sections 509(a)(1) and 170(B)(1)(A)(vi) or Also, explain in detail any changes made contain a statement similar to the
section 509(a)(2). in response to the action against your following:
organization or the decision reached.
The M school admits students of any
Specific Line Items race, color, and national or ethnic
Establishment of Racially
origin.
Line 1. Answer “Yes,” if you have a Nondiscriminatory Policy
regularly scheduled curriculum, a regular
faculty of qualified teachers, a regularly Every private school is subject to the
enrolled student body, and facilities where provisions of Revenue Procedure 75-50, Line 8a. If you answered “No” to Line 8,
your educational activities are regularly 1975-2 C.B. 587, modified by Rev. Proc. check the box on line 8a if you agree that
carried on. 2019-22, 2019-22 I.R.B. 1260. See Pub. all future printed materials, including
557, which sets forth the requirements of website content, will contain a statement
If you answer “Yes,”you should Rev. Proc. 75-50 under the section for of nondiscriminatory policy as to students
TIP maintain in your records evidence Private Schools. similar to the one provided above.
that you meet these factors, such
as: Publication of racially nondiscrimina- Line 9. You must make your
tory policy. A section 501(c)(3) nondiscriminatory policy known to all
• A list of required courses of study, organization that is a private school must segments of the general community
dates and times courses are offered, and publish a notice of its racially served by the school. One way to meet
other information about how to complete this requirement is to publish your
required courses;

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nondiscriminatory policy annually in a If you complete line 12 indicating hospital if its principal function is providing
newspaper or over broadcast media. Rev. TIP you do or will provide loans or treatment services, as described above.
Proc. 2019-22 now allows this publication scholarships, be sure your
requirement to be satisfied by response to Part IV, line 15 is consistent A hospital doesn't include convalescent
continuously displaying your with your response here. homes, homes for children or the aged, or
nondiscrimination statement on your institutions whose principal purposes or
Internet site, as described below. Line 13. Identify each of your function is to train handicapped individuals
Check “Yes,” if you make your racially incorporators, founders, board members, to pursue a vocation.
nondiscriminatory policy known to all donors of land, and donors of buildings by
segments of the general community you name (whether individuals or Medical research organization. An
serve by: organizations). organization is a “medical research
organization” if its principal purpose or
• Publishing a notice of your policy in a Line 14. Answer “Yes,” if any individuals function is the direct, continuous, and
newspaper of general circulation that or organizations on your list have an active conduct of medical research in
serves all racial segments of the objective to keep public or private school conjunction with a hospital. The hospital
community; education segregated by race and explain with which the organization is affiliated
• publicizing your policy over broadcast how these individuals or organizations must be described in section 501(c)(3), a
media in a way that is reasonably promote segregation in public or private federal hospital, or an instrumentality of a
expected to be effective; or schools. governmental unit, such as a municipal
• display a notice of your policy at all hospital.
times on your primary, publicly accessible Line 15. Answer “Yes,” if on a continuing
Internet homepage in a manner basis, you will maintain for a minimum
reasonably expected to be noticed by period of 3 years the following records. “Medical research” means investigations,
visitors to the homepage. • Your racial composition (similar to the experiments, and studies to discover,
information requested on Schedule B, develop, or verify knowledge relating to
See Rev. Proc. 75-50, as modified by line 11). the causes, diagnosis, treatment,
Rev. Proc. 2019-22, for guidance on the • Evidence that your scholarships and prevention, or control of human physical or
format and content of the required notice loans are awarded on a racially mental diseases and impairments. For
and whether any exceptions may apply to nondiscriminatory basis (similar to the more information, see Regulations section
you. information requested on Schedule B, 1.170A-9(c)(2).
A notice published in the legal line 12).
TIP notices section or classified • Copies of all materials used by you or Cooperative hospital service
advertisements of your local on your behalf to solicit contributions. organization. A cooperative hospital
newspaper generally is not acceptable. • Copies of brochures, application forms, service organization performs one or more
advertisements, and catalogues dealing of the specific services listed below for
Line 9a. If you answered “No,” to line 9, with student admissions, programs, and one or more exempt hospitals on a
check the box on line 9a if you agree that financial aid. cooperative basis. The services listed
below are exclusive. A cooperative service
you will publicize your nondiscriminatory Answer “No,” if you don’t maintain organization that provides services other
policy in a way that meets the records and explain how you meet the than those listed below, or that provides
requirements of Revenue Procedure 75– recordkeeping requirements under Rev. services to an organization other than an
50, as modified by Revenue Procedure Proc. 75-50. exempt hospital, doesn’t qualify for
2019-22.
Failure to maintain these records exemption under section 501(c)(3). The
list of services includes:
Line 11. Enter the racial composition of ! or produce them upon the proper
your student body, faculty, and CAUTION request will create a presumption 1. Data processing;
administrative staff in the spaces that you haven’t complied with the 2. Purchasing (including the
provided. Enter actual numbers, rather requirements of Rev. Proc. 75-50. purchasing of insurance on a group basis);
than percentages, for the current year and
projected numbers for the next academic Schedule C. Hospitals and 3. Warehousing;
year. If the number is zero, then enter “0.” Medical Research 4. Billing and collection (including the
purchasing of patron accounts receivable
If you’re not operational, submit an Organizations on a recourse basis);
estimate based on the best information
available (such as the racial composition An organization qualifies as a hospital for 5. Food;
of the community you serve). purposes of classification under sections 6. Clinical;
Don’t identify students, faculty, 509(a)(1) and 170(b)(1)(iii) if it is a: 7. Industrial engineering;
! and staff by name. • Hospital,
CAUTION • Medical research organization 8. Laboratory;
operated in conjunction with a hospital, or 9. Printing;
Line 12. Enter the racial composition of • Cooperative hospital service 10. Communications;
students to whom you award loans and organization.
scholarships in the spaces provided. Enter 11. Record center; and
actual numbers, rather than percentages, Hospital. An organization is a “hospital” 12. Personnel services (including
for the current year and projected if its principal purpose or function is selection testing, training, and education
numbers for the next academic year. If the providing medical or hospital care or of personnel).
number is zero, then enter “0.” If you won’t medical education or research. Medical
provide any loans or scholarships, check care includes treatment of any physical or
the box provided. mental disability or condition, on an
Don’t identify students by name. inpatient or outpatient basis. Thus, if an Specific Line Items
organization is a rehabilitation institution, Line 1. Answer “Yes,” if your organization
CAUTION! outpatient clinic, or community mental is a medical research organization, as
health or drug treatment center, it is a described above.

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Line 1a. As a medical research to indicate how you determine who is the broad interests of the community
organization, you must be associated with eligible for the services, how you inform served by the hospital facility, including
a hospital described in section 501(c)(3), the general public about your policy, any those with special knowledge of or
a federal hospital, or an instrumentality of requirements you require of patients to expertise in public health, and must be
a government. Provide the name of the receive reduced cost or free care, and any made widely available to the public. Each
hospital(s) you’re associated with and agreements you might have with hospital facility must conduct a CHNA at
describe the relationship(s). municipalities or government agencies to least once every 3 years and adopt an
subsidize the cost of admitting or treating implementation strategy to meet the
Line 1b. List your assets and their fair patients through this policy. community health need identified through
market value and the portion of your such CHNA.
assets directly devoted to medical Line 7. Answer “Yes,” if you have a
research. Don’t complete the remainder of formal program of medical training and Answer “Yes,” if the hospital facility
Schedule C. research. If you answer “Yes,” describe conducted a complying CHNA in the
your program, including the programs you current tax year or in either of the 2
Line 2. Answer “Yes,” if you’re a offer, the scope of such programs, and immediately preceding tax years or if the
cooperative hospital service organization affiliation with other hospitals or medical hospital facility intends to conduct a
and describe the services you provide to care providers with which you carry on the CHNA before the end of its first 3-year
your member hospitals and the exempt medical training or research programs. period.
status of your membership. Don’t
complete the remainder of Schedule C. Line 8. Answer “Yes,” if you have a Line 10b. A financial assistance policy
formal program of community educational (FAP), sometimes referred to as a charity
Line 3. Answer “Yes,” if all the doctors in programs and describe your programs, care policy, is a policy describing how an
your community are eligible for staff including the types of programs offered, organization will provide financial
privileges at your facility. You must answer the scope of the programs, and affiliation assistance at its hospital(s) and other
“Yes,” even if staff privileges at your with other hospitals or medical care facilities, if any. Financial assistance
facilities are limited by capacity, provided providers with whom you offer community includes free or discounted health
that all qualified medical professionals in educational programs. services provided to persons who meet
your community may seek and would be the organization’s criteria for financial
considered for eligibility. Line 9. Answer “Yes,” if you have a board assistance and are unable to pay for all or
of directors that is representative of the a portion of the services. Financial
Answer “No,” if all doctors in your community you serve or if an assistance doesn’t include:
community aren’t eligible for staff organization described under section • Bad debt or uncollectible charges that
privileges at your facility. 501(c)(3) with a community board the organization recorded as revenue but
If you answer “No,” describe in detail exercises rights or powers over you. wrote off due to a patient’s failure to pay or
how you limit eligibility for staff privileges Answer “Yes,”if you’re subject to a the cost of providing such care to such
at your facility. Include details of your state corporate practice of medicine law patients;
eligibility criteria and selection procedures that requires your governing board to be • The difference between the cost of care
for your courtesy staff of doctors. composed solely of physicians licensed to provided under Medicaid or other
Line 4. Answer “Yes,” if you admit all practice medicine in the state. means-tested government programs or
patients in your community who can pay Line 9a. List each board member by under Medicare and the revenue derived
for themselves or through some form of name and describe that person’s therefrom;
third-party reimbursement (for example, relationship to you. Also, for each board • Self-pay or prompt pay discounts; or
private health insurance, Medicare, or member, describe if and how that • Contractual adjustments with any
Medicaid). individual represents the community. third-party payors.
Answer “No,” if you limit admission for Generally, hospital employees and staff Answer “Yes,” if the hospital facility has
these individuals in any way and describe physicians aren’t individuals considered to adopted a written financial assistance
your admission policy in detail, including be community representatives. If you policy and a written policy relating to
how and why you restrict patient operate under a parent organization emergency medical care as required by
admission. whose board of directors isn’t comprised section 501(r)(4).
Line 5. Answer “Yes,” if you offer of a majority of individuals who are Line 10c. Under section 501(r)(5), the
emergency medical or hospital care at representative of the community you maximum amounts that can be charged to
your facility on a 24-hour basis, seven serve, provide the requested information FAP-eligible individuals for emergency or
days a week. for your parent organization's board of other medically necessary care are the
directors as well. amounts generally billed to individuals
Line 5a. Answer “Yes,” if the reason you who have insurance covering such care.
don’t maintain a full-time emergency room Line 10. Section 501(r). Answer “Yes,” if
is either because you’re a specialty you operate a facility that is required by a Answer “Yes,” if the hospital facility:
hospital where emergency care would be state to be licensed, registered, or 1. Limits or will limit any charges to
inappropriate for the services you provide similarly recognized as a hospital. FAP-eligible individuals to whom the
or another emergency medical care facility Organizations that respond “Yes,” to this hospital facility provided emergency or
that provides such services is located so question are required to meet additional other medically necessary services to not
near to you as to make such services as requirements described in section 501(r) more than the amounts generally billed to
you might provide duplicative. to be considered a hospital exempt from individuals who had insurance covering
taxation by section 501(c).
Line 6. Answer “Yes,” if you provide free such care; and
or low-cost medical or hospital care Line 10a. A community health needs 2. Prohibits, or upon beginning
services. If you answer “Yes,” describe assessment (CHNA) is an assessment of operations will prohibit, the use of gross
your policy and to whom you provide the significant health needs of the charges as described in section 501(r)(5).
these services. Include details on how community. To meet the requirements of
these services promote benefits to the section 501(r)(3), a CHNA must take into The hospital facility may check “Yes,” if
community. For example, you may want account input from persons who represent it charged more than the amounts
generally billed to individuals who had

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insurance covering such care to an             • It meets one of three required             is vested in the same persons who control 
individual if:                                 relationship tests with the supported        or manage your supported 
• The charge in excess of the amounts          organization(s); and                         organization(s).
generally billed (AGB) wasn’t made or          • It isn’t controlled by disqualified  “     • Type III (“operated in connection 
requested as a pre-condition of providing      persons,” directly or indirectly. See        with” relationship; responsive to the 
medically necessary care to the                Appendix C for a definition of a             needs or demands of, and having 
FAP-eligible individual;                       “disqualified person.”                       significant involvement in the affairs of, the 
• As of the time of the charge, the                                                         supported organization(s)): One or more 
FAP-eligible individual hadn’t submitted a     A supporting organization can also           of your officers, directors, or trustees are 
complete FAP application and hadn’t            support the charitable purposes of           elected or appointed by the officers, 
otherwise been determined by the hospital      organizations that are exempt under          directors, trustees, or membership of your 
facility to be FAP eligible for the care; and, sections 501(c)(4), (5), or (6).             supported organization(s); one or more of 
• If the individual subsequently submits a                                                  your officers, directors, trustees, or other 
complete FAP application and is                Specific Line Items                          important office holders are also members 
determined to be FAP-eligible for care, the    Line 1.  List the name, address, and EIN     of the governing body of your supported 
hospital facility refunds any amount that      of each organization you support.            organization(s); or your officers, directors, 
exceeds the amount he or she is                                                             or trustees maintain a close and 
determnined to be personally responsible       Line 2.  Answer “Yes,” if each supported     continuous working relationship with the 
for paying as a FAP-eligible individual,       organization has a letter from the IRS       officers, directors, or trustees of your 
unless such excess amount is less than         recognizing it as a public charity under     supported organization(s).
$5.                                            section 509(a)(1) or 509(a)(2).
                                                                                                    If you don't meet one of these 
Line 10d.  Answer “Yes,” if the hospital               Before you file your application,     TIP    three relationship tests, you aren't 
facility has, or will have at the beginning of  TIP    use Tax Exempt Organization                  described in section 509(a)(3) and 
operation, either a separate written billing           Search on IRS.gov to confirm         should review the other foundation 
and collections policy, or include in a        whether each of your supported               classification options in Part VII, line 1.
written FAP:                                   organizations is currently recognized as 
• A description of any actions that the        exempt and is classified as a public         Line 4. Describe how your governing 
hospital facility (or other authorized party)  charity.                                     board and officers are selected, including 
may take related to obtaining payment of a                                                  where (if applicable) this information is in 
bill for medical care, including, but not      Line 2a.   Answer “Yes,” if any supported    your governing document, bylaws, or 
limited to, any extraordinary collection       organization you listed on line 1 received a other internal rules and regulations.
actions (ECAs);                                letter from the IRS stating that it’s exempt 
                                                                                              Type III organizations must also 
• The process and time frames the              under sections 501(c)(4), (5), or (6) and 
                                                                                            describe how your officers, directors, or 
hospital facility (or other authorized party)  meets the public support test under 
                                                                                            trustees maintain a close and continuing 
uses in taking those actions (including, but   section 509(a)(2). See Pub. 557 for 
                                                                                            relationship with the officers, directors, or 
not limited to, the reasonable efforts it will information on the public support test for 
                                                                                            trustees of your supported organization(s).
make to determine whether an individual        section 509(a)(2).
is FAP-eligible before engaging in ECAs);        If you answer “No,” describe how each      Line 5. Prohibited control by disquali-
and                                            organization you support is a public charity fied person. You can’t be described in 
• The office, department, committee, or        under section 509(a)(1) or 509(a)(2). For    section 509(a)(3) if you’re directly or 
other body with the final authority or         example, if you support a church or          indirectly controlled by disqualified 
responsibility for determining that the        foreign organization that hasn’t received a  persons. You are controlled if disqualified 
hospital facility has made reasonable          determination letter recognizing it as a     persons:
efforts to determine whether an individual     public charity, you should describe how      • Can exercise 50% or more of the total 
is FAP-eligible and may therefore engage       this organization qualifies as a public      voting power of your governing body;
in ECAs against the individual.                charity under section 509(a)(1) or 509(a)    • Have authority to affect significant 
                                               (2). See Pub. 557 for information on public  decisions, such as power over your 
Schedule D. Section                            charities under sections 509(a)(1) and       investment decisions, or power over your 
                                               509(a)(2).                                   charitable disbursement decisions; or
509(a)(3) Supporting                                                                        • Can exercise veto power over your 
                                               Line 3. Relationship test. To qualify        actions.
Organizations                                  under section 509(a)(3), you must show 
                                                                                              Although control is generally 
                                               that you meet one of three relationship 
                                                                                            demonstrated where disqualified persons 
Supporting organizations are described in      tests with your supported organization(s). 
                                                                                            have the authority over your governing 
section 509(a)(3). The term “supported         Select the option that best describes your 
                                                                                            body to require you to take an action or 
organization” refers to an organization that   relationship with your supported 
                                                                                            refrain from taking an action, indirect 
a supporting organization benefits. A          organization(s).
                                                                                            control by disqualified persons will also 
supporting organization may support more       • Type I (“operated, supervised, or 
                                                                                            disqualify you as a supporting 
than one supported organization.               controlled by” relationship; comparable 
                                                                                            organization.
                                               to a parent–subsidiary relationship): A 
An organization qualifies as a supporting      majority of your governing board or            See Appendix C for a description of the 
organization (for purposes of classification   officers are elected or appointed by the     terms “disqualified person,” “family,” 
under section 509(a)(3)) if:                   governing body, members of the               “foundation manager,” and “business 
• It is organized and at all times thereafter  governing body, officers acting in their     relationship.”
is operated exclusively for the benefit of,    official capacity, or the membership of              Public charities and foundation 
to perform the function of, or to carry out    your supported organization(s).               TIP    managers who otherwise are 
the purposes of one or more public             • Type II (“supervised or controlled in              disqualified persons only because 
charities described in section 509(a)(1) or    connection with” relationship;               they are foundation managers aren't 
509(a)(2);                                     comparable to a brother–sister               disqualified persons for this purpose.
                                               relationship): Your control or management 

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Line 7. Organizational test. If you officers, directors, or trustees of each modifications, reduced by total
answered “No,” you are a Type III supported organization; and deductions. Gross income doesn’t include
supporting organization, you must amend 2. Exercise a substantial degree of gifts, grants, or contributions. See
your organizing document to specify direction over the policies, programs, and Appendix C.
your supported organization(s) by name; activities of each supported organization. For purposes of this line, “non-exempt-use
or you won’t meet the organizational test assets” are all assets of the supporting
under section 509(a)(3) and need to For example, N, an organization
reconsider your requested public charity described in section 501(c)(3), is the organization other than:
classification in Part VII, line 1. parent organization of a healthcare system 1. Assets described in Regulations
consisting of two hospitals (Q and R) and section 53.4942(a)(2)(c)(2)(i) through (iv),
Line 7a. If you answered “No,” you won’t an outpatient clinic (S), each of which is and
meet the organizational test under section described in section 509(a)(1), and a 2. Exempt-use assets, which are
509(a)(3) unless you amend your taxable subsidiary (T). N is the sole assets that are used (or held for use)
organizing document to specify your member of each of Q, R, and S. Under the directly in carrying out the exempt
supported organization(s) by name, charter and bylaws of each of Q, R, and S, purposes of your supported organization.
purpose, or class, and need to reconsider N appoints all members of the board of See Regulations section 1.509(a)-4(i)(8)
your requested public charity classification directors of each corporation. N engages for more information.
in Part VII, line 1. in the overall coordination and supervision
Line 8. When responding to this question, of the healthcare system’s exempt Line 13a. List the total amount you
don’t include donors that are section subsidiary corporations Q, R, and S in distribute(d) annually to each supported
509(a)(1), (2), or (4) organizations. approval of their budgets, strategic organization. Also, indicate how each
planning, marketing, resource allocation, amount will vary from year to year.
This prohibition on contributions securing tax-exempt bond financing, and
TIP from controlling donors only community education. N also manages Line 13b. List the total annual income for
applies to Type I and Type III and invests assets that serve as each supported organization. If you
supporting organizations. endowments of Q, R, and S. distribute your income to, or for the use of,
a particular department or program of an
Line 9. Type III responsiveness test. Line 12. Answer “Yes,” if you conduct organization, list the annual revenue of the
Answer “Yes,” if, because of your activities that the supported organization supported department or program.
relationship described in line 3, the would otherwise need to conduct in
supported organization has a significant furtherance of its exempt purposes and Line 13c. Answer “Yes,” if your funds are
involvement in your investment policies, describe the activities that you conduct. “earmarked” for a particular program or
activity conducted by your supported
making and timing of grants, and directing Holding title to and managing assets organization.
the use of your income and assets, and that are used (or held for use) directly in
explain how your supported organization carrying out the exempt purposes of your
is involved in these matters. supported organization (exempt-use Schedule E. Effective Date
assets) are activities that directly further The questions in this schedule will help us
Line 10. Type III notification require- the exempt purposes of your supported determine the effective date of exemption
ment. A Type III supporting organization organization. Conversely, with certain if you’re either seeking reinstatement after
must provide the notice described in this exceptions, fundraising, making grants automatic revocation or you’re filing this
question. If you’re a Type III supporting (whether to the supported organization or application more than 27 months after the
organization, you’ll be required to answer to third parties), and investing and end of the month in which you were legally
this question annually on your annual managing non-exempt-use assets aren’t formed.
information return (Schedule A of Form activities that directly further the exempt
990 or 990-EZ). purposes of the supported organization. Specific Line Items
Lines 11–13. Type III integral part test. See Regulations section 1.509(a)-4(i)(4)
An organization seeking classification as a (ii) for more information. Line 1. Answer “Yes,” if your exempt
status was automatically revoked under
Type III supporting organization must Line 13. To satisfy the integral part test section 6033(j)(1) for failure to file required
meet an integral part test, which is as a non-functionally integrated supporting annual returns or notices for 3 consecutive
satisfied by maintaining significant organization, you must distribute at least years and you’re applying for
involvement in the operations of one or 85% of your annual net income or 3.5% reinstatement.
more supported organizations and of the aggregate fair market value of all
providing support on which the supported of your non-exempt-use assets (whichever Rev. Proc. 2014-11, 2014-3 I.R.B. 411,
organization(s) are dependent. A Type III is greater) to your supported at IRS.gov/irb/2014-03_IRB establishes
supporting organization may be organization(s). You can use Part V of several different procedures for reinstating
functionally integrated (lines 11–12) or Schedule A (Form 990 or 990-EZ) to help an organization’s exempt status
non-functionally integrated (lines 13 and determine your answer to this question. depending upon its size, the number of
13a–c) depending on the manner in which times it’s been automatically revoked, and
it meets the integral part test. Functionally The distributable amount for the the timeliness of filing for reinstatement.
integrated Type III supporting TIP first tax year an organization is Review the revenue procedure to
organizations are subject to fewer treated as a non-functionally determine which section applies to you.
restrictions and requirements than integrated Type III supporting organization
non-functionally integrated Type IIII is zero. Line 1a. Select the section of Rev. Proc.
supporting organizations. 2014-11 under which you’re applying for
reinstatement.
Line 11. Answer “Yes,” if you’re the For purposes of this line, “net income” has
parent of all your supported organizations the same meaning as the term “adjusted Section 4. Select this section if:
because you: net income.” In general, “adjusted net • You were eligible to file either Form
1. Have the power to appoint or elect, income” is the excess of gross income, 990-EZ or Form 990-N for each of the 3
directly or indirectly, a majority of the including gross income from any unrelated consecutive years that you failed to file;
trade or business, determined with certain

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• This is the first time you’ve been Describe how you exercised ordinary Schedule F. Low-Income
automatically revoked pursuant to section business care and prudence in
6033(j)(1); and determining and attempting to comply with Housing
• You’re submitting this application no your filing requirements in each of the 3 To qualify for tax exemption, low-income
later than 15 months after the later of the years of revocation. Include a detailed housing must provide affordable housing
date of your Revocation Letter or the date explanation of all the facts and for a significant segment of individuals in
on which the IRS posted your name on the circumstances that led to the failure, the your community with low incomes. Your
Auto-Revocation List at discovery of the failure, and the steps you low-income housing may serve a
apps.irs.gov/app/eos/. have taken or will take to avoid or mitigate combination of purposes, such as for
By selecting this item, you’re also future failures to file timely returns or poor, frail, and elderly persons.
attesting that your failure to file wasn’t notices.
intentional and you’ve put in place Section 7. Select this section if you’re Specific Line Items
procedures to file required returns or seeking reinstatement with an effective Line 1. The “type” of facility may be an
notices in the future. date of reinstatement of the date of apartment complex, condominium,
If you were classified as a private submission of this application. cooperative, or private residence, etc.
TIP foundation prior to your Line 2. Generally, if you didn’t file Form Line 6. Answer “Yes,” if you charge daily,
automatic revocation, you weren't 1023 within 27 months of formation, the weekly, monthly, or annual fees or
eligible to file either Form 990-EZ or Form effective date of your exempt status will be maintenance charges.
990-N and, therefore, aren't eligible to the date you filed Form 1023 (submission Line 8. Government programs include
request reinstatement under Section 4. date). We may grant requests for an federal, state, or local government
earlier effective date when there’s programs.
If your exempt status was evidence to establish you acted
! automatically revoked more than reasonably and in good faith, and the
CAUTION once, you’re not eligible for Schedule G. Successors
grant of relief won’t prejudice the interests
reinstatement under Section 4; however, of the government. to Other Organizations
you may apply for reinstatement under
Section 5, Section 6, or Section 7. Select the appropriate box to indicate You should consider this schedule as a
whether you accept the submission date successor organization if any of the
Section 5. Select this section if: as the effective date of your exempt status following situations pertain to you.
or whether you are requesting an earlier • You took or will take over activities
• You’re ineligible to file for reinstatement effective date. previously conducted by another
under Section 4, and
• You’re submitting this application not Line 2a. You may be eligible for organization.
later than 15 months after the later of the consideration for relief from the • You took or will take over 25% or more
date of your Revocation Letter or the date requirement that you file Form 1023 within of the fair market value of the net assets
on which the IRS posted your name on the 27 months of formation if you can of another organization.
Auto-Revocation List at establish that you acted reasonably and in • You were established upon the
apps.irs.gov/app/eos/. good faith, and that granting an extension conversion of an organization from
By selecting this item, you’re also won’t prejudice the interests of the for-profit to non-profit status.
attesting that you filed the required annual government. The other organization is the
returns, your failure to file was not Describe in detail your reasons for filing predecessor organization. You should
intentional, and you have put in place late, how you discovered your failure to complete this schedule regardless of
procedures to file required returns or file, any reliance on professional advice or whether the predecessor (other
notices in the future. advice from the IRS, and any other organization) was exempt or not exempt
Describe how you exercised ordinary information you believe will support your from federal income tax.
business care and prudence in request for relief. Also, you may want to For purposes of this schedule, a
determining and attempting to comply with provide a comparison of (1) what your “for-profit” organization is one in which
your filing requirements in at least 1 of the aggregate tax liability would be if you had persons are permitted to have an
3 years of revocation. Include a detailed filed this application within the 27-month ownership or partnership interest, such as
explanation of all the facts and period with (2) what your aggregate corporate stock. It includes sole
circumstances that led to the failure, the liability would be if you were exempt as of proprietorships, corporations, and other
discovery of the failure, and the steps you your formation date. entities that provide for ownership
have taken or will take to avoid or to We may consider the following factors. interests.
mitigate future failures to file timely returns • You filed Form 1023 before we
or notices. discovered your failure to file. Schedule H. Organizations
• You failed to file because of intervening Providing Scholarships,
Section 6. Select this section if you are events beyond your control.
applying for reinstatement of your • You exercised reasonable diligence, Fellowships, Educational
tax-exempt status more than 15 months but you weren’t aware of the filing Loans, or Other
from the later of the date of the Revocation requirements. (The complexity of your
Letter or the date on which the IRS posted filing and experience in these matters may Educational Grants to
your name on the Auto-Revocation List at be taken into consideration.) Individuals and Private
apps.irs.gov/app/eos/. • You reasonably relied on written advice Foundations Requesting
By selecting this item, you’re also from us.
attesting that you filed the required annual • You reasonably relied on the advice of Advance Approval of
returns, your failure to file wasn’t a qualified tax professional who failed to Individual Grant
intentional, and you have put in place file or advise you to file Form 1023. Procedures
procedures to file required returns or
notices in the future. Complete this schedule if you provide
scholarships, fellowships, grants, loans, or

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other distributions to individuals for     If you make educational loans,              charities-non-profit/private-foundations/
educational purposes. When answering       describe the terms of the loan (for         advance-approval-of-grant-making-
the questions on this schedule, you should example, the factors you consider in        procedures.
demonstrate how these distributions        selecting or approving loan recipients, 
                                                                                       Line 1a. Check the box for section 
further your exempt purposes.              interest rate, duration, forgiveness 
                                                                                       “4945(g)(1)” if your award qualifies as a 
                                           provision, etc.). Also, describe whether 
        If you’re a private foundation,                                                scholarship or fellowship grant that’s 
                                           any financial institutions or other lenders 
                                                                                       awarded on an objective and 
  !     you’re subject to the rules under  are involved in your program.
CAUTION section 4945 and may incur an                                                  nondiscriminatory basis and is used for 
excise tax if you make grants for the      Explain how you will publicize your         study at a school (see Schedule B for 
purpose described above without seeking    program and whether you publicize to the    what is considered a school).
advance approval of your grant-making      general public or to another group of 
                                                                                       Check the box for “4945(g)(3)” if the 
procedures (see Schedule H–Section II).    possible recipients. Include specific 
                                                                                       purpose of your award is to achieve a 
                                           information about the geographic area in 
                                                                                       specific objective, produce a report or 
Generally, distributions made to           which your program will be publicized and 
                                                                                       other similar product, or improve or 
individuals may advance educational        the means you will use, such as through 
                                                                                       enhance a literary, artistic, musical, 
purposes if selection is made:             newspaper advertisements, school district 
                                                                                       scientific, teaching, or other similar 
• In a non-discriminatory fashion in terms announcements, or community groups.
of racial preference;                                                                  capacity, skill, or talent of the recipient. 
• Based on need and/or merit; and          Line 2. Organizations that make grants to   Include your educational loan program 
• To a charitable class in terms of being  individuals must maintain adequate          under this section.
available to an open-ended group, rather   records and case histories showing the      You may check more than one box.
than to pre-selected individuals.          name and address of each recipient, 
                                           pursuant Rev. Rul. 56-304, 1956-2 C.B.              If your award qualifies as a prize 
A scholarship or fellowship is tax free to 306 but don’t provide this information as   TIP     or award that is subject to the 
the recipient only if he or she is a       part of your application.                           provisions of section 74(b) and 
candidate for a degree at an eligible                                                  your recipient is selected from the general 
educational institution and uses the                                                   public, you don’t have to request advance 
scholarship or fellowship to pay qualified Section II                                  approval of your grant-making procedures 
education expenses.                        If you requested public charity             since a prize or award isn’t subject to the 
Qualified education expenses include       classification in Part VII, line 1, don’t   advance approval procedure requirements 
tuition and fees; and course-related       complete Schedule H – Section II.           because it isn’t a grant for travel, study, or 
expenses such as books, supplies, and      Line 1. Answer “Yes,” if you’re a private   other similar purposes. See Rev. Ruls. 
equipment. Room and board, travel,         foundation and you’re requesting            77-380, 1977-2 C.B. 419; 76-460, 1976-2 
research, clerical help, and non-required  advance approval of your grant-making       C.B. 371; and 75-393, 1975-2 C.B. 451.
equipment aren’t qualified education       procedures under section 4945(g).           Line 4. Answer “Yes,” if you award 
expenses. See Pub. 970, Tax Benefits for   Answer “No,” if you’re a private foundation scholarships on a preferential basis 
Education, for additional information.     but don’t wish to request advance           because you require, as an initial 
Selection of individuals using a lottery   approval of your grant-making procedures    qualification, that the individual be an 
system generally hasn’t been approved by   under section 4945(g). If you answer “No”   employee or be related to an employee of 
the IRS.                                   the amounts you distribute as educational   a particular employer.
                                           grants provided to individuals may be 
Specific Line Items                        considered taxable expenditures under       Line 7. For purposes of this schedule, a 
                                           section 4945.                               program for children of employees of a 
Section I                                                                              particular employer includes children and 
                                           For more information about advance 
Line 1. If you conduct more than one       approval of grant-making procedures of a    family members of employees.
grant program, describe each program       private foundation, go to IRS.gov/
separately.

Instructions for Form 1023                               -23-

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Paperwork Reduction Act Notice. We ask for the information on this form to carry out the Internal Revenue laws of the United 
States. You are required to give us the information. We need it to ensure that you are complying with these laws and to allow us to 
figure and collect the right amount of tax.
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form 
displays a valid OMB control number. Books or records relating to a form or its instructions must be retained as long as their contents 
may become material in the administration of any Internal Revenue law. Generally, tax returns and return information are confidential, 
as required by section 6103. However, certain returns and return information of tax exempt organizations and trusts are subject to 
public disclosure and inspection, as provided by section 6104.
The time needed to complete and file this form will vary depending on individual circumstances. The estimated burden for tax 
exempt organizations filing this form is approved under OMB control number 1545-0047 and is included in the estimates shown in the 
instructions for their information return.
Comments and suggestions. If you have comments concerning the accuracy of this time estimate or suggestions for making this 
form simpler, we would be happy to hear from you. You can send us comments from IRS.gov/FormComments. Or you can write to:
Internal Revenue Service
Tax Forms and Publications Division
1111 Constitution Ave. NW, IR-6526
Washington, DC 20224

                                                              -24- Instructions for Form 1023

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Appendix A: Sample Conflict of Interest Policy

Note. This Sample Conflict of       indirectly, through business,     conflict of interest is discussed  4. Violations of the Conflict 
Interest Policy is intended to      investment, or family:            and voted upon. The                of Interest Policy 
provide an example of a              a. An ownership or               remaining board or committee 
conflict of interest policy for      investment interest in any       members shall decide if a             a. If the governing board or 
organizations. The sample            entity with which the            conflict of interest exists.          committee has reasonable 
                                                                                                            cause to believe a member 
conflict of interest policy does     Organization has a               3. Procedures for Address-            has failed to disclose 
not prescribe any specific           transaction or                   ing the Conflict of Interest          actual or possible conflicts 
requirements. Therefore,             arrangement,                                                           of interest, it shall inform 
organizations should use a           b. A compensation                    a. An interested person 
                                                                          may make a presentation           the member of the basis 
conflict of interest policy that     arrangement with the                                                   for such belief and afford 
                                                                          at the governing board or 
best fits their organization.        Organization or with any                                               the member an opportunity 
                                                                          committee meeting, but 
                                     entity or individual with                                              to explain the alleged 
                                                                          after the presentation, 
Note. Items marked Hospital          which the Organization                                                 failure to disclose.
                                                                          he/she shall leave the 
insert — for hospitals that          has a transaction or                                                   b. If, after hearing the 
                                                                          meeting during the 
complete Schedule C are              arrangement, or                                                        member's response and 
                                                                          discussion of, and the vote 
intended to be adopted by            c. A potential ownership or                                            after making further 
                                                                          on, the transaction or 
hospitals.                           investment interest in, or                                             investigation as warranted 
                                                                          arrangement involving the 
Article I                            compensation                                                           by the circumstances, the 
                                                                          possible conflict of 
                                     arrangement with, any                                                  governing board or 
                                                                          interest.
Purpose                              entity or individual with                                              committee determines the 
The purpose of the conflict of       which the Organization is            b. The chairperson of the 
                                                                          governing board or                member has failed to 
interest policy is to protect this   negotiating a transaction                                              disclose an actual or 
                                                                          committee shall, if 
tax-exempt organization's            or arrangement.                                                        possible conflict of 
                                                                          appropriate, appoint a 
(Organization) interest when it      d. Compensation includes                                               interest, it shall take 
                                                                          disinterested person or 
is contemplating entering into       direct and indirect                                                    appropriate disciplinary 
                                                                          committee to investigate 
a transaction or arrangement         remuneration as well as                                                and corrective action.
                                                                          alternatives to the 
that might benefit the private       gifts or favors that aren’t 
                                                                          proposed transaction or 
interest of an officer or director   insubstantial. A financial                                          Article IV
                                                                          arrangement.
of the Organization or might         interest isn’t necessarily a                                        Records of Proceedings
result in a possible excess          conflict of interest. Under          c. After exercising due 
                                                                          diligence, the governing 
benefit transaction. This policy     Article III, Section 2, a                                           The minutes of the governing 
                                                                          board or committee shall 
is intended to supplement but        person who has a financial                                          board and all committees with 
                                                                          determine whether the 
not replace any applicable           interest may have a                                                 board delegated powers shall 
                                                                          Organization can obtain, 
state and federal laws               conflict of interest only if                                        contain:
                                                                          with reasonable efforts, a 
governing conflict of interest       the appropriate governing                                           a. The names of the persons 
                                                                          more advantageous 
applicable to nonprofit and          board or committee                                                  who disclosed or otherwise 
                                                                          transaction or arrangement 
charitable organizations.            decides that a conflict of                                          were found to have a financial 
                                                                          from a person or entity that 
                                     interest exists.
Article II                                                                would not give rise to a       interest in connection with an 
                                    Article III                           conflict of interest.          actual or possible conflict of 
Definitions                                                               d. If a more advantageous      interest, the nature of the 
                                    Procedures                            transaction or arrangement     financial interest, any action 
1. Interested Person   Any                                                isn’t reasonably possible      taken to determine whether a 
director, principal officer, or     1. Duty to Disclose  In 
member of a committee with          connection with any actual or         under circumstances not        conflict of interest was present, 
governing board delegated           possible conflict of interest, an     producing a conflict of        and the governing board's or 
powers, who has a direct or         interested person must                interest, the governing        committee's decision as to 
indirect financial interest, as     disclose the existence of the         board or committee shall       whether a conflict of interest in 
defined below, is an interested     financial interest and be given       determine by a majority        fact existed.
person.                             the opportunity to disclose all       vote of the disinterested      b. The names of the persons 
                                    material facts to the directors       directors whether the          who were present for 
 [Hospital insert – for             and members of committees             transaction or arrangement     discussions and votes relating 
hospitals that complete             with governing board                  is in the Organization best    to the transaction or 
Schedule C. If a person is an       delegated powers considering          interest, for its own benefit, arrangement, the content of 
interested person with respect      the proposed transaction or           and whether it is fair and     the discussion, including any 
to any entity in the health care    arrangement.                          reasonable. In conformity      alternatives to the proposed 
                                                                          with the above                 transaction or arrangement, 
system of which the                 2. Determining Whether a              determination, it shall        and a record of any votes 
organization is a part, he or       Conflict of Interest Exists           make its decision as to        taken in connection with the 
she is an interested person         After disclosure of the financial     whether to enter into the      proceedings.
with respect to all entities in the interest and all material facts,      transaction or 
health care system.]                and after any discussion with         arrangement.
2. Financial Interest  A            the interested person, he/she 
person has a financial interest     shall leave the governing 
if the person has, directly or      board or committee meeting 
                                    while the determination of a 

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Article V                        prohibited from providing             b. Has read and               b. Whether partnerships, 
                                 information to any committee          understands the policy,       joint ventures, and 
Compensation                     regarding compensation.               c. Has agreed to comply       arrangements with 
a. A voting member of the         [Hospital insert-for                 with the policy, and          management 
governing board who receives     hospitals that complete               d. Understands the            organizations conform to 
compensation, directly or        Schedule C Physicians who             Organization is charitable    the Organization's written 
indirectly, from the             receive compensation from the         and in order to maintain its  policies, are properly 
Organization for services is     Organization, whether directly        federal tax exemption it      recorded, reflect 
precluded from voting on         or indirectly or as employees         must engage primarily in      reasonable investment or 
matters pertaining to that       or independent contractors,           activities that accomplish    payments for goods and 
member's compensation.           are precluded from                    one or more of its            services, further charitable 
                                 membership on any committee           tax-exempt purposes.          purposes and don't result 
                                                                                                     in inurement, 
b. A voting member of any        whose jurisdiction includes       Periodic Reviews                  impermissible private 
committee whose jurisdiction     compensation matters. No 
includes compensation            physician, either individually or To ensure the Organization        benefit, or in an excess 
matters and who receives         collectively, is prohibited from  operates in a manner              benefit transaction.
compensation, directly or        providing information to any      consistent with charitable 
indirectly, from the             committee regarding physician     purposes, and doesn't engage     Article VIII
Organization for services is     compensation.]                    in activities that could         Use of Outside Experts
precluded from voting on                                           jeopardize its tax-exempt 
matters pertaining to that       Article VI                        status, periodic reviews shall   When conducting the periodic 
member's compensation.                                             be conducted. The periodic       reviews, as provided for in 
                                 Annual Statements                 reviews shall, at a minimum,     Article VII, the Organization 
c. No voting member of the       Each director, principal officer, include the following subjects:  may, but need not, use outside 
                                                                                                    advisors. If outside experts are 
governing board or any           and member of a committee             a. Whether compensation      used, their use shall not relieve 
committee whose jurisdiction     with governing board                  arrangements and benefits    the governing board of its 
includes compensation            delegated powers shall                are reasonable, based on     responsibility for ensuring 
matters and who receives         annually sign a statement             competent survey             periodic reviews are 
indirectly, from the 
compensation, directly or        which affirms such person:            information, and the result  conducted.
Organization, either              a. Has received a copy of            of arm's length bargaining.
individually or collectively, is  the conflict of interest 
                                  policy,

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Appendix B: States With Statutory Provisions Satisfying the Requirements of 
              Internal Revenue Code Section 508(e)
              The following states have adopted legislation satisfying the requirements of Section 508(e) relating to 
              private  foundation  governing  instruments.  Information  derived  from  Revenue  Ruling  75-38,  1975-1 
              C.B. 161.

ALABAMA — except where otherwise provided by a decree of a court of competent jurisdiction or by a provision in the 
private foundation's governing instrument, which in either case has been entered or made after October 1, 1971, and 
expressly limits the applicability of state law. 
ALASKA — except for such private foundations that expressly provide in their governing instruments that the applicable 
sections of Alaska law don't apply to them.
ARKANSAS — except for such private foundations which expressly provide in their governing instruments that the 
applicable sections of Arkansas law don't apply to them and except in the case of trusts where otherwise provided by decree 
of a court of competent jurisdiction.
CALIFORNIA — except where otherwise provided by a court of competent jurisdiction. 
COLORADO — with respect to trusts that are private foundations except where otherwise provided by a court of competent 
jurisdiction. 
CONNECTICUT — except where otherwise provided by a court of competent jurisdiction. 
DELAWARE — except for such private foundations, which expressly provide in their governing instruments that the 
applicable sections of Delaware law don't apply to them. 
DISTRICT OF COLUMBIA — except for such corporations, which expressly provide in their governing instruments that the 
applicable sections of District of Columbia law don't apply to them and except in the case of trusts where otherwise provided 
by a court of competent jurisdiction. (For purposes of this statute, corporations include corporations organized under any Act 
of Congress applicable to the District of Columbia as well as corporations organized under the laws of the District of 
Columbia.) 
FLORIDA — except for such trusts that file a proper election not to be subject to the applicable provisions of Florida law and 
for such corporations as to which a court of competent jurisdiction has otherwise determined.
GEORGIA — except for such private foundations that file a proper election not to be subject to such law.
HAWAII — no exceptions.
IDAHO — except for such private foundations that expressly provide in their governing instruments that the applicable 
sections of Idaho law don't apply to them.
ILLINOIS — except for such corporations that have express provisions to the contrary in their articles of incorporation and 
except for trusts where it is otherwise provided by a court of competent jurisdiction. 
INDIANA — except where otherwise determined by a court of competent jurisdiction with respect to private foundations 
organized before January 1, 1970.
IOWA — except for such private foundations which expressly provide in their governing instruments that the applicable 
sections of Iowa law don't apply to them.
KANSAS — except where otherwise provided by a court of competent jurisdiction. 
KENTUCKY — except, with respect to corporations in existence on July 1, 1972, to the extent that such a corporation 
provides to the contrary by amendment to its articles of incorporation adopted after July 1, 1972, and, with respect to trusts in 
existence on July 1, 1972, where action is properly commenced on or before December 31, 1972, in a court of competent 
jurisdiction to excuse the trust from compliance with the requirements of section 508(e) of the Code.
LOUISIANA — except for such private foundations that expressly provide in their governing instruments that the applicable 
sections of Louisiana law don't apply to them. 
MAINE — except where otherwise provided by a court of competent jurisdiction. 
MARYLAND — except where otherwise provided by a court of competent jurisdiction. 
MASSACHUSETTS — except where otherwise provided by a court of competent jurisdiction. 
MICHIGAN — with respect to trusts that are private foundations except for such private foundations which file a notice of 
inconsistency under Michigan law. 

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MINNESOTA — except for private foundations that have been held by a court of competent jurisdiction not to be affected by 
such state statute. 
MISSISSIPPI — except where otherwise provided by a court of competent jurisdiction. 
MISSOURI — except for private foundations that have been held by a court of competent jurisdiction not to be affected by 
such state statute. 
MONTANA — except in the case of trusts where otherwise provided by court decree entered after March 28, 1974, and 
except in the case of a corporation that has an express provision to the contrary in its articles of incorporation.
NEBRASKA — except for such trusts that effectively elect to be excluded from the applicable sections of Nebraska law, for 
such corporations which have governing instruments expressly providing to the contrary, and except as a court of competent 
jurisdiction has otherwise determined in any given case. 
NEVADA — no exceptions. 
NEW HAMPSHIRE — except where it is otherwise provided by a court of competent jurisdiction. 
NEW JERSEY — except for such private foundations that expressly provide in their governing instruments that the 
applicable sections of New Jersey law don't apply to them. 
NEW YORK — except where such law conflicts with any mandatory direction of an instrument by which assets were 
transferred prior to June 1, 1971, and such conflicting direction hasn’t been removed legally. 
NORTH CAROLINA — except for such private foundations which expressly provide in their governing instruments that the 
applicable sections of North Carolina law don't apply to them and except for trusts that have their governing instruments 
reformed by a decree of the Superior Court of North Carolina. 
NORTH DAKOTA — with respect to trusts that are private foundations except where otherwise provided by a court of 
competent jurisdiction.
OHIO — except in the case of trusts where it is provided otherwise by a court of competent jurisdiction and except in the 
case of corporations in existence on September 17, 1971, which expressly adopt contrary provisions in their governing 
instruments after September 17, 1971. 
OKLAHOMA — except for such private foundations that file a proper election not to be subject to such law.
OREGON — no exceptions.
PENNSYLVANIA — except where otherwise provided by a court of competent jurisdiction. 
RHODE ISLAND — except where otherwise provided by a court of competent jurisdiction. 
SOUTH CAROLINA — except for private foundations that expressly provide in their governing instruments that the 
applicable sections of South Carolina law don't apply to them. 
SOUTH DAKOTA — except where otherwise provided by a court of competent jurisdiction. 
TENNESSEE — except where otherwise provided by a court of competent jurisdiction. 
TEXAS — except for such private foundations that a proper election not to be subject to such law. 
UTAH — with respect to trusts that are private foundations except where otherwise provided by a court of competent 
jurisdiction.
VERMONT — except where otherwise provided by a court of competent jurisdiction. 
VIRGINIA — except for private foundations whose governing instruments contain express provisions to the contrary or that 
have filed a proper election not to be subject to such law. 
WASHINGTON — except for such private foundations that expressly provide in their governing instruments that the 
applicable sections of Washington law don't apply to them. 
WEST VIRGINIA — with respect to trusts that are private foundations except for such trusts which provide in their governing 
instruments that the applicable sections of West Virginia law don't apply to them. 
WISCONSIN — except as may otherwise be provided by decree of a court of competent jurisdiction. 
WYOMING — except where otherwise provided by a court of competent jurisdiction. 

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Appendix C: Glossary of Terms

Adjusted net income (for Schedule D) Adjusted net income includes: gross income from any unrelated trade or 
                                     business; gross income from functionally related businesses; interest 
                                     payments received on loans; amounts received or accrued as repayments 
                                     of amounts taken as qualifying distributions for any tax year; amounts 
                                     received or accrued from the sale or other disposition of property to the 
                                     extent acquisition of the property was treated as a qualifying distribution 
                                     for any tax year; any amounts set aside for a specific project to the extent 
                                     the full set-aside was not necessary for the project; interest on 
                                     government obligations normally excluded under section 103; net 
                                     short-term capital gains on sale or other disposition of property; and 
                                     income received from an estate if the estate is considered terminated for 
                                     income tax purposes because of a prolonged administration period. 
                                      
                                     It doesn't include: gifts, grants, and contributions received; long-term 
                                     capital gains or losses; net section 1231 gains; capital gain dividends; the 
                                     excess of fair market value over adjusted basis of property distributed to 
                                     the U.S. or a possession or political subdivision, a state or its political 
                                     subdivision, a charitable trust, or corporation for public purposes; or 
                                     income received from an estate during the administration period.
                                      
                                     In computing adjusted net income, deduct the following: ordinary and 
                                     necessary expenses paid or incurred for the production or collection of 
                                     gross income, or for the management, conservation, or collection of gross 
                                     income (includes operating expenses such as compensation of officers, 
                                     employee wages and salaries, interest, rent, and taxes); straight-line 
                                     depreciation and depletion (not percentage depletion); and expenses and 
                                     interest paid or incurred to carry tax-exempt obligations. Don't deduct net 
                                     short-term capital losses for the year in which they occur (these losses 
                                     cannot be carried back or carried over to earlier or later tax years); the 
                                     excess of expenses for property used for exempt purposes over the 
                                     income received from the property; charitable contributions made by you; 
                                     net operating losses; and special deductions for corporations.
                                      
Arm's length                         A transaction between parties having adverse (or opposing) interests 
                                     where none of the participants are in a position to exercise substantial 
                                     influence over the transaction because of business or family 
                                     relationship(s) with more than one of the parties.
                                      
Authorized representative            An individual eligible to practice before the IRS who holds a power of 
                                     attorney (Form 2848 or other similar documents) that authorizes him or 
                                     her to represent the organizations in tax matters, including the application 
                                     for tax-exempt status.
                                      
Bingo                                A game of chance played with cards that are generally printed with 5 rows 
                                     of 5 squares each, on which participants place markers to form a 
                                     pre-selected pattern to win the game. Bingo is gambling.
                                      
Business relationship                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.
                                      
Bylaws                               The internal rules and regulations of an organization.
                                      
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Certification of filing            Evidence that, on a specific date, articles of incorporation (for a 
                                   corporation) or articles of organization (for a limited liability company) 
                                   were accepted for filing by appropriate state authority resulting in the 
                                   creation of a state-law entity.
                                    
Community                          The local or regional geographic area to be served by an organization.
                                    
Compensation                       All forms of income from working, including salary or wages; deferred 
                                   compensation; retirement benefits, whether in the form of a qualified or 
                                   non-qualified employee plan (for example, pensions or annuities); fringe 
                                   benefits (for example, personal vehicle, meals, lodging, personal and 
                                   family educational benefits, low interest-loans, payment of personal travel, 
                                   entertainment, or other expenses, athletic or country club membership, 
                                   and personal use of your property); and bonuses.
                                    
Conflict of interest policy        A set of procedures to identify potential conflicts of interest and to reduce 
                                   the likelihood that persons in a position of authority over an organization 
                                   may use that authority to receive an inappropriate benefit. A conflict of 
                                   interest may arise 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. 
                                    
Controlled by disqualified persons See the definition of a disqualified person below. A section 509(a)(3) 
                                   supporting organization, may not be controlled directly or indirectly by 
                                   disqualified persons (other than the organization’s officers, directors or 
                                   trustees). An organization is controlled by disqualified persons if 
                                   disqualified persons can exercise 50% or more of the total voting power 
                                   held by the organization’s governing body. For this purpose, controlled 
                                   includes the authority to affect significant decisions, such as power over 
                                   investment decisions, or charitable disbursement decisions, as well as the 
                                   power to veto such decision. Control may be direct or indirect. 
                                    
Corporation                        An entity organized under a federal or state corporation law (including the 
                                   statutes of a federally recognized Indian tribal or Alaskan native 
                                   government). 
                                    
Develop                            The planning, financing, construction, or provision of similar services 
                                   involved in the acquisition of real property, such as land or a building.
                                    
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Disqualified person Any individual or organization that is any of the following relationships.

a. A substantial contributor to you (see Substantial contributor).

b. An officer, director, trustee, or any other individual who has similar
powers or responsibilities.

c. An individual who owns more than 20% of the total combined voting
power of a corporation that is a substantial contributor to you.

d. An individual who owns more than 20% of the profits interest of a
partnership that is a substantial contributor to you.

e. An individual who owns more than 20% of the beneficial interest of a
trust or estate that is a substantial contributor to you.

f. A member of the family of any individual described in a, b, c, d, or e
above.

g. A corporation in which any individuals described in a, b, c, d, e, or f
above hold more than 35% of the total combined voting power.

h. A trust or estate in which any individuals described in a, b, c, d, e, or
f above hold more than 35% of the beneficial interests.

i. A partnership in which any individuals described a, b, c, d, e, or f
above hold more than 35% of the profits interest.

Earmark Donations or other contributions given to an organization on the condition
or understanding that they will be used to assist particular individuals or
specific identified groups.

Expenses Financial burdens or outlays, costs (of doing business), and business
outlays chargeable against revenues. For purposes of this form, expenses
mean direct and indirect expenses.

Fair market value 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.

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.

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

For-profit A business entity whose activities are conducted or maintained to make a
profit (for example, revenues greater than expenses) for its private
shareholders or owners.

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

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Fundraising The organized activity of raising funds, whether by volunteers, employees,
or paid independent contractors.

Gaming The term gaming includes activities such as Bingo, Beano, lotteries,
pull-tabs, pari-mutuel betting, Calcutta wagering, pickle jars, punch
boards, tip boards, tip jars, certain video games, 21, raffles, keno,
split-the-pot, and other games of chance.

Gross investment income As defined in section 509, gross investment income means the gross
amount of income from interest, dividends, payments with respect to
securities loans, rents, and royalties; but not including any such income to
the extent included in computing the tax imposed by section 511.

Gross receipts For purposes of Part VI-A. Statement of Revenues and Expenses, gross
receipts include monies earned from activities related to an organization’s
charitable or other section 501(c)(3) activities, such as selling admissions
or merchandise, performing services, or furnishing facilities.

Hospital Hospital or medical care includes the treatment of any physical or mental
disability or condition, whether on an inpatient or outpatient basis. A
hospital includes the following.

a. Hospitals and rehabilitation institutions, outpatient clinics, or
community mental health or drug treatment centers if the principal
purpose or function is the providing of medical or hospital care or
medical education or research.

b. Medical research organizations, if the principal purpose or function
is the continuous active conduct of medical research in conjunction
with a hospital.

Influence legislation The act of directly contacting or urging the public to contact members of a
legislative body for the purpose of proposing, supporting, or opposing
legislation. Attempting to influence legislation includes advocating the
adoption or rejection of legislation.

Intellectual property A type of property (distinct from real or personal property) including the
following.

a. Patents (for inventions).

b. Copyrights (for literary and artistic works such as novels, poems,
plays, films, musical works, drawings, paintings, photographs,
sculptures, architectural designs, performances, recordings, film, and
radio or television programs).

c. Trade names, trademarks, and service marks (for symbols, names,
images, and designs).

d. Formulas, know-how, and trade secrets.

Joint venture A legal agreement in which the parties 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.

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Limited liability company       A limited liability company (LLC) is a business entity organized in the 
                                United States under state law. Generally, an LLC may be classified for 
                                federal income tax purposes as a partnership, corporation, or an entity 
                                disregarded as separate from its owner by applying the rules in Regulation 
                                section 301.7701-3. However, an LLC that has been determined to be, or 
                                claims to be, exempt from taxation under section 501(a) is treated as 
                                having made an election to be classified as a corporation under 
                                Regulation section 301.7701-3(c)(1)(v). 
                                 
Low-income housing              Rental or ownership housing provided to persons based on financial need.
                                 
Mailing address                 Address where correspondence is received.
                                 
Manage                          Manage means to direct or administer.
                                 
Medical care                    The treatment of any physical or mental disability or condition, whether on 
                                an inpatient or outpatient basis.
                                 
Medical research organization   An organization whose principal purpose or function is the continuous 
                                active conduct of medical research in conjunction with a hospital.
                                 
Net income (for Schedule D)     See Adjusted net income.
                                 
Non-fixed payment               A non-fixed 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 non-fixed payment because the 
                                governing body has discretion over whether the bonus is paid and the 
                                amount of the bonus.
                                 
Organizing document             The organizing document depends on the form of the organization. For a 
                                corporation, the document is the articles of incorporation. For an LLC, the 
                                document is the articles of organization. For an unincorporated 
                                association, the document is the articles of association or constitution. The 
                                organizing document of a trust is the trust agreement.
                                 
Political campaign intervention An organization participates in a political campaign, if it promotes or 
                                opposes, through political literature, brochures, pamphlets, hosting or 
                                participating in events, etc., the candidacy of an individual for public office. 
                                Debates and nonpartisan voter education aren’t considered political.
                                 
Predecessor                     An organization whose activities or assets were taken over by another 
                                organization.
                                 
Private foundation              An organization that is exempt under section 501(c)(3) is a private 
                                foundation unless it is a church, school, hospital, governmental unit, entity 
                                that undertakes testing for public safety, organization that has broad 
                                financial support from the general public, or organization that supports one 
                                or more other organizations that are themselves classified as public 
                                charities.
                                 
Private operating foundation    A type of private foundation that makes qualifying distributions directly for 
                                the active conduct of its educational, charitable, and religious purposes. 
                                “Directly for the active conduct” means that the distributions are used by 
                                the foundation itself to carry out the programs for which it is organized and 
                                operated. Grants made to assist other organizations or individuals are 
                                normally considered indirect.
                                 
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Public charity An organization that is exempt under section 501(c)(3) is excepted from
private foundation status because it is described in section 509(a)(1)
(which cross references sections 170(b)(1)(i) through (vi), and (ix)), 509(a)
(2), 509(a)(3), or 509(a)(4).

Reasonable compensation 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. Reasonable compensation is
important because excessive benefits in the form of compensation to
disqualified persons may result in the imposition of excise taxes and
jeopardize the organization's tax-exempt status.

Related The family or business relationships between persons.

Relationship A relationship may exist between one organization and another in the
following situations.

a. One organization controls the other through common officers,
directors, or trustees, or through authority to approve budgets or
expenditures.

b. Both organizations were created at approximately the same time
and by the same persons.

c. The organizations operate in a coordinated manner with respect to
facilities, programs, employees, or other activities.

d. The same persons exercise substantial influence over both
organizations.

Revenue Revenue means gross revenue amounts.

Revenue Procedure An official statement of a procedure published in the IRS Internal Revenue
Bulletin (previously the Cumulative Bulletin) that either affects the rights or
duties of taxpayers or other members of the public under the Internal
Revenue Code and related statutes, treaties, and regulations or, although
not necessarily affecting the rights and duties of the public, should be a
matter of public knowledge.

Revenue Ruling An official interpretation by the IRS of the Internal Revenue laws and
related statutes, treaties, and regulations, that has been published in the
IRS Internal Revenue Bulletin (previously the Cumulative Bulletin).
Revenue Rulings are issued only by the Office of Associate Chief Counsel
and are published for the information and guidance of taxpayers, IRS
officials, and others concerned.

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School A school is an educational organization whose primary function is the
presentation of formal instruction and that normally maintains a regular
faculty and curriculum and normally has a regularly enrolled body of pupils
or students in attendance at the place where its educational activities are
regularly carried on. A school may include the following.

a. Primary, secondary, preparatory, or high school.

b. College or university.

c. Trade or technical school.

d. Nursery or preschool.

e. School that you operate as an activity, such as school that is
operated as an activity of a museum, historical society, or church.

Similarly situated Similarly situated organizations means tax-exempt or taxable
organizations of a comparable size, purpose, and resources.

Substantial contributor An individual or organization that contributed more than $5,000 to an
organization from the date it was formed or other date that its exemption
would be effective, to the end of the year in which the contributions were
received. This total amount contributed must also be more than 2% of all
the contributions the organization received. A creator of a trust is treated
as a substantial contributor regardless of the amount contributed.

Successor An organization that took over:

a. More than a negligible amount of the activities that were previously
conducted by another organization,

b. 25% or more of the fair market value of the net assets of another
organization, or

c. Was established upon the conversion of an organization from
for-profit to non-profit status.

Trust A trust is an entity that may be formed by a trust agreement or declaration
of trust. A trust may also be formed through a will.

Unincorporated association An unincorporated association formed under state law must have at least
two members who have signed a written document for a specifically
defined purpose.

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Unrelated business income Income from a trade or business regularly conducted by an exempt 
                          organization and not substantially related to the performance by the 
                          organization of its exempt purpose or function. See Pub. 598.
                           
Unusual grant             Substantial contribution or bequest from a disinterested person that, by its 
                          size, adversely affects classification as a public charity. It is:
                             
                            a. Unusual, 
                             
                            b. Unexpected, and
                             
                            c. Received from an unrelated party. 

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Appendix D: National Taxonomy of 
Exempt Entities (NTEE) Codes
Arts, Culture & Humanities             B92  Remedial Reading &              E65  Organ & Tissue Banks             G99 Voluntary Health Associations, 
                                            Encouragement                   E6A  Pharmacies & Drugstores              Medical Disciplines N.E.C.
Code                                   B94  Parent & Teacher Groups         E70  Public Health                    G9B Surgical Specialties
A01  Alliances & Advocacy              B99  Education N.E.C.                E80  Health (General & Financing)     Medical Research
     Assistance                        Environment
A02  Management & Technical                                                 E86  Patient & Family Support         Code
A03  Professional Societies &          Code                                 E90  Nursing                          H01 Alliances & Advocacy
     Associations                      C01  Alliances & Advocacy            E91  Nursing Facilities               H02 Management & Technical 
A05  Research Institutes & Public      C02  Management & Technical          E92  Home Health Care                     Assistance
     Policy Analysis                        Assistance                      E99  Health Care N.E.C.               H03 Professional Societies & 
                                                                                                                      Associations
A11  Single Organization Support       C03  Professional Societies &        Mental Health & Crisis                H05 Research Institute & Public 
A12  Fund Raising & Fund Distribution       Associations
A19  Support N.E.C.                    C05  Research Institutes & Public    Intervention                              Policy Analysis
A20  Arts & Culture                         Policy Analysis                 Code                                  H11 Single Organization Support
A23  Cultural & Ethnic Awareness       C11  Single Organization Support     F01  Alliances & Advocacy             H12 Fundraising & Fund Distribution
A24  Folk Arts                         C12  Fundraising & Fund Distribution F02  Management & Technical           H19 Support N.E.C.
A25  Art Education                     C19  Support N.E.C.                       Assistance                       H20 Birth Defects & Genetic Diseases 
A26  Arts & Humanities Councils &      C20  Pollution Abatement & Control   F03  Professional Societies &             Research
     Agencies                          C27  Recycling                            Associations                     H25 Down Syndrome Research
A27  Community Celebrations            C30  Natural Resources Conservation  F05  Research Institutes & Public     H30 Cancer Research
A30  Media & Communications                 & Protection                         Policy Analysis                  H32 Breast Cancer Research
A31  Film & Video                      C32  Water Resources, Wetland        F11  Single Organization Support      H40 Diseases of Specific Organs 
A32  Television                             Conservation & Management       F12  Fundraising & Fund Distribution      Research
A33  Printing & Publishing             C34  Land Resources Conservation     F19  Support N.E.C.                   H41 Eye Diseases, Blindness & 
A34  Radio                             C35  Energy Resources Conservation   F20  Substance Abuse Dependency,          Vision Impairments Research
                                            & Development                        Prevention & Treatment           H42 Ear & Throat Diseases Research
A40  Visual Arts                       C36  Forest Conservation             F21  Substance Abuse Prevention       H43 Heart & Circulatory System 
A50  Museums                           C40  Botanical, Horticultural &      F22  Substance Abuse Treatment            Diseases & Disorders Research
A51  Art Museums                            Landscape Services              F30  Mental Health Treatment          H44 Kidney Diseases Research
A52  Children’s Museums                C41  Botanical Gardens & Arboreta    F31  Psychiatric Hospitals            H45 Lung Diseases Research
A54  History Museums                   C42  Garden Clubs                    F32  Community Mental Health          H48 Brain Disorders Research
A56  Natural History & Natural         C50  Environmental Beautification         Centers                          H50 Nerve, Muscle & Bone Diseases 
     Science Museums                   C60  Environmental Education         F33  Residential Mental Health            Research
A57  Science & Technology Museums      C99  Environmental N.E.C.                 Treatment                        H51 Arthritis Research
A60  Performing Art                                                         F40  Hot Line & Crisis Intervention   H54 Epilepsy Research
A61  Performing Arts Centers           Animal-Related                       F42  Sexual Assault Services          H60 Allergy-Related Diseases 
A62  Dance                             Code                                 F50  Addictive Disorders N.E.C.           Research
A63  Ballet                            D01  Alliance & Advocacy             F52  Smoking Addiction                H61 Asthma Research
A65  Theater                           D02  Management & Technical          F53  Eating Disorders & Addictions    H70 Digestive Diseases & Disorders 
A68  Music                                  Assistance                      F54  Gambling Addiction                   Research
A69  Symphony Orchestras               D03  Professional Societies &        F60  Counseling                       H80 Specifically Named Diseases 
                                            Associations
A6A  Opera                             D05  Research Institutes & Public    F70  Mental Health Disorders              Research
A6B  Singing & Choral Groups                Policy Analysis                 F80  Mental Health Associations       H81 AIDS Research
A6C  Bands & Ensembles                 D11  Single Organization Support     F99  Mental Health & Crisis           H83 Alzheimer’s Disease Research
A6E  Performing Arts Schools           D12  Fundraising & Fund Distribution      Intervention N.E.C.              H84 Autism Research
                                                                                                                  H90 Medical Disciplines Research
A70  Humanities Organizations          D19  Support N.E.C.                  Volutary Health Associations &        H92 Biomedicine & Bioengineering 
A80  Historical Organizations          D20  Animal Protection & Welfare     Medical Disciplines                       Research
A82  Historical Societies & Historic   D30  Wildlife Preservation &         Code                                  H94 Geriatrics Research
     Preservation                           Protection                      G01  Alliances & Advocacy             H96 Neurology & Neuroscience 
A84  Commemorative Events              D31  Protection of Endangered        G02  Management & Technical               Research
A90  Arts Service                           Species                              Assistance                       H98 Pediatrics Research
A99  Arts, Culture & Humanities        D32  Bird Sanctuaries                G03  Professional Societies &         H99 Medical Research N.E.C.
     N.E.C.                            D33  Fisheries Resources                  Associations                     H9B Surgical Specialties Research
Education                              D34  Wildlife Sanctuaries            G05  Research Institute & Public      Crime & Legal-Related
Code                                   D40  Veterinary Services                  Policy Analysis
B01  Alliances & Advocacy              D50  Zoos & Aquariums                G11  Single Organization Support      Code
     Organizations                     D60  Animal Services N.E.C.          G12  Fundraising & Fund Distribution  I01 Alliances & Advocacy
B02  Management & Technical            D61  Animal Training                 G19  Support N.E.C.                   I02 Management & Technical 
     Assistance                        D99  Animal Related N.E.C.           G20  Birth Defects & Genetic Diseases     Assistance
B03  Professional Society &            Health Care                          G25  Down Syndrome                    I03 Professional Societies & 
                                                                                                                      Associations
     Associations                                                           G30  Cancer                           I05 Research Institutes & Public 
B05  Research Institutes & Public      Code                                 G32  Breast Cancer                        Policy Analysis
     Policy Analysis                   E01  Alliances & Advocacy            G40  Diseases of Specific Organs      I11 Single Organization Support
B11  Single Organization Support       E02  Management & Technical          G41  Eye Diseases, Blindness &        I12 Fundraising & Fund Distribution
B12  Fundraising & Fund Distribution        Assistance                           Vision Impairments               I19 Support N.E.C.
B20  Elementary & Secondary                 Associations
B19  Support N.E.C.                    E03  Professional Societies &        G42  Ear & Throat Diseases            I20 Crime Prevention
     Schools                           E05  Research Institutes & Public    G43  Heart & Circulator System        I21 Youth Violence Prevention
B21  Preschools                             Policy Analysis                      Diseases & Disorders             I23 Drunk Driving-Related
B24  Primary & Elementary Schools      E11  Single Organization Support     G44  Kidney Diseases                  I30 Correctional Facilities
B25  Secondary & High Schools          E12  Fundraising & Fund Distribution G45  Lung Diseases                    I31 Half-Way Houses for Offenders 
B28  Special Education                 E19  Support N.E.C.                  G48  Brain Disorder                       & Ex-Offenders
B29  Charter Schools                   E20  Hospitals                       G50  Nerve, Muscle, & Bone Diseases   I40 Rehabilitation Services for 
B30  Vocational & Technical Schools    E21  Community Health Systems        G51  Arthritis                            Offenders
B40  Higher Education Institutions     E22  General Hospitals               G54  Epilepsy                         I43 Inmate Support
B41  Two-Year Colleges                 E24  Specialty Hospitals             G60  Allergy Related Diseases         I44 Prison Alternatives
B42  Two-Year Colleges                 E30  Ambulatory & Primary Health     G61  Asthma                           I50 Administration of Justice
                                            Care                            G70  Digestive Diseases & Disorders   I51 Dispute Resolution & Mediation
B43  Undergraduate Colleges            E31  Group Health Practices          G80  Specific Named Disorders         I60 Law Enforcement
B50  Graduate & Professional Schools   E32  Community Clinics               G81  AIDS                             I70 Protection Against Abuse
B60  Adult Education                   E40  Reproductive Health Care        G83  Alzheimer’s Diseases             I71 Spouse Abuse Prevention
B70  Libraries                         E42  Family Planning                 G84  Autism                           I72 Child Abuse Prevention
B80  Student Services                  E50  Rehabilitative Care             G90  Medical Disciplines              I73 Sexual Abuse Prevention
B82  Scholarships & Student Financial  E60  Health Support                  G92  Biomedicine & Bioengineering     I80 Legal Services
     Aid                               E61  Blood Banks                     G94  Geriatrics                       I83 Public Interest Law
B83  Student Sororities & Fraternities E62  Emergency Medical Services &    G96  Neurology & Neuroscience         I99 Crime & Legal-Related N.E.C.
B84  Alumni Associations                    Transport                       G98  Pediatrics
B90  Educational Services

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Appendix D: National Taxonomy of Exempt Entities (NTEE) Codes (Continued)
Employment                           L25  Housing Rehabilitation          O12  Fundraising & Fund Distribution  International, Foreign Affairs & 
Code                                 L30  Housing Search Assistance       O19  Support N.E.C.                   National Security
J01  Alliances & Advocacy            L40  Temporary Housing               O20  Youth Centers & Clubs            Code
J02  Management & Technical          L41  Homeless Shelters               O21  Boys Clubs                       Q01 Alliances & Advocacy
     Assistance                      L4A  Hotels (except Casino Hotels) & O22  Girls Clubs                      Q02 Management & Technical 
J03  Professional Societies &             Motels                          O23  Boys & Girls Clubs                   Assistance
     Associations                    L4B  Bed and Breakfast Inns          O30  Adult & Child - Matching         Q03 Professional Societies & 
J05  Single Organization Support     L50  Homeowners & Tenants                 Programs                             Associations
J11  Consumer Lending                     Associations                    O31  Big Brothers & Big Sisters       Q05 Research Institutes & Public 
J12  Fundraising & Fund Distribution L80  Housing Support                 O40  Scouting                             Policy Analysis
J19  Support N.E.C.                  L81  Home Improvement & Repairs      O41  Boy Scouts of America            Q11 Single Organization Support
J20  Employment Preparation &        L82  Housing Expense Reduction       O42  Girl Scouts of the U.S.A.        Q12 Fundraising & Fund Distribution
     Procurement                          Support                         O43  Camp Fire                        Q19 Support N.E.C.
J21  Vocational Counseling           L99  Housing & Shelter N.E.C.        O50  Youth Development Programs       Q20 Promotion of International 
J22  Job Training                    Public Safety, Disaster              O51  Youth Community Service Clubs        Understanding
J30  Vocational Rehabilitation       Preparedness & Relief                O52  Youth Development - Agricultural Q21 International Cultural Exchange
J32  Goodwill Industries             Code                                 O53  Youth Development - Business     Q22 International Academic 
J33  Sheltered Employment            M01  Alliances & Advocacy            O54  Youth Development - Citizenship      Exchange
J40  Labor Unions                    M02  Management & Technical          O55  Youth Development - Religious    Q23 International Exchange N.E.C.
J99  Employment N.E.C.                    Assistance                           Leadership                       Q30 International Development
Food, Agriculture & Nutrition        M03  Professional Societies &        O99  Youth Development N.E.C.         Q31 International Agricultural 
                                          Associations                                                              Development
Code                                 M05  Research Institutes & Public    Human Services                        Q32 International Economic 
K01  Alliances & Advocacy                 Policy Analysis                 Code                                      Development
K02  Management & Technical          M11  Single Organization Support     P01  Alliances & Advocacy             Q33 International Relief
     Assistance                      M12  Fundraising & Fund Distribution P02  Management & Technical           Q35 International Democracy & Civil 
K03  Professional Societies &        M19  Support N.E.C.                       Assistance                           Society Development
     Associations                    M20  Disaster Preparedness & Relief  P03  Professional Societies &         Q40 International Peace & Security
K05  Research Institutes & Public         Services                             Associations                     Q41 Arms Control & Peace
     Policy Analysis                 M23  Search & Rescue Squads          P05  Research Institutes & Public     Q42 United Nations Associations
                                                                               Policy Analysis                  Q43 National Security
K11  Single Organization Support     M24  Fire Prevention                 P11  Single Organization Support      Q50 International Affairs, Foreign 
K12  Fundraising & Fund Distribution M40  Safety Education                P12  Fundraising & Fund Distribution      Policy & Globalization
K19  Support N.E.C.                  M41  First Aid                       P19  Support N.E.C.                   Q51 International Economic & Trade 
K20  Agricultural Programs           M42  Automotive Safety               P20  Human Service Organizations          Policy
K25  Farmland Preservation           M60  Public Safety Benevolent        P21  American Red Cross               Q70 International Human Rights
K26  Animal Husbandry                     Associations                    P22  Urban League                     Q71 International Migration & 
K28  Farm Bureaus & Granges          M99  Public Safety, Disaster         P24  Salvation Army                       Refugee Issues
K2A  Other Vegetable (except Potato)      Preparedness & Relief N.E.C.                                          Q99 International, Foreign Affairs & 
     & Melon Farming                 Recreation & Sports                  P26  Volunteers of America                National Security N.E.C.
K2B  Soil Preparation, Planting, &                                        P27  Young Men’s or Women 
     Cultivating                     Code                                      Associations                     Civil Rights, Social Action & 
K2C  Wineries                        N01  Alliances & Advocacy            P28  Neighborhood Centers             Advocacy
K30  Food Programs                   N02  Employment Services             P29  Thrift Shops                     code
K31  Food Banks & Pantries           N03  Professional Societies &        P30  Children & Youth Services        R01 Alliances & Advocacy 
K34  Congregate Meals                     Associations                    P31  Adoption                             Organizations
K35  Soup Kitchens                   N05  Research Institutes & Public    P32  Foster Care                      R02 Management & Technical 
K36  Meals on Wheels                      Policy Analysis                                                           Assistance
K40  Nutrition                       N11  Single Organization Support     P33  Child Day Care
K50  Home Economics                  N12  Fundraising & Fund Distribution P40  Family Services                  R03 Professional Societies & 
K6A  Meat Markets                    N19  Support N.E.C.                  P42  Single Parent Agencies               Associations
K6B  Confectionery & Nut Stores      N20  Camps                           P43  Family Violence Shelters,        R05 Research Institutes & Public 
                                                                               Services                             Policy Analysis
K6C  Caterers                        N2A  RV (Recreational Vehicle) Parks P44  In-Home Assistance               R11 Single Organization Support
                                          & Campgrounds
K6D  Mobile Food Services            N2B  Recreational and Vacation       P45  Family Services for Adolescent   R12 Fundraising & Fund Distribution
K6E  Drinking Places                      Camps (Except Campgrounds)           Parents                          R19 Support N.E.C.
K6F  Snack Nonalcoholic Beverage     N30  Physical Fitness & Community    P46  Family Counseling                R20 Civil Rights
     Bars                                 Recreational Facilities         P47  Pregnancy Centers                R22 Minority Rights
K90  Limited-Service Restaurants     N31  Community Recreational Centers  P50  Personal Social Services         R23 Disabled Persons’ Rights
K91  Supermarkets & Other Grocery    N32  Parks & Playgrounds             P51  Financial Counseling             R24 Womens’ Rights
     (except Convenience) Stores     N40  Sports Training Facilities,     P52  Transportation Assistance        R25 Seniors’ Rights
K92  Convenience Stores                   Agencies                        P58  Gift Distribution                R26 Lesbian & Gay Rights
K93  Fruit & Vegetable Markets       N50  Recreational Clubs              P60  Emergency Assistance             R28 Childrens’ Rights
K94  All Other Specialty Food Stores N52  Fairs                           P61  Travelers’ Aid                   R30 Intergroup & Race Relations
K95  Food (Health) Supplement        N60  Amateur Sports                  P62  Victims’ Services                R40 Voter Education & Registration
     Stores                          N61  Fishing & Hunting               P70  Residential Care & Adult Day     R60 Civil Liberties
K96  Warehouse Clubs &               N62  Basketball                           Programs                         R61 Reproductive Rights
     Supercenters                    N63  Baseball & Softball             P71  Adult Day Care                   R62 Right to Life
K97  Food Service Contractors        N64  Soccer                          P73  Group Homes                      R63 Censorship, Freedom of Speech 
K98  Full-Service Restaurants        N65  Football                        P74  Hospices                             & Press
K99  Food, Agriculture & Nutrition   N66  Racquet Sports                  P75  Supportive Housing for Older     R67 Right to Die & Euthanasia
     N.E.C.                                                                    Adults                           R99 Civil Rights, Social Action & 
                                     N67  Swimming & Other Water 
Housing & Shelter                         Recreation                      P76  Homes for Children &                 Advocacy N.E.C.
Code                                 N68  Winter Sports                        Adolescents                      Community Improvement & 
L01  Alliances & Advocacy            N69  Equestrian                      P7A  Residential Intellectual &       Capacity Building
                                                                               Developmental Disability 
L02  Management & Technical          N6A  Golf                                 Facilities (Group Homes,         Code
     Assistance                      N70  Amateur Sports Competitions          Intermediate Care Facilities &   S01 Alliances & Advocacy
L03  Professional Societies &        N71  Olympics                             Hospitals)                       S02 Management & Technical 
     Associations                    N72  Special Olympics                P80  Centers to Support the               Assistance
L05  Research Institutes & Public    N80  Professional Athletic Leagues        Independence of Specific         S03 Professional Societies & 
     Policy Analysis                                                           Populations                          Associations
L11  Single Organization Support     N99  Recreation & Sports N.E.C.      P81  Senior Centers                   S05 Research Institutes & Public 
L12  Fundraising & Fund Distribution Youth Development                    P82  Developmentally Disabled             Policy Analysis
L19  Support N.E.C.                  Code                                      Centers                          S11 Single Organization Support
L20  Housing Development,            O01  Alliances & Advocacy            P83  Womens’ Centers                  S12 Fund Raising & Fund Distribution
     Construction & Management       O02  Management & Technical          P84  Ethnic & Immigrant Centers       S19 Support N.E.C.
L21  Low-Income & Subsidized Rental       Assistance                      P85  Homeless Centers                 S20 Community & Neighborhood 
     Housing                         O03  Professional Societies &        P86  Blind & Visually Impaired            Development
L22  Senior Citizens’ Housing &           Associations                         Centers                          S21 Community Coalitions
     Retirement Communities          O05  Research Institutes & Public    P87  Deaf & Hearing Impaired Centers  S22 Neighborhood & Block 
L24  Independent Housing for People       Policy Analysis                 P88  LGBT Centers                         Associations
     with Disabilities               O11  Single Organization Support     P99  Human Services N.E.C.

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Appendix D: National Taxonomy of Exempt Entities (NTEE) Codes (Continued)
S30  Economic Development            U03  Professional Societies &         V37  Labor Studies                    X70 Hinduism
S31  Urban & Community Economic           Associations                     V99  Social Science N.E.C.            X80 Religious Media & 
     Development                     U05  Research Institutes & Public     Public & Societal Benefit                 Communications
S32  Rural Economic Development           Policy Analysis                                                        X81 Religious Film & Video
S40  Business & Industry             U11  Single Organization Support      Code                                  X82 Religious Television
S41  Chambers of Commerce &          U12  Fundraising & Fund Distribution  W01  Alliances & Advocacy             X83 Religious Printing & Publishing
     Business Leagues                U19  Support N.E.C.                   W02  Management & Technical           X84 Religious Radio
S43  Small Business Development      U20  General Science                       Assistance                       X90 Interfaith Coalitions
S46  Boards of Trade                 U21  Marine Science & Oceanography    W03  Professional Societies &         X99 Religion Related, N.E.C.
S47  Real Estate Associations        U30  Physical & Earth Sciences             Associations
S50  Nonprofit Management            U31  Astronomy                        W05  Research Institutes & Public     Mutual & Membership Benefit
                                                                                Policy Analysis
S80  Community Service Clubs         U33  Chemistry & Chemical             W11  Single Organization Support      Code
S81  Womens’ Service Clubs                Engineering                      W12  Fundraising & Fund Distribution  Y01 Alliances & Advocacy
S82  Mens’ Service Clubs             U34  Mathematics                      W19  Support N.E.C.                   Y02 Management & Technical 
                                                                                                                     Assistance
S99  Community Improvement &         U36  Geology                          W20  Government & Public              Y03 Professional Societies & 
     Capacity Building N.E.C.        U40  Engineering & Technology              Administration                       Associations
Philanthropy, Volunteerism &         U41  Computer Science                 W22  Public Finance, Taxation &       Y05 Research Institutes & Public 
Grantmaking Foundations              U42  Engineering                           Monetary Policy                      Policy Analysis
Code                                 U50  Biological & Life Sciences       W24  Citizen Participation            Y11 Single Organization Support
                                          Research                         W30  Military & Veterans’ 
T01  Alliances & Advocacy            U99  Science & Technology N.E.C.           Organizations                    Y12 Fundraising & Fund Distribution
T02  Management & Technical          Social Science                        W40  Public Transportation Systems    Y19 Support N.E.C.
     Assistance                                                            W50  Telecommunications               Y20 Insurance Providers
T03  Professional Societies &        Code                                  W60  Financial Institutions           Y22 Local Benevolent Life Insurance 
                                                                                                                     Associations
     Associations                    V01  Alliances & Advocacy             W61  Credit Unions                    Y23 Mutual Insurance Companies & 
T05  Research Institutes & Public    V02  Management & Technical           W70  Leadership Development               Associations
     Policy Analysis                      Assistance
T11  Single Organization Support     V03  Professional Societies &         W80  Public Utilities                 Y24 Supplemental Unemployment 
T12  Fundraising & Fund Distribution      Associations                     W90  Consumer Protection                  Compensation
T19  Support N.E.C.                  V05  Research Institutes & Public     W99  Public & Societal Benefit N.E.C. Y25 State-Sponsored Workers’ 
                                                                                                                     Compensation Reinsurance 
T20  Private Grantmaking                  Policy Analysis                  Religion-Related                          Organizations
     Foundations                     V11  Single Organization Support                                            Y30 Pension & Retirement Funds
T21  Corporate Foundations           V12  Fund Raising & Fund Distribution Code
T22  Private Independent Foundations V19  Support N.E.C.                   X01  Alliances & Advocacy             Y33 Teachers’ Retirement Fund 
T23  Private Operating Foundations   V20  Social Science                   X02  Management & Technical               Associations
T30  Public Foundations              V21  Anthropology & Sociology              Assistance                       Y34 Employee-Funded Pension 
T31  Community Foundations           V22  Economics                        X03  Professional Societies &             Trusts
                                                                                Associations                     Y35 Multi-Employer Pension Plans
T40  Volunteerism Promotion          V23  Behavioral Science               X05  Research Institutes & Public     Y40 Fraternal Societies
T50  Philanthropy, Charity &         V24  Political Science                     Policy Analysis                  Y41 Fraternal Beneficiary Societies
     Volunteerism Promotion          V25  Population Studies               X11  Single Organization Support      Y42 Domestic Fraternal Societies
T70  Federated Giving Programs       V26  Law & Jurisprudence              X12  Fundraising & Fund Distribution  Y43 Voluntary Employees Beneficiary 
T90  Named Trusts N.E.C.             V30  Interdisciplinary Research       X19  Support N.E.C.                       Associations (Non-Government)
T99  Philanthropy, Voluntarism &     V31  Black Studies                    X20  Christianity                     Y44 Voluntary Employees Beneficiary 
     Grantmaking Foundations N.E.C.  V32  Women’s Study                    X21  Protestant                           Associations (Government)
Science & Technology                 V33  Ethnic Studies                   X22  Roman Catholic                   Y50 Cemeteries
Code                                 V34  Urban Studies                    X30  Judaism                          Y99 Mutual & Membership Benefit 
                                                                                                                     N.E.C.
U01  Alliances & Advocacy            V35  International Studies            X40  Islam
U02  Management & Technical          V36  Gerontology                      X50  Buddhism
     Assistance

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Index
 
                              Distribution of assets at 
A                               dissolution 8                 N                            S
Annual filing requirements  4                                 NASCO   2                    Sample conflict of interest 
Annual returns for foreign                                    NTEE 37                       policy  25
  organizations  5            E                                                            Scholarships, fellowships, 
Answers 2                     EIN (See Employer                                             grants, loans   22
Appendix:                       identification number)        O                            School:
  Glossary of terms 29        Employer identification         Operated 2                    Racially nondiscriminatory 
  Sample conflict of interest   number  6                       Qualification  2                 policy 17
  policy     25               Expedite requests 3             Organizational structure 6    School   17
  States with statutory                                       Organized 2                  Section 501(c)(3) organization:
  provisions satisfying the                                     Qualification  2            Eligibility 1
  requirements of section     F                               Organizing document   2       Private foundations          2
  508(e)     27               Filing assistance 4               Dissolution clause  8       Public charities   2
Application for exemption:    Foreign organizations   5         Purpose clause   7          Public charities and private 
  Group exemption   3           Annual returns  5               Required provisions 7            foundations  2
  Language and currency         Canadian organizations   5      Unincorporated              Qualifications    2
  requirements     3            General 5                       association      7          Recognition   1
  Past, present and planned     United States territories and                              Signature 4
  activities    3                  possessions                                             State registration:
  Purpose    3                     organizations  6           P                             NASCO       2
  User fee   3                Form 2848 4                     Past, present and planned    States with section 508(e) 
Application package           Form 8821 4                       activities 3                provisions    27
  assembly   3                For-profit organization 22      Pay.gov 6                    States with statutory provisions 
Articles of incorporation 6                                   Person to contact  6          satisfying the requirements 
Assistance   4                                                Political campaign            of section 508(e)            27
Authorized representative   6 G                                 intervention   2           Successor    22
                              Glossary of terms 29            Predecessor   22             Supporting organization         20
                              Group exemption   3             Private foundations  2
C                                                             processing the application:
Canadian organizations    5                                     Expedite requests   3      T
Church 16                     H                               Public charities 2           Trust 7
  Prescribed course of        Homes for the elderly or        Public charities and private 
  study      17                 handicapped   22                foundations    2
Compensation:                 Hospital 18                     Public inspection  4         U
  Definition 10               How to answer  2                Purpose clause:              Unincorporated association        7
Corporation:                                                    Charitable   7             United States territories and 
  Articles of incorporation 6                                                               possessions   6
                              L                                                            User fee 3
                              Language and currency           Q
D                               requirements    3             Qualification:
Definitions:                  LLC (See Limited liability        Operated    2              W
  Authorized                    company)                        Organized    2             What to file:
  representative    6         Low-income housing   22           Political campaign          Required schedules             3
  Charitable   7                                                intervention     2         When to file 4
  Church  16                                                  Qualifications 2
  Compensation    10          M
  Corporation   6             Mailing address 6
  For-profit organization  22 Medical research  18            R
  Hospital   18               Medical research                Representation   4
  Medical research  18          organization 18                 Form 2848    4
  Medical research            Month and annual accounting       Form 8821    4
  organization    18            period 6

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