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Department of the Treasury
Internal Revenue Service
Instructions for Form 1024

(Rev. January 2022)
Application for Recognition of Exemption Under Section 501(a) or Section 521 of
the Internal Revenue Code

Section references are to the Internal Revenue Tax Forms and Publications You Your answers must provide sufficient
Code unless otherwise noted. can download or print all of the forms and detail about your past, present, and
Note. Keep a copy of the completed Form publications you may need at IRS.gov/ planned activities to demonstrate that
1024 in the organization’s permanent FormsPubs. Otherwise, you can go to you're described in the subsection of
records. IRS.gov/OrderForms to place an order 501(c), 501(d), or section 521 under which
and have forms mailed to you. You should you are seeking recognition of exemption.
receive your order within 10 business We won't be able to recognize you as tax
Future Developments days. exempt based on a mission statement
For the latest information about unless you also describe the activities that
developments related to Form 1024 and further accomplish your mission. We need
its instructions, such as legislation What's New
enacted after they were published, go to Organizations filing Form 1024, to understand the specific activities you
IRS.gov/Form1024. Application for Recognition of Exemption undertake to accomplish your exempt
Under Section 501(a) or Section 521 of purpose(s).
Reminder the Internal Revenue Code, must Financial data. Financial data, whether
complete and submit their Form 1024 budgets or actual, should be consistent
Don't include social security application electronically (including paying with other information presented in your
numbers on publicly disclosed forms. the correct user fee) using Pay.gov. application. Budgeted financial data
Because the IRS is required to disclose
approved exemption applications and Organizations requesting should be prepared based on your current
information returns, don't include social determinations under subsections 501(c) plans. We recognize that your actual
security numbers on this form. Documents (11), (14), (16), (18), (21), (22), (23), (26), financial results may vary from the
subject to disclosure include supporting (27), (28), (29) or section 501(d) budgeted amounts.
information filed with the form and previously submitted letter applications, Past, present, and planned activities.
correspondence with the IRS about the but now are required to submit the Many items on Form 1024 are written in
filing. electronic Form 1024. Organizations the present tense; however, base your
requesting determination under section answers on your past, present, and
Phone Help 521 may also submit the electronic Form planned activities.
If you have questions and/or need help 1024 instead of Form 1028, Application for
completing Form 1024, please call Recognition of Exemption Under Section Language and currency requirements.
877-829-5500. This toll-free telephone 521 of the Internal Revenue Code. Form Complete Form 1024 and attachments in
service is available Monday through 1024 has been revised accordingly. English. Provide an English translation if
Friday. your organizational document, bylaws, or
any other attachments are in any other
Email Subscription General Instructions language.
The IRS provides a subscription-based Social security number. Don't enter Report financial information in United
email service for tax professionals and social security numbers on this form or States dollars (specify the conversion rate
representatives of tax-exempt any attachments because the IRS is used). Combine amounts from within and
organizations. The IRS sends subscribers required to disclose approved exemption outside the United States and report the
periodic updates regarding exempt applications and information returns. totals on the financial statements.
organization tax law and regulations, Documents subject to disclosure include
available services, and other information. supporting information filed with the form Purpose of Form
To subscribe, visit IRS.gov/Charities. and correspondence with the IRS related Don't use Form 1024 if you are
to the application.
How To Get Forms and ! applying under Section 501(c)(3)
“You” and “us.” Throughout these CAUTION or Section 501(c)(4). Instead, use
Publications instructions and Form 1024, the terms Form 1023-EZ, Form 1023, or Form
Internet. You can access the IRS “you” and “your” refer to the organization 1024-A.
website 24 hours a day, 7 days a week, at that is applying for tax-exempt status. The Form 1024 is used by most types of
IRS.gov to do the following: terms “us” and “we” refer to the IRS. organizations to apply for recognition of
• Download forms, instructions, and exemption under section 501(a) or section
Answers
publications. 521.
• Order IRS products online. Form 1024 asks you to answer a series of
• Research your tax questions online. questions and provide information to Certain organizations aren't required to
• Search publications by topic or assist us in determining if you meet the apply for tax-exempt status; however, they
keyword. requirements for tax exemption under the may wish to file Form 1024 to receive a
• Use the online Internal Revenue Code, subsection you applied. Answer questions determination letter of IRS recognition of
regulations, or other official guidance. completely. If an explanation provided for their section 501(c) status in order to
• View Internal Revenue Bulletins (IRBs) an earlier question also applies to a later obtain certain incidental benefits such as:
published since 1995. question, your response to the later • Public recognition of tax-exempt status,
• Sign up at IRS.gov/Charities to receive question may simply refer to your previous • Possible exemption from certain state
local and national tax news by email. answer. taxes,

Dec 27, 2021 Cat. No. 47909G

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• Advance assurance to donors of victims of emergencies such as floods and recognition of your exempt status will be
deductibility of contributions (in certain hurricanes. the date you submitted Form 1024.
cases), and • An IRS error has caused delays in
• Nonprofit mailing privileges, etc. review of the application. For exceptions and special rules,
including automatic extensions, see Pub.
Group exemption. Don't use Form 1024 User Fee 557.
to apply for a group exemption. We may The law requires payment of a user fee How To File
issue a group exemption to a central with each application. You must pay this
organization recognizing, on a group fee through Pay.gov when you file Form As of January 3, 2022, the IRS requires
basis, the exemption of subordinate 1024. that Form 1024 applications for
organizations on whose behalf the central recognition of exemption be submitted
organization has applied. See Pub. 557 for Payments can be made directly from electronically online at Pay.gov. The IRS
information on how to apply for a group your bank account or by credit or debit will provide a 90-day grace period during
exemption. card. You won't be able to submit Form which it will continue to accept paper
Leaving a group exemption. A 1024 without paying the correct fee. versions of Form 1024 (and letter
applications from organizations previously
subordinate organization under a group User fee amounts are listed in Rev. required to submit in that format). To
exemption can use Form 1024 to leave the Proc. 2022-5, updated annually. For the submit Form 1024, you must:
group and obtain individual exemption. If current Form 1024 user fee, go to
1. Register or have previously
you're a subordinate organization and IRS.gov/Charities-Non-Profits/User-Fees-
registered for an account on Pay.gov.
wish to leave a group, you should notify for-Tax-Exempt-and-Government-Entities-
your parent organization of your intent to Division. You can also call 877-829-5500. 2. Enter “Form 1024” or “1024” in the
leave the group ruling before filing Form search box and select Form 1024.
1024. What To File 3. Complete the form.
Application for Reinstatement All applicants must complete Parts I
through VIII of Form 1024 and must Filing Assistance
of Exempt Status and provide any required attachments. For help in completing this form or general
Retroactive Reinstatement questions relating to exempt
Attachments to Form 1024
If your tax-exempt status was organizations, you may access
automatically revoked for failure to file a A complete application will include one or information on our website at IRS.gov/EO.
return or notice for 3 consecutive years, more documents in addition to Form 1024.
You may find the following publications
you must apply to have your tax-exempt Pay.gov can accommodate only one available on IRS.gov.helpful.
status reinstated. You must complete and uploaded file. Before submitting Form • Pub. 557, Tax-Exempt Status for Your
submit Form 1024 and pay the appropriate 1024, consolidate your attachments into a Organization.
user fee, even if you did not previously single PDF file. Combine your • Pub. 598, Tax on Unrelated Business
choose to apply for recognition of attachments in the following order. Income of Exempt Organizations.
exemption. • Organizing document (required). • Pub. 3079, Tax-Exempt Organizations
If your application is approved, your • Amendments to your organizing and Gaming.
date of reinstatement will generally be the document in chronological order (required • Pub. 4221-NC, Compliance Guide for
filing date of the application unless you if applicable). Tax Exempt Organizations (Other than
qualify for reinstatement of exemption • Bylaws or other rules of operation and 501(c)(3) Public Charities and Private
retroactive to your date of automatic amendments (if adopted). Foundations).
revocation. See Rev. Proc. 2014-11, • Form 2848, Power of Attorney and
2014-3 I.R.B. 411 at IRS.gov/IRB2014-3 Declaration of Representative (if Signature Requirements
for details, including additional applicable). An officer, director, trustee, or other official
requirements for retroactive reinstatement. • Form 8821, Tax Information who is authorized to sign for the
Authorization (if applicable). organization must digitally sign Form 1024
Requesting Expedited Review • Supplemental responses (if your at the end of Part VIII. The signature must
We generally review applications for response won't fit in the provided text be accompanied by the title or authority of
exemption in the order we receive them. field) and any additional information you the signer and the date.
We expedite processing of an application want to provide to support your request
only where a written request presents a (optional). Authorized Representative
compelling reason for processing the Form 2848. Upload a completed Form
application ahead of others. Even if your Expedite request (optional). Put your
request for expedited processing is name and EIN on each page of your 2848 if you want to authorize a
approved, this does not mean your supplemental response and identify the representative to represent you regarding
application will be immediately approved part and line number to which the your application. An individual authorized
or denied. Expedited processing means information relates. by Form 2848 may not sign the application
unless that person is also an officer,
that it will be assigned to a specialist for When To File director, trustee, or other official who is
review ahead of applications received Generally, if you file Form 1024 within 27 authorized to sign the application.
earlier in time. Circumstances generally months after the month in which you were A Centralized Authorization File
warranting expedited processing include legally formed, and we approve your TIP (CAF) number isn't required to be
the following. application, the effective date of listed on Form 2848.
• A grant to the applicant is pending and recognition of your exempt status will be
the failure to secure the grant may have an your legal date of formation. Form 8821. Upload a completed Form
adverse impact on the organization's
8821 if you want to authorize us to discuss
ability to continue operations. If you otherwise meet the requirements your application with the person you have
• The purpose of the newly created for tax exempt status but don't meet the appointed on that form.
organization is to provide disaster relief to requirements for recognition from your
date of formation, the effective date of

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Form 8821 doesn't authorize your                     If a Form 990-series return is due  If you post the documents on your 
appointee to advocate your position with       !     while your application is pending,  website, you can give any person 
respect to the federal tax laws; to execute  CAUTION complete and submit the return      requesting copies the website where the 
waivers, consents, or closing agreements;    according to Form 990-series form's         documents may be found, but you don't 
or to otherwise represent you before the     instructions.                               need to provide copies of the information. 
IRS. If you want to authorize an individual                                              However, even if these documents are 
to represent you, use Form 2848.             Public Inspection                           posted on your website, you must still 
                                                                                         allow public inspection without charge at 
After You Submit Form 1024                   Information available for public in-        your main office during regular business 
Unless we approve a request for              spection. If we approve exempt status       hours.
expedited processing, we'll assign and       under section 501(a) or section 521, the 
work your application in the order we        information that will be open for public    Documents aren't considered available 
received it.                                 inspection includes the following.          for public inspection on a website if the 
                                             • Your complete Form 1024 and any           otherwise disclosable information is edited 
No additional information needed.       If   supporting documents.                       or subject to editing by a third party when 
our review shows that you meet the           • All correspondence between you and        posted. To date, the IRS hasn't approved 
requirements for tax-exempt status, we'll    the IRS concerning Form 1024, including     any third-party websites for posting.
send you a determination letter stating that Form 2848.                                  See Pub. 557 for additional information 
you're exempt.                               • Your determination letter.                on public inspection requirements.
Additional information needed.        If we  • Annual information returns (Form 990, 
can't make a determination without more      990-EZ, or 990-N) including schedules,      Foreign Organizations
information, we'll write or call you.        except for the names and addresses of       Foreign organizations are those that were 
Examples of the types of questions you       contributors and other identifying          created in countries other than the United 
may be asked are available at IRS.gov/       information about contributors.             States, its territories, or its possessions. 
                                                                                         Foreign organizations may apply for 
charities-non-profits/charitable-            Information not available for public in-    tax-exempt status on income earned in the 
organizations/exempt-organization-           spection. The following items won't be      United States in the same way that 
sample-questions.                            open for public inspection.                 domestic organizations apply for exempt 
If the additional information you provide    • Any information relating to a trade       status. See Language and currency 
shows that you meet the requirements for     secret, patent, style of work, or apparatus requirements, earlier.
exemption, we'll send you a determination    that, if released, would adversely affect 
letter stating that you're exempt under      you (we must approve withholding this               Contributions by U.S. residents to 
either section 501(a) or section 521. If we  information).                               !       foreign organizations generally 
determine that you don't qualify for         • Any other information that would          CAUTION aren't deductible. Tax treaties 
exemption, we'll send you a letter that      adversely affect national defense (we       between the United States and certain 
explains our position and your appeal        must approve withholding this               foreign countries provide specific limited 
rights.                                      information).                               exceptions.
                                             • User fee payment information.
Annual Return or Notice While                • Contributors' names and addresses         Annual returns for foreign organiza-
Your Application Is Pending                  and other identifying information about     tions. A foreign organization that obtains 
Unless you qualify for an exception from     contributors included with Form 990 or      exemption must file an information return 
the requirement to file an annual return or  990-EZ.                                     annually (Form 990 or Form 990-EZ). 
notice, your filing obligations began as     • Form 990-T.                               However, a foreign organization may file 
                                                                                         Form 990-N (e-Postcard) instead of Form 
soon as you were formed. If you have an        When applying for tax-exempt status,      990 or Form 990-EZ when its gross 
annual information return or tax return due  you must clearly identify any information   receipts from U.S. source income are 
while your Form 1024 is pending,             that isn't open to public inspection by     normally $50,000 or less and it hasn't 
complete the return checking the             marking it as “NOT SUBJECT TO PUBLIC        conducted significant activity in the United 
“Application Pending” box in the heading,    INSPECTION” and include an explanation      States. See the Instructions for Form 990 
Item B, and submit the return as indicated   of why you're asking for the information to and Form 990-EZ for further information. A 
in those instructions.                       be withheld. We will decide whether to 
                                                                                         foreign organization that is subject to 
                                             withhold the identified information from 
                                                                                         unrelated business income tax must file 
If you're eligible to file a Form 990-N,     public inspection.                          Form 990-T.
e-Postcard, call 877-829-5500 and 
request to be set up to allow filing of Form Making documents available for public 
                                                                                         Organizations created in U.S. territo-
990-N.                                       inspection.   Both the organization and 
                                                                                         ries and possessions.  Organizations 
                                             the IRS must make the information that is 
                                                                                         created in possessions and territories of 
Note: It takes the IRS up to 6 weeks to      subject to disclosure available for public 
                                                                                         the United States are generally treated as 
update its records before you can file your  inspection. The public may request a copy 
                                                                                         domestic organizations. If you were 
Form 990-N.                                  of the information available for public 
                                                                                         created in a U.S. possession or territory, 
                                             inspection from us by submitting Form 
You can find information on return filing                                                you must complete all required parts of 
                                             4506-A. The public may also request 
                                                                                         Form 1024 to apply for recognition of 
requirements and exceptions in Pubs. 557     inspection of the information or a copy of 
and 598.                                                                                 exempt status.
                                             the information directly from you.
                                                                                         Annual filing requirements for an 
        You may also be required to file       You may post the documents required 
                                                                                         organization created in a U.S. territory or 
TIP     other returns, such as               to be available for public inspection on 
                                                                                         possession are similar to those outlined 
        employment tax returns or benefit    your own website. Information returns and 
                                                                                         above for foreign organizations (see Rev. 
plan returns, which aren't discussed here.   your exemption application materials must 
                                                                                         Proc. 2011-15).
                                             be posted exactly as filed with the IRS. 
                                             You may delete only the information that 
                                             isn't open for public inspection.           Specific Instructions

Instructions for Form 1024                                      -3-

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Part I

Part I, Line Part I, Identification of Applicant
1 Enter your complete name exactly as it appears in your organizing document, including amendments.
2 If you have an "in care of" name, enter it here; otherwise, leave this space blank.
3–9 Enter your complete address where all correspondence will be sent. If mail isn't delivered to your street address and you have a P.O. Box, list
your P.O. Box information instead of your street address. For a foreign address, enter your province or state and foreign postal code where
indicated.
10 Employer Identification Number (EIN). You must have your own EIN. Enter the 9-digit EIN the IRS assigned to you. If you don't have an
EIN, you must apply for one before submitting your application. You can find out how to apply for an EIN by visiting IRS.gov and searching for
“apply for an EIN.” You may apply for an EIN online or by fax or mail. International applicants may call 267-941-1099 (toll call).

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

CAUTION! Don’t use the EIN of a related or other organization.
11 Month Tax Year Ends. Select the month your tax year (annual accounting period) ends. Your tax year is the 12-month period on which your
annual financial records are based.

TIP Check your bylaws or other rules of operation for consistency with the tax year you enter here.
12 Person to Contact. Enter the name and title of the person you want us to contact if we need more information. The person to contact may be
an officer, director, trustee, or other individual who is permitted to speak with us according to your bylaws or other rules of operation. Your
person to contact may also be an authorized representative, such as an attorney, certified public accountant, or enrolled agent, for whom
you’re submitting a completed Form 2848 with Form 1024-A.
13 Provide a daytime telephone number for the contact listed on line 12.
14 You may provide a fax number for the contact listed on line 12.
15 Pay.gov will populate this field with the current user fee for filing Form 1024-A.
16 If you have a website, enter its complete web address. Also, list any websites maintained on your behalf. The information on your website
should be consistent with the information in your Form 1024-A.
17 Officers, directors, and trustees. Enter the full names, titles, and mailing addresses of your officers, directors, and/or trustees. You may use
the organization's address for mailing. If you have more than five, check the box provided to add more officer, director, and/or trustee
information.

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

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Part II

Part II, Line Part II. Organizational Structure
You must be a corporation, limited liability company, unincorporated association, or trust to be tax exempt under section 501(c)(4). Sole
proprietorships, partnerships, or loosely affiliated groups of individuals aren't eligible.
1 Type of organization and copy of organizing document. Select your type of organization and, before submitting the form, upload a copy of
your organizing document (including any amendments) as part of the required attachment.

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

Copy of organizing document (articles of incorporation and any amendments). A corporation's organizing document is its articles of
incorporation.

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

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

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

Copy of organizing document (articles of organization and operating agreement (if adopted) and any amendments). Instead of
articles of incorporation, an LLC's organizing document is its state-approved articles of organization. If it has adopted an operating agreement,
then this document is also part of its organizing document.

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

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

TIP If you’re an LLC and want to be treated as a disregarded entity by a tax-exempt member, don’t file an exemption application.

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

Copy of organizing document (articles of association or constitution and any amendments). Your organizing document must include
the name of the organization, its purpose, the date the document was adopted, and the signatures of at least two individuals.

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

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

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

Copy of organizing document (trust agreement/declaration of trust or will and any amendments). Your trust agreement (and any
amendments) must be signed by at least one trustee.

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

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

CAUTION! If your trust agreement continues to provide for distributions for non-charitable interests, you won’t qualify for tax-exempt status.

Instructions for Form 1024 -5-

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Part II, Line Part II. Organizational Structure
2 Formation date. The date you enter should be consistent with your organizing document.
• If you’re a corporation, enter the date that your articles of incorporation were filed and approved by the appropriate authority.
• If you're an LLC, enter the date that the appropriate authority filed your articles of organization or other organizing document.
• If you're an unincorporated association, enter the date that your organizing document was adopted by the signatures of at least two
individuals.
• If you’re a trust (other than a trust formed by a will), enter the date your trust was funded. If your trust agreement provided for any
non-charitable interests, enter the date that non-charitable interests expired. If you were formed by a will, enter the date of death or the date
any non-charitable interests expired.
3 State of formation. Enter the jurisdiction (for instance, the state or the federally recognized tribal government) under the laws of which you
were incorporated or otherwise formed. This may not be the place in which you’re physically located. For example, if you’re physically located
in New York, but incorporated under Massachusetts law, enter Massachusetts.

For purposes of completing this application, you’re formed under the laws of a foreign country if you aren't formed under the laws of the U.S.,
its territories and possessions, federally recognized Indian tribal or Alaska native governments, or the District of Columbia.
4 Bylaws are generally the internal rules and regulations of an organization. If you have bylaws, upload a current copy (including any
amendments). Bylaws don't need to be signed unless they are your organizing document as described in the instructions for Line 1 above.

Part III

Part III, Line Part III. Your Activities
REMINDER Answer all questions in this part as they pertain to your past, present, and planned activities.
1 Describe completely and in detail your past, present, and planned activities. Your narrative description of activities should be thorough and
accurate because we determine whether you qualify for 501(c)(4) exempt status based on the information in your application.

For each past, present, or planned activity, include information that answers the following questions:
• What is the activity?
• Who conducts the activity?
• What percentage of your total time is allocated to the activity? (Combined time percentages should add up to 100%)
• How is the activity funded (for example, donations, fees, etc.) and what percentage of your overall expenses is allocated to this activity?
• How does the activity further your exempt purposes?
2 National Taxonomy of Exempt Entities (NTEE) code. An NTEE code is a three-character series of letters and numbers that generally
describe a type of organization. Enter the code from the list of NTEE codes, located in the Appendix A, that best describes you. For more
information and more detailed definitions of these codes developed by the National Center for Charitable Statistics (NCCS), visit the Urban
Institute, NCCS website at nccs.urban.org.

TIP NTEE codes are also used for purposes other than identification of organizations described in section 501(c)(4). Therefore, all codes in
the list don’t necessarily correspond to a section 501(c)(4) purpose.
3 Describe any money or time (whether volunteer or paid) you spent or will spend attempting to influence the selection, nomination, election, or
appointment of any person to any federal, state, or local public office or to an office in a political organization.
4 If you (including any predecessor organization) lost your section 501(c)(3) status due to carrying on propaganda or otherwise attempting to
influence legislation or due to participating in, or intervening in, any political campaign on behalf of (or in opposition to) any candidate for public
office, then you will not be treated as an organization described in section 501(c)(4). This rule will not apply if you were a church or
church-affiliated organization described in section 501(h)(5) in the tax year immediately preceding the tax year in which section 501(c)(3)
status was lost.
5 You are a successor to another organization if you:
• Took or will take over activities previously conducted by another organization,
• Took or will take over 25% or more of the fair market value of the net assets of another organization, or
• Were established upon the conversion of an organization from for-profit to nonprofit status.
5a A for-profit organization is one in which persons are permitted to have an ownership or partnership interest, such as corporate stock. It
includes sole proprietorships, corporations, and other entities that provide for ownership interests.
7 Indicate if you distribute, or plan to distribute, any of your property or funds (such as a distribution of profits) to your shareholders or members
8 A relationship between you and the recipient organization includes the following situations.
• You control the recipient organization, or it controls you through common officers, directors, or trustees, or through authority to approve
budgets or expenditures.
• You and the recipient organization were created at approximately the same time and by the same persons.
• You and the recipient organization operate in a coordinated manner with respect to facilities, programs, employees, or other activities.
• Persons who exercise substantial influence over you also exercise substantial influence over the recipient organization.
8a Answer “Yes” if you make grants, loans, or other distributions (such as goods) to a foreign organization.
8e-g The Office of Foreign Assets Control (OFAC) of the U.S. Department of the Treasury administers and enforces economic and trade sanctions
based on U.S. foreign policy and national security goals against certain governments, entities, and individuals, as directed in Executive
Orders. As part of the comprehensive and sustained campaign against terrorist financing, all U.S. persons, including U.S.-based charities, are
prohibited from dealing with persons (individuals and entities) identified as being associated with terrorism on OFAC’s Specially Designated
Nationals and Blocked Persons List (OFAC SDN List). Information about OFAC sanction programs and the OFAC SDN List are available at
treasury.gov/ofac.
9 A foreign country is a country other than the U.S., its territories and possessions, and the District of Columbia.

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Part III, Line Part III. Your Activities
9a-c The Office of Foreign Assets Control (OFAC) of the U.S. Department of the Treasury administers and enforces economic and trade sanctions
based on U.S. foreign policy and national security goals against certain governments, entities, and individuals, as directed in Executive
Orders. As part of the comprehensive and sustained campaign against terrorist financing, all U.S. persons, including U.S.-based charities, are
prohibited from dealing with persons (individuals and entities) identified as being associated with terrorism on OFAC’s Specially Designated
Nationals and Blocked Persons List (OFAC SDN List). Information about OFAC sanction programs and the OFAC SDN List are available at
treasury.gov/ofac.
10 Answer “Yes” if you are a membership organization formed to own and maintain common green areas, streets, and sidewalks and to enforce
covenants to preserve the appearance of a development.
11 Answer “Yes” if your membership is limited to employees of a designated person or persons in a particular municipality and your net earnings
will be devoted exclusively to charitable, educational, or recreational purposes.

Part IV

Part IV, Line Part IV. Compensation and Other Financial Arrangements
1 Answer “Yes” if you do or will pay compensation to your officers, directors, trustees, employees, members, or independent contractors.
1a A conflict of interest arises when a person in a position of authority over an organization, such as a director, officer, or manager, may benefit
personally from a decision he or she could make. Adoption of a conflict of interest policy is not required to obtain tax-exempt status. However,
by adopting a policy, you will be choosing to put in place procedures that will help you avoid the possibility that those in positions of authority
may receive an inappropriate benefit.

Reasonable compensation is the amount that would ordinarily be paid for like services by like organizations under like circumstances as of the
date the compensation arrangement is made. Establishing and documenting reasonable compensation is important because excessive
compensation may result in excise taxes on both the individual and you. In addition, excessive compensation may jeopardize your tax-exempt
status.
1b A fixed payment means a payment that is either a set dollar amount or fixed through a specific formula where the amount doesn’t depend on
discretion. For example, a base salary of $200,000 that is adjusted annually based on the increase in the Consumer Price Index is a fixed
payment.

A nonfixed payment means a payment that depends on discretion. For example, a bonus of up to $100,000 that is based on an evaluation of
performance by the governing board is a nonfixed payment because the governing body has discretion over whether the bonus is paid and the
amount of the bonus.
2 Don’t include purchases or sales of goods and services in your normal course of operations that are available to the general public under
similar terms and conditions. Answer “Yes” if any of your officers, directors, or trustees:
• Is an officer, director, or trustee in another organization to which you will purchase or sell goods, services, or assets from or to; or
• Possesses more than 35% ownership interest in any organization to which you will purchase or sell goods, services, or assets from or to.

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

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

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

Fair market value is the price at which property or the right to use property would change hands between a willing buyer and a willing seller,
neither being under any compulsion to buy, sell, or transfer property or the right to use property, and both having reasonable knowledge of
relevant facts.
3 Answer “Yes” if any of your officers, directors, or trustees:
• Is an officer, director, or trustee in another organization that has a lease, contract, loan, or other agreement with you; or
• Possesses more than a 35% ownership interest in any organization that has a lease, contract, loan, or other agreement with you.

For example, answer “Yes,” if one of your directors is an officer for a section 501(c)(3) organization with whom you have a lease for office
space or if one of your directors owns more than 35% of the voting stock of a corporation to which you made a loan.
4 Indicate if you perform any services for any other organization or individual for which you receive a fee.
5 A joint venture is a legal agreement in which the persons jointly undertake a transaction for mutual profit. Generally, each person contributes
assets and shares risks. Like a partnership, joint ventures can involve any type of business transaction and the persons involved can be
individuals, groups of individuals, companies, or corporations.

Instructions for Form 1024 -7-

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Part V

Part V Part V. Financial Data
A. Line A. Statement of Revenue and Expenses
You must complete the Statement of Revenue and Expenses for a total of 3 years including the current year.

Completed less than 1 year. If you existed less than 1 year, provide projections of your likely income and expenses for your current year and
next 2 years based on a reasonable and good faith estimate of your finances for a total of 3 years financial information.

Completed at least 1 year but fewer than 3. If you’ve existed for more than 1 year but fewer than 3 years, provide your actual income and
expenses for the current year and 1 year prior and projected income and expenses for next year for a total of 3 years financial information.

Completed more than 3 years. If you’ve existed more than 3 years, provide your actual income and expenses for the current year and 2
years prior for a total of 3 years financial information.

CAUTION! We may request financial data for more than 3 years.

Preparing the statement. Prepare the statement using the method of accounting you use in keeping your books and records. Place financial
information for the year you’re filing this form in the column marked Current tax year.

Prepare the statement using the accounting period you entered on Part I, line 11. Enter “0” if a particular revenue or expense doesn’t apply to
you.

Your financial information should reflect your activities described in this application.
1 Enter the total gifts, grants, and contributions you receive. Include items of value that you receive as gifts, grants, or contributions. Do not
include membership dues reported in line 2.
2 Enter the amount you receive from members to provide support to the organization. Do not include payments from members, or on behalf of
members, to purchase admissions, merchandise, services, or use of facilities.
3 Enter your gross income from dividends, interest, payments received on securities, loans, rents, and royalties that are held for investment
purposes.
4 Enter your net income from unrelated business activities. Unrelated business income generally is income from any trade or business activity
that is regularly carried on, not conducted with substantially all (at least 85%) volunteer labor, and not related to your exempt purposes. (You
can take this amount from Form 990-T, if filed.)

See Pub. 598 for additional information regarding unrelated business income.
5 Enter amounts any local tax authority collects from the public on your behalf.
6 Enter the value of services or facilities a governmental unit furnishes to you. Use the fair market value of the services or facilities. Don’t include
the value of services or facilities generally provided to the public without charge.
7 Enter the total income from all sources not reported on lines 1 through 6, or lines 9 and 11. Provide an itemized list showing each type and
amount of income included on this line. Also, briefly describe each type of income.
9 Enter income from activities that you conduct to further your exempt purposes (excluding amounts listed on other lines). Also, include as gross
receipts the income from activities conducted:
• Intermittently (not regularly carried on), such as an occasional auction;
• With substantially all (at least 85%) volunteer labor, such as a car wash;
• For the convenience of members, students, patients, officers, or employees, such as a parking lot for a school's students and employees; or
• With substantially all contributed merchandise, such as a thrift store.

See Pub. 598 for additional information regarding income that isn’t from an unrelated trade or business.

Gross receipts also includes payment by a governmental unit that may be called a grant but is actually payment for a service or facility for the
use of the government payer, rather than for the direct benefit of the public.

Example. The state government gives a conservation group a grant to study the effects of a new sewage treatment plant on an ecologically
significant woodland area. Although the payment is called a grant, it is actually gross receipts that should be included on Line 9. The payment
is by a governmental unit (state) for a study for its own use, not for the direct benefit of the general public. A for-profit consulting company could
have done the study rather than by the tax-exempt conservation group.

Provide an itemized list of your gross receipts in line 24, describing the sources and amounts of income. For payments by a governmental unit,
list the payer, the purpose of the payment, and the payment amount.t.
11 Enter any net gain or loss on the sale of capital assets. Provide an itemized list by asset category (for example, real estate or securities)
showing gross sales, cost or other basis/sales expenses), and gain or loss by asset category in line 24. You may use the format in Figure 2.

Figure 2. Net Gain or Loss On Sales of Capital Assets
Categories
(A) Real Estate (B) Securities (C) Other
1. Gross Sales Price of assets
(other than inventory)
by category
2. Less: Cost or other basis and
sales expense
3. Gain or (loss). Subtract line 2
from line 1.
4. Net gain or (loss) — Add line 3 of columns (A), (B), and (C). Enter here and on Form 1024-A, Part IX-A.
Statement of Revenues and Expenses, line 11.

13 Enter the total expenses you incur for soliciting gifts, grants, and contributions included on line 1. Include fees paid to professional fund raisers
for soliciting gifts, grants, and contributions.

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Part V Part V. Financial Data
14 Enter the total amounts you pay out to both individuals and organizations. Provide an itemized list on line 24, identifying recipients (using letter
designations such as A, B, C, etc., for individuals) a brief description of the purposes or conditions of payments, and the amounts paid.

Maintain (but don’t submit) a list showing the names of recipients associated with each letter designation.
15 Enter total payments you make to or for the benefit of your members. Provide an itemized list in line 25, identifying recipients (using letter
designations), a brief description of the purposes or conditions of payment, and the amounts paid. Do not include any amounts reported on
line 14.

Maintain (but don’t submit) a list showing the names of recipients associated with each letter designation.
16 Enter the total amount of compensation you pay to your officers, directors, and trustees.
17 Enter the total amount of salaries you pay to employees (not reported on line 16 above).
18 Enter your total interest expense for the year. Don’t include mortgage interest treated as an occupancy expense on line 19.
19 Enter the amount you pay for the use of office space or other facilities, heat, light, power, and other utilities, outside janitorial services,
mortgage interest, real estate taxes, and similar expenses.
20 Enter the total depreciation, depletion, and similar expenses you incur.
21 Enter the total professional fees you pay. Professional fees are amounts charged by individuals and entities that aren’t your employees. They
include fees for professional fundraisers (other than fees included on line 13, above), accounting services, legal counsel, consulting services,
contract management, or any independent contractors.
22 Enter any expenses you didn’t include in the lines above, such as for program services. Provide an itemized list in line 24, showing the type
and amount of each significant expense.
B, Line B. Balance Sheet

Complete the balance sheet for your most recently completed tax year. If you haven’t completed a full tax year, use the most current
information available. Be sure to enter the year-end date for the information provided and not the date you prepare this application. Enter “0” if
a particular asset or liability doesn’t apply to you.
1 Enter your total cash in checking and savings accounts, temporary cash investments (money market funds, CDs, treasury bills, or other
obligations that mature in less than 1 year), and petty cash funds.
2 Enter your total accounts receivable that arose from the sale of goods and/or performance of services, less any reserve for bad debt.
3 Enter the amount of materials, goods, and supplies you purchased or manufactured and held to be sold or used in some future period.
4 Enter the total amount of bonds or notes you issued that will be repaid to you. Provide an itemized list in line 19 that shows the name of the
borrower (using a letter designation), the borrower’s relationship to you, a brief description of the obligation, the rate of return, the due date,
and the amount due.

Maintain (but don’t submit) a list showing the names of borrowers associated with each letter designation.
5 Enter the total fair market value of corporate stocks you hold. Provide an itemized list of your corporate stock holdings in line 19.

For stock of closely held corporations, list the name of the corporation, a brief summary of the corporation's capital structure, the number of
shares held, and their value as carried on your books. If such valuation doesn't reflect current fair market value, also include fair market value.

For stock traded on an organized exchange or in substantial quantities over the counter, the schedule should show the name of the
corporation, a description of the stock and the principal exchange on which it is traded, the number of shares held, and their value as carried
on the organization's books.
6 Enter your total amount of loans (personal and mortgage loans) receivable. Provide an itemized list that identifies each borrower name (using a
letter designation), the borrower’s relationship to you, purpose of loan, repayment terms, interest rate, and original amount of loan. Report
each loan separately, even if more than one loan was made to the same person.

Maintain (but don’t submit) a list showing the names of borrowers associated with each letter designation.
7 Enter the total book value of your other investments. Include the total book value of governmental securities (federal, state, and municipal),
buildings, and equipment held for investment purposes. Provide an itemized list in line 19 identifying and reporting the book value of each
building/item of equipment held for investment purposes.
8 Enter the total book value of buildings and equipment not held for investment purposes. This includes facilities you own and equipment you
use in conducting your exempt activities. Provide an itemized listing of these assets held at the end of the current tax year/period, including the
cost or other basis.
9 Enter the total book value of land not held for investment purposes.
10 Enter the total book value of any other category of your assets not reported on lines 1 through 9, for example, patents, copyrights, or other
intangible assets. Provide an itemized list of each assets in line 19.
12 Enter the total of accounts your accounts payable to suppliers and others, such as salaries payable, accrued payroll taxes, and interest
payable.
13 Enter the total unpaid portion of grants and contributions you committed to pay to other organizations or individuals.
14 Enter the total of your mortgages and other notes payable outstanding at the end of the current year/period. Provide an itemized list in line 19
showing each note separately and the lender's name, purpose of loan, repayment terms, interest rate, and original amount.
15 Enter the total amount of any other liabilities not reported on lines 12 through 14. Provide an itemized list in line 19 of these liabilities, including
the amounts you owe.
17 Under fund accounting, an organization segregates its assets, liabilities, and net assets into separate funds according to restrictions on the use
of certain assets. Each fund is like a separate entity in that it has a self-balancing set of accounts showing assets, liabilities, equity (fund
balance), income, and expenses. If you don’t use fund accounting, report only the net assets account balances, which include capital stock,
paid-in capital, retained earnings or accumulated income, and endowment funds.

Instructions for Form 1024 -9-

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Part VI

Part VI, Line Part VI, Effective Date
       1      Use the formation date you listed in Part II, line 2, and the date you submit this electronic form and required user fee payment to determine 
              whether you’re submitting this application within 27 months of the end of the month in which you were formed. 
       2      Answer “Yes” if your exempt status was automatically revoked under section 6033(j)(1) for failure to file required annual returns or notices for 3 
              consecutive years and you’re applying for reinstatement. 
               
              Revenue Procedure 2014-11, 2014-3 I.R.B 411, establishes several different procedures for reinstating an organization’s exempt status 
              depending upon its size, the number of times it’s been automatically revoked, and the timeliness of filing for reinstatement. Review the revenue 
              procedure to determine which section applies to you.
       2a     Select the section of Revenue Procedure 2014-11 under which you’re applying for reinstatement.
               
              Section 4. Select this section if:
              • You were eligible to file either Form 990-EZ or Form 990-N for each of the three consecutive years that you failed to file;
              • This is the first time you have been automatically revoked pursuant to section 6033(j)(1); and
              • You’re submitting this application not later than 15 months after the later of the date of your Revocation Letter or the date on which the IRS 
              posted your name on the Auto-Revocation List at apps.irs.gov/app/eos/.
               
              By selecting this item, you’re also attesting that your failure to file was not intentional and you have put in place procedures to file required 
              returns or notices in the future. 
               
              CAUTION! If your exempt status was automatically revoked more than once, you’re not eligible for reinstatement under Section 4; however, 
              you may apply for reinstatement under Section 5, Section 6, or Section 7.
               
              Section 5. Select this section if:
              • You are ineligible to file for reinstatement under Section 4, and
              • You’re submitting this application not later than 15 months after the later of the date of your Revocation Letter or the date on which the IRS 
              posted your name on the Auto-Revocation List at apps.irs.gov/app/eos/.
               
              By selecting this item, you’re also attesting that you have filed the required annual returns, your failure to file was not intentional, and you have 
              put in place procedures to file required returns or notices in the future.
               
              Describe how you exercised ordinary business care and prudence in determining and attempting to comply with your filing requirements in at 
              least 1 of the 3 years of revocation. Include a detailed explanation of all the facts and circumstances that led to the failure, the discovery of the 
              failure, and the steps you have taken or will take to avoid or mitigate future failures to file timely returns or notices.
               
              Section 6. Select this section if:
              • You’re applying for reinstatement of your tax-exempt status more than 15 months from the later of the date of the Revocation Letter or the 
              date on which the IRS posted your name on the Revocation List Auto-Revocation List at apps.irs.gov/app/eos/.
               
              By selecting this item, you’re also attesting that you have filed the required annual returns, your failure to file was not intentional, and you have 
              put in place procedures to file required returns or notices in the future.
               
              Describe how you exercised ordinary business care and prudence in determining and attempting to comply with your filing requirements in 
              each of the 3 years of revocation. Include a detailed explanation of all the facts and circumstances that led to the failure, the discovery of the 
              failure, and the steps you have taken or will take to avoid or mitigate future failures to file timely returns or notices.
               
              Section 7. Select this section if you’re seeking reinstatement with an effective date of reinstatement of the date of submission of this 
              application.

                                                                       -10-                                   Instructions for Form 1024

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Part VII

Part VII Part VII. Annual Filing Requirement
Most organizations must file an annual notice (Form 990 or 990-EZ) or notice (Form 990-N, Electronic Notice (e-Postcard)). Exceptions to this
rule include certain affiliates of a governmental unit. You can find more detailed information about filing requirements and exceptions from the
requirement to file in the Instructions for Form 990.

Unless specifically required to file Form 990 or Form 990-EZ (see the Instructions for Form 990), most organizations that normally have gross
receipts of $50,000 or less may satisfy their filing obligation with the Form 990-N, Electronic Notice (e-Postcard).

CAUTION! If you fail to file a required information return or notice for three consecutive years, your exempt status will be automatically revoked.
1 Answer “Yes” if you’re claiming you are excepted from filing a Form 990-series return or notice and indicate the reason you believe you’re
excepted from filing. See Pub. 557 and Instructions for Form 8940, Request for Miscellaneous Determination, for more information on the
requirements for the various filing exceptions.

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

Part VIII

Part VIII Part VIII. Notification Requirement Under Section 506
Section 506 requires an organization notify the IRS of its intent to operate as a section 501(c)(4) organization. Form 8976, Notice of Intent to
Operate Under Section 501(c)(4), must be submitted electronically at services.irs.gov/datamart/login.do, and requires payment of a user fee at
Pay.gov. You can find more information about section 501(c)(4) notification requirements at irs.gov/form8976.
TIP For certain exceptions to the requirement to submit Form 8976 for organizations in existence as of July 8, 2016, see Rev. Proc. 2016-41
for information regarding the timing for submitting the notification.
1 Answer “Yes” if you submitted Form 8976 within 60 days of your formation date. If you answer “No,” explain why you did not submit the
notification.

Part IX

Part IX Part IX - Signature
Signature requirements. An officer, director, trustee, or other official who is authorized to sign for the organization must sign Form 1024-A.
The signature must be accompanied by the title or authority of the signer and the date.

TIP The person signing Form 1024-A must be listed as an officer, director, or trustee within the first five entries of Part I, Line 17.

Upload Checklist

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

You must upload a copy of your organizing document and any amendments to it along with a copy of your bylaws, if adopted. The other listed
documents are not required.

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

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

If your PDF file exceeds the 15MB limit, remove any items over the limit and contact IRS Customer Accounts Services at 877-829-5500 for
assistance on how to submit the removed items.

Part I. Identification of Lines 3–9. Enter your complete address Line 10. Employer Identification Num-
Applicant where all correspondence will be sent. If ber (EIN). You must have your own EIN.
mail isn't delivered to your street address Enter the 9-digit EIN the IRS assigned to
Line 1. Enter your complete name exactly and you have a P.O. Box, list your P.O. you. If you don't have an EIN, you must
as it appears in your organizing document, Box information instead of your street apply for one before submitting your
including amendments. address. For a foreign address, enter your application. You can find out how to apply
Line 2. If you have an “in care of” name, province or state and foreign postal code for an EIN by visiting IRS.gov and
enter it here; otherwise, leave this space where indicated. searching for “apply for an EIN.” You may
blank. apply for an EIN online or by fax or mail.

Instructions for Form 1024 -11-

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International applicants may call amendments) as part of the required reproduced. It must be accompanied by a
267-941-1099 (toll call). attachment. declaration, signed by an officer
authorized to sign for you, that it is a
Don't apply for an EIN more than Corporation. A corporation is an entity
complete and correct copy of the articles
TIP once. If you're unsure of your EIN organized under a federal or state statute,
of organization and that it contains all the
or whether you have one, call or a statute of a federally recognized
powers, principles, purposes, functions,
877-829-5500 for assistance. Indian tribal or Alaskan native
and other provisions by which you
government.
Don't use the EIN of a related or currently govern yourself.
Copy of organizing document (articles
If you're an LLC with a tax-exempt
! other organization. of incorporation and any amend-
CAUTION TIP organization as its sole member
ments). A corporation's organizing
and you want to be treated as a
Line 11. Month tax year ends. Select document is its articles of incorporation.
disregarded entity, don't file an exemption
the month your tax year (annual If you formed under state statute, your application.
accounting period) ends. Your tax year is articles of incorporation (and any
the 12-month period on which your annual amendments) must show certification of Unincorporated association. An
financial records are based. filing. This means your articles show unincorporated association formed under
Line 12. Person to contact. Enter the evidence that on a specific date they were state law must have at least two members
name and title of the person you want us filed with and approved by an appropriate who have signed a written document that
to contact if we need more information. state authority. The document must be an creates an entity with a specifically
The person to contact may be an officer, exact copy of what is on file with your defined purpose.
director, trustee, or other individual who is state.
Copy of organizing document (articles
permitted to speak with us according to If you don't have a copy of your articles of association or constitution and any
your bylaws or other rules of operation. of incorporation showing evidence of amendments). Your organizing
Your person to contact may also be an having been filed and approved by an document must include the name of the
authorized representative, such as an appropriate state official, you may submit organization, its purpose, the date the
attorney, certified public accountant, or a substitute copy of your articles of document was adopted, and the
enrolled agent, for whom you're submitting incorporation. This substitute copy may be signatures of at least two individuals.
a completed Form 2848 with Form 1024. handwritten, typed, printed, or otherwise
Line 13. Provide a daytime telephone reproduced. It must be accompanied by a If your copy doesn’t contain the proper
number for the contact listed on line 12. declaration, signed by an officer signatures and date of adoption, you may
authorized to sign for you, that it is a submit a written declaration that states
Line 14. You may provide a fax number complete and correct copy of the articles your copy is a complete and accurate
for the contact listed on line 12. of incorporation and that it contains all the copy of the signed and dated original.
Line 15. Pay.gov will populate this field powers, principles, purposes, functions, Your declaration should clearly indicate
with the current user fee for filing Form and other provisions by which you the original date of adoption.
1024. currently govern yourself. Bylaws may be considered an
Line 16. If you have a website, enter the Limited liability company. A limited TIP organizing document only if they
complete web address. Also, list any liability company (LLC) that files its own include the required elements
websites maintained on your behalf. The exemption application and is recognized listed above.
information on your website should be as exempt under either section 501(a) or
consistent with the information in your section 521 is automatically treated as a Trust. A trust may be formed by a trust
Form 1024. corporation rather than a partnership. agreement or declaration of trust. A trust
may also be formed through a will.
Line 17. Officers, directors, and trust- Copy of organizing document (articles Generally, a trust must be funded with
ees. Enter the full names, titles, and of organization and operating agree- property, such as money, real estate, or
mailing addresses of your officers, ment (if adopted) and any amend- personal property.
directors, and/or trustees. You may use ments). Instead of articles of
the organization's address for mailing. If incorporation, an LLC's organizing Copy of organizing document (trust
you have more than five, check the box document is its state-approved articles of agreement/declaration of trust or will
provided to add more officer, director, organization. and any amendments). Your trust
agreement (and any amendments) must
and/or trustee information. If it has adopted an operating be signed by at least one trustee.
The person who is signing Form 1024 agreement, then this document is also part
must be listed within the first five entries of of its organizing document. If you formed If your trust agreement copy isn't
line 17. under state statute, your articles of signed, you may submit a written
organization (and any amendments) must declaration that states your copy is a
Part II. Organizational Structure show certification of filing. This means complete and accurate copy of the signed
You must be a corporation, limited liability your articles show evidence that on a and dated original. Your declaration
company, unincorporated association, or specific date they were filed with and should clearly indicate the original date
trust to be tax exempt. Sole approved by an appropriate state that it was signed.
proprietorships, partnerships, or loosely authority. The document must be an exact For trusts created by a will, include a
affiliated groups of individuals aren't copy of what is on file with your state. copy of the death certificate or a statement
eligible. If you don't have a copy of your articles indicating the date of death, and a copy of
Line 1. Type of organization and copy of organization showing evidence of the relevant portions of the will.
of organizing document. Select your having been filed and approved by an If your trust agreement continues
type of organization and, before appropriate state official, you may submit ! to provide for distributions for
submitting the form, upload a copy of your a substitute copy of your articles of CAUTION non-charitable interests, you won't
organizing document (including any organization. This substitute copy may be qualify for tax-exempt status.
handwritten, typed, printed, or otherwise

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Line 2. Formation date. The date you For purposes of completing this • What percentage of your total time is
enter should be consistent with your application, you're formed under the laws allocated to the activity? (Combined time
organizing document. of a foreign country if you aren't formed percentages should add up to 100%)
• If you're a corporation, enter the date under the laws of the Unites States, its • How is the activity funded (for example,
that your articles of incorporation were territories and possessions, federally donations, fees, etc.) and what
filed and approved by the appropriate recognized Indian tribal or Alaska native percentage of your overall expenses is
authority. governments, or the District of Columbia. allocated to this activity?
• If you're an LLC, enter the date that the Line 4. Bylaws are generally the internal • How does the activity further your
exempt purposes?
appropriate authority filed your articles of rules and regulations of an organization. If
organization or other organizing you have bylaws, upload a current copy 501(c)(15) - Mutual Insurance Compa-
document. (including any amendments). Bylaws don't nies or Associations. If you are applying
• If you're an unincorporated association, need to be signed unless they are your under section 501(c)(15), provide the
enter the date that your organizing organizing document as described in the following in addition to your narrative
document was adopted by the signatures instructions for line 1 above. description of activities:
of at least two individuals. • Whether you're a member of a
• If you're a trust (other than a trust Part III. Your Activities controlled group of corporations as
formed by a will), enter the date your trust Reminder. Answer all questions in this defined in section 831(c)(2)(C)(ii).
was funded. If your trust agreement part as they pertain to your past, present, (Disregard section 1563(b)(2)(B) in
provided for any non-charitable interests, and planned activities. determining whether the organization is a
enter the date that non-charitable interests member of a controlled group.)
expired. If you were formed by a will, enter Line 1. Describe completely and in detail
the date of death or the date any your past, present, and planned activities. Note. You would be considered a
non-charitable interests expired. Your narrative description of activities member of a controlled group of
should be thorough and accurate because corporations if you were not exempt from
Line 3. State of formation. Enter the we determine whether you qualify for tax under section 501(a). In applying
jurisdiction (for instance, the state or the exempt status based on the information in section 1563(a), use a “more than 50%”
federally recognized tribal government) your application. stock ownership test to determine whether
under the laws of which you were
incorporated or otherwise formed. This For each past, present, or planned the applicant or any other corporation is a
may not be the place in which you're activity, include information that answers member of a controlled group.
physically located. For example, if you're the following questions: • If you are a such a member, include in
physically located in New York, but • What is the activity? the following table the total amount
incorporated under Massachusetts law, • Who conducts the activity? received by you and all other members of
enter Massachusetts. the controlled group. If not, include only
the amounts that relate to you.
(a) Current Year 3 Prior Tax Years
From __________ (b) (c) (d)
To __________ __________ __________ __________
1. Direct written premiums *
2. Reinsurance assumed **
3. Reinsurance ceded **
4. Net written premiums
((line 1 plus line 2) minus line 3)
*1. In addition to other direct written premiums, include on line 1 the full amount of any prepaid or advance premium in the year the prepayment is received.
For example, if a $5,000 premium for a 3-year policy was received in the current year, include the full $5,000 amount in the Current Year column.
**2 and **3. If you entered an amount on line 2 or 3, upload a copy of the reinsurance agreement into which you have entered.

501(c)(29) - CO-OP Health Insurance • No substantial part of your activities organization. Enter the code from the list
Issuers. If you are applying under section constitutes, or has constituted since the of NTEE codes, located in Appendix A,
501(c)(29) as a qualified nonprofit health later of your date of formation or March 23, that best describes you. For more
insurance issuer (QNHII), provide the 2010, carrying on propaganda, or information and more detailed definitions
following in addition to your narrative otherwise attempting to influence of these codes developed by the National
description of activities: legislation; and Center for Charitable Statistics (NCCS),
• You do not participate or intervene in visit the Urban Institute, NCCS website at
1. Upload a copy of both the Notice of (including the publishing or distributing of nccs.urba.org.
Award issued by Centers for Medicare statements) any political campaign on
NTEE codes are also used for
and Medicaid Services (CMS) and the behalf of (or in opposition to) any
TIP purposes other than identification
fully executed Loan Agreement with CMS. candidate for public office, nor have you of organizations described in
2. The following representations: so participated or intervened since the
section 501(a) or section 521. Therefore,
• Except to the extent allowed by section later of your date of formation or March 23,
all codes in the list don't necessarily
1322(c)(4) of the Patient Protection and 2010.
Affordable Care Act, no part of your net correspond to a section 501(a) or section
earnings inures to the benefit of any Line 2. National Taxonomy of Exempt 521 purpose.
private shareholder or individual, or has so Entities (NTEE) code. An NTEE code is
inured since the later of your date of a three-character series of letters and Line 3. Describe any money or time
formation or March 23, 2010; numbers that generally describe a type of (whether volunteer or paid) you spent or

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will spend attempting to influence the and enforces economic and trade decision he or she could make. Adoption
selection, nomination, election, or sanctions based on U.S. foreign policy of a conflict of interest policy is not
appointment of any person to any federal, and national security goals against certain required to obtain tax-exempt status.
state, or local public office or to an office in governments, entities, and individuals, as However, by adopting a policy, you will be
a political organization. directed in Executive Orders. As part of choosing to put in place procedures that
the comprehensive and sustained will help you avoid the possibility that
Line 4. You are a successor to another
campaign against terrorist financing, all those in positions of authority may receive
organization if you:
U.S. persons, including U.S.-based an inappropriate benefit.
• Took or will take over activities
charities, are prohibited from dealing with
previously conducted by another Reasonable compensation is the
persons (individuals and entities)
organization, amount that would ordinarily be paid for
identified as being associated with
• Took or will take over 25% or more of like services by like organizations under
terrorism on OFAC's Specially Designated
the fair market value of the net assets of like circumstances as of the date the
Nationals and Blocked Persons List
another organization, or compensation arrangement is made.
(OFAC SDN List). Information about
• Were established upon the conversion Establishing and documenting reasonable
OFAC sanction programs and the OFAC
of an organization from for-profit to compensation is important because
SDN List are available at treasury.gov/
nonprofit status. excessive compensation may result in
ofac. If you make grants, loans, excise taxes on both the individual and
Line 4a. A for-profit organization is one in distributions, or you provide goods or you. In addition, excessive compensation
which persons are permitted to have an services to a foreign organization or may jeopardize your tax-exempt status.
ownership or partnership interest, such as engage in activities in a foreign country,
corporate stock. It includes sole you are responsible to know whether an Line 1b. A fixed payment means a
proprietorships, corporations, and other OFAC sanctions program applies and payment that is either a set dollar amount
entities that provide for ownership whether your activities require a license or fixed through a specific formula where
interests. from OFAC to engage in a transaction that the amount doesn't depend on discretion.
Line 5. Answer “Yes” if you have otherwise would be prohibited. For example, a base salary of $200,000
that is adjusted annually based on the
members and enter the requested Line 11. A foreign country is a country increase in the Consumer Price Index is a
information. other than the United States, its territories fixed payment.
Line 6. Indicate if you distribute, or plan and possessions, and the District of
to distribute, any of your property or funds Columbia. A nonfixed payment means a payment
that depends on discretion. For example,
(such as a distribution of profits) to your Lines 11a–11c. The Office of Foreign a bonus of up to $100,000 that is based on
shareholders or members. Assets Control (OFAC) of the U.S. an evaluation of performance by the
Line 7. Answer “Yes” if you have or will Department of the Treasury administers governing board is a nonfixed payment
issue stock as a means of indicating and enforces economic and trade because the governing body has
ownership by your members or others. sanctions based on U.S. foreign policy discretion over whether the bonus is paid
Enter the requested information. and national security goals against certain and the amount of the bonus.
governments, entities, and individuals, as
Line 8. If you should cease operations as directed in Executive Orders. As part of Line 2. Don't include purchases or sales
a tax-exempt organization, explain to the comprehensive and sustained of goods and services in your normal
whom your assets will be distributed. campaign against terrorist financing, all course of operations that are available to
Line 9. Answer “Yes” if you provide or will U.S. persons, including U.S.-based the general public under similar terms and
provide insurance through a third party or charities, are prohibited from dealing with conditions. Answer “Yes” if any of your
provide the insurance yourself. persons (individuals and entities) officers, directors, or trustees:
identified as being associated with • Is an officer, director, or trustee in
Line 10. Answer “Yes” if you make terrorism on OFAC's Specially Designated another organization from or to which you
grants, loans, or other distributions (such Nationals and Blocked Persons List will purchase or sell goods, services, or
as goods) to a foreign organization. A (OFAC SDN List). Information about assets; or
relationship between you and the recipient OFAC sanction programs and the OFAC • Possesses more than 35% ownership
organization includes the following SDN List are available at treasury.gov/ interest in any organization to which you
situations. ofac. If you make grants, loans, will purchase or sell goods, services, or
• You control the recipient organization, distributions, or you provide goods or assets.
or it controls you through common services to a foreign organization or An arm's length standard exists where
officers, directors, or trustees, or through engage in activities in a foreign country, the parties have an adverse (or opposing)
authority to approve budgets or you are responsible to know whether an interest. For example, a seller wants to sell
expenditures. OFAC sanctions program applies and his goods at the highest possible price,
• You and the recipient organization were whether your activities require a license while a buyer wants to buy at the lowest
created at approximately the same time from OFAC to engage in a transaction that possible price. These are adverse
and by the same persons. otherwise would be prohibited. interests.
• You and the recipient organization In negotiating with a person, an
operate in a coordinated manner with Part IV. Compensation and
adverse interest is assumed if that person
respect to facilities, programs, employees, Other Financial Arrangements is otherwise unrelated to you in the sense
or other activities. of not being in a position to exercise
Line 1. Answer “Yes” if you pay or will
Persons who exercise substantial pay compensation to your officers, substantial influence over you or your
influence over you also exercise directors, trustees, employees, members, affairs. If the person is in a position to
substantial influence over the recipient or independent contractors. exercise substantial influence over your
organization. affairs, then an arm's length standard
Line 1a. A conflict of interest arises when requires additional precautions to
Lines 10d–10f. The Office of Foreign a person in a position of authority over an eliminate the effect of the relationship.
Assets Control (OFAC) of the U.S. organization, such as a director, officer, or
Department of the Treasury administers manager, may benefit personally from a

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Using a conflict of interest policy, actual income and expenses for the Line 6. Enter the value of services or
information about comparable current year and 1 year prior and facilities a governmental unit furnishes to
transactions between unrelated parties, projected income and expenses for next you. Use the fair market value of the
and reliable methods for evaluating the year for a total of 3 years financial services or facilities. Don't include the
transaction, are examples of precautions information. value of services or facilities generally
that would help make the negotiation provided to the public without charge.
Completed more than 3 years. If
process equivalent to one between
you've existed more than 3 years, provide
unrelated persons. Line 7. Enter the total income from all
your actual income and expenses for the sources not reported on lines 1 through 6,
Fair market value is the price at which current year and 2 years prior for a total of or lines 9, and line 11. Provide an itemized
property or the right to use property would 3 years financial information. list showing each type and amount of
change hands between a willing buyer
and a willing seller, neither being under We may request financial data for income included on this line. Also, briefly
describe each type of income.
any compulsion to buy, sell, or transfer ! more than 3 years.
CAUTION
property or the right to use property, and Line 9. Enter income from activities that
both having reasonable knowledge of Preparing the statement. Prepare the you conduct to further your exempt
relevant facts. statement using the method of accounting purposes (excluding amounts listed on
Line 3. Answer “Yes” if any of your you use in keeping your books and other lines). Also, include as gross
officers, directors, or trustees: records. Place financial information for the receipts the income from activities
• Is an officer, director, or trustee in year you're filing this form in the column conducted:
another organization that has a lease, marked Current tax year. • Intermittently (not regularly carried on),
such as an occasional auction;
contract, loan, or other agreement with Prepare the statement using the With substantially all (at least 85%)
you; or accounting period you entered on Part I, •
volunteer labor, such as a car wash;
• Possesses more than a 35% ownership line 11. Enter “0” if a particular revenue or For the convenience of members,
interest in any organization that has a expense doesn't apply to you. •
students, patients, officers, or employees,
lease, contract, loan, or other agreement Your financial information should reflect such as a parking lot for a school's
with you. your activities described in this students and employees; or
For example, answer “Yes,” if one of application. • With substantially all contributed
your directors is an officer for a section merchandise, such as a thrift store.
501(c)(3) organization with whom you Line 1. Enter the total gifts, grants, and
have a lease for office space or if one of contributions you receive. Include items of See Pub. 598 for additional information
your directors owns more than 35% of the value that you receive as gifts, grants, or regarding income that isn't from an
voting stock of a corporation to which you contributions. Do not include membership unrelated trade or business. Gross
made a loan. dues reported on line 2. receipts also includes payment by a
governmental unit that may be called a
Line 4. Indicate if you perform any Line 2. Enter the amount you receive grant but is actually payment for a service
services for any other organization or from members to provide support to the or facility for the use of the government
individual for which you receive a fee. organization. Do not include payments payer, rather than for the direct benefit of
from members or on behalf of members to the public.
Line 5. A joint venture is a legal purchase admissions, merchandise,
agreement in which the persons jointly services, or use of facilities. Note. The state government gives a
undertake a transaction for mutual profit. conservation group a grant to study the
Generally, each person contributes assets Line 3. Enter your gross income from
and shares risks. Like a partnership, joint dividends, interest, payments received on effects of a new sewage treatment plant
ventures can involve any type of business securities, loans, rents, and royalties that on an ecologically significant woodland
transaction and the persons involved can are held for investment purposes. area. Although the payment is called a
grant, it is actually gross receipts that
be individuals, groups of individuals, Line 4. Enter your net income from should be included on Line 9.
companies, or corporations. unrelated business activities. Unrelated
business income generally is income from The payment is by a governmental unit
Part V. Financial Data any trade or business activity that is (state) for a study for its own use, not for
A. Statement of Revenue and regularly carried on, not conducted with the direct benefit of the general public. A
Expenses substantially all (at least 85%) volunteer for-profit consulting company could have
labor, and not related to your exempt done the study rather than by the
You must complete the Statement of purposes. Special rules apply to tax-exempt conservation group.
Revenue and Expenses for a total of 3 organizations described in section 501(c) Provide an itemized list of your gross
years including the current year. (7), (9), or (17). In addition, unrelated receipts on line 24, describing the sources
Completed less than 1 year. If you business income can be generated by and amounts of income. For payments by
existed less than 1 year, provide assets you acquire with debt a governmental unit, list the payer, the
projections of your likely income and (“debt-financed income”). (You can take purpose of the payment, and the payment
expenses for your current year and next 2 this amount from Form 990-T, if filed.) amount.
years based on a reasonable and good See Pub. 598 for additional information Line 11. Enter any net gain or loss on the
faith estimate of your finances for a total of regarding unrelated business income. sale of capital assets. Provide an itemized
3 years financial information. Line 5. Enter amounts any local tax list by asset category (for example, real
Completed at least 1 year but fewer authority collects from the public on your estate or securities) showing gross sales,
than 3. If you've existed for more than 1 behalf. cost or other basis/sales expenses), and
year but fewer than 3 years, provide your gain or loss by asset category on line 24.
You may use the format in Figure 2.

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Figure 2. Net Gain or Loss On Sales of Capital Assets
Category
(A) Real Estate (B) Securities (C) Other
1. Gross Sales Price of assets (other
than inventory) by category
2. Less: Cost or other basis and sales
expense
3. Gain or (loss). Subtract line 3 from
line 1.
4. Net gain or (loss) ---- Add line 3 of Columns (A), (B), and (C), Enter here and on Form 1024-A, Part IX-A. Statement of
Revenues and Expenses, line 11.

Line 13. Enter the total expenses you for professional fundraisers (other than itemized list of your corporate stock
incur for soliciting gifts, grants, and fees included on line 13, above), holdings on line 19.
contributions included on line 1. Include accounting services, legal counsel, For stock traded on an organized
fees paid to professional fundraisers for consulting services, contract exchange or in substantial quantities over
soliciting gifts, grants, and contributions. management, or any independent the counter, the schedule should show the
contractors. name of the corporation, a description of
Line 14. Enter the total amounts you pay
out to both individuals and organizations. Line 22. Enter any expenses you didn't the stock and the principal exchange on
Provide an itemized list on line 24, include in the lines above, such as for which it is traded, the number of shares
identifying recipients (using letter program services. Provide an itemized list held, and their value as carried on the
designations such as A, B, C, etc., for on line 24, showing the type and amount organization's books.
individuals) a brief description of the of each significant expense. Line 6. Enter your total amount of loans
purposes or conditions of payments, and B. Balance Sheet (personal and mortgage loans) receivable.
the amounts paid. Provide an itemized list on line 19 that
Complete the balance sheet for your most identifies each borrower name (using a
Maintain (but don't submit) a list recently completed tax year. If you haven't letter designation), the borrower's
showing the names of recipients completed a full tax year, use the most relationship to you, purpose of loan,
associated with each letter designation. current information available. Be sure to repayment terms, interest rate, and
Line 15. Enter total payments you make enter the year-end date for the information original amount of loan. Report each loan
to or for the benefit of your members. provided and not the date you prepare this separately, even if more than one loan
Provide an itemized list on line 24, application. Enter “0” if a particular asset was made to the same person.
identifying recipients (using letter or liability doesn't apply to you.
Maintain (but don't submit) a list
designations), a brief description of the Line 1. Enter the total interest and non- showing the names of borrowers
purposes or conditions of payment, and interest-bearing cash in checking and associated with each letter designation.
the amounts paid. Do not include any savings accounts, temporary cash
amounts reported on line 14. investments (money market funds, CDs, Line 7. Enter the total book value of your
Maintain (but don't submit) a list treasury bills, or other obligations that other investments. Include the total book
showing the names of recipients mature in less than 1 year), change funds, value of governmental securities (federal,
associated with each letter designation. and petty cash funds. state, and municipal), buildings, and
equipment held for investment purposes.
Line 16. Enter the total amount of Line 2. Enter your total accounts Provide an itemized list on line 19
compensation you pay to your officers, receivable that arose from the sale of identifying and reporting the book value of
directors, and trustees. goods and/or performance of services, each building/item of equipment held for
Line 17. Enter the total amount of less any reserve for bad debt. investment purposes.
salaries you pay to employees (not Line 3. Enter the amount of materials, Line 8. Enter the total book value of
reported on line 16 above). goods, and supplies you purchased or buildings and equipment not held for
Line 18. Enter your total interest expense manufactured and held to be sold or used investment purposes. This includes
for the year. Don't include mortgage in some future period. facilities you own and equipment you use
interest treated as an occupancy expense Line 4. Enter the total amount of bonds or in conducting your exempt activities.
on line 19. notes you issued that will be repaid to you. Provide an itemized listing on line 19 of
Line 19. Enter the amount you pay for the Provide an itemized list on line 19 that these assets held at the end of the current
use of office space or other facilities, heat, shows the name of the borrower (using a tax year/period, including the cost or other
light, power, and other utilities, outside letter designation), the borrower's basis.
janitorial services, mortgage interest, real relationship to you, a brief description of Line 9. Enter the total book value of land
estate taxes, and similar expenses. the obligation, the rate of return, the due not held for investment purposes.
date, and the amount due.
Line 10. Enter the total book value of any
Line 20. Enter the total depreciation, Maintain (but don't submit) a list other category of your assets not reported
depletion, and similar expenses you incur. showing the names of borrowers on lines 1 through 9, for example, patents,
Line 21. Enter the total professional fees associated with each letter designation. copyrights, or other intangible assets.
you pay. Professional fees are amounts Line 5. Enter the total fair market value of Provide an itemized list of each asset on
charged by individuals and entities that corporate stocks you hold. Provide an line 19.
aren't your employees. They include fees

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Line 12. Enter the total of your accounts • This is the first time you have been circumstances that led to the failure, the
payable to suppliers and others, such as automatically revoked pursuant to Section discovery of the failure, and the steps you
salaries payable, accrued payroll taxes, 6033(j)(1); and have taken or will take to avoid or mitigate
and interest payable. • You're submitting this application not future failures to file timely returns or
later than 15 months after the later of the notices.
Line 13. Enter the total unpaid portion of date of your Revocation Letter or the date
grants and contributions you committed to on which the IRS posted your name on the Section 7. Select this section if you're
pay to other organizations or individuals. Auto-Revocation List at seeking reinstatement with an effective
Line 14. Enter the total of your mortgages apps.irs.gov/app/eos/. date of reinstatement of the date of
submission of this application.
and other notes payable outstanding at By selecting Section 4, you're also
the end of the current year/period. Provide attesting that your failure to file was not Part VII. Annual Filing
an itemized list on line 19 showing each intentional and you have put in place Requirements
note separately and the lender's name, procedures to file required returns or Most organizations must file an annual
purpose of loan, repayment terms, interest notices in the future. information return (Form 990 or 990-EZ) or
rate, and original amount.
If your exempt status was notice (Form 990-N, Electronic Notice
Line 15. Enter the total amount of any ! automatically revoked more than (e-Postcard)). Exceptions to this rule
other liabilities not reported on lines 12 CAUTION once, you're not eligible for include certain affiliates of a governmental
through 14. Provide an itemized list on reinstatement under Section 4; however, unit. You can find more detailed
line 19 of these liabilities, including the you may apply for reinstatement under information about filing requirements and
amounts you owe. Section 5, Section 6, or Section 7. exceptions from the requirement to file in
If the organization doesn’t use fund the Instructions for Form 990.
accounting, report only the “net assets” Section 5. Select this section if:
account balances, such as capital stock, • You are ineligible to file for Unless specifically required to file Form
paid-in capital, and retained earnings or reinstatement under Section 4; and 990 or Form 990-EZ (see the Instructions
accumulated income. • You're submitting this application not for Form 990), most organizations that
later than 15 months after the later of the normally have gross receipts of $50,000 or
Line 17. Under fund accounting, an date of your Revocation Letter or the date less may satisfy their filing obligation with
organization segregates its assets, on which the IRS posted your name on the the Form 990-N, Electronic Notice
liabilities, and net assets into separate Auto-Revocation List at (e-Postcard).
funds according to restrictions on the use apps.irs.gov/app/eos/.
of certain assets. Each fund is like a Note. Organizations exempt under
separate entity in that it has a By selecting Section 5, you're also section 501(d) use Form 1065, U.S.
self-balancing set of accounts showing attesting that you have filed the required Return of Partnership Income, to satisfy
assets, liabilities, equity (fund balance), annual returns, your failure to file was not their annual filing requirement.
income, and expenses. If you don't use intentional, and you have put in place Organizations exempt under section 521
fund accounting, report only the net assets procedures to file required returns or use Form 1120-C, U.S. Income Tax
account balances, which include capital notices in the future. Return for Cooperative Associations, to
stock, paid-in capital, retained earnings or Describe how you exercised ordinary satisfy their annual filing requirements.
accumulated income, and endowment business care and prudence in If you fail to file a required
funds. determining and attempting to comply with ! information return or notice for 3
your filing requirements in at least 1 of the CAUTION consecutive years, your exempt
Part VI. Reinstatement After 3 years of revocation. Include a detailed status will be automatically revoked.
Automatic Revocation explanation of all the facts and
circumstances that led to the failure, the Line 1. Answer “Yes” if you're claiming
Line 1. Answer “Yes” if your exempt discovery of the failure, and the steps you you are excepted from filing a Form
status was automatically revoked under have taken or will take to avoid or mitigate 990-series return or notice and indicate
section 6033(j)(1) for failure to file required future failures to file timely returns or the reason you believe you're excepted
annual returns or notices for 3 consecutive notices. from filing. See Pub. 557 and Instructions
years and you're applying for
reinstatement. Section 6. Select this section if: for Form 8940, Request for Miscellaneous
Rev. Proc. 2014-11, 2014-3 I.R.B 411, • You're applying for reinstatement of Determination, for more information on the
provides procedures for seeking your tax-exempt status more than 15 requirements for the various filing
reinstatement of an organization's exempt months from the later of the date of the exceptions.
status depending upon its size, the Revocation Letter or the date on which the Provide information regarding how you
number of times it's been automatically IRS posted your name on meet your requested exception in your
revoked, and the timeliness of filing for Auto-Revocation List at narrative description of activities or as part
reinstatement. Review the revenue apps.irs.gov/app/eos/. of an uploaded supplemental response.
procedure to determine which section By selecting Section 6, you're also For example, if you're claiming exception
applies to you. attesting that you have filed the required as an affiliate of a governmental unit
annual returns, your failure to file was not based on Rev. Proc. 95-48, you must
Line 1a. Select the section of Rev. Proc. intentional, and you have put in place demonstrate that your bylaws or other
2014-11 under which you're applying for procedures to file required returns or organizational documents state that your
reinstatement. notices in the future. board members were appointed by a
Section 4. Select this section if: Describe how you exercised ordinary governmental unit, an affiliate of a
• You were eligible to file either Form business care and prudence in governmental unit, a public official acting
990-EZ or Form 990-N for each of the 3 determining and attempting to comply with in an official capacity, or elected by the
consecutive years that you failed to file; your filing requirements in each of the 3 public at large, pursuant to local statute or
years of revocation. Include a detailed ordinance. Also include information
explanation of all the facts and demonstrating that you meet at least two
(2) of the affiliation factors listed in Rev.

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Proc. 95-48, Section 4.03 and how you For your application to be complete, exempt by the IRS, you are required to
meet all of the facts and circumstances you must upload a copy of your organizing give us this information. We need it to
detailed in Rev. Proc. 95-48, Section 4.04. document and any amendments to it determine whether the organization meets
along with a copy of your bylaws, if the legal requirements for tax-exempt
Part VIII. Signature adopted. The other documents in the status.
Signature Requirements upload checklist are optional unless The organization isn’t required to
required for a complete response to a provide the information requested on a
An officer, director, trustee, or other official question. form that is subject to the Paperwork
who is authorized to sign for the
organization must sign Form 1024. The Put your name and EIN on each page Reduction Act unless the form displays a
signature must be accompanied by the of your supplemental response and valid OMB control number. Books or
title or authority of the signer and the date. identify the Part and Line number to which records relating to a form or its instructions
the information relates. must be retained as long as their contents
The person signing Form 1024 may become material in the administration
Pay.gov can accommodate only one
TIP must be listed as an officer, of any Internal Revenue law. The rules
director, or trustee within the first uploaded file. Consolidate your
five entries of Part I, Line 17. attachments into a single PDF file not to governing the confidentiality of the Form
exceed 15MB. 1024 application are covered in section
6104.
Upload Checklist Paperwork Reduction Act Notice. We
The time needed to complete and file
ask for the information on this form to carry
this form will vary depending on individual
Documents to upload. Check the boxes out the Internal Revenue laws of the
circumstances.
to indicate which documents are included United States. If you want your
in the file you upload with your application. organization to be recognized as tax The estimated average times are:

Taxpayer Burden for Exempt Organizations

Learning about Preparing and
the law or the sending the form
Form 1024 Recordkeeping form to the IRS
Parts I–III 26 hr., 1 min. 3 hr., 2 min. 5 hr., 35 min.
Part IV 1 hr., 40 min. 47 min. 51 min.
Sch. A 2 hr., 52 min. 18 min. 21 min.
Sch. C 57 min. 12 min. 13 min.
Sch. D 4 hr., 4 min. 18 min. 22 min.
Sch. E 1 hr., 40 min. 18 min. 20 min.
Sch. F 2 hr., 23 min. 6 min. 8 min.
Sch. G 1 hr., 54 min. 6 min. 7 min.
Sch. H 1 hr., 40 min. 6 min. 7 min.
Sch. I 5 hr., 30 min. 30 min. 36 min.
Sch. J 2 hr., 23 min. 6 min. 8 min.
Sch. K 3 hr., 21 min. 6 min. 9 min.

Comments and suggestions. If you and types of shares of your stock that are Line 4. Answer “Yes” if you engage or will
have comments concerning the accuracy held by each. engage in any activities other than holding
of these time estimates or suggestions for Line 2. Describe the property to which title to property and collecting income
making Form 1024 simpler, we would be you hold or will hold title. therefrom. Describe the activities in detail.
happy to hear from you.
Line 3. Answer “Yes” if you turn over the Line 5. Check the appropriate box below
You can send us comments from entire amount of your income, less to indicate the section under which you
IRS.gov/FormComments. expenses, to your parent organization. are applying.
Or you can write to the The type of distribution is immaterial. It Line 5a. Answer “Yes” if your
could be termed a dividend on stock or shareholders or beneficiaries are
Internal Revenue Service given some other description. What is permitted to dismiss your investment
Tax Forms and Publications Division important is that the income must be adviser upon a majority vote.
1111 Constitution Ave. NW, IR-6526 distributed to the exempt organization. A
If you answer “No,” explain why your
Washington, DC 20224 mere obligation to use the income for the
shareholders or beneficiaries aren't
parent's benefit doesn't satisfy this
permitted to dismiss your investment
Don’t send Form 1024 to this address. requirement.
adviser upon a majority vote of your
Instead, see Where To File, earlier. Often, an exempt parent occupies shareholders or beneficiaries.
realty that the title-holding company owns.
Schedule A The exempt parent generally doesn't pay Line 5b. Answer “Yes” if your
rent. In this situation, the statutory shareholders or beneficiaries are
Organizations described in requirement that income be paid over to permitted to terminate their interest in you
section 501(c)(2) or 501(c) the parent is satisfied if the title-holding by selling or exchanging their stock to any
(25) --Title holding corporations company turns over whatever income is organization described in section 501(c)
or trusts available. (25)(C) so long as the sale or exchange
does not increase the number of your
If you answer “No,” state the purpose shareholders or beneficiaries above 35, or
Line 1. Provide the requested information for which the excess is or will be retained. by having their stock or interest redeemed
on each organization for which you hold
title to property. Also indicate the number

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by you after they provide you 90 days Schedule C. information on business prospects.
notice. Explain in detail.
If you answer “No,” explain why your Organizations described in Line 5. Answer “Yes” if you market or will
shareholders or beneficiaries aren't section 501(c)(6) --Business market a specific product(s) and/or
permitted to terminate their interest in you leagues, chambers of brand(s) within an industry. Identify the
in such a way. specific product(s) and/or brand(s) and
commerce, etc.
Line 5c. Answer “Yes” if you hold or will explain in detail how you market them.
hold interests in partnerships or real estate Line 1. Select your type of organization
trusts. Describe the interests in detail. from the list. Line 6. Answer “Yes” if you limit or will
limit your activities to users of a specific
A business league, in general, is an product within an industry. Explain in
Line 5d. Answer “Yes” if you make or will association of persons having some detail.
make mortgage loans. Describe the loans common business interest, the purpose of
in detail. which is to promote that common interest Line 7. Answer “Yes” if you operate or will
Line 5e. Answer “Yes” if you hold and not to engage in a regular business of operate a listing or referral system. Explain
property through a corporation, a kind ordinarily carried on for profit. Trade in detail.
partnership, or trust. Identify the associations and professional
corporation, partnership, or trust and associations are considered business Schedule D
describe the property held. leagues.
Organizations described in
A chamber of commerce is usually
Schedule B. composed of the merchants and traders of section 501(c)(7) --Social clubs
a city.
Organizations described in Line 1. Answer “Yes” if personal contact,
A board of trade often consists of commingling, and fellowship exist among
section 501(c)(5) --Labor, persons engaged in similar lines of members. If not, explain.
agricultural, or horticultural business. For example, a nonprofit Line 2. Answer “Yes” if you conduct
organizations organization formed to regulate the sale of activities such as take-out food sales,
a specified agricultural commodity to liquor sales, operation of a gas station,
Line 1. Select your type of organization assure equal treatment of producers, parking garage, barber shop, etc.
from the list. warehouse workers, and buyers is a board Describe these activities and indicate the
A labor organization is an association of trade. percentage of your time and resources
of workers who have combined to protect Chambers of commerce and boards of devoted to them.
and promote the interests of their trade usually promote the common
members by bargaining collectively with economic interests of all the commercial Line 3. Answer “Yes” if you have entered
their employers to secure better working enterprises in a given trade community. or will enter into any contract or agreement
conditions, wages, and similar benefits. for the management or operation of your
A real estate board consists of property and/or activities, such as
Agricultural and horticultural members interested in improving the restaurants, pro shops, lodges. Describe
organizations are connected with raising business conditions in the real estate field. any written or oral arrangements that you
livestock, cultivating land, raising and It isn't organized for profit and no part of made or intend to make, with whom you
harvesting crops or aquatic resources, the net earnings inures to the benefit of have or will have such arrangements, how
cultivating useful or ornamental plants, any private shareholder or individual. the terms are or will be negotiated at arm's
and similar pursuits.
The Internal Revenue Code specifically length, and how you determine you pay no
Chambers of commerce and boards of defines professional football leagues as more than fair market value or you are
trade usually promote the common exempt organizations under section paid at least fair market value.
economic interests of all the commercial 501(c)(6). They are exempt whether or not
Line 4. Answer “Yes” if gross receipts
enterprises in a given trade community. they administer a pension fund for football
from your activities will include amounts
A real estate board consists of players.
paid by non-members for goods and
members interested in improving the Line 2. Describe your members' common services. Explain in detail.
business conditions in the real estate field. business interests.
It isn't organized for profit and no part of Line 5. Answer “Yes” if non-members,
the net earnings inures to the benefit of Line 3. Describe any services you other than guests of members, are
any private shareholder or individual. perform or will perform for members or permitted or will be permitted to use the
The Internal Revenue Code specifically others. You must show that your purpose club facilities or participate in or attend any
defines professional football leagues as is the improvement of business conditions. functions or activities conducted by you.
exempt organizations under section This isn't established by evidence of Describe the functions or activities in
501(c)(6). They are exempt whether or not particular services that provide a which there has been or will be
they administer a pension fund for football convenience or economy to individual non-member participation or admittance.
players. members in their businesses, such as
Line 6. Enter the figure for the current
advertising that carries the name of
Line 2. Describe your members' common members, interest-free loans, assigning year and each of the prior tax years.
business interests. exclusive franchise areas, operation of a Line 7. Enter the figure for the current
real estate multiple listing system, or year and each of the prior tax years.
operation of a credit reporting agency.
Line 8. Answer “Yes” if your charter,
Line 4. Answer “Yes” if you restrict or will bylaws, other governing instrument, or any
restrict your membership to individuals, written policy statement contain any
firms, associations, and/or corporations, provision that provides for discrimination
each representing a different trade, against any person on the basis of race,
business, occupation, or profession, and color, or religion. Identify where this
organized for the purpose of exchanging provision is located; whether or not it will

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be kept; and if you have such a provision Line 2. Answer “Yes” if you provide or will information you believe will support your
that will be repealed, deleted, or otherwise provide deferred compensation benefits, request for relief. Also, you may want to
stricken from your requirements, state property or malpractice insurance, loans provide a comparison of (1) what your
when this will be done. (other than loans at times of disaster or aggregate tax liability would be if you had
Line 9. Answer “Yes” if you restrict or will whole life insurance policy loans), savings filed this application within the 27-month
restrict your membership to members of a plans, reimbursement of commuting period with (2) what your aggregate
particular religion. Explain in detail. expenses, or benefits similar to those liability would be if you were exempt as of
provided by a pension, stock bonus or your formation date.
Line 9a. Answer “Yes” if you are an profit sharing plan. Describe these We may consider the following factors.
auxiliary of a section 501(c)(8) fraternal benefits in detail. • You failed to file because of intervening
beneficiary society. Provide the name and events beyond your control.
EIN of the organization. Line 3. Provide the requested information
for each plan as of the last day of the most • You exercised reasonable diligence,
but you weren’t aware of the filing
Line 9b. Answer “Yes” if you, in good recent plan year. If you have more than
requirements. (The complexity of your
faith, limit your membership to the one plan, at the end of this form, upload a
filing and experience in these matters may
members of a particular religion in order to separate schedule.
further the teachings or principles of that be taken into consideration.)
religion and not to exclude individuals of a Line 4. State the number of persons, if • You reasonably relied on written advice
particular race or color. any, other than employees and their from us.
dependents (for example, the proprietor of • You reasonably relied on the advice of
Schedule E a business whose employees are a qualified tax professional who failed to
members of the association) who are file or advise you to file Form 1024.
Organizations described in entitled to receive benefits. • You filed the required Form 990 series
section 501(c)(8) or 501(c) Line 5. Answer “Yes” if any employees or returns consistent with your requested
(10) --Fraternal beneficiary classes of employees are entitled to status.
societies, orders, or benefits to which other employees or
classes of employees are not entitled. Schedule G
associations. Explain in detail. Organizations described in
Unlike organizations exempt under section
501(c)(8), organizations exempt under Line 6. Answer “Yes” if you are organized section 501(c)(12)—Benevolent
section 501(c)(10) are not “beneficiary” under the terms of a collective bargaining
societies; that is, they may not provide for agreement. At the end of this form, upload life insurance associations,
the payment of life, sick, accident or other a current copy. mutual ditch or irrigation
benefits to their members. Ensure your Line 7. Use the formation date you listed companies, mutual or
selection in Part II is consistent with your in Part II, line 2, and the date you will cooperative telephone
operations. submit this electronic form and required companies, or like
Line 1. Operating under the lodge system user fee payment to determine whether organizations
means carrying on activities under a form you’re submitting this application within 27
of organization that is composed of local months from the month in which you were Line 1. Select your type of organization
branches, chartered by a parent formed. from the list.
organization, largely self-governing, and Line 7a. Generally, if you didn't file Form A benevolent life insurance association
called lodges, chapters, or the like. 1024 within 27 months of formation, the of a purely local character is one that
Line 2. Answer “Yes” if you operate or will effective date of your exempt status will be confines its business activities to a
operate for the exclusive benefit of the the date you filed Form 1024 (submission particular community, place, or district,
members of an organization operating date). We may grant requests for an irrespective of political subdivisions.
under the lodge system. Explain in detail. earlier effective date when there's Ditch and irrigation companies,
evidence to establish you acted telephone companies, electric companies,
Line 3. Answer “Yes” if you are a reasonably and in good faith, and the and “like organizations” that seek
subordinate or local lodge, etc. List the grant of relief won't prejudice the interests exemption under section 501(c)(12) must
name, address, and EIN of your parent of the government. See Rev. Proc. 2021-5 be organized and operated as mutual or
organization. (updated annually) for more information. cooperative organizations.
Line 4. Answer “Yes” if you are a parent Select the appropriate box to indicate Line 2. Answer “Yes” if your business
or grand lodge. List the name, address, whether you accept the submission date activities will be confined to a particular
and EIN of each subordinate lodge in as the effective date of your exempt status community, place, or district. If “No,”
active operation. or whether you are requesting an earlier explain in detail.
effective date.
Line 3. List the counties or geographical
Schedule F Line 7b. You may be eligible for region from which your members are or
consideration for relief from the will be accepted.
Organizations described in requirement that you file Form 1024 within
section 501(c)(9) --Voluntary 27 months of formation if you can Line 4. Answer “Yes” if members have
employees' beneficiary establish that you acted reasonably and in democratic control. If “No,” explain in
associations good faith, and that granting an extension detail.
won’t prejudice the interests of the Democratic Control means you
Line 1. Describe in detail the benefits you government periodically hold democratically
provide or will provide. For each benefit Describe in detail your reasons for filing conducted meetings with members.
include the account, duration, eligibility late, how you discovered your failure to Election of officers must be on a one
requirements, and the circumstances that file, any reliance on professional advice or member, one vote basis. Meetings must
will entitle a recipient to payment of the advice from the IRS, and any other have a quorum of members in attendance
benefit. or voting by proxy.

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Line 5 Answer “Yes” if the rights and Line 2. Select the state credit union law Line 15. Answer “Yes” if you are a mutual
interests of members in your annual under which you are organized and fund organized before September 1, 1957.
savings are determined in proportion to operated from the drop down menu.
Line 15a. Answer “Yes” if you provide
their business with you.
Line 3. Answer “Yes” if you are being reserve funds for-- and insurance of
Line 6. Answer “Yes” if you keep the operated under uniform bylaws adopted shares or deposits in-- a domestic building
records necessary to determine at any by the state you selected on Line 3a. and loan association, cooperative bank
time each member’s rights and interests in If you answer “No,” explain in detail the without capital stock organized and
such savings, including assets acquired rules and regulations under which you are operated for mutual purposes and without
with the savings. operated. profit, mutual savings bank not having
capital stock represented by shares, or a
Line 7. Answer “Yes” if the rights and Line 4. Answer “Yes” if you comply or will mutual savings bank described in section
interests of members are forfeited upon comply with the state credit union law 591(b).
termination of membership. Explain in requirements, including their purposes,
detail. security, and rate of interest charged Line 15b. Select the type of organization
Line 8. Answer “Yes” if you receive or will thereon, in making loans. for which you provide reserve funds and
insurance of shares or deposits.
receive at least 85% of your income from If you answer “No,” explain in detail
amounts collected from members for the why you do not or will not comply with Line 15c. Provide the name of the
sole purposes of meeting losses and state credit union law requirements. organization for which you provide reserve
expenses. If “No,” explain in detail. funds and insurance of shares or deposits.
Line 5. Answer “Yes” if you limit or will
limit your investments to securities which Line 15d. Answer “Yes” if 85% or more of
Schedule H are legal investments for credit unions your income is attributable to providing
Organizations described in under the state credit union law. reserve funds and to investments.
section 501(c) If you answer “No,” explain in detail If you answer “No,” specify the
why you do not or will not comply with percentage of your income that is
(13)—Cemeteries, crematoria, state credit union law requirements. attributable to providing reserve funds and
and like corporations to investments.
Line 6. Answer “Yes” if you distribute or
Line 1. Answer “Yes” if you are claiming will distribute dividends on shares, if any,
exemption as a perpetual care fund for an as prescribed by the state credit union Schedule J
organization described in section 501(c) law. Organizations described in
(13). If you answer “No,” explain in detail section 501(c)(17)—Trusts
Line 1a. Answer “Yes” if the cemetery why you do not or will not comply with
organization, for which funds are held, has state credit union law requirements. providing for the payment of
supplemental unemployment
established exemption under section Line 7. Answer “Yes” if you are operated
501(c)(13). If “No,” explain in detail. for the mutual benefit of your members. compensation benefits
Line 1b. Answer “Yes” if your funds are Line 8. Answer “Yes” if your members Line 1. A full description of the
devoted exclusively to the perpetual care share a common bond such as supplemental unemployment benefits
and maintenance of the non-profit association, occupation, or residence. available to the participants must
cemetery as a whole. If “No,” explain in Describe the common bond in detail. accompany your application, showing the
detail. amount, duration, eligibility requirements,
Line 9. Describe how your governing and the circumstances that will entitle a
Line 2. Answer “Yes” if you operate or will board and officers are selected, including recipient to payment of the benefit.
operate a mortuary. Explain in detail. where (if applicable) this information is in
A copy of your plan documents that
Line 3. Answer “Yes” if you engage or will your governing document, bylaws, or
describe such benefits and the terms and
engage in land sale agreements, other internal rules and regulations.
conditions of eligibility for each benefit
percentage-of-sales land sale Line 10. Answer “Yes” if you issue or will should be uploaded at the end of the form.
agreements, or other similar financial issue stock as a means of indicating
Line 2. Answer “Yes” if you provide or will
arrangements. Describe in detail any ownership by your members or others.
provide benefits for individual proprietors,
written or oral arrangements that you Describe the provisions for the issuance of
partners, or self-employed persons under
made or intend to make, with whom you stock to shareholders that would take
the plan. Explain in detail.
have or will have such arrangements, how ownership in the corporation and share in
the terms are or will be negotiated at arm's the earnings. Line 3. Provide the requested information
length, and how you determine you pay no for each plan as of the last day of the most
more than fair market value or you are Line 11. Answer “Yes” if you allow or will
recent plan year and enter that date in the
paid at least fair market value. allow individuals who aren’t members to
space provided. If you have more than
be shareholders. Explain in detail.
Line 4. Answer “Yes” if you currently, or one plan, at the end of this form, upload a
will, own, operate, or maintain a cemetery Line 12. If you answer “No,” explain in separate schedule.
for pets. Explain in detail. detail why you do not or will not ensure
Line 4. Answer “Yes” if the creator of the
that loans to members benefit the
trust or a contributor to the trust; a brother
Schedule I borrower and meet their needs.
or sister (whole or half-blood), a spouse,
Line 13. Answer “Yes” if you make or will an ancestor, or a lineal descendant of
Organizations described in make loans to individuals who aren’t such a creator or contributor; or a
section 501(c)(14)—Credit members. Explain in detail. corporation controlled directly or indirectly
Unions Line 14. Answer “Yes” if you advertise or by such a creator or contributor has or will
Line 1. Answer “Yes” if you are formed will advertise to individuals who aren’t (a) borrow or receive any part of the trust’s
under a state credit union law. members. Explain in detail. income or corpus, (b) receive any
compensation for personal services, (c)

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obtain any part of the trust’s services, or Schedule K persons related to them within two
(d) sell or purchase any securities or other degrees of blood relationship.
properties from or to the trust. Organizations described in (Grandparents, brothers, sisters, and
Line 5. Use the formation date you listed section 501(c)(19)—A post, grandchildren are the most distant
relationships allowable.)
in Part II, line 2, and the date you will organization, auxiliary unit,
submit this electronic form and required etc., of past or present Line 2d. Answer “Yes” if all of your
user fee payment to determine whether members are themselves members of a
you’re submitting this application within 27 members of the Armed Forces post or organization, past or present
months from the month in which you were of the United States members of the Armed Forces of the
formed. Line 1. Answer “Yes” if you are a post or United States, spouses of members of
Line 5a. Generally, if you didn’t file Form organization of past or present members such a post or organization, or related to
1024 within 27 months of formation, the of the Armed Forces of the United States. members of such a post or organization
within two degrees of blood relationship.
effective date of your exempt status will be Line 1a. Enter the total number of your
the date you filed Form 1024 (submission members. Line 3. Answer “Yes” if you are a trust or
date). We may grant requests for an foundation organized for the benefit of an
earlier effective date when there’s Line 1b. Enter the number of your exempt post or organization of past or
evidence to establish you acted members that are present or former present members of the Armed Forces of
reasonably and in good faith, and the members of the U.S. Armed forces. the United States.
grant of relief won’t prejudice the interests Line 1c. Enter the total number of your Line 3a. Answer “Yes” if your corpus or
of the government. See Rev. Proc. 2021-5 members that are cadets (include income be used solely for the funding of
(updated annually) for more information. students in college or university ROTC such an exempt organization (including
Select the appropriate box to indicate programs or at armed services academies necessary related expenses). If not,
whether you accept the submission date only), or spouses, widows, or widowers of answer “No” and explain.
as the effective date of your exempt status cadets or past or present members of the
or whether you are requesting an earlier U.S. Armed Forces. Line 3b. Answer “Yes” if you are formed
effective date. for charitable purposes and your
Line 1d. Answer “Yes” if you have a organizational document contain a proper
Line 5b. You may be eligible for membership category other than the ones dissolution provision as described in
consideration for relief from the asked about above. Describe other section 1.501(c)(3)-1(b)(4) of the Income
requirement that you file Form 1024 within membership categories and state the Tax Regulations.
27 months of formation if you can number of members in each category.
establish that you acted reasonably and in Line 4. Answer “Yes” if you currently, or
good faith, and that granting an extension Line 1e. Answer “Yes” if you wish to will, (a) rent your facilities to the general
won’t prejudice the interests of the apply for a determination that public; (b) make your facilities, such as bar
government. contributions to your organization are and dining facilities, open to the general
deductible by donors. public; (c) sell liquor and/or food to
Describe in detail your reasons for filing members and/or the general public for
late, how you discovered your failure to Line 1f. Enter the number of your
file, any reliance on professional advice or members from line 1b that are war consumption off premises; or (d) conduct
advice from the IRS, and any other veterans. (A war veteran is a person who gaming activities with the general public.
information you believe will support your served in the Armed Forces of the United Explain in detail, including the percentage
request for relief. Also, you may want to States during the following periods of war: of your time and resources devoted to
provide a comparison of April 21, 1898, through July 4, 1902; April such activities.
1. What your aggregate tax liability 6, 1917, through November 11, 1918;
would be if you had filed this application December 7, 1941, through December 31, Schedule L
within the 27-month period with 1946; June 27, 1950, through January 31, Organizations described in
1955; August 5, 1964, through May 7,
2. What your aggregate liability would 1975; and August 2, 1990, through a section 501(d)—Religious and
be if you were exempt as of your formation future date to be set by law or Presidential apostolic organizations
date. Proclamation.)
We may consider the following factors. Line 1. Answer “Yes” if you are organized
• You failed to file because of intervening Line 2. Answer “Yes” if you are an for the purpose of operating a communal
events beyond your control. auxiliary unit or society of a post or religious community where members live a
• You exercised reasonable diligence, organization of past or present members communal life following your tenets and
but you weren’t aware of the filing of the Armed Forces of the United States. teachings.
requirements. (The complexity of your Enter the name, address, and EIN of the
filing and experience in these matters may post or organization. Line 2. Answer “Yes” if you maintain a
common or community treasury.
be taken into consideration.) Line 2a. Answer “Yes” if you are affiliated
• You reasonably relied on written advice with and organized according to the Line 3. Answer “Yes” if all your members
from us. bylaws and regulations formulated by live in a communal manner.
• You reasonably relied on the advice of such an exempt post or organization. A Line 4. Answer “Yes” if your members are
a qualified tax professional who failed to copy of such bylaws or regulations should permitted to own, in their own names, any
file or advise you to file Form 1024. be uploaded at the end of this form. real or personal property.
• You filed the required Form 990 series
returns consistent with your requested Line 2b. Enter the total number of your Line 5. Answer “Yes” if your members are
status. members. required to furnish their own support (food,
Line 2c. Enter the number of your clothing, and shelter).
members that are themselves past or Line 6. State your membership
present members of the Armed Forces of requirements, the method of member
the United States, or are their spouses, or admission, members’ right to property

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owned at the time they’re admitted and required by state law. State the names Requested information is required for
terminating members’ rights to share in and purposes of the reserves and specify the 2 preceding years regardless of the
the organization’s property, or to a return the amounts of each. current year requirement. Please note that
of any property contributed. if no information is required for the current
Line 8. Describe who is accorded voting
year, the preceding years information
rights in the cooperative and how many
period can end on any day which is within
Schedule M votes one person may have. If a person
60 days of the date of the application.
Organizations described in may be entitled to more than one vote,
explain in detail how voting rights are Line 17. Enter the value of agricultural
section 521 – Farmers' acquired. products marketed or handled for
Cooperative Associations members and non-members below:
Line 9. Answer “Yes” if you are a
Line 1. Complete the table. Show the federated cooperative. Line 17a. Members – Note: If it is
necessary to own one or more shares of
number of shares of each class of capital Line 10. Answer “Yes” if all your member
stock in order to become a member,
stock currently outstanding, if any, the cooperatives are exempt under section
include only the amount of business
value of the consideration for which it was 521.
issued, and the rate of dividend paid. transacted with persons actually owning
Line 11. Answer “Yes” if the nonexempt the required number of shares.
Line 2. Complete the table. Show the member cooperatives have the same
number of shares of capital stock (other annual accounting period as you. If “No,” Line 17a.1 List the amount actually
than non-voting preferred) owned by describe the method that you use or will produced by members.
current and active producers, inactive use to provide a common or comparable Line 17a.2 List the amount not actually
producers, and non-producers. unit of time for analyzing and evaluating produced by members but marketed by
The term “producer” means an your operations and those of your them through you
individual or corporation engaged in members.
farming as a business receiving income Line 17b.1 Non-members
based on farm production rather than fixed Line 12. Answer “Yes” if you do business
Line 17b.2 List the amount not actually
compensation. For example, a corporation with or will do business with both
produced by non-members but marketed
leases its land to a tenant farmer who members and non-members. Explain in
by them through you
agrees to pay a rental fee based on a detail.
Line 17c. List the amount by
percentage of the farm crops produced. Line 13. Answer “Yes” if you pay or will
nonproducers (purchased from
Both the landowner and the tenant farmer pay patronage dividends. Explain in detail
nonproducers for marketing by you)
qualify as producers. whether they will be paid to members and
“Current and active” producers are non-members on the same basis. Line 18. Enter the value of supplies and
equipment purchased for or sold to
patrons of a cooperative who market more Line 14. Answer “Yes” if you allocate or
members and non-members below:
than 50% of their products or purchase will allocate patronage dividends based on
more than 50% of their supplies and an obligation in existence before you Line 18a. List the amount from members
equipment through the cooperative during received the amounts allocated. Explain who were producers Note: If it is
the cooperative's tax year. the obligation in detail. necessary to own one or more shares of
stock in order to become a member,
Line 3. Answer “Yes” if you issue or will Line 15. Explain how distribution is or will
include only the amount of business
issue non-voting preferred stock. Explain be made of the proceeds of products
transacted with persons actually owning
in detail whether the owners, upon marketed for members and non-members.
the required number of shares.
dissolution or liquidation, may share in the Also, if you operate on a basis of allocated
profits of the association beyond fixed units (i.e., functional, departmental, etc.), Line 18b. List the amount from
dividends. explain how losses are or will be treated. non-members who were producers
Line 4. Answer “Yes” if you make or will Line 16. Explain how you charge for Line 18c. List the amount from members
make any provisions for retiring the voting supplies and equipment purchased for and non-members who were not
stock held by a non-producer. Explain in members and non-members. producers
detail.
Line 17 – 19. The information requested Line 19. List the amount of business
Line 5. Enter the legal rate of interest in on lines 17 through 19 must be completed done with the United States Government
the state where you are located. If the for the current year and each of the 2 or any of its agencies
state in which you are located differs from immediately preceding years (or for the Line 20. Answer “Yes” if all the net
the state in which you are incorporated, time you have existed if less than 3 years). earnings (after payment of dividends, if
enter the legal rate of interest in the state The requested information for the current any, on capital stock) for the years shown
of your incorporation. year must cover the period beginning on on lines 17-19 were distributed as
Line 6. Answer “Yes” if you are required the first day of your established annual patronage dividends. If your net earnings
by state law to accumulate and maintain accounting period and ending on any day were not distributed as patronage
reserves. State the names and purposes which is within 60 days of the date of the dividends, also indicate whether they were
of the reserves and specify the amounts of application. If the date of the application is apportioned on the records to all patrons
each. less than 60 days after the first day of the on a patronage basis.
current accounting period, no information
Line 7. Answer “Yes” if you maintain or is required for the current year.
will maintain any reserves other than those

Instructions for Form 1024 -23-

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Appendix A: 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

                                                                          -24-

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Appendix A: 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 Children’s 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.

                                                                        -25-

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Appendix A: 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  Women’s Service Clubs                Engineering                      W12  Fundraising & Fund Distribution  Y01 Alliances & Advocacy
S82  Men’s 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  Voluntaryism Promotion          V23  Behavioral Science               X05  Research Institutes & Public     Y40 Fraternal Societies
T50  Philanthropy, Charity &         V24  Political Science                     Policy Analysis                  Y41 Fraternal Beneficiary Societies
     Voluntaryism 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, Voluntaryism &    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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