# Instructions for Form 1023 > Briefs, arguments, decisions, and more. URL: https://www.frixlaw.com/law-library/documents/agency%3Airs%3Acfba5a2c49e4314f ## Record - **Collection:** Agency decision - **Document type:** Agency decision ## Text Instructions for Form 1023 (Rev. December 2024) Application for Recognition of Exemption Under Section 501(c)(3) of the Internal Revenue Code Section references are to the Internal Revenue Code unless otherwise noted. Contents Page Future Developments . . . . . . . . . . . . 1 Overview of Organizations Described in Section 501(c) (3) . . . . . . . . . . . . . . . . . . . . . 1 General Instructions . . . . . . . . . . . . . 2 Answers . . . . . . . . . . . . . . . . . . . . 3 Purpose of Form . . . . . . . . . . . . . . . 3 What To File . . . . . . . . . . . . . . . . . . 3 When To File . . . . . . . . . . . . . . . . . 4 Filing Assistance . . . . . . . . . . . . . . . 4 Signature Requirements . . . . . . . . . . 4 Authorized Representative . . . . . . . . 4 Public Inspection . . . . . . . . . . . . . . . 5 Foreign Organizations . . . . . . . . . . . 5 Specific Instructions . . . . . . . . . . . . . 6 Part I. Identification of Applicant . . . . . 6 Part II. Organizational Structure . . . . . 6 Part III. Required Provisions in Your Organizing Document . . . . . 7 Part IV. Your Activities . . . . . . . . . . . . 8 Part V. Compensation and Other Financial Arrangements . . . . . . 10 Part VI. Financial Data . . . . . . . . . . 11 Part VII. Foundation Classification . . . . . . . . . . . . . 14 Part VIII. Effective Date . . . . . . . . . . 15 Part IX. Annual Filing Requirement . . . . . . . . . . . . . 15 Part X. Signature . . . . . . . . . . . . . . 16 Schedule A. Churches . . . . . . . . . . 16 Schedule B. Schools, Colleges, and Universities . . . . . . . . . . . 17 Schedule C. Hospitals and Medical Research Organizations . . . . . . . . . . . . . 18 Schedule D. Section 509(a)(3) Supporting Organizations . . . . . 20 Schedule E. Effective Date . . . . . . . 22 Schedule F. Low-Income Housing . . . 23 Schedule G. Successors to Other Organizations . . . . . . . . . . . . . 23 Schedule H. Organizations Providing Scholarships, Fellowships, Educational Loans, or Other Educational Grants to Individuals and Private Foundations Requesting Advance Approval of Individual Grant Procedures . . . . . . . . . . . . . . 23 Appendix A: Sample Conflict of Interest Policy . . . . . . . . . . . . . 26 Appendix B: States With Statutory Provisions Satisfying the Requirements of Internal Revenue Code Section 508(e) . . . . . . . . . . . . . . . . . . 28 Jan 7, 2025 Contents Page Appendix C: Glossary of Terms . . . . 30 Appendix D: National Taxonomy of Exempt Entities (NTEE) Codes . . . . . . . . . . . . . . . . . 38 Index . . . . . . . . . . . . . . . . . . . . . 41 Note. Keep a copy of the completed Form 1023 for your permanent records. Future Developments For the latest information about developments related to Form 1023 and its instructions, such as legislation enacted after they were published, go to IRS.gov/Form1023. What's New Organizations requesting recognition of tax-exempt status under section 501(c)(3) must complete and submit their Form 1023 (or Form 1023-EZ, if eligible) applications electronically (including paying the correct user fee) using Pay.gov. Continuous-use form and instructions. Form 1023 and these instructions have been converted from an annual reversion to continuous use. Use these instructions for tax year 2024 and subsequent years until a superseding revision is issued. Reminder Don't include social security numbers on publicly disclosed forms. Because the IRS is required to disclose approved exemption applications and information returns, don't include social security numbers on this form. Documents subject to disclosure include supporting information filed with the form and correspondence with the IRS about the filing. Phone Help If you have questions and/or need help completing Form 1023, please call 877-829-5500. This toll-free telephone service is available Monday through Friday. Email Subscription The IRS provides a subscription-based email service for tax professionals and representatives of tax-exempt organizations. We send subscribers periodic updates regarding exempt organization tax law and regulations, available services, and other information. To subscribe, visit IRS.gov/Charities. How To Get Forms and Publications Internet. You can access the IRS website 24 hours a day, 7 days a week, at IRS.gov to do the following. • Download forms, instructions, and publications. • Order IRS products online. • Research your tax questions online. • Search publications by topic or keyword. • Use the online Internal Revenue Code, regulations, or other official guidance. • View Internal Revenue Bulletins (IRBs) published since 1995. • Sign up at IRS.gov/Charities-NonProfits to receive local and national tax news by email. Tax forms and publications. You can download or print all of the forms and publications you may need at IRS.gov/ FormsPubs. Otherwise, you can go to IRS.gov/OrderForms to place an order and have forms mailed to you. You should receive your order within 10 business days. Overview of Organizations Described in Section 501(c)(3) How To Request Recognition of Tax-Exempt Status Under Section 501(c)(3) Section 501(c)(3) describes organizations organized and operated exclusively for religious, charitable, scientific, testing for public safety, literary, or educational purposes, or to foster national or international amateur sports competition, or for the prevention of cruelty to children or animals. Unless an exception applies, an organization must file Form 1023 or Form 1023-EZ (if eligible) to obtain recognition of exemption from federal income tax under section 501(c)(3). You can find information about eligibility to file Form 1023-EZ at IRS.gov/Charities. Organizations not required to obtain recognition of exemption. The following types of organizations may be considered tax exempt under section 501(c)(3) without filing Form 1023 (or Form 1023-EZ). Instructions for Form 1023 (Rev. 12-2024) Catalog Number 17132z Department of the Treasury Internal Revenue Service www.irs.gov • Churches, including synagogues, temples, and mosques. • Integrated auxiliaries of churches and conventions or associations of churches. • Any organization that has gross receipts in each tax year of normally not more than $5,000. For more information on gross receipts exceptions, go to IRS.gov/Charities. Even though these organizations aren't required to seek recognition of exemption, they may choose to file Form 1023 (or Form 1023-EZ, if eligible) to receive a determination letter stating they are recognized as exempt under section 501(c)(3) status. The determination letter will also state whether an organization must file annual information returns or notices and will specify whether contributions to that organization are tax deductible. Requirements for Tax-Exempt Status Under Section 501(c)(3) To qualify for exemption under section 501(c)(3), an organization must be organized and operated exclusively for one or more exempt purposes. Organized. An organization must be organized as a corporation, a limited liability company (LLC), an unincorporated association, or a trust. Its organizing document (corporate articles of incorporation, LLC articles of organization, articles of association or constitution of an unincorporated association, or trust agreement or declaration of trust) must limit the organization's purpose(s) and permanently dedicate its assets to exempt purposes. Operated. An organization described in section 501(c)(3) must be operated to further one or more of the exempt purposes stated in its organizing document. Certain other activities are prohibited or restricted, including, but not limited to, the following activities. A section 501(c)(3) organization must: • Absolutely refrain from participating in the political campaigns of candidates for local, state, or federal office; • Ensure its assets and earnings don’t unjustly enrich board members, officers, key management employees, or other insiders; • Not further non-exempt purposes (such as purposes that benefit private interests) more than insubstantially; • Not operate for the primary purpose of conducting a trade or business that isn’t related to its exempt purpose(s); • Not engage in activities that are illegal or violate fundamental public policy; and • Limit its legislative activities. 2 Legislative and political campaign intervention. Section 501(c)(3) denies exemption to an organization if a substantial part of its activities is attempting to influence legislation or if it directly or indirectly participates or intervenes in any political campaign on behalf of (or in opposition to) any candidate for elective public office. These issues are described in more detail in the instructions for Part IV, lines 5 and 6. Public Charities and Private Foundations Every organization described in section 501(c)(3) is classified as a private foundation unless it qualifies for one of the public charity exceptions. For some organizations, the primary distinction between a public charity and a private foundation is its sources of financial support. Public charities. The following section 501(c)(3) organizations are classified as public charities. • Organizations that are public charities based upon their activities (without regard to their sources of support), such as churches, schools, hospitals, medical research organizations, and cooperative hospital service organizations and agricultural research organizations (sections 509(a)(1) and 170(b)(1)(A)(i), (ii), (iii), and (ix)). • Organizations that normally receive substantial support from grants, governmental units, and/or contributions from the general public (sections 509(a)(1) and 170(b)(1)(A)(iv) and (vi)). • Organizations that normally receive more than one-third of their support from contributions, membership fees, and gross receipts from activities related to their exempt functions, and not more than one-third of their support from gross investment income and net unrelated business income (section 509(a)(2)). • Organizations that support other public charities (supporting organizations) (section 509(a)(3)). • Organizations that test for public safety (section 509(a)(4)). Private foundations. Section 501(c)(3) organizations that don’t fit into any of the foundation classifications above are private foundations. Private foundations are further classified as nonoperating private foundations or private operating foundations (section 4942(j)(3)). Nonoperating private foundations. Nonoperating private foundations generally accomplish their exempt purpose by making grants and don’t otherwise engage directly in charitable activities. Private operating foundations. A private operating foundation actively conducts exempt programs. Private operating foundations are subject to more favorable rules than other private foundations in terms of charitable contribution deductions and attracting grants from private foundations. In order to be classified as a private operating foundation, an organization must meet certain support tests. Search for “private operating foundations” at IRS.gov for more information. Key distinctions between public charities and private foundations. Foundation classification is important because different tax rules apply to the operations of each entity. For more information on the different rules, see IRS.gov/Charities-Non-Profits/EOOperational-Requirements-PrivateFoundations-and-Public-Charities. Foundation classification has TIP nothing to do with the name of the organization. Many organizations that aren't private foundations include the word “foundation” in their names. State Registration Requirements Tax exemption under section 501(c)(3) is a matter of federal law. After receiving federal tax exemption, an organization may also be required to register with one or more states where it holds assets or where it will solicit contributions. The organization may also need to seek exemption from state taxes. The National Association of State Charity Officials (NASCO) maintains a website that provides informational links to the various states for these purposes. It can be accessed at nasconet.org. General Instructions Social Security number. Don't enter social security numbers on this form or any attachments because the IRS is required to disclose approved exemption applications and information returns. Documents subject to disclosure include supporting information filed with the form and correspondence with the IRS related to the application. “You” and “us.” Throughout these instructions and Form 1023, the terms “you” and “your” refer to the organization that is applying for tax-exempt status. The terms “us” and “we” refer to the IRS. Definitions. Terms in bold type in Form 1023 are defined throughout these instructions and in Appendix C. Instructions for Form 1023 Answers Form 1023 asks you to answer a series of questions and provide information to assist us in determining if you meet the requirements for tax exemption under section 501(c)(3). Answer questions completely. If you believe you previously answered the question, you may refer to your previous answer. Your answers must provide sufficient detail about your past, CAUTION present, and planned activities to demonstrate that you're described in section 501(c)(3). We won't be able to recognize you as tax exempt based on a mission statement (such as providing assistance to the poor) unless you also describe the activities that further accomplish your mission. We need to understand the specific activities you will undertake to accomplish your section 501(c)(3) exempt purpose(s). ! Financial data. Financial data, whether budgeted or actual, should be consistent with other information presented in your application. For example, if you're requesting public charity classification under one of the public support tests, your financial data should show contributions from the public or receipts from providing exempt services. Budgeted financial data should be prepared based upon your current plans. We recognize that your actual financial results may vary from the budgeted amounts. Past, present, and planned activities. Many items on Form 1023 are written in the present tense; however, base your answers on your past, present, and planned activities. Language and currency requirements. Prepare Form 1023 and attachments in English. Provide an English translation if the articles of organization, bylaws, or any other attachments are in any other language. Report financial information in U.S. dollars (specify the conversion rate used). Combine amounts from within and outside the United States and report the total for each on the financial statements. Purpose of Form Completed Form 1023 required to apply for recognition of section 501(c)(3) exemption. Use Form 1023, including the appropriate user fee, to apply for recognition of exemption from federal income tax under section 501(c)(3). If approved, we will issue a determination letter that describes your tax-exempt status and your qualification to receive tax-deductible charitable contributions. The determination letter will also show Instructions for Form 1023 your specific foundation classification (described earlier) and annual filing requirements. Form 1023-EZ. You may be TIP eligible to file Form 1023-EZ, Streamlined Application for Recognition of Exemption Under Section 501(c)(3) of the Internal Revenue Code, which is a streamlined version of Form 1023. Complete the Form 1023-EZ Eligibility Worksheet in the Instructions for Form 1023-EZ to determine if you're eligible to file Form 1023-EZ. You can visit IRS.gov/Charities for more information on application requirements. Leaving a group exemption. A subordinate organization under a group exemption can use Form 1023 to leave the group and obtain individual exemption. If you're a subordinate organization and wish to leave a group, you should notify your parent organization of your intention to leave the group ruling before filing Form 1023. Application for Reinstatement of Exempt Status and Retroactive Reinstatement If your tax-exempt status was automatically revoked for failure to file a return or notice 3 consecutive years, you must apply to have your tax-exempt status reinstated. You must complete and submit Form 1023, including Schedule E (or, if eligible, Form 1023-EZ), and pay the appropriate user fee. If your application is approved, your date of reinstatement will generally be the filing date of the application, unless you qualify for reinstatement of exemption retroactive to your date of automatic revocation. See Rev. Proc. 2014-11, 2014-03 I.R.B. 411 for details, including additional requirements for retroactive reinstatement. User Fee The law requires payment of a user fee with each application. You must pay this fee through Pay.gov when you file Form 1023. Payments can be made directly from your bank account or by credit or debit card. You won't be able to submit Form 1023 without paying the correct fee. User fee amounts are listed in Rev. Proc. 2020-5, updated annually. For the current Form 1023 user fee, go to Rev. Proc. 2020-5, 2020-1 I.R.B. 241, at IRS.gov/Charities-Non-Profits/User-Feesfor-Tax-Exempt-and-Government-EntitiesDivision. You can also call 877-829-5500. Group Exemption Don't use Form 1023 to apply for a group exemption. We may issue to a central organization, a group exemption that recognizes, on a group basis, the exemption of subordinate organizations on whose behalf the central organization has applied. See Pub. 557 for information on how to apply for a group exemption. What To File All applicants, unless otherwise noted, must complete Parts I through X of Form 1023, plus any required schedules and attachments. The following organizations must complete additional schedules to Form 1023. Requesting Expedited Review We generally review applications for exemption in the order we receive them. We only expedite processing of an application where a written request presents a compelling reason for processing the application ahead of others. This does not mean your application will be immediately approved or denied. Circumstances generally warranting expedited processing include the following. • A grant to the applicant is pending and the failure to secure the grant may have an adverse impact on the organization's ability to continue operations. • The purpose of the newly created organization is to provide disaster relief to victims of emergencies such as floods and hurricanes. • An IRS error has caused delays in review of the application. 3 THEN you must complete Schedule IF you’re A church . . . . . . . . . . . A A school, college, or university . . . . . . . . . . B A hospital or medical research organization C . . A section 509(a)(3) supporting organization . . . . . . . . D Filing this application more than 27 months from your date of formation and/or applying for reinstatement of tax-exempt status after being automatically revoked . . . . . . . . . . . E A low-income housing organization . . . . . . . . F A successor to other organizations . . . . . . . . G An organization providing scholarships, fellowships, educational loans, or other educational grants to individuals and/or a private foundation requesting approval of individual grant procedures . . . . . . . . . Generally, if you file Form 1023 within 27 months after the end of the month in which you were legally formed, and we approve your application, the effective date of your exempt status will be your legal date of formation. If you don’t file Form 1023 within 27 months, the effective date of your exempt status will be the date you filed Form 1023. For exceptions and special rules, see Part VIII. Effective Date and Schedule E. How to File As of January 31, 2020, the IRS requires that Form 1023 applications for recognition of exemption be submitted electronically online at Pay.gov. The IRS will provide a 90-day grace period during which it will continue to accept paper versions of Form 1023. To submit Form 1023, you must: 1. Register for an account on Pay.gov. 2. Enter "1023" in the search box and select Form 1023. 3. Complete the form. Filing Assistance H Attachments To Form 1023 A complete application will include one or more documents in addition to Form 1023. Pay.gov can accommodate only one uploaded file. Before submitting Form 1023, consolidate your attachments into a single PDF file. Combine your attachments in the following order. • Organizing document (required). • Amendments to your organizing document in chronological order (required if applicable). • Bylaws or other rules of operation and amendments (if adopted). • Form 2848, Power of Attorney and Declaration of Representative (if applicable). • Form 8821, Tax Information Authorization (if applicable). • Supplemental responses (if your response won't fit in the provided text field) and any additional information you want to provide to support your request (optional). • Expedite request (optional). Put your name and EIN on each page of your supplemental response and identify the part and line number to which the information relates. 4 When To File For help in completing this form or general questions relating to an exempt organization, you may access information on our website at IRS.gov/EO. You may find the following publications available on IRS.gov helpful. • Pub. 517, Social Security and Other Information for Members of the Clergy and Religious Workers. • Pub. 526, Charitable Contributions. • Pub. 557, Tax-Exempt Status for Your Organization. • Pub. 598, Tax on Unrelated Business Income of Exempt Organizations. • Pub. 1771, Charitable Contributions Substantiation and Disclosure Requirements. • Pub. 1828, Tax Guide for Churches and Religious Organizations. • Pub. 3079, Tax-Exempt Organizations and Gaming. • Pub. 3833, Disaster Relief: Providing Assistance Through Charitable Organizations. • Pub. 4220, Applying for 501(c)(3) Tax-Exempt Status. • Pub. 4221-PC, Compliance Guide for 501(c)(3) Public Charities. • Pub. 4221-PF, Compliance Guide for 501(c)(3) Private Foundations. Signature Requirements An officer, director, trustee, or other official who is authorized to sign for the organization must digitally sign Form 1023 at the end of Part X. The signature must be accompanied by the title or authority of the signer and the date. Authorized Representative Form 2848. Upload a completed Form 2848 if you want to authorize a representative to represent you regarding your application. An individual authorized by Form 2848 may not sign the application unless that person is also an officer, director, trustee, or other official who is authorized to sign the application. A Centralized Authorization File (CAF) number isn’t required to be CAUTION listed on Form 2848. ! Form 8821. Upload a completed Form 8821 if you want to authorize us to discuss your application with the person you have appointed on that form. Form 8821 doesn’t authorize your appointee to advocate your position with respect to the federal tax laws; to execute waivers, consents, or closing agreements; or to otherwise represent you before the IRS. If you want to authorize an individual to represent you, use Form 2848. After You Submit Form 1023 Unless we approve a request for expedited processing, we will assign and work your application in the order we received it. No additional information needed. If our review shows that you meet the requirements for tax-exempt status under section 501(c)(3), we will send you a determination letter stating that you’re exempt under section 501(c)(3) and identifying your foundation classification. Additional information needed. If we can’t make a determination without more information, we will write or call you. Examples of the types of questions we may ask you are available at IRS.gov/ Charities-Non-Profits/CharitableOrganizations/Exempt-OrganizationSample-Questions. If the additional information you provide shows that you meet the requirements for exemption, we will send you a determination letter stating that you're exempt under section 501(c) (3). If we determine that you don't qualify for exemption, we will send you a letter that explains our position and your appeal rights. Annual Return or Notice While Your Application Is Pending Unless you qualify for an exception from the requirement to file an annual return or notice, your filing obligations begin as soon as you were formed. If you have an information return or tax return due while your Form 1023 is pending, complete the return, mark the “Application Pending” box in the heading, Item B, and submit the return as indicated in those instructions. If you’re eligible to file a Form 990-N, e-Postcard, call 877-829-5500 and Instructions for Form 1023 request to be set up to allow filing of Form 990-N . Figure 1. 990 Series Forms Filed by Exempt Organizations Note. It takes the IRS up to 6 weeks to update its records before you can file your Form 990-N. Type of Annual Return You can find information on return filing requirements and exceptions in Pubs. 557 and 598 and in the instructions to the annual returns listed in Figure 1. Form 990, Return of Organization Exempt from Income Tax Section 501(c)(3) public charities Form 990-EZ, Short Form Return of Organization Exempt from Income Tax Section 501(c)(3) public charities whose gross receipts during the year were less than $200,000 and total assets at the end of the year were less than $500,000 Form 990-PF, Return of Private Foundation Private foundations, including private operating foundations, regardless of financial status Form 990-T, Exempt Organization Business Income Tax Return Public charities and private foundations that have gross unrelated business income of $1,000 or more Form 990-N Electronic Notice (e-Postcard) for Tax-Exempt Organizations Not Required to File Form 990 or Form 990-EZ Most small public charities with gross receipts of $50,000 or less can file a Form 990-N, if they choose not to file a Form 990 or Form 990–EZ instead. marking it as “NOT SUBJECT TO PUBLIC INSPECTION” and include an explanation of why you’re asking for the information to be withheld. We will decide whether to withhold the identified information from public inspection. See Pub. 557 for additional information on public inspection requirements. You may also be required to file TIP other returns, such as employment tax returns or benefit plan returns, which aren't discussed here. If a Form 990-series return is due while your application is pending, CAUTION complete and submit the return according to Form 990-series form's instructions. ! Public Inspection Information available for public inspection. If we approve exempt status under section 501(c)(3), the following information that will be open for public inspection includes the following. • Your complete Form 1023 and any supporting documents. • All correspondence between you and the IRS concerning Form 1023, including Form 2848. • Your determination letter. • Annual information returns (Forms 990, 990-EZ, or 990-PF). • Schedule A, included with Forms 990 or 990-EZ. • Schedule B, included with Forms 990 or 990-EZ, excluding the names and addresses of contributors and other identifying information about contributors. • Schedule B, included with Form 990-PF, including names, addresses, and other identifying information about contributors. • Exempt Organization Business Income Tax Return (Form 990-T). Information not available for public inspection. The following items won’t be open for public inspection. • Any information relating to a trade secret, patent, style of work, or apparatus that, if released, would adversely affect you (we must approve withholding this information). • Any other information that would adversely affect national defense (we must approve withholding this information). • User fee payment information. • Contributors' names and addresses and identifying information about contributors included with Forms 990 or 990-EZ and the Schedule B filed with these forms. When applying for tax-exempt status, you must clearly identify any information that isn’t open for public inspection by Instructions for Form 1023 Making documents available for public inspection. Both you and the IRS must make the information that is subject to disclosure available for public inspection. The public may request a copy of the information available for public inspection from us by submitting Form 4506-A. The public may also request inspection of the information or a copy of the information directly from you. You may post the documents required to be available for public inspection on your own website. Information returns and your exemption application materials must be posted exactly as filed with the IRS. You may only delete the information that isn’t open for public inspection. If you post the documents on your website, you can give any person requesting copies the website where the documents may be found, but you don’t need to provide copies of the information. However, even if these documents are posted on your website, you must still allow public inspection without charge at your main office during regular business hours. Documents aren’t considered available for public inspection on a website if the otherwise disclosable information is edited or subject to editing by a third party when posted. To date, the IRS hasn’t approved any third-party websites for posting. Who Should File Foreign Organizations Foreign organizations are those that were created in countries other than the United States, its territories, or its possessions. Foreign organizations may apply for tax-exempt status on income earned in the United States in the same way that domestic organizations apply for exempt status. See Language and currency requirements, earlier. If you’re a foreign organization applying for exempt status, you must complete all required parts of Form 1023. However, see the special rules below for certain Canadian organizations. Contributions by U.S. residents to TIP foreign organizations generally aren’t deductible. Tax treaties between the U.S. and certain foreign countries provide specific limited exceptions. Annual returns for foreign organizations. A foreign organization that obtains exemption as a public charity must file an information return annually (Form 990 or Form 990-EZ). A foreign organization that is a private foundation must file Form 990-PF annually. However, a foreign organization, other than a private foundation or a section 509(a)(3) supporting organization, may file Form 990-N (e-Postcard) instead of Form 990 or Form 990-EZ when its gross receipts from U.S. sources are normally $50,000 or less and it hasn’t conducted significant activity 5 in the United States. See the Instructions for Form 990 and Form 990-EZ, and the Instructions for Form 990-PF for further information. A foreign organization that is subject to unrelated business income tax must file Form 990-T. Canadian Organizations Canadian organizations that have received a Notification of Registration from the Canada Revenue Agency (formerly Canada Customs and Revenue Agency), and whose registrations haven’t been revoked (“Canadian registered charities”), are automatically recognized in the U.S. as section 501(c)(3) organizations and aren’t required to file Form 1023. Canadian registered charities are also presumed to be private foundations. If you’re a Canadian registered charity and want to be listed as a section 501(c)(3) organization on IRS.gov or request classification as a public charity rather than a private foundation, mail or fax the information below to: Internal Revenue Service Exempt Organization Determinations Room 6403 P.O. Box 2508 Cincinnati, OH 45201 (855) 204-6184 No user fee is required. • A letter stating the organization’s request (listing as a section 501(c)(3) organization on IRS.gov or classification as a public charity). • The legal name and complete mailing address of the organization. • The organization’s EIN. • The month its tax year ends. • The organization’s date of formation. • A contact name and telephone number. • The public charity status it is requesting (if applicable) and information demonstrating how it meets the requirements of that status (see Part VII, line 1, and related questions and schedules). • This penalty of perjury statement: I declare under the penalties of perjury that I have examined this request, including the accompanying documents, and to the best of my knowledge and belief, the request contains all the relevant facts relating to the request, and such facts are true, correct, and complete. • The signature of an officer, director, trustee, or other authorized person. • A copy of the organization’s Notification of Registration. • Form 8833, Treaty-Based Return Position Disclosure Under Section 6114 or 7701(b). on which your annual financial records are based. Organizations Created in U.S. Territories and Possessions Organizations created in possessions and territories of the U.S. are generally treated as domestic organizations. If you were created in a U.S. possession or territory, you must complete all required parts of Form 1023 to apply for exempt status under section 501(c)(3). Charitable contributions to you are deductible by donors if you qualify for exempt status under section 501(c)(3). Annual filing requirements for an organization created in a U.S. territory or possession are similar to those outlined above for foreign organizations (see Rev. Proc. 2011-15 at IRS.gov/pub/irs-irbs/ irb11-03.pdf). Specific Instructions Part I. Identification of Applicant Line 1a. Enter your complete name exactly as it appears in your organizing document, including amendments. Line 1b. If you have an “in care of” name, enter it here; otherwise, leave this space blank. Line 1c-i. Enter your complete address where all correspondence will be sent. If mail isn’t delivered to your street address and you have a P.O. box, list your P.O. box information instead of your street address. For a foreign address, enter your province or state and foreign postal code where indicated. Line 2. 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 search for “apply for an EIN.” You may apply for an EIN online or by fax or mail. International applicants may call 267-941-1099 (toll call). Don’t apply for an EIN more than TIP once. If you’re unsure of your EIN or whether you have one, call 877-829-5500 for assistance. ! Don’t use the EIN of a related or other organization. CAUTION Line 3. Month tax year ends. Select the month your tax year (annual accounting period) ends. Your tax year (annual accounting period) is the 12-month period 6 Check your bylaws or other rules TIP of operation for consistency with the tax year (annual accounting period) you enter here. Line 4. 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 the Form 1023. Line 5. Provide a daytime telephone number for the contact listed on line 4. Line 6. You may provide a fax number for the contact listed on line 4. Line 7. Pay.gov will populate this field with the current user fee for filing Form 1023. Line 8. Enter your complete website address if you have one. Also, list any websites maintained on your behalf. The information on your website should be consistent with the information in your Form 1023. Line 9. 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 officers, directors, or trustees, check the box provided to add more officer, director, and/or trustee information. The person who is signing Form 1023 must be listed within the first five entries of line 9. Part II. Organizational Structure You must be a corporation, limited liability company, unincorporated association, or trust to be tax exempt under section 501(c)(3). Sole proprietorships, partnerships, or loosely affiliated groups of individuals aren’t eligible. Line 1. Type of organization and copy of organizing document. Select your type of organization, and before submitting the form, upload a copy of your organizing document (including any amendments) as part of the required attachment. Corporation. A corporation is an entity organized under a federal or state statute, or a statue of federally recognized Indian tribal or Alaskan native government. Instructions for Form 1023 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 organization, 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 certificate 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. Instructions for Form 1023 If you are an LLC and want to be TIP 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. Bylaws may be considered an TIP 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. If your trust agreement continues to provide for distributions for CAUTION non-charitable interests, you won’t qualify for tax-exempt status. ! Line 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. Line 3. State of formation. Enter the jurisdiction (for instance, the state or the federally recognized tribal government) under the laws of which you were incorporated or otherwise formed. This may not be the place in which you’re physically located. For example, if you’re physically located in New York, but incorporated under Massachusetts law, enter Massachusetts. For purposes of completing this application, you’re formed under the laws of a foreign country if you’re not formed under the laws of the United States, its territories and possessions, federally recognized Indian tribal or Alaska native governments, or the District of Columbia. Line 4. “Bylaws” are generally the internal rules and regulations of an organization. If you have bylaws, upload a current copy (including any amendments). Bylaws don’t need to be signed unless they are your organizing document as described in the instructions for line 1 above. Line 5. Successor organization. You are a “successor” if you: • Took over activities previously conducted by another organization, • Took 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 non-profit status. If you’re a successor organization, complete Schedule G, Successors to Other Organizations. Your predecessor organization TIP may have been either a tax-exempt or non-exempt organization. Part III. Required Provisions in Your Organizing Document Line 1. Purpose clause. Your organizing document must limit your purposes to those described in section 501(c)(3). Those purposes are charitable, religious, educational, scientific, literary, testing for public safety, fostering national or international amateur sports 7 competition, and preventing cruelty to children or animals. The generally accepted legal definition of “charitable” includes relief of the poor, the distressed, or the underprivileged; advancement of religion; advancement of education or science; erecting or maintaining public buildings, monuments, or works; lessening the burdens of government; lessening neighborhood tensions; eliminating prejudice and discrimination; defending human and civil rights secured by law; and combating community deterioration and juvenile delinquency. Therefore, the phrase “relief of the poor” in your organizing document properly limits your purposes. Limiting your purposes by reference to section 501(c)(3) generally will be sufficient to meet the organizational test under section 501(c)(3). Your organizing document may also sufficiently limit your purpose by reference to a specific charitable purpose such as “relief of the elderly within the meaning of section 501(c)(3).” However, purposes listed in your organizing document broader than those listed in section 501(c)(3) may cause you to fail the organizational test. In that case, you will need to amend your organizing document before applying. A reference to section 501(c)(3) won’t ensure that your purposes are limited to those described in section 501(c)(3) if other provisions describing your purposes include one or more non-exempt purposes. The following is an example of an acceptable purpose clause. The organization is organized exclusively for charitable, religious, educational, and scientific purposes under section 501(c)(3) of the Internal Revenue Code, or corresponding sections of any future federal tax code. See Pub. 557 for further information and examples of how to limit your purposes. Line 2. Dissolution clause. Your organizing document must provide for the permanent dedication of your assets to a section 501(c)(3) purpose. This means that if you dissolve your organization in the future, your assets must be distributed for an exempt purpose described in section 501(c)(3), or to the federal government, or to a state or local government, for a public purpose. In certain states, you may rely on state law to establish the permanent dedication of assets for exempt purposes. This is based on Rev. Proc. 82-2, 1982-1 C.B. 367. For additional information, search “Operation of state law” at IRS.gov. 8 Foreign organizations may be able to rely upon the applicable laws of their jurisdiction in a similar manner. If relying on a foreign law, you must provide a copy of the applicable law with an English translation. Naming a specific organization to receive your assets upon dissolution will be acceptable only if your organizing document requires that the specific organization to be exempt under section 501(c)(3) at the time your dissolution takes place and provides for a qualified alternative recipient if the named organization isn’t exempt under section 501(c)(3) at that time. If your organizing document states that your assets would be distributed to members or private individuals or for any purpose other than those provided in section 501(c)(3), you must amend your organizing document to remove such statements. The following is an example of an acceptable dissolution clause. Upon the dissolution of this organization, assets shall be distributed for one or more exempt purposes within the meaning of section 501(c)(3) of the Internal Revenue Code, or corresponding section of any future federal tax code, or shall be distributed to the federal government, or to a state or local government, for a public purpose. See Pub. 557 for further information and examples of acceptable language for dedication of assets in your organizing document. Part IV. Your Activities Reminder Answer all questions in this part as they pertain to your past, present, and future activities. Line 1. Describe completely and in detail your past, present, and planned activities. Don’t refer to or repeat the purposes in your organizing document or speculate about potential future programs. Your narrative description of activities should be thorough and accurate because we determine whether you qualify for section 501(c)(3) exempt status based on the information in your application. You should describe either actual or planned activities. For example, if you plan to further educational purposes by operating an afterschool homework club, you would describe that activity rather than cite that you will further educational purposes. If you were also contemplating offering scholarships in the future, but currently have no plans to do so, then the scholarship activity would be speculative, and you should not describe it. Some organizations (such as credit counseling organizations (see Part IV, line 8), childcare organizations (see Part IV, line 12), agricultural research organizations (see Part VII, line 1), or cooperative hospital service organizations (see Schedule C)) must meet specific operational requirements to qualify for exemption under section 501(c)(3). If you’re such an organization, be certain to include an explanation in your activity description of how activities you conduct (or don’t conduct, if the specific operational requirement limits permissible activities) satisfy those specific operational requirements. For each past, present, or planned activity, include information that answers the following questions. • What is the activity? • Who conducts the activity? • Where is the activity conducted? • 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 allocable to this activity? • How does the activity further your exempt purposes? Line 2. National Taxonomy of Exempt Entities (NTEE) code. An NTEE code is a three-character series of letters and numbers that generally describes a type of organization. Enter the code that best describes your organization from the list of NTEE codes, located in Appendix D. 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. NTEE codes are also used for TIP purposes other than identification of organizations described in section 501(c)(3). Therefore, all codes in the list don't necessarily correspond to a section 501(c)(3) purpose. Line 3. If programs are limited to specific individuals, describe how you select or identify those individuals. If programs are available only for members, describe membership criteria, any membership dues, any different membership levels, and the benefit each membership level receives. Line 4. Describe any business or family relationship between individuals who receive goods, services, or funds through your programs and any officers, directors, Instructions for Form 1023 trustees, or highest compensated employees or independent contractors. For purposes of this form, “highest compensated” employees or independent contractors are persons to whom you pay over $100,000 of compensation, including compensation from related organizations. Line 5. You participate in a political campaign if you promote or oppose the candidacy of an individual for public office. Candidate debates and nonpartisan voter education and registration may be permitted. See Rev. Rul. 2007-41, 2007-25 I.R.B. 1421 at IRS.gov/irb/ 2007-25_I.R.B. 1421 and Pub. 1828 for more information and examples. Organizations described in section 501(c)(3) are prohibited CAUTION from supporting or opposing candidates for public office in any political campaign. If you answer “Yes,” you aren’t qualified for tax exemption under section 501(c)(3) and should reconsider whether the filing of application Form 1023 is appropriate for you. See Pub. 557 for a description of other code sections under which you may qualify. ! Line 6. You are attempting to influence legislation if you directly contact or urge the public to contact members of a legislative body for the purpose of proposing, supporting, or opposing legislation. You are also attempting to influence legislation if you advocate the adoption or rejection of legislation. If you answer “Yes,” your explanation should include the percentage of your total time and total funds spent on such legislative activities. Organizations described in section 501(c)(3) are prohibited from engaging in a substantial amount of legislative activities. Whether you’re engaged in substantial legislative activities depends on all of the facts and circumstances. For this purpose, “legislation” includes action by Congress, a state legislature, a local council, or a similar governing body, with respect to acts, bills, resolutions or similar items (such as legislative confirmation of appointive offices). Legislation also includes action by the public in a referendum, ballot initiative, constitutional amendment, or similar procedure. Legislation generally doesn’t include actions by executive, judicial, or administrative bodies. Organizations may involve themselves in issues of public policy without being engaged in legislative activity. For example, organizations may conduct educational meetings, prepare and distribute educational materials, or otherwise consider public policy issues. Similarly, an organization may appear before a governmental body at its request Instructions for Form 1023 to offer testimony about a decision that may affect the organization’s existence. A private foundation isn’t allowed TIP to engage in any activities to influence legislation. Line 6a. Form 5768. Most public charities are eligible to elect to make expenditures to influence legislation by filing Form 5768, Election/Revocation of Election by an Eligible Section 501(c)(3) Organization To Make Expenditures To Influence Legislation. By filing Form 5768, your legislative activities will be measured solely by an expenditure limit under section 501(h) rather than by whether the legislative activity is considered substantial. Form 5768 describes the types of organizations that are eligible to make an election. You must file Form 5768 by mailing it to the address on the form. For a discussion of influencing legislation and the requirements of section 501(h), see Pub. 557. Churches and private foundations aren’t eligible to make this section CAUTION 501(h) election. ! Line 7. Intellectual property includes the following: • Patents (for inventions); • Copyrights (for literary and artistic works such as novels, poems, plays, films, musical works, drawings, paintings, photographs, sculptures, architectural designs, performances, recordings, film, and radio or television programs); • Trade names, trademarks, and service marks (for symbols, names, images, and designs); and • Formulas, know-how, and trade secrets. Line 8. These activities involve the education of the consumer on budgeting, personal finance, financial literacy, mortgage foreclosure assistance, or other consumer credit areas. These activities may also involve assisting the consumer in consolidating debt and negotiating between debtors and creditors to lower interest rates and waive late and over-limit fees. If you answer “Yes,” you may be subject to the requirements of section 501(q). Search “501(q)” on IRS.gov for information on these requirements and whether they apply to you. Line 9. 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 operated 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. Line 9b. Answer “Yes,” if you make grants, loans, or other distributions (such as goods) to a foreign organization. Line 9g–i. 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 Designed Nationals and Blocked Persons List (OFAC SDN List). Information about OFAC sanction programs and the OFAC SDN List are available at www.treasury.gov/ofac. Line 10. A “foreign country” is a country other than the U.S., its territories and possessions, and the District of Columbia. Line 10a–c. See instructions for lines 9g– i. Line 11. You are a sponsoring organization of a donor-advised fund if you establish separate accounts that you own or control for a donor whereby the donor or donor-advisor may make recommendations about the investments of or distributions from the account. See Pub. 557 for more information on the definitions of sponsoring organizations and donor-advised funds. You can't sponsor a donor-advised fund if you're a CAUTION private foundation. ! Line 12. A “school” is an educational organization whose primary function is the presentation of formal instruction and which normally maintains a regular faculty and curriculum and that normally has a regularly enrolled body of pupils or students in attendance at the place where its educational activities are regularly carried on. A school may include the following. • Primary, secondary, preparatory, or high school. • College or university. • Trade or technical school. • Nursery or pre-school. • School that you operate as an activity, such as a school that is operated as an 9 activity of a museum, historical society, or church. If you're a nursery or pre-school TIP that doesn't meet the description line 12. of a school, answer “No,” to If you’re a nursery, pre-school, or TIP child care organization that doesn’t meet the description of a school, you may still further an educational purpose if substantially all the care you provide is for the purpose of enabling individuals to be gainfully employed and your services are available to the general public (section 501(k)). If you’re a school, or if you operate a school as an activity (even if it is a secondary activity), complete Schedule B. See Pub. 557 for additional information. Line 13. “Hospital” or “medical care” includes the treatment of any physical or mental disability or condition, whether as an inpatient or outpatient. A hospital includes the following. • Hospitals and rehabilitation institutions, outpatient clinics, or community mental health or drug treatment centers if the principal purpose or function is the providing of medical or hospital care or medical education or research. • Medical research organizations if the principal purpose or function is the continuous active conduct of medical research in conjunction with a hospital. If you provide “hospital or medical care,” or you’re a medical research organization, complete Schedule C. See Pub. 557 for additional information. Line 14. “Low-income housing” refers to rental or ownership housing provided to persons based on financial need. If you provide low-income housing, complete Schedule F. Line 15. Answer “Yes,” if you pay money to an individual as a scholarship, fellowship, or education loan; for travel, study, or other similar purposes. Also, answer “Yes,” if you pay such amounts on behalf of an individual to a school or a tuition or educational savings program. Complete Schedule H—Section I. Travel, study, or other similar purposes include payments made to enhance a literary, artistic, musical, scientific, teaching or other similar capacity, skill, or talent of the individual recipient. These payments include, for example, amounts paid to: • Vocational high school students to be used to purchase basic tools; • Teachers to induce them to teach in a public school system in an economically depressed area; and • A scientific researcher to underwrite that individual’s research project. 10 Educational grants don’t include amounts you pay to an individual as compensation, such as payments made to a consultant for personal services or to produce a report for you. Educational grants don’t include amounts paid to another organization that distributes your funds as a scholarship to an individual if you have no role in the selection process. If you're a “private foundation” as described in Part VII, you must CAUTION obtain advance approval of your grant-making procedures. You can use Schedule H—Section II, to request advance approval as part of this application process. You can complete Section II when you complete Part VII. Foundation Classification. ! Line 16. “Fundraising”includes efforts to raise funds through appeals for financial support. Fundraising may be conducted by your employees or volunteers, through an agent, or through an independent contractor. Check all the boxes that apply. For purposes of this application, “bingo” is a game of chance played with cards that generally are printed with five rows of five squares each on which participants place markers to form a pre-selected pattern to win the game. “Other (non-bingo) gaming activities” include pull-tabs, raffles, keno, split-the-pot, and other games of chance. Gaming doesn’t further an TIP exempt purpose under section 501(c)(3). Except to the extent that an exception may apply, your revenue from gaming activities will be subject to unrelated business income tax. See Pub. 3079 for further information about gaming. Part V. Compensation and Other Financial Arrangements Reminder. Answer all questions in this part as they pertain to your past, present, and future activities. For purposes of Part V, compensation includes: • Salary or wages; • Deferred compensation; • Retirement benefits, whether in the form of a qualified or non-qualified employee plan (pensions or annuities); • Fringe benefits (personal vehicle, meals, lodging, personal and family educational benefits, low-interest loans, payment of personal travel, entertainment, or other expense, athletic or country club membership, and personal use of your property); and • Bonuses. Example. An organization could compensate a director as follows: Wages Director Compensation . . . Salary as Chief Executive Officer . . . . . . . . . . . . . . . Deferred retirement . . . . . . Health insurance policy . . . Use of a vehicle . . . . . . . . Total Compensation $2,500 40,000 2,000 5,000 5,000 $54,500 Make sure the information you provide in Part V is consistent with the information you enter in Part VI. Financial Data. Line 1. Compensation. Check “Yes,” if you do or you will compensate your officers, directors, or trustees. Also, check “Yes,” if you will or you do have highest compensated employees or highest compensated independent contractors. For purposes of this form, “highest compensated” employees or independent contractors are persons to whom you pay over $100,000 of compensation, including compensation from related organizations. For information on determining if an individual is an employee or an independent contractor, see Pub. 15-A, Employer’s Supplemental Tax Guide. Line 1e. “Similarly situated organizations” means tax-exempt or taxable organizations of comparable size, purpose, and resources. Adjustments due to geographic area and other specified conditions are appropriate, but you should document the adjustments. You should document the sources(s) of comparable compensation data, both taxable and non-taxable, and retain copies in your permanent records. Line 1g. “Reasonable compensation” is the amount that would ordinarily be paid for like services by like organizations under like circumstance as of the date the compensation arrangement is made. Establishing and documenting your decisions about compensation is important because excess compensation (including cash and other benefits that aren’t accounted for as reasonable compensation for services) may result in excise taxes on both the individual and you, and may jeopardize your tax exemption. Line 2. 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 they could make. A sample Conflict of Interest Policy is included as Appendix A. This sample conflict of Instructions for Form 1023 interest policy doesn’t prescribe any specific requirements. Therefore, organizations should use a conflict of interest policy that best fits their organizations. Adoption of a conflict of interest policy isn’t required to obtain tax-exempt status. However, by adopting the sample policy or a similar policy, you will be choosing to put in place procedures that will help your officers, directors, and trustees recognize situations that could present potential or actual conflicts of interest so that you can take steps to reduce the risk that those in positions of authority over you may receive an inappropriate benefit. The sample conflict of interest TIP policy in Appendix A includes items marked “Hospital insert–for hospitals that complete Schedule C” that are intended to be adopted by hospitals. Line 3. 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 salary of $200,000 that is adjusted annually based on the increase in the Consumer Price Index is a fixed payment. A “non-fixed payment” means a payment that depends on discretion. For example, a bonus of up to $100,000 that is based on an evaluation of performance by the governing board is a non-fixed payment because the governing body has discretion over whether the bonus is paid and on the amount of the bonus. Line 4. 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 of another organization (other than a section 501(c)(3) organization) that you will purchase or sell goods, services, or assets from or to; or • Possesses more than 35% ownership interest in any organization that you will purchase or sell goods, services, or assets from or to. Arm’s length. An arm’s length standard exists where the parties have an adverse (or opposing) interest. For example, a seller wants to sell their 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 Instructions for Form 1023 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. Completed less than 1 year. If you’ve existed for less than 1 year, provide projections of your likely income and expenses for your current year and projections of your likely income and expenses for the next 2 years based on a reasonable and good faith estimate of your future finances for a total of 3 years of financial information. Place financial information for the year you’re filing this application in the column marked Current tax year. Fair market value. This 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. Completed more than 1 year, fewer than 5 years. If you’ve existed for more than 1 year but fewer than 5 years, provide your actual income and expenses for each completed year you’ve existed and projections of your likely income and expenses based on a reasonable and good faith estimate of your future finances for your current year and each year you haven’t existed, for a total of 4 years of financial information. Place financial information for the year you’re filing this application in the column marked Current tax year. Line 5. Answer “Yes,” if any of your officers, directors, or trustees: • Is an officer, director, or trustee in another organization (other than a section 501(c)(3) 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)(4) organization with whom you have a lease for office space, or if one of your directors owns more than 35% of the voting stock of a corporation to which you made a loan. Line 6. “Develop” means the planning, financing, construction, or provision of similar services involved in the acquisition of real property, such as land or a building. For example, you should provide information regarding the services of a consultant who arranges your acquisition of a facility through the issuance of tax-exempt bonds. Line 7. “Manage” means to direct or administer. For example, you would provide information about an organization hired to administer a museum gift shop. Line 8. 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. Part VI. Financial Data Line 1. Select the option that best describes you to determine the years of revenues and expenses you need to provide. Completed 5 years or more. If you’ve existed for 5 years or more, provide your actual income and expenses for your 5 most recently completed tax years. Place financial information for your most recently completed tax year in the column marked Current tax year. ! We may request financial information for more than 5 years. CAUTION A. Statement of Revenue and Expenses Preparing the statement. Prepare the statement using the method of accounting you use in keeping your books and records. Prepare the statement using the accounting period entered on Part I, line 3. Enter “0” if a particular revenue or expense doesn’t apply to you. Your financial information should reflect your activities described in this application. Line 1. Enter the total gifts, grants, and contributions you receive (other than membership dues reported on line 2 and described below). Include items of value that you receive as gifts, grants, or contributions. For example, if one of your activities is a food drive, include the value of the donated food on this line. Also include on this line payments a governmental unit makes to enable you to both accomplish your exempt purpose(s) and to provide a service or facility directly to the general public. See the instructions for line 9 if you’re uncertain whether revenue should be included as a grant on line 1 or as gross 11 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 expenses. 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 1023, Part VI - A. Statement of Revenues and Expenses, line 11. receipts on line 9. Include unusual grants on line 12 and not on line 1. Examples. 1. A city pays the symphony orchestra to provide free music programs in the public schools. The programs are open to the public. This income received from a governmental unit accomplishes the orchestra's exempt purpose and directly provides a service to the general public. This income is a grant to the symphony orchestra that should be listed on line 1. 2. The symphony orchestra sells tickets to the public for its fall season. Such income is gross receipts received from the general public in performance of the symphony orchestra’s exempt function and should be listed on line 9. 3. The public school system pays the orchestra to create several musical pieces suitable for the school system’s elementary music curriculum. This payment by a governmental unit for the music compositions is primarily for the school system’s own use, not for the direct benefit of the public. Therefore, this income is gross receipts received from a governmental unit in performance of the orchestra’s exempt function that should be listed on line 9. Line 2. Enter the amount you receive from members to provide support to the organization. Don’t include payments from members or on behalf of members to purchase admissions, merchandise, services, or use of facilities. Line 3. Enter your gross income from dividends, interest, payments received on securities, loans, rents, and royalties you hold for investment purposes. See Pub. 598 for additional information regarding royalties treated as unrelated business income. Line 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, and not related to 12 your exempt purpose. Certain exceptions and exclusions may apply. Report on line 9 income from activities that aren’t related to the accomplishment of your exempt purposes, but aren’t considered unrelated business activities. For example, report income from the sale of merchandise by volunteers that isn’t treated as an unrelated trade or business on line 9. See Pub. 598 for additional information regarding unrelated business income. Line 5. Enter amounts any local tax authority collects from the public on your behalf. Line 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 by the governmental unit to the public without charge. Line 7. Enter your total income from all sources not reported on lines 1 through 6, or lines 9, 11, and 12. Provide an itemized list in line 25, showing each type and amount of income included, and a brief description of each type of income. Line 8. Lines 1 through 7 will be added for you. Line 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’ve done the study rather than by the tax-exempt conservation group. Provide an itemized list of your gross receipts in line 25, 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. Line 10. Lines 8 and 9 will be added for you. Line 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 25. You may use the format in Figure 2. Line 12. Enter any “unusual grants,” which generally are any substantial contributions and bequests you received from disinterested persons that, by their size, adversely affect your classification as a public charity. “Unusual grants” are unusual, unexpected, and received from an unrelated party. Provide an itemized list of any unusual grants, including the amount in line 25, and explain how it was unusual, unexpected, and from an unrelated party. For additional information about unusual grants and a description of public charity classifications, see Pub. 557. Line 13. Lines 10 through 12 will be added for you. Lines 14. Enter the total expenses you incur for soliciting gifts, grants, and contributions included on line 1. Include fees paid to professional fundraisers for soliciting gifts, grants, and contributions. Line 15. Enter the total amount you pay out to both individuals and organizations. Provide an itemized list in line 25, identifying recipients (using letter designations such as A, B, C, etc.), a brief Instructions for Form 1023 description of the purposes or conditions of payments, and the amounts paid. Colleges, universities, and other educational institutions and agencies subject to the Family Educational Rights and Privacy Act (20 U.S.C. 1232g) don’t need to list the names of individuals to whom they provided scholarships or other financial assistance where such disclosure would violate the privacy provisions of the law. Instead, group each type of financial aid provided, indicate the number of individuals who received the aid, and specify the aggregate dollar amount. Maintain (but don’t submit) a list showing the names of recipients associated with each letter designation. Line 16. Enter total payments you make to or for the benefit of your members (not including any amounts listed on line 15). Provide an itemized list in line 25, identifying recipients (using letter designations), a brief description of the purposes or condition of payments, and the amounts paid. Maintain (but don’t submit) a list showing the names of recipients associated with each letter designation. Line 17. Enter the total amount of compensation you pay to your officers, directors, and trustees. Line 18. Enter the total amount of salaries and wages you pay to employees (not reported on line 17). Line 19. Enter your total interest expenses for the year. Don’t include mortgage interest treated as an occupancy expense on line 20. Line 20. 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. Line 21. Enter the total depreciation, depletion, and similar expenses you incur. Line 22. 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 listed on line 14, earlier), accounting services, legal counsel, consulting services, contract management, or any independent contractors. Line 23. Enter any expenses you didn’t include in the lines above, such as for program services. Provide an itemized list in line 25, showing the type and amount of each significant expense. Line 24. Lines 14 through 23 will be added for you. Instructions for Form 1023 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. Line 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. Line 2. Enter your total accounts receivable that arose from the sale of goods and/or performance of services, less any reserve for bad debt. Line 3. Enter the amount of materials, goods, and supplies you purchased or manufactured and held to be sold or used in some future period. Line 4. Enter the total amount of bonds or notes you issued that will be repaid to you. Provide an itemized list in line 19, that shows the name of each borrower (using a letter designation), the borrower’s relationship to you, a brief description of the obligation, the rate of return, the due date, and the amount due. Maintain (but don’t submit) a list showing the names of borrowers associated with each letter designation. Line 5. Enter the total fair market value of corporate stocks you hold. Provide an itemized list of your corporate stock holdings in line 19. For stock of closely held corporations, list the name or 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 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, list the name of the corporation, a description of the stock, and the principal exchange on which it is traded, the number of shares held, their value as carried on your books, and their fair market value. Line 6. Enter your total amount of loans (personal and mortgage loans) receivable. Provide an itemized list in line 19 that identifies each borrower (using a letter designation), the borrower’s relationship to you, purpose of loan, repayment terms, interest rate, and original amount of loan. Report each loan separately, even if more than one loan was made to the same person. Maintain (but don’t submit) a list showing the names of borrowers associated with each letter designation. Line 7. Enter the total book value of your other investments. Include the total book value of government securities (federal, state, and municipal), and 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. Line 8. Enter the total book value of buildings and equipment not held for investment purposes. This includes facilities you own and equipment you use in conducting your exempt activities. Provide an itemized list in line 19 of these assets held at the end of the current tax year/period, including the cost or other basis. Line 9. Enter the total book value of land not held for investment purposes. Line 10. Enter the total book value of any other category of your assets not reported on lines 1 through 9, for example, patents, copyrights, or other intangible assets. Provide an itemized list of each asset in line 19. Line 11. Lines 1 through 10 will be added for you. Line 12. Enter the total amount of your accounts payable to suppliers and others, such as salaries payable, accrued payroll taxes, and interest payable. Line 13. Enter the total unpaid portion of grants and contributions you committed to pay to other organizations or individuals. Line 14. Enter the total of your mortgages and other notes payable outstanding at the end of the current tax year/period. Provide an itemized list in line 19 showing each note separately, including the lender’s name, purpose of loan, repayment terms, interest rate, and original amount. Line 15. Enter the total amount of any other liabilities not reported on lines 12 through 14. Provide an itemized list in line 19 of these liabilities, including the amounts you owe. Line 16. Lines 12 through 15 will be added for you. Line 17. Under fund accounting, an organization segregates its assets, liabilities, and net assets into separate funds according to restrictions on the use of certain assets. Each fund is like a separate entity in that it has a self-balancing set of accounts showing assets, liabilities, equity (fund balance), income, and expenses. If you don’t use fund accounting, report only the “net assets” account balances, which include capital stock, paid-in capital, retained 13 earnings or accumulated income, and endowment funds. Line 18. Lines 16 and 17 will be added for you. Part VII. Foundation Classification Organizations that are exempt under section 501(c)(3) are private foundations unless they are: • Churches, schools, hospitals, governmental units, entities that undertake testing for public safety, organizations that have broad financial support from the general public; or • Organizations that support one or more organization(s) that are themselves classified as public charities. Section 501(c)(3) organizations excepted from private foundation classification are public charities. Unless you meet one of the exceptions above, you’re a private foundation. You can only select one TIP foundation classification. Line 1. Select the foundation classification you’re requesting from the list below. The form will then take you to additional lines or parts of the application that you must complete based on your response. 509(a)(1) and 170(b)(1)(A)(vi). Select this classification if you normally receive a substantial part of your support from grants from governmental units or from contributions from the general public, or a combination of these sources. Typically, you would show a substantial part of your income on Part VI-A. Statement of Revenue and Expenses, lines 1 and 2. Under this public charity classification, you must meet the one-third public support test or 10% facts and circumstances test. See Pub. 557 for more information. Public support test. An organization must receive either: 1. At least one-third of its total support from governmental agencies, contributions from the general public, and contributions or grants from other public charities; or 2. At least 10% of its total support from governmental agencies, contributions from the general public, and contributions or grants from other public charities; and also satisfy a facts and circumstances test. Facts and circumstances test. Facts and circumstances include: 1. The amount of support you received from the general public, governmental units, or public charities; 14 2. Whether you have a continuous and bona fide program for solicitation of funds from the general public, governmental units, or public charities, or carry on activities designed to attract support from organizations or other governmental units, and 3. All other facts and circumstances, including the public nature of your governing board, the extent to which your facilities or programs are publicly available, the extent to which nature your dues encourage membership, and whether your activities are likely to appeal to persons having a broad common interest or purpose. For additional information about the 10% facts and circumstances test, see Pub. 557 and Reg. 1.170A-9(f)(3). 509(a)(2). Select this classification if you normally receive more than one-third of your support from contributions, membership fees, and gross receipts from activities related to your exempt functions, or a combination of these sources, and not more than one-third of your support from gross investment income and net unrelated business income. Typically, you would show a substantial part of your income on Part VI-A. Statement of Revenues and Expenses, lines 1, 2, and 9. Under this public charity classification, you must meet both the “one-third public support test ” and the “not-more-than-one-third investment income and net unrelated business income test,” lines 1 through 13. See Pub. 557 for additional information about these tests. 509(a)(1) and 170(b)(1)(A)(i). Select this classification if your primary purpose is operating a church or convention or association of churches. The term “church” includes mosques, temples, synagogues, etc. If you select this box, complete Schedule A. 509(a)(1) and 170(b)(1)(A)(ii). Select this classification if your primary purpose is operating a school. If you select this box, complete Schedule B. If you operate a school but it isn’t your primary purpose, don’t select this classification. However, you must still complete Schedule B. See Part IV, line 12. 509(a)(1) and 170(b)(1)(A)(iii). Select this classification if your primary purpose is providing medical or hospital care or medical eduction or research (performed in association with a hospital). If you select this box, complete Schedule C. A hospital includes a rehabilitation institute, outpatient clinic, community mental health clinic, drug treatment center, or skilled nursing facility. A hospital doesn’t include convalescent homes, homes for children or the aged, or institutions whose principal purpose or function is to train handicapped individuals to pursue some vocation. Cooperative hospital service organizations described in section 501(e) should also check this box and complete Schedule C. 509(a)(1) and 170(b)(1)(A)(iv). Select this classification if you’re organized and operated exclusively to benefit a college or university owned or operated by a governmental unit. You must also normally receive a substantial part of your support from a governmental unit or from contributions from the general public. 509(a)(1) and 170(b)(1)(A)(ix). Select this classification if you’re an agricultural research organization described in section 170(b)(1)(A)(ix) operated in conjunction with a land grant college or university or a non-land grant college of agriculture. In Part IV, line 1, include information detailing your agricultural research program and how you will spend contributions to your program, including a description of how you’re engaged in the continuous active conduct of agricultural research (as defined in Section 1404 of the Agricultural Research, Extension, and Teaching Policy Act of 1977), information showing that you’re operated in conjunction with a land grant college or university or a non-land grant college of agriculture (as defined in Section 1404 of the Agricultural Research, Extension, and Teaching Policy Act of 1977), and information discussing the timing of when you will spend contributions for research. 509(a)(3). Select this classification if you’re organized and operated to support one or more public charities described in section 509(a)(1) or 509(a)(2) or an organization that is tax exempt under section 501(c)(4), (5), or (6) and meets the public support test of section 509(a)(2). See the instructions for Schedule D for more information about the requirements for this classification, including the required relationship you must have with your supported organization(s). Complete Schedule D. 509(a)(4). Select this classification if your primary purpose is to test products to determine their acceptability for use by the general public. Contributions to organizations of this type aren’t deductible under section 170(c). Also, organizations that primarily test for specific manufacturers don’t qualify for exemption under section 501(c) (3). Select my classification for me. Select this option if you believe you’re a public charity but would like the IRS to select the correct public charity classification (509(a) Instructions for Form 1023 (1) and 170(b)(1)(A)(vi) or 509(a)(2)) for you. Private foundation. Select this classification if you don’t meet one of the exceptions listed above. Line 1a. Section 508(e) provides that a private foundation isn’t tax exempt unless its organizing document contains specific provisions. These specific provisions require that you operate to avoid liability for excise taxes under sections 4941(d), 4942, 4943(c), 4944, and 4945(d). You can also meet these provisions by reliance on state law. See Pub. 557 for samples of provisions that will meet section 508(e). Also, see Appendix B for a list of states that have enacted statutory provisions that satisfy the requirement of section 508(e), subject to notations. Appendix B is based on Rev. Rul. 75-38, 1975-1 C.B. 161. Line 1c. Some private foundations are private operating foundations. Private operating foundations make qualifying distributions directly for the active conduct of their educational, charitable, and religious purposes. “Directly for the active conduct” means that you use the distributions yourself to carry out the programs for which you’re organized and operated. Grants made to assist other organizations or individuals are normally considered indirect. Line 1d. If you have existed for 1 year or more, you must provide information that demonstrates you meet the requirements to be classified as a private operating foundation, including the income test and either the endowment test, the assets test, or the support test. If you have existed for less than 1 year, you must sufficiently describe how you’re likely to meet these requirements and tests. You may also submit an affidavit or opinion of counsel giving enough facts about your operations and support to enable us to determine that you’re likely to meet these requirements. See Pub. 557 for additional information about private operating foundations. Line 2. Confirmation of public support status. If you have been in existence for more than 5 years, and you requested classification as a public charity described in sections 509(a)(1) and 170(b)(1)(A)(vi), you must confirm that you meet the public support test. To show that you meet the required public charity support test, complete lines 2(i) and 2(ii). Calculate your public support based on the accounting method you used to complete Part VI-A, Statement of Revenues and Expenses. Line 2(i). 509(a)(1) and 170(b)(1)(A) (vi). Check “Yes,” if you received contributions from any person, company, or organization (other than a governmental Instructions for Form 1023 unit described in section 170(c)(1) or a publicly supported organization under section 170(b)(1)(A)(vi)), whose gifts totaled more than 2% of the amount on the total of amounts entered on line 8 of Part VI-A, Statement of Revenue and Expenses, and identify those contributors by letter (A, B, C, etc.) and list the amount(s) contributed by each. Keep, but don’t submit, a list of the names of your donors with the associated letter designations. Line 2(ii). Use Schedule A (Form 990 or 990-EZ) Public Charity Status and Public Support, Part II, Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi), and its instructions to determine if you met the public support test for your most recent 5-year period. Line 2a(i). 509(a)(2). Check “Yes,” if you received amounts listed on lines 1, 2, and 9 of Part VI-A, Statement of Revenue and Expenses, from any disqualified persons and identify those disqualified persons by letter (A, B, C, etc.) and list the amounts contributed by each. Keep, but don’t submit, a list of the names of your donors with the associated letter designations. Line 2a(ii). Check “Yes,” if you received amounts paid by an individual or organization greater than the larger of 1% of line 10, of Part VI-A, Statement of Revenues and Expenses, or $5,000 for any completed tax year, and identify those individuals or organizations by letter and list the amount(s) received from each. Keep, but don’t submit, a list of the names of your donors with the associated letter designations. Don’t include disqualified persons in this list. Disqualified persons CAUTION should be listed in line 2(a)(i). For purposes of this application, a “disqualified person” is any individual or organization that is any of the following. 1. A “substantial contributor” to you (defined below). 2. An officer, director, trustee, or any other individual who has similar powers or responsibilities. 3. An individual who owns more than 20% of the total combined voting power of a corporation that is a substantial contributor. 4. An individual who owns more than 20% of the profits interest of a partnership that is a substantial contributor. 5. An individual who owns more than 20% of the beneficiary interest of a trust or estate that is a substantial contributor. 6. A member of the family of any individual described in 1, 2, 3, 4, or 5 above. ! 7. A corporation in which any individuals described 1, 2, 3, 4, 5, or 6 above hold more than 35% of the total combined voting power. 8. A trust or estate in which any individuals described in 1, 2, 3, 4, 5, or 6 above hold more than 35% of the beneficial interests. 9. A partnership in which any individuals described in 1, 2, 3, 4, 5, or 6 above hold more than 35% of the profits interest. Substantial contributor. A substantial contributor is any individual or organization that gave more than $5,000 to you from the date you were formed or other date that your exemption would be effective, to the end of the year in which the contributions were received. This total amount contributed must also be more than 2% of all the contributions you received. A creator of a trust is treated as a substantial contributor regardless of the amount contributed. For more information regarding substantial contributors, go to IRS.gov/Charities-Non-Profits/PrivateFoundations/Substantial-ContributorPrivate-Foundation. Family members. A “member of the family” includes the spouse, ancestors, children, grandchildren, great-grandchildren, and their spouses. For additional information concerning members of the family, go to IRS.gov/ Charities-Non-Profits/CharitableOrganizations/Member-of-the-Family. Further information about disqualified persons, can be obtained at IRS.gov/ Charities-Non-Profits/IRC-Setion-4946Definition-of-Disqualified-Person. Line 2a(iii). Use Schedule A (Form 990 or 990-EZ), Public Charity Status and Public Support, Part III, Support Schedule for Organizations Described in Section 509(a)(2), and its instructions to determine if you meet the public support test for your most recent 5-year period. Part VIII. Effective Date Line 1. Use the formation date you listed in Part II, line 2, and the date you will submit this electronic form and required user fee payment to determine whether you’re submitting this application within 27 months from the month in which you were formed. If you’re not submitting this application within 27 months from your formation, complete Schedule E. Part IX. Annual Filing Requirement Most organizations must file an annual return (Form 990, 990-EZ, or Form 990-PF) or notice (Form 990-N, Electronic 15 Notice (e-Postcard)). Exceptions to this rule include churches, certain church affiliated organizations, and 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. The following are some general rules. • A private foundation must file Form 990-PF annually, regardless of its gross receipts. • Unless specifically required to file Form 990 or Form 990-EZ (see the Instructions for Form 990), most public charities that normally have gross receipts of $50,000 or less may satisfy their filing obligation with Form 990-N, Electronic Notice (e-Postcard). If you fail to file a required information return or notice for 3 CAUTION consecutive years, your exempt status will be automatically revoked. ! Line 1. Check “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 the 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. Part X. Signature Signature requirements. An officer, director, trustee, or other official who is authorized to sign for the organization must sign Form 1023. The signature must be accompanied by the title or authority of the signer and the date. The person signing Form 1023 TIP must be listed as an officer, director, or trustee within the first five entries of Part I, line 9. 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 16 attachments into a single PDF file, which cannot 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. Schedule A. Churches There is no single definition of the word “church” for tax purposes. When determining whether a section 501(c)(3) religious organization is described as a church (described in section 509(a)(1) and 170(b)(1)(A)(i)), we will consider characteristics generally attributed to churches and the facts and circumstances of each organization applying for public charity classification as a “church.” The characteristics generally attributed to churches are: • A distinct legal existence, • A recognized creed and form of worship, • A definite and distinct ecclesiastical government, • A formal code of doctrine and discipline, • A distinct religious history, • A membership not associated with any other church or denomination, • Ordained ministers ministering to the congregation, • Ordained ministers selected after completing prescribed courses of study, • A literature of its own, • Established places of worship, • Regular congregations, • Regular religious services, • Sunday schools for the religious instruction of the young, and • Schools for the preparation of ministers. Although you don’t need to meet each of the above criteria to be classified as a church, you’re generally required to have a congregation or other religious membership group. For purposes of foundation classification under section 509(a)(1) and 170(b)(1)(A)(i), the term “church” includes, without limitation, mosques, temples, and synagogues, and certain other forms of religious organizations. For more information, see Pub. 1828. The practices and rituals associated with your religious beliefs or creed must not be illegal or contrary to public policy. Specific Line Items Line 1. Describe your written creed, statement of faith, or summary of beliefs. Line 2. Your literature includes any writings about your beliefs, rules, or history. Line 3. A “code of doctrine and discipline” refers to a body of laws or rules that govern behavior. Line 4. A “religious hierarchy or ecclesiastical government” refers to people or institutions that exercise significant influence or authority over your church. Line 5. Answer “Yes,” if you’re part of a group of churches with similar beliefs and structures, such as a convention, association, or union of churches. Line 6. A “form of worship” refers to religious practices that express your devotion to your creed, faith, or beliefs. Line 7. Indicate the regular days and times of your religious services. Describe the order of events during your regular worship service and explain how the activities conducted as part of your services further your religious purposes. Line 7a. Enter the average number of members and non-members who attend your regularly scheduled religious services. Line 8. An “established place of worship” is a place where you hold regularly scheduled religious services. It may be a place that you own, rent, or that is provided free for your use. Line 9. An “established congregation” or “other religious membership group” includes individuals who regularly attend and take part in the religious services of your organization at an established location. An established congregation generally doesn’t include members of only one family. If you answer “No,” because you don’t have an established congregation or other religious membership, you may be a religious organization that doesn’t qualify as a church. If you don’t qualify as a church, you will need to go back to Part VII, line 1, to reconsider your public charity classification. You may request classification as TIP a church at a later date after you establish a congregation or other religious membership group. For information about this option, see Form 8940, Request for Miscellaneous Determination Under Section 507, 509(a), 4940, 4942, 4945, and 6033 of the Internal Revenue Code, or contact our customer account service representatives at 877-829-5500 (toll-free). Line 9a. Enter the total number of your current members. If you have no members, enter zero (0). Line 9b. Answer “Yes,” if you have a prescribed way to become a member. Answer “Yes,” even if you just keep records of who is currently a member. Describe Instructions for Form 1023 any actions required for individuals to become members. Line 9c. Describe any rights and benefits of members. You should include details of any levels of membership and the rights and/or benefits associated with each level. Line 9d. If your members may be associated with another denomination or church, describe the circumstances in which your members would be members of your church and another church. Line 9e. See Appendix C for a description of the word “family.” Line 10. Answer “Yes,” if you conduct baptisms, weddings, funerals, or other religious rites. Line 11. A school for the religious instruction of the young refers to any regularly scheduled religious, educational activities for youth. Line 12. A “prescribed course of study” refers to formal or informal training. It doesn’t include self-ordination or paying a fee for an ordination certificate without completing a course of study. Describe the course of study completed by your religious leaders. Line 15. Provide any additional information you would like us to consider that would help us classify you as a church. Schedule B. Schools, Colleges, and Universities An organization qualifies as a school (for purposes of classification under sections 509(a)(1) and 170(b)(1)(A)(ii)) if all the following applies. It: • Presents formal instruction as its primary function, • Has a regularly scheduled curriculum, • Has a regular faculty of qualified teachers, • Has a regularly enrolled student body, and • Has a place where educational activities are regularly carried on. The term “school” includes primary, secondary, preparatory, high schools, colleges, and universities. An organization won’t be described as a school under sections 509(a)(1) and 170(b)(1)(A)(ii) if it engages in both educational and non-educational activities, unless the latter are merely incidental to the educational activities. Non-traditional schools such as an outdoor survival school or a yoga school may qualify. However, an organization may further an educational purpose without satisfying all the conditions listed above that describe a school. Such organizations may qualify as public charities based upon their sources of support as organizations described in sections 509(a)(1) and 170(B)(1)(A)(vi) or section 509(a)(2). Specific Line Items Line 1. Answer “Yes,” if you have a regularly scheduled curriculum, a regular faculty of qualified teachers, a regularly enrolled student body, and facilities where your educational activities are regularly carried on. If you answer “Yes,” you should TIP maintain in your records evidence as: that you meet these factors, such • A list of required courses of study, dates and times courses are offered, and other information about how to complete required courses; • Certification by the appropriate state authority or successful completion of required training for qualified teachers; • Records of regular attendance by students at your facility; and • A lease agreement or deed for your facility. If you answer “No,” you may not meet the requirements of a school and you may need to go back to Part VII, line 1, to reconsider your foundation classification if you requested classification as a school under sections 509(a)(1) and 170(b)(1)(A) (ii). Line 2. Answer “Yes,” if your primary function of the school is the presentation of formal instruction. If you answer “No,” you may not meet the requirements for classification as a school and may want to go back to Part VII, line 1, to reconsider your foundation classification if you requested classification as a school under sections 509(a)(1) and 170(b)(1)(A)(ii). Line 3. Answer “Yes,” if you’re a public school and explain how you’re operated by the state or a subdivision of a state, including if you have a signed contract or agreement with a state or local government under which you operate and receive funding. If you answer “Yes,” don’t complete the remainder of Schedule B. Line 4. Answer “Yes,” if you were formed or substantially expanded when public schools in your district or county were desegregated by court order. If you're unsure whether to answer “Yes,” contact an appropriate CAUTION school official. ! Line 5. Answer “Yes,” if a state or federal administrative agency or judicial body ever determined your organization to be racially discriminatory. Identify the parties involved and the forum in which the case was presented. Explain the reason for the action, the decision reached, and provide legal citations (if any) for the decision. Also, explain in detail any changes made in response to the action against your organization or the decision reached. Establishment of Racially Nondiscriminatory Policy Every private school is subject to the provisions of Revenue Procedure 75-50, 1975-2 C.B. 587, modified by Rev. Proc. 2019-22, 2019-22 I.R.B. 1260. See Pub. 557, which sets forth the requirements of Rev. Proc. 75-50 under the section for Private Schools. Publication of racially nondiscriminatory policy. A section 501(c)(3) organization that is a private school must publish a notice of its racially nondiscriminatory policy as to students as follows. The M school admits students of any race, color, national origin, and ethnic origin to all the rights, privileges, programs, and activities generally accorded or made available to students at the school. It doesn't discriminate on the basis of race, color, national origin, and ethnic origin in administration of its educational policies, admission policies, scholarship and loan programs, and athletic and other school-administered programs. Annual certification. A private school must certify annually that it meets the requirements of Rev. Proc. 75-50, as modified by Rev. Proc. 2019-22, by filing Schedule A (Form 990, or Form 990-EZ) Organization Exempt Under Section 501(c)(3). Schools that don’t file Form 990 or 990-EZ must make the certification by filing Form 5578, Annual Certification of Racial Nondiscrimination for a Private School Exempt From Federal Income Tax. Line 7. Answer “Yes,” if your organizing document or bylaws contain a nondiscriminatory statement as to students similar to the one shown above or if you adopted such a policy by resolution of your governing body. State where your policy is located in your organizing document, bylaws, or if it is in an adopted resolution. If you answered “No,” you must adopt a nondiscriminatory policy before submitting this application. Line 8. Answer “Yes,” if your brochures, application forms, advertisements, and catalogues dealing with student 17 . admissions, programs, and scholarships contain a statement similar to the following: The M school admits students of any race, color, and national or ethnic origin. Line 8a. If you answered “No” to Line 8, check the box on line 8a if you agree that all future printed materials, including website content, will contain a statement of nondiscriminatory policy as to students similar to the one provided above. Line 9. You must make your nondiscriminatory policy known to all segments of the general community served by the school. One way to meet this requirement is to publish your nondiscriminatory policy annually in a newspaper or over broadcast media. Rev. Proc. 2019-22 now allows this publication requirement to be satisfied by continuously displaying your nondiscrimination statement on your Internet site, as described below. Check “Yes,” if you make your racially nondiscriminatory policy known to all segments of the general community you serve by: • Publishing a notice of your policy in a newspaper of general circulation that serves all racial segments of the community; • publicizing your policy over broadcast media in a way that is reasonably expected to be effective; or • display a notice of your policy at all times on your primary, publicly accessible Internet home page in a manner reasonably expected to be noticed by visitors to the home page. See Rev. Proc. 75-50, as modified by Rev. Proc. 2019-22, for guidance on the format and content of the required notice and whether any exceptions may apply to you. A notice published in the legal TIP notices section or classified advertisements of your local newspaper generally is not acceptable. Line 9a. If you answered “No,” to line 9, check the box on line 9a if you agree that you will publicize your nondiscriminatory policy in a way that meets the requirements of Revenue Procedure 75– 50, as modified by Revenue Procedure 2019-22. Line 11. Enter the racial composition of your student body, faculty, and administrative staff in the spaces provided. Enter actual numbers, rather than percentages, for the current year and projected numbers for the next academic year. If the number is zero, then enter “0.” 18 If you’re not operational, submit an estimate based on the best information available (such as the racial composition of the community you serve). ! Don’t identify students, faculty, and staff by name. CAUTION Line 12. Enter the racial composition of students to whom you award loans and scholarships in the spaces provided. Enter actual numbers, rather than percentages, for the current year and projected numbers for the next academic year. If the number is zero, then enter “0.” If you won’t provide any loans or scholarships, check the box provided. ! Don’t identify students by name. CAUTION If you complete line 12 indicating TIP you do or will provide loans or scholarships, be sure your response to Part IV, line 15 is consistent with your response here. Line 13. Identify each of your incorporators, founders, board members, donors of land, and donors of buildings by name (whether individuals or organizations). Line 14. Answer “Yes,” if any individuals or organizations on your list have an objective to keep public or private school education segregated by race and explain how these individuals or organizations promote segregation in public or private schools. Line 15. Answer “Yes,” if on a continuing basis, you will maintain for a minimum period of 3 years the following records. • Your racial composition (similar to the information requested on Schedule B, line 11). • Evidence that your scholarships and loans are awarded on a racially nondiscriminatory basis (similar to the information requested on Schedule B, line 12). • Copies of all materials used by you or on your behalf to solicit contributions. • Copies of brochures, application forms, advertisements, and catalogues dealing with student admissions, programs, and financial aid. Answer “No,” if you don’t maintain records and explain how you meet the recordkeeping requirements under Rev. Proc. 75-50. Failure to maintain these records or produce them upon the proper CAUTION request will create a presumption that you haven’t complied with the requirements of Rev. Proc. 75-50. ! Schedule C. Hospitals and Medical Research Organizations An organization qualifies as a hospital for purposes of classification under sections 509(a)(1) and 170(b)(1)(iii) if it is a: • Hospital, • Medical research organization operated in conjunction with a hospital, or • Cooperative hospital service organization. Hospital. An organization is a “hospital” if its principal purpose or function is providing medical or hospital care or medical education or research. Medical care includes treatment of any physical or mental disability or condition, on an inpatient or outpatient basis. Thus, if an organization is a rehabilitation institution, outpatient clinic, or community mental health or drug treatment center, it is a hospital if its principal function is providing treatment services, as described above. A hospital doesn't include convalescent homes, homes for children or the aged, or institutions whose principal purposes or function is to train handicapped individuals to pursue a vocation. Medical research organization. An organization is a “medical research organization” if its principal purpose or function is the direct, continuous, and active conduct of medical research in conjunction with a hospital. The hospital with which the organization is affiliated must be described in section 501(c)(3), a federal hospital, or an instrumentality of a governmental unit, such as a municipal hospital. “Medical research” means investigations, experiments, and studies to discover, develop, or verify knowledge relating to the causes, diagnosis, treatment, prevention, or control of human physical or mental diseases and impairments. For more information, see Regulations section 1.170A-9(c)(2). Cooperative hospital service organization. A cooperative hospital service organization performs one or more of the specific services listed below for one or more exempt hospitals on a cooperative basis. The services listed below are exclusive. A cooperative service organization that provides services other than those listed below, or that provides services to an organization other than an exempt hospital, doesn’t qualify for exemption under section 501(c)(3). The list of services includes: 1. Data processing; 2. Purchasing (including the purchasing of insurance on a group basis); 3. Warehousing; 4. Billing and collection (including the purchasing of patron accounts receivable on a recourse basis); 5. Food; 6. Clinical; 7. Industrial engineering; 8. Laboratory; 9. P [Text truncated at 120,000 characters. The full text is on the page linked above.] --- Source: Frix Law Library, https://www.frixlaw.com/law-library/documents/agency%3Airs%3Acfba5a2c49e4314f. Public record. Not legal advice.