Instructions for Form 1023 (Rev. January 2020)

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Instructions for Form 1023

(Rev. January 2020)

Application for Recognition of Exemption Under Section 501(c)(3) of the Internal

Revenue Code

Department of the Treasury

Internal Revenue Service

Section references are to the Internal Revenue

Code unless otherwise noted.

Contents Page

Future Developments ............1

What's New ..................1

Overview of Organizations

Described in Section 501(c)

(3) .....................1

General Instructions .............2

Answers ....................2

Purpose of Form ...............3

What To File .................3

When To File .................4

Filing Assistance ...............4

Signature Requirements ..........4

Authorized Representative ........4

Public Inspection ...............4

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 ............. 13

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 ....... 21

Schedule F. Low-Income

Housing ................ 22

Schedule G. Successors to Other

Organizations ............. 22

Schedule H. Organizations

Providing Scholarships,

Fellowships, Educational

Loans, or Other Educational

Grants to Individuals and

Private Foundations

Requesting Advance

Approval of Individual Grant

Procedures .............. 22

Appendix A: Sample Conflict of

Interest Policy ............. 25

Appendix B: States With Statutory

Provisions Satisfying the

Requirements of Internal

Contents Page

Revenue Code Section

508(e) .................. 27

Appendix C: Glossary of Terms .... 29

Appendix D: National Taxonomy of

Exempt Entities (NTEE)

Codes ................. 37

Index ..................... 40

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.

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.

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.

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.

•

Profits 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).

•

Churches, including synagogues,

temples, and mosques.

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•

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.

Legislative and political campaign in-

tervention. 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 chari-

ties 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/EO-

Operational-Requirements-Private-

Foundations-and-Public-Charities.

Foundation classification has

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

www.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.

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.

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Your answers must provide

sufficient detail about your past,

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 ap-

ply 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

your specific foundation classification

(described earlier) and annual filing

requirements.

Form 1023-EZ. You may be

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

CAUTION

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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.

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.

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-Fees-

for-Tax-Exempt-and-Government-Entities-

Division. 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.

IF you’re

THEN you

must

complete

Schedule

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 ......... H

Attachments To Form 1023

A complete application will include one or

more documents in addition to Form 1023.

Instructions for Form 1023

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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.

When To File

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

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

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’ll send you a

determination letter stating that you’re

exempt under section 501(c)(3) and

identifying your foundation classification.

CAUTION

Additional information needed.

If we

can’t make a determination without more

information, we’ll write or call you.

Examples of the types of questions we

may ask you are available at

IRS.gov/

Charities-Non-Profits/Charitable-

Organizations/Exempt-Organization-

Sample-Questions. If the additional

information you provide shows that you

meet the requirements for exemption, we'll

send you a determination letter stating that

you're exempt under 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

request to be set up to allow filing of Form

990-N (note, it takes the IRS up to 6

weeks to update its records before you

can file your Form 990-N).

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.

You may also be required to file

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,

complete and submit the return

according to Form 990-series form's

instructions.

Public Inspection

Information available for public in-

spection. 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

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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

marking it as “NOT SUBJECT TO PUBLIC

INSPECTION” and include an explanation

of why you’re asking for the information to

be withheld. We will decide whether to

withhold the identified information from

public inspection.

Making documents available for public

inspection. Both 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.

See Pub. 557 for additional information

on public inspection requirements.

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, above.

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

foreign organizations generally

aren’t deductible. Tax treaties

between the U.S. and certain foreign

countries provide specific limited

exceptions.

Annual returns for foreign organiza-

tions. 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

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U.S. sources are normally $50,000 or less

and it hasn’t conducted significant activity

in the United States. See the Instructions

for Form 990 and Form 990-EZ, 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).

Figure 1. 990 Series Forms Filed by Exempt Organizations

Type of Annual Return Who Should File

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.

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•

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).

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 Num-

ber (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

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.

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

on which your annual financial records are

based.

Check your bylaws or other rules

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 trust-

ees. 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,

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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.

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

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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.

If you are an LLC and want to be

treated as a disregarded entity by

a tax-exempt member, don’t file

an exemption application.

Unincorporated association. An

unincorporated association formed

under state law must have at least two

members who have signed a written

document that creates an entity with a

specifically defined purpose.

Copy of organizing document

(articles of association or constitution

and any amendments). Your organizing

document must include the name of the

organization, its purpose, the date the

document was adopted, and the

signatures of at least two individuals. If

your copy doesn’t contain the proper

signatures and date of adoption, you may

submit a written declaration that states

your copy is a complete and accurate

copy of the signed and dated original.

Your declaration should clearly indicate

the original date of adoption.

Bylaws may be considered an

organizing document only if they

include the required elements

listed above.

Trust. A trust may be formed by a trust

agreement or declaration of trust. A trust

may also be formed through a will.

Generally, a trust must be funded with

property, such as money, real estate, or

personal property.

Copy of organizing document (trust

agreement/declaration of trust or will

and any amendments). Your trust

agreement (and any amendments) must

be signed by at least one trustee. If your

trust agreement copy isn’t signed, you

may submit a written declaration that

states your copy is a complete and

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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

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,

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•

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

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

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.

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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.

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

www.nccs.urban.org.

NTEE codes are also used for

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,

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

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

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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

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.

Figure 2.

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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.

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

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.

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You can only select one

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;

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

TIP

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)

(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.

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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

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

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

CAUTION

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/Private-

Foundations/Substantial-Contributor-

Private-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/Charitable-

Organizations/Member-of-the-Family.

Further information about disqualified

persons, can be obtained at IRS.gov/

Charities-Non-Profits/IRC-Setion-4946-

Definition-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

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).

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If you fail to file a required

information return or notice for 3

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

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

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.”

CAUTION

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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

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 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

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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

maintain in your records evidence

that you meet these factors, such

as:

•

A list of required courses of study,

dates and times courses are offered, and

other information about how to complete

required courses;

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•

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

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 nondiscrimina-

tory policy. A section 501(c)(3)

organization that is a private school must

publish a notice of its racially

CAUTION

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

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

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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 homepage in a manner

reasonably expected to be noticed by

visitors to the homepage.

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

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.”

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.

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.

TIP

CAUTION

If you complete line 12 indicating

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

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

TIP

CAUTION

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. Printing;

10.

Communications;

11.

Record center; and

12.

Personnel services (including

selection testing, training, and education

of personnel).

Specific Line Items

Line 1. Answer “Yes,” if your organization

is a medical research organization, as

described above.

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Line 1a. As a medical research

organization, you must be associated with

a hospital described in section 501(c)(3),

a federal hospital, or an instrumentality of

a government. Provide the name of the

hospital(s) you’re associated with and

describe the relationship(s).

Line 1b. List your assets and their fair

market value and the portion of your

assets directly devoted to medical

research. Don’t complete the remainder of

Schedule C.

Line 2. Answer “Yes,” if you’re a

cooperative hospital service organization

and describe the services you provide to

your member hospitals and the exempt

status of your membership. Don’t

complete the remainder of Schedule C.

Line 3. Answer “Yes,” if all the doctors in

your community are eligible for staff

privileges at your facility. You must answer

“Yes,” even if staff privileges at your

facilities are limited by capacity, provided

that all qualified medical professionals in

your community may seek and would be

considered for eligibility.

Answer “No,” if all doctors in your

community aren’t eligible for staff

privileges at your facility.

If you answer “No,” describe in detail

how you limit eligibility for staff privileges

at your facility. Include details of your

eligibility criteria and selection procedures

for your courtesy staff of doctors.

Line 4. Answer “Yes,” if you admit all

patients in your community who can pay

for themselves or through some form of

third-party reimbursement (for example,

private health insurance, Medicare, or

Medicaid).

Answer “No,” if you limit admission for

these individuals in any way and describe

your admission policy in detail, including

how and why you restrict patient

admission.

Line 5. Answer “Yes,” if you offer

emergency medical or hospital care at

your facility on a 24-hour basis, seven

days a week.

Line 5a. Answer “Yes,” if the reason you

don’t maintain a full-time emergency room

is either because you’re a specialty

hospital where emergency care would be

inappropriate for the services you provide

or another emergency medical care facility

that provides such services is located so

near to you as to make such services as

you might provide duplicative.

Line 6. Answer “Yes,” if you provide free

or low-cost medical or hospital care

services. If you answer “Yes,” describe

your policy and to whom you provide

these services. Include details on how

these services promote benefits to the

community. For example, you may want

to indicate how you determine who is

eligible for the services, how you inform

the general public about your policy, any

requirements you require of patients to

receive reduced cost or free care, and any

agreements you might have with

municipalities or government agencies to

subsidize the cost of admitting or treating

patients through this policy.

Line 7. Answer “Yes,” if you have a

formal program of medical training and

research. If you answer “Yes,” describe

your program, including the programs you

offer, the scope of such programs, and

affiliation with other hospitals or medical

care providers with which you carry on the

medical training or research programs.

Line 8. Answer “Yes,” if you have a

formal program of community educational

programs and describe your programs,

including the types of programs offered,

the scope of the programs, and affiliation

with other hospitals or medical care

providers with whom you offer community

educational programs.

Line 9. Answer “Yes,” if you have a board

of directors that is representative of the

community you serve or if an

organization described under section

501(c)(3) with a community board

exercises rights or powers over you.

Answer “Yes,”if you’re subject to a

state corporate practice of medicine law

that requires your governing board to be

composed solely of physicians licensed to

practice medicine in the state.

Line 9a. List each board member by

name and describe that person’s

relationship to you. Also, for each board

member, describe if and how that

individual represents the community.

Generally, hospital employees and staff

physicians aren’t individuals considered to

be community representatives. If you

operate under a parent organization

whose board of directors isn’t comprised

of a majority of individuals who are

representative of the community you

serve, provide the requested information

for your parent organization's board of

directors as well.

Line 10. Section 501(r). Answer “Yes,” if

you operate a facility that is required by a

state to be licensed, registered, or

similarly recognized as a hospital.

Organizations that respond “Yes,” to this

question are required to meet additional

requirements described in section 501(r)

to be considered a hospital exempt from

taxation by section 501(c).

Line 10a. A community health needs

assessment (CHNA) is an assessment of

the significant health needs of the

community. To meet the requirements of

section 501(r)(3), a CHNA must take into

account input from persons who represent

the broad interests of the community

served by the hospital facility, including

those with special knowledge of or

expertise in public health, and must be

made widely available to the public. Each

hospital facility must conduct a CHNA at

least once every 3 years and adopt an

implementation strategy to meet the

community health need identified through

such CHNA.

Answer “Yes,” if the hospital facility

conducted a complying CHNA in the

current tax year or in either of the 2

immediately preceding tax years or if the

hospital facility intends to conduct a

CHNA before the end of its first 3-year

period.

Line 10b. A financial assistance policy

(FAP), sometimes referred to as a charity

care policy, is a policy describing how an

organization will provide financial

assistance at its hospital(s) and other

facilities, if any. Financial assistance

includes free or discounted health

services provided to persons who meet

the organization’s criteria for financial

assistance and are unable to pay for all or

a portion of the services. Financial

assistance doesn’t include:

•

Bad debt or uncollectible charges that

the organization recorded as revenue but

wrote off due to a patient’s failure to pay or

the cost of providing such care to such

patients;

•

The difference between the cost of care

provided under Medicaid or other

means-tested government programs or

under Medicare and the revenue derived

therefrom;

•

Self-pay or prompt pay discounts; or

•

Contractual adjustments with any

third-party payors.

Answer “Yes,” if the hospital facility has

adopted a written financial assistance

policy and a written policy relating to

emergency medical care as required by

section 501(r)(4).

Line 10c. Under section 501(r)(5), the

maximum amounts that can be charged to

FAP-eligible individuals for emergency or

other medically necessary care are the

amounts generally billed to individuals

who have insurance covering such care.

Answer “Yes,” if the hospital facility:

1. Limits or will limit any charges to

FAP-eligible individuals to whom the

hospital facility provided emergency or

other medically necessary services to not

more than the amounts generally billed to

individuals who had insurance covering

such care; and

2. Prohibits, or upon beginning

operations will prohibit, the use of gross

charges as described in section 501(r)(5).

The hospital facility may check “Yes,” if

it charged more than the amounts

generally billed to individuals who had

Instructions for Form 1023

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insurance covering such care to an

individual if:

•

The charge in excess of the amounts

generally billed (AGB) wasn’t made or

requested as a pre-condition of providing

medically necessary care to the

FAP-eligible individual;

•

As of the time of the charge, the

FAP-eligible individual hadn’t submitted a

complete FAP application and hadn’t

otherwise been determined by the hospital

facility to be FAP eligible for the care; and,

•

If the individual subsequently submits a

complete FAP application and is

determined to be FAP-eligible for care, the

hospital facility refunds any amount that

exceeds the amount he or she is

determnined to be personally responsible

for paying as a FAP-eligible individual,

unless such excess amount is less than

$5.

Line 10d. Answer “Yes,” if the hospital

facility has, or will have at the beginning of

operation, either a separate written billing

and collections policy, or include in a

written FAP:

•

A description of any actions that the

hospital facility (or other authorized party)

may take related to obtaining payment of a

bill for medical care, including, but not

limited to, any extraordinary collection

actions (ECAs);

•

The process and time frames the

hospital facility (or other authorized party)

uses in taking those actions (including, but

not limited to, the reasonable efforts it will

make to determine whether an individual

is FAP-eligible before engaging in ECAs);

and

•

The office, department, committee, or

other body with the final authority or

responsibility for determining that the

hospital facility has made reasonable

efforts to determine whether an individual

is FAP-eligible and may therefore engage

in ECAs against the individual.

Schedule D. Section

509(a)(3) Supporting

Organizations

Supporting organizations are described in

section 509(a)(3). The term “supported

organization” refers to an organization that

a supporting organization benefits. A

supporting organization may support more

than one supported organization.

An organization qualifies as a supporting

organization (for purposes of classification

under section 509(a)(3)) if:

•

It is organized and at all times thereafter

is operated exclusively for the benefit of,

to perform the function of, or to carry out

the purposes of one or more public

charities described in section 509(a)(1) or

509(a)(2);

•

It meets one of three required

relationship tests with the supported

organization(s); and

•

It isn’t controlled by “disqualified

persons,” directly or indirectly. See

Appendix C for a definition of a

“

disqualified person.”

A supporting organization can also

support the charitable purposes of

organizations that are exempt under

sections 501(c)(4), (5), or (6).

Specific Line Items

Line 1. List the name, address, and EIN

of each organization you support.

Line 2. Answer “Yes,” if each supported

organization has a letter from the IRS

recognizing it as a public charity under

section 509(a)(1) or 509(a)(2).

Before you file your application,

use Tax Exempt Organization

Search on IRS.gov to confirm

whether each of your supported

organizations is currently recognized as

exempt and is classified as a public

charity.

Line 2a. Answer “Yes,” if any supported

organization you listed on line 1 received a

letter from the IRS stating that it’s exempt

under sections 501(c)(4), (5), or (6) and

meets the public support test under

section 509(a)(2). See Pub. 557 for

information on the public support test for

section 509(a)(2).

If you answer “No,” describe how each

organization you support is a public charity

under section 509(a)(1) or 509(a)(2). For

example, if you support a church or

foreign organization that hasn’t received a

determination letter recognizing it as a

public charity, you should describe how

this organization qualifies as a public

charity under section 509(a)(1) or 509(a)

(2). See Pub. 557 for information on public

charities under sections 509(a)(1) and

509(a)(2).

Line 3. Relationship test. To qualify

under section 509(a)(3), you must show

that you meet one of three relationship

tests with your supported organization(s).

Select the option that best describes your

relationship with your supported

organization(s).

•

Type I (“operated, supervised, or

controlled by” relationship; comparable

to a parent–subsidiary relationship): A

majority of your governing board or

officers are elected or appointed by the

governing body, members of the

governing body, officers acting in their

official capacity, or the membership of

your supported organization(s).

•

Type II (“supervised or controlled in

connection with” relationship;

comparable to a brother–sister

relationship): Your control or management

TIP

is vested in the same persons who control

or manage your supported

organization(s).

•

Type III (“operated in connection

with” relationship; responsive to the

needs or demands of, and having

significant involvement in the affairs of, the

supported organization(s)): One or more

of your officers, directors, or trustees are

elected or appointed by the officers,

directors, trustees, or membership of your

supported organization(s); one or more of

your officers, directors, trustees, or other

important office holders are also members

of the governing body of your supported

organization(s); or your officers, directors,

or trustees maintain a close and

continuous working relationship with the

officers, directors, or trustees of your

supported organization(s).

If you don't meet one of these

three relationship tests, you aren't

described in section 509(a)(3) and

should review the other foundation

classification options in Part VII, line 1.

Line 4. Describe how your governing

board and officers are selected, including

where (if applicable) this information is in

your governing document, bylaws, or

other internal rules and regulations.

Type III organizations must also

describe how your officers, directors, or

trustees maintain a close and continuing

relationship with the officers, directors, or

trustees of your supported organization(s).

Line 5. Prohibited control by disquali-

fied person. You can’t be described in

section 509(a)(3) if you’re directly or

indirectly

controlled by disqualified

persons. You are controlled if disqualified

persons:

•

Can exercise 50% or more of the total

voting power of your governing body;

•

Have authority to affect significant

decisions, such as power over your

investment decisions, or power over your

charitable disbursement decisions; or

•

Can exercise veto power over your

actions.

Although control is generally

demonstrated where disqualified persons

have the authority over your governing

body to require you to take an action or

refrain from taking an action, indirect

control by disqualified persons will also

disqualify you as a supporting

organization.

See Appendix C for a description of the

terms “disqualified person,” “family,”

“foundation manager,” and “business

relationship.”

Public charities and foundation

managers who otherwise are

disqualified persons only because

they are foundation managers aren't

disqualified persons for this purpose.

TIP

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Line 7. Organizational test. If you

answered “No,” you are a Type III

supporting organization, you must amend

your organizing document to specify

your supported organization(s) by name;

or you won’t meet the organizational test

under section 509(a)(3) and need to

reconsider your requested public charity

classification in Part VII, line 1.

Line 7a. If you answered “No,” you won’t

meet the organizational test under section

509(a)(3) unless you amend your

organizing document to specify your

supported organization(s) by name,

purpose, or class, and need to reconsider

your requested public charity classification

in Part VII, line 1.

Line 8. When responding to this question,

don’t include donors that are section

509(a)(1), (2), or (4) organizations.

This prohibition on contributions

from controlling donors only

applies to Type I and Type III

supporting organizations.

Line 9. Type III responsiveness test.

Answer “Yes,” if, because of your

relationship described in line 3, the

supported organization has a significant

involvement in your investment policies,

making and timing of grants, and directing

the use of your income and assets, and

explain how your supported organization

is involved in these matters.

Line 10. Type III notification require-

ment. A Type III supporting organization

must provide the notice described in this

question. If you’re a Type III supporting

organization, you’ll be required to answer

this question annually on your annual

information return (Schedule A of Form

990 or 990-EZ).

Lines 11–13. Type III integral part test.

An organization seeking classification as a

Type III supporting organization must

meet an integral part test, which is

satisfied by maintaining significant

involvement in the operations of one or

more supported organizations and

providing support on which the supported

organization(s) are dependent. A Type III

supporting organization may be

functionally integrated (lines 11–12) or

non-functionally integrated (lines 13 and

13a–c) depending on the manner in which

it meets the integral part test. Functionally

integrated Type III supporting

organizations are subject to fewer

restrictions and requirements than

non-functionally integrated Type IIII

supporting organizations.

Line 11. Answer “Yes,” if you’re the

parent of all your supported organizations

because you:

1. Have the power to appoint or elect,

directly or indirectly, a majority of the

TIP

officers, directors, or trustees of each

supported organization; and

2. Exercise a substantial degree of

direction over the policies, programs, and

activities of each supported organization.

For example, N, an organization

described in section 501(c)(3), is the

parent organization of a healthcare system

consisting of two hospitals (Q and R) and

an outpatient clinic (S), each of which is

described in section 509(a)(1), and a

taxable subsidiary (T). N is the sole

member of each of Q, R, and S. Under the

charter and bylaws of each of Q, R, and S,

N appoints all members of the board of

directors of each corporation. N engages

in the overall coordination and supervision

of the healthcare system’s exempt

subsidiary corporations Q, R, and S in

approval of their budgets, strategic

planning, marketing, resource allocation,

securing tax-exempt bond financing, and

community education. N also manages

and invests assets that serve as

endowments of Q, R, and S.

Line 12. Answer “Yes,” if you conduct

activities that the supported organization

would otherwise need to conduct in

furtherance of its exempt purposes and

describe the activities that you conduct.

Holding title to and managing assets

that are used (or held for use) directly in

carrying out the exempt purposes of your

supported organization (exempt-use

assets) are activities that directly further

the exempt purposes of your supported

organization. Conversely, with certain

exceptions, fundraising, making grants

(whether to the supported organization or

to third parties), and investing and

managing non-exempt-use assets aren’t

activities that directly further the exempt

purposes of the supported organization.

See Regulations section 1.509(a)-4(i)(4)

(ii) for more information.

Line 13. To satisfy the integral part test

as a non-functionally integrated supporting

organization, you must distribute at least

85% of your annual

net income or 3.5%

of the aggregate fair market value of all

of your non-exempt-use assets (whichever

is greater) to your supported

organization(s). You can use Part V of

Schedule A (Form 990 or 990-EZ) to help

determine your answer to this question.

The distributable amount for the

first tax year an organization is

treated as a non-functionally

integrated Type III supporting organization

is zero.

For purposes of this line, “net income” has

the same meaning as the term “adjusted

net income.” In general, “adjusted net

income” is the excess of gross income,

including gross income from any unrelated

trade or business, determined with certain

TIP

modifications, reduced by total

deductions. Gross income doesn’t include

gifts, grants, or contributions. See

Appendix C.

For purposes of this line, “non-exempt-use

assets” are all assets of the supporting

organization other than:

1. Assets described in Regulations

section 53.4942(a)(2)(c)(2)(i) through (iv),

and

2. Exempt-use assets, which are

assets that are used (or held for use)

directly in carrying out the exempt

purposes of your supported organization.

See Regulations section 1.509(a)-4(i)(8)

for more information.

Line 13a. List the total amount you

distribute(d) annually to each supported

organization. Also, indicate how each

amount will vary from year to year.

Line 13b. List the total annual income for

each supported organization. If you

distribute your income to, or for the use of,

a particular department or program of an

organization, list the annual revenue of the

supported department or program.

Line 13c. Answer “Yes,” if your funds are

“earmarked” for a particular program or

activity conducted by your supported

organization.

Schedule E. Effective Date

The questions in this schedule will help us

determine the effective date of exemption

if you’re either seeking reinstatement after

automatic revocation or you’re filing this

application more than 27 months after the

end of the month in which you were legally

formed.

Specific Line Items

Line 1. Answer “Yes,” if your exempt

status was automatically revoked under

section 6033(j)(1) for failure to file required

annual returns or notices for 3 consecutive

years and you’re applying for

reinstatement.

Rev. Proc. 2014-11, 2014-3 I.R.B. 411,

at IRS.gov/irb/2014-03_IRB establishes

several different procedures for reinstating

an organization’s exempt status

depending upon its size, the number of

times it’s been automatically revoked, and

the timeliness of filing for reinstatement.

Review the revenue procedure to

determine which section applies to you.

Line 1a. Select the section of Rev. Proc.

2014-11 under which you’re applying for

reinstatement.

Section 4. Select this section if:

•

You were eligible to file either Form

990-EZ or Form 990-N for each of the 3

consecutive years that you failed to file;

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•

This is the first time you’ve been

automatically revoked pursuant to section

6033(j)(1); and

•

You’re submitting this application no

later than 15 months after the later of the

date of your Revocation Letter or the date

on which the IRS posted your name on the

Auto-Revocation List at

apps.irs.gov/app/eos/.

By selecting this item, you’re also

attesting that your failure to file wasn’t

intentional and you’ve put in place

procedures to file required returns or

notices in the future.

If you were classified as a private

foundation prior to your

automatic revocation, you weren't

eligible to file either Form 990-EZ or Form

990-N and, therefore, aren't eligible to

request reinstatement under Section 4.

If your exempt status was

automatically revoked more than

once, you’re not eligible for

reinstatement under Section 4; however,

you may apply for reinstatement under

Section 5, Section 6, or Section 7.

Section 5. Select this section if:

•

You’re ineligible to file for reinstatement

under Section 4, and

•

You’re submitting this application not

later than 15 months after the later of the

date of your Revocation Letter or the date

on which the IRS posted your name on the

Auto-Revocation List at

apps.irs.gov/app/eos/.

By selecting this item, you’re also

attesting that you filed the required annual

returns, your failure to file was not

intentional, and you have put in place

procedures to file required returns or

notices in the future.

Describe how you exercised ordinary

business care and prudence in

determining and attempting to comply with

your filing requirements in at least 1 of the

3 years of revocation. Include a detailed

explanation of all the facts and

circumstances that led to the failure, the

discovery of the failure, and the steps you

have taken or will take to avoid or to

mitigate future failures to file timely returns

or notices.

Section 6. Select this section if you are

applying for reinstatement of your

tax-exempt status more than 15 months

from the later of the date of the Revocation

Letter or the date on which the IRS posted

your name on the Auto-Revocation List at

apps.irs.gov/app/eos/.

By selecting this item, you’re also

attesting that you filed the required annual

returns, your failure to file wasn’t

intentional, and you have put in place

procedures to file required returns or

notices in the future.

TIP

CAUTION

Describe how you exercised ordinary

business care and prudence in

determining and attempting to comply with

your filing requirements in each of the 3

years of revocation. Include a detailed

explanation of all the facts and

circumstances that led to the failure, the

discovery of the failure, and the steps you

have taken or will take to avoid or mitigate

future failures to file timely returns or

notices.

Section 7. Select this section if you’re

seeking reinstatement with an effective

date of reinstatement of the date of

submission of this application.

Line 2. Generally, if you didn’t file Form

1023 within 27 months of formation, the

effective date of your exempt status will be

the date you filed Form 1023 (submission

date). We may grant requests for an

earlier effective date when there’s

evidence to establish you acted

reasonably and in good faith, and the

grant of relief won’t prejudice the interests

of the government.

Select the appropriate box to indicate

whether you accept the submission date

as the effective date of your exempt status

or whether you are requesting an earlier

effective date.

Line 2a. You may be eligible for

consideration for relief from the

requirement that you file Form 1023 within

27 months of formation if you can

establish that you acted reasonably and in

good faith, and that granting an extension

won’t prejudice the interests of the

government.

Describe in detail your reasons for filing

late, how you discovered your failure to

file, any reliance on professional advice or

advice from the IRS, and any other

information you believe will support your

request for relief. Also, you may want to

provide a comparison of (1) what your

aggregate tax liability would be if you had

filed this application within the 27-month

period with (2) what your aggregate

liability would be if you were exempt as of

your formation date.

We may consider the following factors.

•

You filed Form 1023 before we

discovered your failure to file.

•

You failed to file because of intervening

events beyond your control.

•

You exercised reasonable diligence,

but you weren’t aware of the filing

requirements. (The complexity of your

filing and experience in these matters may

be taken into consideration.)

•

You reasonably relied on written advice

from us.

•

You reasonably relied on the advice of

a qualified tax professional who failed to

file or advise you to file Form 1023.

Schedule F. Low-Income

Housing

To qualify for tax exemption, low-income

housing must provide affordable housing

for a significant segment of individuals in

your

community with low incomes. Your

low-income housing may serve a

combination of purposes, such as for

poor, frail, and elderly persons.

Specific Line Items

Line 1. The “type” of facility may be an

apartment complex, condominium,

cooperative, or private residence, etc.

Line 6. Answer “Yes,” if you charge daily,

weekly, monthly, or annual fees or

maintenance charges.

Line 8. Government programs include

federal, state, or local government

programs.

Schedule G. Successors

to Other Organizations

You should consider this schedule as a

successor organization if any of the

following situations pertain to you.

•

You took or will take over activities

previously conducted by another

organization.

•

You took or will take over 25% or more

of the fair market value of the net assets

of another organization.

•

You were established upon the

conversion of an organization from

for-profit to non-profit status.

The other organization is the

predecessor organization. You should

complete this schedule regardless of

whether the predecessor (other

organization) was exempt or not exempt

from federal income tax.

For purposes of this schedule, a

“for-profit” organization is one in which

persons are permitted to have an

ownership or partnership interest, such as

corporate stock. It includes sole

proprietorships, corporations, and other

entities that provide for ownership

interests.

Schedule H. Organizations

Providing Scholarships,

Fellowships, Educational

Loans, or Other

Educational Grants to

Individuals and Private

Foundations Requesting

Advance Approval of

Individual Grant

Procedures

Complete this schedule if you provide

scholarships, fellowships, grants, loans, or

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other distributions to individuals for

educational purposes. When answering

the questions on this schedule, you should

demonstrate how these distributions

further your exempt purposes.

If you’re a private foundation,

you’re subject to the rules under

section 4945 and may incur an

excise tax if you make grants for the

purpose described above without seeking

advance approval of your grant-making

procedures (see Schedule H–Section II).

Generally, distributions made to

individuals may advance educational

purposes if selection is made:

•

In a non-discriminatory fashion in terms

of racial preference;

•

Based on need and/or merit; and

•

To a charitable class in terms of being

available to an open-ended group, rather

than to pre-selected individuals.

A scholarship or fellowship is tax free to

the recipient only if he or she is a

candidate for a degree at an eligible

educational institution and uses the

scholarship or fellowship to pay qualified

education expenses.

Qualified education expenses include

tuition and fees; and course-related

expenses such as books, supplies, and

equipment. Room and board, travel,

research, clerical help, and non-required

equipment aren’t qualified education

expenses. See Pub. 970, Tax Benefits for

Education, for additional information.

Selection of individuals using a lottery

system generally hasn’t been approved by

the IRS.

Specific Line Items

Section I

Line 1. If you conduct more than one

grant program, describe each program

separately.

CAUTION

If you make educational loans,

describe the terms of the loan (for

example, the factors you consider in

selecting or approving loan recipients,

interest rate, duration, forgiveness

provision, etc.). Also, describe whether

any financial institutions or other lenders

are involved in your program.

Explain how you will publicize your

program and whether you publicize to the

general public or to another group of

possible recipients. Include specific

information about the geographic area in

which your program will be publicized and

the means you will use, such as through

newspaper advertisements, school district

announcements, or community groups.

Line 2. Organizations that make grants to

individuals must maintain adequate

records and case histories showing the

name and address of each recipient,

pursuant Rev. Rul. 56-304, 1956-2 C.B.

306 but don’t provide this information as

part of your application.

Section II

If you requested public charity

classification in Part VII, line 1, don’t

complete Schedule H – Section II.

Line 1. Answer “Yes,” if you’re a private

foundation and you’re requesting

advance approval of your grant-making

procedures under section 4945(g).

Answer “No,” if you’re a private foundation

but don’t wish to request advance

approval of your grant-making procedures

under section 4945(g). If you answer “No”

the amounts you distribute as educational

grants provided to individuals may be

considered taxable expenditures under

section 4945.

For more information about advance

approval of grant-making procedures of a

private foundation, go to IRS.gov/

charities-non-profit/private-foundations/

advance-approval-of-grant-making-

procedures.

Line 1a. Check the box for section

“4945(g)(1)” if your award qualifies as a

scholarship or fellowship grant that’s

awarded on an objective and

nondiscriminatory basis and is used for

study at a school (see Schedule B for

what is considered a school).

Check the box for “4945(g)(3)” if the

purpose of your award is to achieve a

specific objective, produce a report or

other similar product, or improve or

enhance a literary, artistic, musical,

scientific, teaching, or other similar

capacity, skill, or talent of the recipient.

Include your educational loan program

under this section.

You may check more than one box.

If your award qualifies as a prize

or award that is subject to the

provisions of section 74(b) and

your recipient is selected from the general

public, you don’t have to request advance

approval of your grant-making procedures

since a prize or award isn’t subject to the

advance approval procedure requirements

because it isn’t a grant for travel, study, or

other similar purposes. See Rev. Ruls.

77-380, 1977-2 C.B. 419; 76-460, 1976-2

C.B. 371; and 75-393, 1975-2 C.B. 451.

Line 4. Answer “Yes,” if you award

scholarships on a preferential basis

because you require, as an initial

qualification, that the individual be an

employee or be

related to an employee of

a particular employer.

Line 7. For purposes of this schedule, a

program for children of employees of a

particular employer includes children and

family members of employees.

TIP

Instructions for Form 1023

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Paperwork Reduction Act Notice. We ask for the information on this form to carry out the Internal Revenue laws of the United

States. You are required to give us the information. We need it to ensure that you are complying with these laws and to allow us to

figure and collect the right amount of tax.

You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form

displays a valid OMB control number. Books or records relating to a form or its instructions must be retained as long as their contents

may become material in the administration of any Internal Revenue law. Generally, tax returns and return information are confidential,

as required by section 6103. However, certain returns and return information of tax exempt organizations and trusts are subject to

public disclosure and inspection, as provided by section 6104.

The time needed to complete and file this form will vary depending on individual circumstances. The estimated burden for tax

exempt organizations filing this form is approved under OMB control number 1545-0047 and is included in the estimates shown in the

instructions for their information return.

Comments and suggestions. If you have comments concerning the accuracy of this time estimate or suggestions for making this

form simpler, we would be happy to hear from you. You can send us comments from IRS.gov/FormComments. Or you can write to:

Internal Revenue Service

Tax Forms and Publications Division

1111 Constitution Ave. NW, IR-6526

Washington, DC 20224

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Instructions for Form 1023

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Appendix A: Sample Conflict of Interest Policy

Note. This Sample Conflict of

Interest Policy is intended to

provide an example of a

conflict of interest policy for

organizations. The sample

conflict of interest policy does

not prescribe any specific

requirements. Therefore,

organizations should use a

conflict of interest policy that

best fits their organization.

Note. Items marked Hospital

insert — for hospitals that

complete Schedule C are

intended to be adopted by

hospitals.

Article I

Purpose

The purpose of the conflict of

interest policy is to protect this

tax-exempt organization's

(Organization) interest when it

is contemplating entering into

a transaction or arrangement

that might benefit the private

interest of an officer or director

of the Organization or might

result in a possible excess

benefit transaction. This policy

is intended to supplement but

not replace any applicable

state and federal laws

governing conflict of interest

applicable to nonprofit and

charitable organizations.

Article II

Definitions

1. Interested Person Any

director, principal officer, or

member of a committee with

governing board delegated

powers, who has a direct or

indirect financial interest, as

defined below, is an interested

person.

[Hospital insert – for

hospitals that complete

Schedule C. If a person is an

interested person with respect

to any entity in the health care

system of which the

organization is a part, he or

she is an interested person

with respect to all entities in the

health care system.]

2. Financial Interest A

person has a financial interest

if the person has, directly or

indirectly, through business,

investment, or family:

a. An ownership or

investment interest in any

entity with which the

Organization has a

transaction or

arrangement,

b. A compensation

arrangement with the

Organization or with any

entity or individual with

which the Organization

has a transaction or

arrangement, or

c. A potential ownership or

investment interest in, or

compensation

arrangement with, any

entity or individual with

which the Organization is

negotiating a transaction

or arrangement.

d. Compensation includes

direct and indirect

remuneration as well as

gifts or favors that aren’t

insubstantial. A financial

interest isn’t necessarily a

conflict of interest. Under

Article III, Section 2, a

person who has a financial

interest may have a

conflict of interest only if

the appropriate governing

board or committee

decides that a conflict of

interest exists.

Article III

Procedures

1. Duty to Disclose In

connection with any actual or

possible conflict of interest, an

interested person must

disclose the existence of the

financial interest and be given

the opportunity to disclose all

material facts to the directors

and members of committees

with governing board

delegated powers considering

the proposed transaction or

arrangement.

2. Determining Whether a

Conflict of Interest Exists

After disclosure of the financial

interest and all material facts,

and after any discussion with

the interested person, he/she

shall leave the governing

board or committee meeting

while the determination of a

conflict of interest is discussed

and voted upon. The

remaining board or committee

members shall decide if a

conflict of interest exists.

3. Procedures for Address-

ing the Conflict of Interest

a. An interested person

may make a presentation

at the governing board or

committee meeting, but

after the presentation,

he/she shall leave the

meeting during the

discussion of, and the vote

on, the transaction or

arrangement involving the

possible conflict of

interest.

b. The chairperson of the

governing board or

committee shall, if

appropriate, appoint a

disinterested person or

committee to investigate

alternatives to the

proposed transaction or

arrangement.

c. After exercising due

diligence, the governing

board or committee shall

determine whether the

Organization can obtain,

with reasonable efforts, a

more advantageous

transaction or arrangement

from a person or entity that

would not give rise to a

conflict of interest.

d. If a more advantageous

transaction or arrangement

isn’t reasonably possible

under circumstances not

producing a conflict of

interest, the governing

board or committee shall

determine by a majority

vote of the disinterested

directors whether the

transaction or arrangement

is in the Organization best

interest, for its own benefit,

and whether it is fair and

reasonable. In conformity

with the above

determination, it shall

make its decision as to

whether to enter into the

transaction or

arrangement.

4. Violations of the Conflict

of Interest Policy

a. If the governing board or

committee has reasonable

cause to believe a member

has failed to disclose

actual or possible conflicts

of interest, it shall inform

the member of the basis

for such belief and afford

the member an opportunity

to explain the alleged

failure to disclose.

b. If, after hearing the

member's response and

after making further

investigation as warranted

by the circumstances, the

governing board or

committee determines the

member has failed to

disclose an actual or

possible conflict of

interest, it shall take

appropriate disciplinary

and corrective action.

Article IV

Records of Proceedings

The minutes of the governing

board and all committees with

board delegated powers shall

contain:

a. The names of the persons

who disclosed or otherwise

were found to have a financial

interest in connection with an

actual or possible conflict of

interest, the nature of the

financial interest, any action

taken to determine whether a

conflict of interest was present,

and the governing board's or

committee's decision as to

whether a conflict of interest in

fact existed.

b. The names of the persons

who were present for

discussions and votes relating

to the transaction or

arrangement, the content of

the discussion, including any

alternatives to the proposed

transaction or arrangement,

and a record of any votes

taken in connection with the

proceedings.

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Article V

Compensation

a. A voting member of the

governing board who receives

compensation, directly or

indirectly, from the

Organization for services is

precluded from voting on

matters pertaining to that

member's compensation.

b. A voting member of any

committee whose jurisdiction

includes compensation

matters and who receives

compensation, directly or

indirectly, from the

Organization for services is

precluded from voting on

matters pertaining to that

member's compensation.

c. No voting member of the

governing board or any

committee whose jurisdiction

includes compensation

matters and who receives

compensation, directly or

indirectly, from the

Organization, either

individually or collectively, is

prohibited from providing

information to any committee

regarding compensation.

[Hospital insert-for

hospitals that complete

Schedule C Physicians who

receive compensation from the

Organization, whether directly

or indirectly or as employees

or independent contractors,

are precluded from

membership on any committee

whose jurisdiction includes

compensation matters. No

physician, either individually or

collectively, is prohibited from

providing information to any

committee regarding physician

compensation.]

Article VI

Annual Statements

Each director, principal officer,

and member of a committee

with governing board

delegated powers shall

annually sign a statement

which affirms such person:

a. Has received a copy of

the conflict of interest

policy,

b. Has read and

understands the policy,

c. Has agreed to comply

with the policy, and

d. Understands the

Organization is charitable

and in order to maintain its

federal tax exemption it

must engage primarily in

activities that accomplish

one or more of its

tax-exempt purposes.

Periodic Reviews

To ensure the Organization

operates in a manner

consistent with charitable

purposes, and doesn't engage

in activities that could

jeopardize its tax-exempt

status, periodic reviews shall

be conducted. The periodic

reviews shall, at a minimum,

include the following subjects:

a. Whether compensation

arrangements and benefits

are reasonable, based on

competent survey

information, and the result

of arm's length bargaining.

b. Whether partnerships,

joint ventures, and

arrangements with

management

organizations conform to

the Organization's written

policies, are properly

recorded, reflect

reasonable investment or

payments for goods and

services, further charitable

purposes and don't result

in inurement,

impermissible private

benefit, or in an excess

benefit transaction.

Article VIII

Use of Outside Experts

When conducting the periodic

reviews, as provided for in

Article VII, the Organization

may, but need not, use outside

advisors. If outside experts are

used, their use shall not relieve

the governing board of its

responsibility for ensuring

periodic reviews are

conducted.

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States With Statutory Provisions Satisfying the Requirements of

Internal Revenue Code Section 508(e)

The following states have adopted legislation satisfying the requirements of Section 508(e) relating to

private foundation governing instruments. Information derived from Revenue Ruling 75-38, 1975-1

C.B. 161.

Appendix B:

ALABAMA — except where otherwise provided by a decree of a court of competent jurisdiction or by a provision in the

private foundation's governing instrument, which in either case has been entered or made after October 1, 1971, and

expressly limits the applicability of state law.

ALASKA — except for such private foundations that expressly provide in their governing instruments that the applicable

sections of Alaska law don't apply to them.

ARKANSAS — except for such private foundations which expressly provide in their governing instruments that the

applicable sections of Arkansas law don't apply to them and except in the case of trusts where otherwise provided by decree

of a court of competent jurisdiction.

CALIFORNIA — except where otherwise provided by a court of competent jurisdiction.

COLORADO — with respect to trusts that are private foundations except where otherwise provided by a court of competent

jurisdiction.

CONNECTICUT — except where otherwise provided by a court of competent jurisdiction.

DELAWARE — except for such private foundations, which expressly provide in their governing instruments that the

applicable sections of Delaware law don't apply to them.

DISTRICT OF COLUMBIA — except for such corporations, which expressly provide in their governing instruments that the

applicable sections of District of Columbia law don't apply to them and except in the case of trusts where otherwise provided

by a court of competent jurisdiction. (For purposes of this statute, corporations include corporations organized under any Act

of Congress applicable to the District of Columbia as well as corporations organized under the laws of the District of

Columbia.)

FLORIDA — except for such trusts that file a proper election not to be subject to the applicable provisions of Florida law and

for such corporations as to which a court of competent jurisdiction has otherwise determined.

GEORGIA — except for such private foundations that file a proper election not to be subject to such law.

HAWAII — no exceptions.

IDAHO — except for such private foundations that expressly provide in their governing instruments that the applicable

sections of Idaho law don't apply to them.

ILLINOIS — except for such corporations that have express provisions to the contrary in their articles of incorporation and

except for trusts where it is otherwise provided by a court of competent jurisdiction.

INDIANA — except where otherwise determined by a court of competent jurisdiction with respect to private foundations

organized before January 1, 1970.

IOWA — except for such private foundations which expressly provide in their governing instruments that the applicable

sections of Iowa law don't apply to them.

KANSAS — except where otherwise provided by a court of competent jurisdiction.

KENTUCKY — except, with respect to corporations in existence on July 1, 1972, to the extent that such a corporation

provides to the contrary by amendment to its articles of incorporation adopted after July 1, 1972, and, with respect to trusts in

existence on July 1, 1972, where action is properly commenced on or before December 31, 1972, in a court of competent

jurisdiction to excuse the trust from compliance with the requirements of section 508(e) of the Code.

LOUISIANA — except for such private foundations that expressly provide in their governing instruments that the applicable

sections of Louisiana law don't apply to them.

MAINE — except where otherwise provided by a court of competent jurisdiction.

MARYLAND — except where otherwise provided by a court of competent jurisdiction.

MASSACHUSETTS — except where otherwise provided by a court of competent jurisdiction.

MICHIGAN — with respect to trusts that are private foundations except for such private foundations which file a notice of

inconsistency under Michigan law.

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MINNESOTA — except for private foundations that have been held by a court of competent jurisdiction not to be affected by

such state statute.

MISSISSIPPI — except where otherwise provided by a court of competent jurisdiction.

MISSOURI — except for private foundations that have been held by a court of competent jurisdiction not to be affected by

such state statute.

MONTANA — except in the case of trusts where otherwise provided by court decree entered after March 28, 1974, and

except in the case of a corporation that has an express provision to the contrary in its articles of incorporation.

NEBRASKA — except for such trusts that effectively elect to be excluded from the applicable sections of Nebraska law, for

such corporations which have governing instruments expressly providing to the contrary, and except as a court of competent

jurisdiction has otherwise determined in any given case.

NEVADA — no exceptions.

NEW HAMPSHIRE — except where it is otherwise provided by a court of competent jurisdiction.

NEW JERSEY — except for such private foundations that expressly provide in their governing instruments that the

applicable sections of New Jersey law don't apply to them.

NEW YORK — except where such law conflicts with any mandatory direction of an instrument by which assets were

transferred prior to June 1, 1971, and such conflicting direction hasn’t been removed legally.

NORTH CAROLINA — except for such private foundations which expressly provide in their governing instruments that the

applicable sections of North Carolina law don't apply to them and except for trusts that have their governing instruments

reformed by a decree of the Superior Court of North Carolina.

NORTH DAKOTA — with respect to trusts that are private foundations except where otherwise provided by a court of

competent jurisdiction.

OHIO — except in the case of trusts where it is provided otherwise by a court of competent jurisdiction and except in the

case of corporations in existence on September 17, 1971, which expressly adopt contrary provisions in their governing

instruments after September 17, 1971.

OKLAHOMA — except for such private foundations that file a proper election not to be subject to such law.

OREGON — no exceptions.

PENNSYLVANIA — except where otherwise provided by a court of competent jurisdiction.

RHODE ISLAND — except where otherwise provided by a court of competent jurisdiction.

SOUTH CAROLINA — except for private foundations that expressly provide in their governing instruments that the

applicable sections of South Carolina law don't apply to them.

SOUTH DAKOTA — except where otherwise provided by a court of competent jurisdiction.

TENNESSEE — except where otherwise provided by a court of competent jurisdiction.

TEXAS — except for such private foundations that a proper election not to be subject to such law.

UTAH — with respect to trusts that are private foundations except where otherwise provided by a court of competent

jurisdiction.

VERMONT — except where otherwise provided by a court of competent jurisdiction.

VIRGINIA — except for private foundations whose governing instruments contain express provisions to the contrary or that

have filed a proper election not to be subject to such law.

WASHINGTON — except for such private foundations that expressly provide in their governing instruments that the

applicable sections of Washington law don't apply to them.

WEST VIRGINIA — with respect to trusts that are private foundations except for such trusts which provide in their governing

instruments that the applicable sections of West Virginia law don't apply to them.

WISCONSIN — except as may otherwise be provided by decree of a court of competent jurisdiction.

WYOMING — except where otherwise provided by a court of competent jurisdiction.

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Appendix C: Glossary of Terms

Adjusted net income (for Schedule D) Adjusted net income includes: gross income from any unrelated trade or

business; gross income from functionally related businesses; interest

payments received on loans; amounts received or accrued as repayments

of amounts taken as qualifying distributions for any tax year; amounts

received or accrued from the sale or other disposition of property to the

extent acquisition of the property was treated as a qualifying distribution

for any tax year; any amounts set aside for a specific project to the extent

the full set-aside was not necessary for the project; interest on

government obligations normally excluded under section 103; net

short-term capital gains on sale or other disposition of property; and

income received from an estate if the estate is considered terminated for

income tax purposes because of a prolonged administration period.

It doesn't include: gifts, grants, and contributions received; long-term

capital gains or losses; net section 1231 gains; capital gain dividends; the

excess of fair market value over adjusted basis of property distributed to

the U.S. or a possession or political subdivision, a state or its political

subdivision, a charitable trust, or corporation for public purposes; or

income received from an estate during the administration period.

In computing adjusted net income, deduct the following: ordinary and

necessary expenses paid or incurred for the production or collection of

gross income, or for the management, conservation, or collection of gross

income (includes operating expenses such as compensation of officers,

employee wages and salaries, interest, rent, and taxes); straight-line

depreciation and depletion (not percentage depletion); and expenses and

interest paid or incurred to carry tax-exempt obligations. Don't deduct net

short-term capital losses for the year in which they occur (these losses

cannot be carried back or carried over to earlier or later tax years); the

excess of expenses for property used for exempt purposes over the

income received from the property; charitable contributions made by you;

net operating losses; and special deductions for corporations.

Arm's length A transaction between parties having adverse (or opposing) interests

where none of the participants are in a position to exercise substantial

influence over the transaction because of business or family

relationship(s) with more than one of the parties.

Authorized representative An individual eligible to practice before the IRS who holds a power of

attorney (Form 2848 or other similar documents) that authorizes him or

her to represent the organizations in tax matters, including the application

for tax-exempt status.

Bingo A game of chance played with cards that are generally printed with 5 rows

of 5 squares each, on which participants place markers to form a

pre-selected pattern to win the game. Bingo is gambling.

Business relationship Employment and contractual relationships, and common ownership of a

business where any officers, directors, or trustees, individually or together,

possess more than a 35% ownership interest in common. Ownership

means voting power in a corporation, profits interest in a partnership, or

beneficial interest in a trust.

Bylaws The internal rules and regulations of an organization.

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Certification of filing Evidence that, on a specific date, articles of incorporation (for a

corporation) or articles of organization (for a limited liability company)

were accepted for filing by appropriate state authority resulting in the

creation of a state-law entity.

Community The local or regional geographic area to be served by an organization.

Compensation All forms of income from working, including salary or wages; deferred

compensation; retirement benefits, whether in the form of a qualified or

non-qualified employee plan (for example, pensions or annuities); fringe

benefits (for example, personal vehicle, meals, lodging, personal and

family educational benefits, low interest-loans, payment of personal travel,

entertainment, or other expenses, athletic or country club membership,

and personal use of your property); and bonuses.

Conflict of interest policy A set of procedures to identify potential conflicts of interest and to reduce

the likelihood that persons in a position of authority over an organization

may use that authority to receive an inappropriate benefit. A conflict of

interest may arise when a person in a position of authority over an

organization, such as a director, officer, or manager, may benefit

personally from a decision he or she could make.

Controlled by disqualified persons See the definition of a disqualified person below. A section 509(a)(3)

supporting organization, may not be controlled directly or indirectly by

disqualified persons (other than the organization’s officers, directors or

trustees). An organization is controlled by disqualified persons if

disqualified persons can exercise 50% or more of the total voting power

held by the organization’s governing body. For this purpose, controlled

includes the authority to affect significant decisions, such as power over

investment decisions, or charitable disbursement decisions, as well as the

power to veto such decision. Control may be direct or indirect.

Corporation An entity organized under a federal or state corporation law (including the

statutes of a federally recognized Indian tribal or Alaskan native

government).

Develop The planning, financing, construction, or provision of similar services

involved in the acquisition of real property, such as land or a building.

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Disqualified person Any individual or organization that is any of the following relationships.

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

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

powers or responsibilities.

c. An individual who owns more than 20% of the total combined voting

power of a corporation that is a substantial contributor to you.

d. An individual who owns more than 20% of the profits interest of a

partnership that is a substantial contributor to you.

e. An individual who owns more than 20% of the beneficial interest of a

trust or estate that is a substantial contributor to you.

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

above.

g. A corporation in which any individuals described in a, b, c, d, e, or f

above hold more than 35% of the total combined voting power.

h. A trust or estate in which any individuals described in a, b, c, d, e, or

f above hold more than 35% of the beneficial interests.

i. A partnership in which any individuals described a, b, c, d, e, or f

above hold more than 35% of the profits interest.

Earmark Donations or other contributions given to an organization on the condition

or understanding that they will be used to assist particular individuals or

specific identified groups.

Expenses Financial burdens or outlays, costs (of doing business), and business

outlays chargeable against revenues. For purposes of this form, expenses

mean direct and indirect expenses.

Fair market value The price at which property, or the right to use property, would change

hands between a willing buyer and a willing seller, neither being under any

compulsion to buy, sell, or transfer property or the right to use property,

and both having reasonable knowledge of relevant facts.

Family Includes an individual's spouse, ancestors, children, grandchildren,

great-grandchildren, siblings (whether by whole or half-blood), and the

spouses of children, grandchildren, great-grandchildren, and siblings.

Foreign country A country other than the United States, its territories and possessions, and

the District of Columbia.

For-profit A business entity whose activities are conducted or maintained to make a

profit (for example, revenues greater than expenses) for its private

shareholders or owners.

Foundation manager Officers, directors, or trustees, or an individual having powers or

responsibilities similar to those of a foundation's officers, directors, or

trustees.

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Fundraising The organized activity of raising funds, whether by volunteers, employees,

or paid independent contractors.

Gaming The term gaming includes activities such as Bingo, Beano, lotteries,

pull-tabs, pari-mutuel betting, Calcutta wagering, pickle jars, punch

boards, tip boards, tip jars, certain video games, 21, raffles, keno,

split-the-pot, and other games of chance.

Gross investment income As defined in section 509, gross investment income means the gross

amount of income from interest, dividends, payments with respect to

securities loans, rents, and royalties; but not including any such income to

the extent included in computing the tax imposed by section 511.

Gross receipts For purposes of Part VI-A. Statement of Revenues and Expenses, gross

receipts include monies earned from activities related to an organization’s

charitable or other section 501(c)(3) activities, such as selling admissions

or merchandise, performing services, or furnishing facilities.

Hospital Hospital or medical care includes the treatment of any physical or mental

disability or condition, whether on an inpatient or outpatient basis. A

hospital includes the following.

a. Hospitals and rehabilitation institutions, outpatient clinics, or

community mental health or drug treatment centers if the principal

purpose or function is the providing of medical or hospital care or

medical education or research.

b. Medical research organizations, if the principal purpose or function

is the continuous active conduct of medical research in conjunction

with a hospital.

Influence legislation The act of directly contacting or urging the public to contact members of a

legislative body for the purpose of proposing, supporting, or opposing

legislation. Attempting to influence legislation includes advocating the

adoption or rejection of legislation.

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

following.

a. Patents (for inventions).

b. Copyrights (for literary and artistic works such as novels, poems,

plays, films, musical works, drawings, paintings, photographs,

sculptures, architectural designs, performances, recordings, film, and

radio or television programs).

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

images, and designs).

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

Joint venture A legal agreement in which the parties jointly undertake a transaction for

mutual profit. Generally, each person contributes assets and shares risks.

Like a partnership, joint ventures can involve any type of business

transaction and the “persons” involved can be individuals, groups of

individuals, companies, or corporations.

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Limited liability company A limited liability company (LLC) is a business entity organized in the

United States under state law. Generally, an LLC may be classified for

federal income tax purposes as a partnership, corporation, or an entity

disregarded as separate from its owner by applying the rules in Regulation

section 301.7701-3. However, an LLC that has been determined to be, or

claims to be, exempt from taxation under section 501(a) is treated as

having made an election to be classified as a corporation under

Regulation section 301.7701-3(c)(1)(v).

Low-income housing Rental or ownership housing provided to persons based on financial need.

Mailing address Address where correspondence is received.

Manage Manage means to direct or administer.

Medical care The treatment of any physical or mental disability or condition, whether on

an inpatient or outpatient basis.

Medical research organization An organization whose principal purpose or function is the continuous

active conduct of medical research in conjunction with a hospital.

Net income (for Schedule D) See Adjusted net income.

Non-fixed payment A non-fixed payment means a payment that depends on discretion. For

example, a bonus of up to $100,000 that is based on an evaluation of

performance by the governing board is a non-fixed payment because the

governing body has discretion over whether the bonus is paid and the

amount of the bonus.

Organizing document The organizing document depends on the form of the organization. For a

corporation, the document is the articles of incorporation. For an LLC, the

document is the articles of organization. For an unincorporated

association, the document is the articles of association or constitution. The

organizing document of a trust is the trust agreement.

Political campaign intervention An organization participates in a political campaign, if it promotes or

opposes, through political literature, brochures, pamphlets, hosting or

participating in events, etc., the candidacy of an individual for public office.

Debates and nonpartisan voter education aren’t considered political.

Predecessor An organization whose activities or assets were taken over by another

organization.

Private foundation An organization that is exempt under section 501(c)(3) is a private

foundation unless it is a church, school, hospital, governmental unit, entity

that undertakes testing for public safety, organization that has broad

financial support from the general public, or organization that supports one

or more other organizations that are themselves classified as public

charities.

Private operating foundation A type of private foundation that makes qualifying distributions directly for

the active conduct of its educational, charitable, and religious purposes.

“Directly for the active conduct” means that the distributions are used by

the foundation itself to carry out the programs for which it is organized and

operated. Grants made to assist other organizations or individuals are

normally considered indirect.

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Public charity An organization that is exempt under section 501(c)(3) is excepted from

private foundation status because it is described in section 509(a)(1)

(which cross references sections 170(b)(1)(i) through (vi), and (ix)), 509(a)

(2), 509(a)(3), or 509(a)(4).

Reasonable compensation Reasonable compensation is the amount that would ordinarily be paid for

like services by like organizations under like circumstances as of the date

the compensation arrangement is made. Reasonable compensation is

important because excessive benefits in the form of compensation to

disqualified persons may result in the imposition of excise taxes and

jeopardize the organization's tax-exempt status.

Related The family or business relationships between persons.

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

following situations.

a. One organization controls the other through common officers,

directors, or trustees, or through authority to approve budgets or

expenditures.

b. Both organizations were created at approximately the same time

and by the same persons.

c. The organizations operate in a coordinated manner with respect to

facilities, programs, employees, or other activities.

d. The same persons exercise substantial influence over both

organizations.

Revenue Revenue means gross revenue amounts.

Revenue Procedure An official statement of a procedure published in the IRS Internal Revenue

Bulletin (previously the Cumulative Bulletin) that either affects the rights or

duties of taxpayers or other members of the public under the Internal

Revenue Code and related statutes, treaties, and regulations or, although

not necessarily affecting the rights and duties of the public, should be a

matter of public knowledge.

Revenue Ruling An official interpretation by the IRS of the Internal Revenue laws and

related statutes, treaties, and regulations, that has been published in the

IRS Internal Revenue Bulletin (previously the Cumulative Bulletin).

Revenue Rulings are issued only by the Office of Associate Chief Counsel

and are published for the information and guidance of taxpayers, IRS

officials, and others concerned.

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School A school is an educational organization whose primary function is the

presentation of formal instruction and that normally maintains a regular

faculty and curriculum and normally has a regularly enrolled body of pupils

or students in attendance at the place where its educational activities are

regularly carried on. A school may include the following.

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

b. College or university.

c. Trade or technical school.

d. Nursery or preschool.

e. School that you operate as an activity, such as school that is

operated as an activity of a museum, historical society, or church.

Similarly situated Similarly situated organizations means tax-exempt or taxable

organizations of a comparable size, purpose, and resources.

Substantial contributor An individual or organization that contributed more than $5,000 to an

organization from the date it was formed or other date that its exemption

would be effective, to the end of the year in which the contributions were

received. This total amount contributed must also be more than 2% of all

the contributions the organization received. A creator of a trust is treated

as a substantial contributor regardless of the amount contributed.

Successor An organization that took over:

a. More than a negligible amount of the activities that were previously

conducted by another organization,

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

organization, or

c. Was established upon the conversion of an organization from

for-profit to non-profit status.

Trust A trust is an entity that may be formed by a trust agreement or declaration

of trust. A trust may also be formed through a will.

Unincorporated association An unincorporated association formed under state law must have at least

two members who have signed a written document for a specifically

defined purpose.

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Unrelated business income Income from a trade or business regularly conducted by an exempt

organization and not substantially related to the performance by the

organization of its exempt purpose or function. See Pub. 598.

Unusual grant Substantial contribution or bequest from a disinterested person that, by its

size, adversely affects classification as a public charity. It is:

a. Unusual,

b. Unexpected, and

c. Received from an unrelated party.

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Appendix D: National Taxonomy of

Exempt Entities (NTEE) Codes

Arts, Culture & Humanities

Code

A01 Alliances & Advocacy

A02 Management & Technical

Assistance

A03 Professional Societies &

Associations

A05 Research Institutes & Public

Policy Analysis

A11 Single Organization Support

A12 Fund Raising & Fund Distribution

A19 Support N.E.C.

A20 Arts & Culture

A23 Cultural & Ethnic Awareness

A24 Folk Arts

A25 Art Education

A26 Arts & Humanities Councils &

Agencies

A27 Community Celebrations

A30 Media & Communications

A31 Film & Video

A32 Television

A33 Printing & Publishing

A34 Radio

A40 Visual Arts

A50 Museums

A51 Art Museums

A52 Children’s Museums

A54 History Museums

A56 Natural History & Natural

Science Museums

A57 Science & Technology Museums

A60 Performing Art

A61 Performing Arts Centers

A62 Dance

A63 Ballet

A65 Theater

A68 Music

A69 Symphony Orchestras

A6A Opera

A6B Singing & Choral Groups

A6C Bands & Ensembles

A6E Performing Arts Schools

A70 Humanities Organizations

A80 Historical Organizations

A82 Historical Societies & Historic

Preservation

A84 Commemorative Events

A90 Arts Service

A99 Arts, Culture & Humanities

N.E.C.

Education

Code

B01 Alliances & Advocacy

Organizations

B02 Management & Technical

Assistance

B03 Professional Society &

Associations

B05 Research Institutes & Public

Policy Analysis

B11 Single Organization Support

B12 Fundraising & Fund Distribution

B19 Support N.E.C.

B20 Elementary & Secondary

Schools

B21 Preschools

B24 Primary & Elementary Schools

B25 Secondary & High Schools

B28 Special Education

B29 Charter Schools

B30 Vocational & Technical Schools

B40 Higher Education Institutions

B41 Two-Year Colleges

B42 Two-Year Colleges

B43 Undergraduate Colleges

B50 Graduate & Professional Schools

B60 Adult Education

B70 Libraries

B80 Student Services

B82 Scholarships & Student Financial

Aid

B83 Student Sororities & Fraternities

B84 Alumni Associations

B90 Educational Services

B92 Remedial Reading &

Encouragement

B94 Parent & Teacher Groups

B99 Education N.E.C.

Environment

Code

C01 Alliances & Advocacy

C02 Management & Technical

Assistance

C03 Professional Societies &

Associations

C05 Research Institutes & Public

Policy Analysis

C11 Single Organization Support

C12 Fundraising & Fund Distribution

C19 Support N.E.C.

C20 Pollution Abatement & Control

C27 Recycling

C30 Natural Resources Conservation

& Protection

C32 Water Resources, Wetland

Conservation & Management

C34 Land Resources Conservation

C35 Energy Resources Conservation

& Development

C36 Forest Conservation

C40 Botanical, Horticultural &

Landscape Services

C41 Botanical Gardens & Arboreta

C42 Garden Clubs

C50 Environmental Beautification

C60 Environmental Education

C99 Environmental N.E.C.

Animal-Related

Code

D01 Alliance & Advocacy

D02 Management & Technical

Assistance

D03 Professional Societies &

Associations

D05 Research Institutes & Public

Policy Analysis

D11 Single Organization Support

D12 Fundraising & Fund Distribution

D19 Support N.E.C.

D20 Animal Protection & Welfare

D30 Wildlife Preservation &

Protection

D31 Protection of Endangered

Species

D32 Bird Sanctuaries

D33 Fisheries Resources

D34 Wildlife Sanctuaries

D40 Veterinary Services

D50 Zoos & Aquariums

D60 Animal Services N.E.C.

D61 Animal Training

D99 Animal Related N.E.C.

Health Care

Code

E01 Alliances & Advocacy

E02 Management & Technical

Assistance

E03 Professional Societies &

Associations

E05 Research Institutes & Public

Policy Analysis

E11 Single Organization Support

E12 Fundraising & Fund Distribution

E19 Support N.E.C.

E20 Hospitals

E21 Community Health Systems

E22 General Hospitals

E24 Specialty Hospitals

E30 Ambulatory & Primary Health

Care

E31 Group Health Practices

E32 Community Clinics

E40 Reproductive Health Care

E42 Family Planning

E50 Rehabilitative Care

E60 Health Support

E61 Blood Banks

E62 Emergency Medical Services &

Transport

E65 Organ & Tissue Banks

E6A Pharmacies & Drugstores

E70 Public Health

E80 Health (General & Financing)

E86 Patient & Family Support

E90 Nursing

E91 Nursing Facilities

E92 Home Health Care

E99 Health Care N.E.C.

Mental Health & Crisis

Intervention

Code

F01 Alliances & Advocacy

F02 Management & Technical

Assistance

F03 Professional Societies &

Associations

F05 Research Institutes & Public

Policy Analysis

F11 Single Organization Support

F12 Fundraising & Fund Distribution

F19 Support N.E.C.

F20 Substance Abuse Dependency,

Prevention & Treatment

F21 Substance Abuse Prevention

F22 Substance Abuse Treatment

F30 Mental Health Treatment

F31 Psychiatric Hospitals

F32 Community Mental Health

Centers

F33 Residential Mental Health

Treatment

F40 Hot Line & Crisis Intervention

F42 Sexual Assault Services

F50 Addictive Disorders N.E.C.

F52 Smoking Addiction

F53 Eating Disorders & Addictions

F54 Gambling Addiction

F60 Counseling

F70 Mental Health Disorders

F80 Mental Health Associations

F99 Mental Health & Crisis

Intervention N.E.C.

Volutary Health Associations &

Medical Disciplines

Code

G01 Alliances & Advocacy

G02 Management & Technical

Assistance

G03 Professional Societies &

Associations

G05 Research Institute & Public

Policy Analysis

G11 Single Organization Support

G12 Fundraising & Fund Distribution

G19 Support N.E.C.

G20 Birth Defects & Genetic Diseases

G25 Down Syndrome

G30 Cancer

G32 Breast Cancer

G40 Diseases of Specific Organs

G41 Eye Diseases, Blindness &

Vision Impairments

G42 Ear & Throat Diseases

G43 Heart & Circulator System

Diseases & Disorders

G44 Kidney Diseases

G45 Lung Diseases

G48 Brain Disorder

G50 Nerve, Muscle, & Bone Diseases

G51 Arthritis

G54 Epilepsy

G60 Allergy Related Diseases

G61 Asthma

G70 Digestive Diseases & Disorders

G80 Specific Named Disorders

G81 AIDS

G83 Alzheimer’s Diseases

G84 Autism

G90 Medical Disciplines

G92 Biomedicine & Bioengineering

G94 Geriatrics

G96 Neurology & Neuroscience

G98 Pediatrics

G99 Voluntary Health Associations,

Medical Disciplines N.E.C.

G9B Surgical Specialties

Medical Research

Code

H01 Alliances & Advocacy

H02 Management & Technical

Assistance

H03 Professional Societies &

Associations

H05 Research Institute & Public

Policy Analysis

H11 Single Organization Support

H12 Fundraising & Fund Distribution

H19 Support N.E.C.

H20 Birth Defects & Genetic Diseases

Research

H25 Down Syndrome Research

H30 Cancer Research

H32 Breast Cancer Research

H40 Diseases of Specific Organs

Research

H41 Eye Diseases, Blindness &

Vision Impairments Research

H42 Ear & Throat Diseases Research

H43 Heart & Circulatory System

Diseases & Disorders Research

H44 Kidney Diseases Research

H45 Lung Diseases Research

H48 Brain Disorders Research

H50 Nerve, Muscle & Bone Diseases

Research

H51 Arthritis Research

H54 Epilepsy Research

H60 Allergy-Related Diseases

Research

H61 Asthma Research

H70 Digestive Diseases & Disorders

Research

H80 Specifically Named Diseases

Research

H81 AIDS Research

H83 Alzheimer’s Disease Research

H84 Autism Research

H90 Medical Disciplines Research

H92 Biomedicine & Bioengineering

Research

H94 Geriatrics Research

H96 Neurology & Neuroscience

Research

H98 Pediatrics Research

H99 Medical Research N.E.C.

H9B Surgical Specialties Research

Crime & Legal-Related

Code

I01 Alliances & Advocacy

I02 Management & Technical

Assistance

I03 Professional Societies &

Associations

I05 Research Institutes & Public

Policy Analysis

I11 Single Organization Support

I12 Fundraising & Fund Distribution

I19 Support N.E.C.

I20 Crime Prevention

I21 Youth Violence Prevention

I23 Drunk Driving-Related

I30 Correctional Facilities

I31 Half-Way Houses for Offenders

& Ex-Offenders

I40 Rehabilitation Services for

Offenders

I43 Inmate Support

I44 Prison Alternatives

I50 Administration of Justice

I51 Dispute Resolution & Mediation

I60 Law Enforcement

I70 Protection Against Abuse

I71 Spouse Abuse Prevention

I72 Child Abuse Prevention

I73 Sexual Abuse Prevention

I80 Legal Services

I83 Public Interest Law

I99 Crime & Legal-Related N.E.C.

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Appendix D: National Taxonomy of Exempt Entities (NTEE) Codes (Continued)

Employment

Code

J01 Alliances & Advocacy

J02 Management & Technical

Assistance

J03 Professional Societies &

Associations

J05 Single Organization Support

J11 Consumer Lending

J12 Fundraising & Fund Distribution

J19 Support N.E.C.

J20 Employment Preparation &

Procurement

J21 Vocational Counseling

J22 Job Training

J30 Vocational Rehabilitation

J32 Goodwill Industries

J33 Sheltered Employment

J40 Labor Unions

J99 Employment N.E.C.

Food, Agriculture & Nutrition

Code

K01 Alliances & Advocacy

K02 Management & Technical

Assistance

K03 Professional Societies &

Associations

K05 Research Institutes & Public

Policy Analysis

K11 Single Organization Support

K12 Fundraising & Fund Distribution

K19 Support N.E.C.

K20 Agricultural Programs

K25 Farmland Preservation

K26 Animal Husbandry

K28 Farm Bureaus & Granges

K2A Other Vegetable (except Potato)

& Melon Farming

K2B Soil Preparation, Planting, &

Cultivating

K2C Wineries

K30 Food Programs

K31 Food Banks & Pantries

K34 Congregate Meals

K35 Soup Kitchens

K36 Meals on Wheels

K40 Nutrition

K50 Home Economics

K6A Meat Markets

K6B Confectionery & Nut Stores

K6C Caterers

K6D Mobile Food Services

K6E Drinking Places

K6F Snack Nonalcoholic Beverage

Bars

K90 Limited-Service Restaurants

K91 Supermarkets & Other Grocery

(except Convenience) Stores

K92 Convenience Stores

K93 Fruit & Vegetable Markets

K94 All Other Specialty Food Stores

K95 Food (Health) Supplement

Stores

K96 Warehouse Clubs &

Supercenters

K97 Food Service Contractors

K98 Full-Service Restaurants

K99 Food, Agriculture & Nutrition

N.E.C.

Housing & Shelter

Code

L01 Alliances & Advocacy

L02 Management & Technical

Assistance

L03 Professional Societies &

Associations

L05 Research Institutes & Public

Policy Analysis

L11 Single Organization Support

L12 Fundraising & Fund Distribution

L19 Support N.E.C.

L20 Housing Development,

Construction & Management

L21 Low-Income & Subsidized Rental

Housing

L22 Senior Citizens’ Housing &

Retirement Communities

L24 Independent Housing for People

with Disabilities

L25 Housing Rehabilitation

L30 Housing Search Assistance

L40 Temporary Housing

L41 Homeless Shelters

L4A Hotels (except Casino Hotels) &

Motels

L4B Bed and Breakfast Inns

L50 Homeowners & Tenants

Associations

L80 Housing Support

L81 Home Improvement & Repairs

L82 Housing Expense Reduction

Support

L99 Housing & Shelter N.E.C.

Public Safety, Disaster

Preparedness & Relief

Code

M01 Alliances & Advocacy

M02 Management & Technical

Assistance

M03 Professional Societies &

Associations

M05 Research Institutes & Public

Policy Analysis

M11 Single Organization Support

M12 Fundraising & Fund Distribution

M19 Support N.E.C.

M20 Disaster Preparedness & Relief

Services

M23 Search & Rescue Squads

M24 Fire Prevention

M40 Safety Education

M41 First Aid

M42 Automotive Safety

M60 Public Safety Benevolent

Associations

M99 Public Safety, Disaster

Preparedness & Relief N.E.C.

Recreation & Sports

Code

N01 Alliances & Advocacy

N02 Employment Services

N03 Professional Societies &

Associations

N05 Research Institutes & Public

Policy Analysis

N11 Single Organization Support

N12 Fundraising & Fund Distribution

N19 Support N.E.C.

N20 Camps

N2A RV (Recreational Vehicle) Parks

& Campgrounds

N2B Recreational and Vacation

Camps (Except Campgrounds)

N30 Physical Fitness & Community

Recreational Facilities

N31 Community Recreational Centers

N32 Parks & Playgrounds

N40 Sports Training Facilities,

Agencies

N50 Recreational Clubs

N52 Fairs

N60 Amateur Sports

N61 Fishing & Hunting

N62 Basketball

N63 Baseball & Softball

N64 Soccer

N65 Football

N66 Racquet Sports

N67 Swimming & Other Water

Recreation

N68 Winter Sports

N69 Equestrian

N6A Golf

N70 Amateur Sports Competitions

N71 Olympics

N72 Special Olympics

N80 Professional Athletic Leagues

N99 Recreation & Sports N.E.C.

Youth Development

Code

O01 Alliances & Advocacy

O02 Management & Technical

Assistance

O03 Professional Societies &

Associations

O05 Research Institutes & Public

Policy Analysis

O11 Single Organization Support

O12 Fundraising & Fund Distribution

O19 Support N.E.C.

O20 Youth Centers & Clubs

O21 Boys Clubs

O22 Girls Clubs

O23 Boys & Girls Clubs

O30 Adult & Child - Matching

Programs

O31 Big Brothers & Big Sisters

O40 Scouting

O41 Boy Scouts of America

O42 Girl Scouts of the U.S.A.

O43 Camp Fire

O50 Youth Development Programs

O51 Youth Community Service Clubs

O52 Youth Development - Agricultural

O53 Youth Development - Business

O54 Youth Development - Citizenship

O55 Youth Development - Religious

Leadership

O99 Youth Development N.E.C.

Human Services

Code

P01 Alliances & Advocacy

P02 Management & Technical

Assistance

P03 Professional Societies &

Associations

P05 Research Institutes & Public

Policy Analysis

P11 Single Organization Support

P12 Fundraising & Fund Distribution

P19 Support N.E.C.

P20 Human Service Organizations

P21 American Red Cross

P22 Urban League

P24 Salvation Army

P26 Volunteers of America

P27 Young Men’s or Women

Associations

P28 Neighborhood Centers

P29 Thrift Shops

P30 Children & Youth Services

P31 Adoption

P32 Foster Care

P33 Child Day Care

P40 Family Services

P42 Single Parent Agencies

P43 Family Violence Shelters,

Services

P44 In-Home Assistance

P45 Family Services for Adolescent

Parents

P46 Family Counseling

P47 Pregnancy Centers

P50 Personal Social Services

P51 Financial Counseling

P52 Transportation Assistance

P58 Gift Distribution

P60 Emergency Assistance

P61 Travelers’ Aid

P62 Victims’ Services

P70 Residential Care & Adult Day

Programs

P71 Adult Day Care

P73 Group Homes

P74 Hospices

P75 Supportive Housing for Older

Adults

P76 Homes for Children &

Adolescents

P7A Residential Intellectual &

Developmental Disability

Facilities (Group Homes,

Intermediate Care Facilities &

Hospitals)

P80 Centers to Support the

Independence of Specific

Populations

P81 Senior Centers

P82 Developmentally Disabled

Centers

P83 Womens’ Centers

P84 Ethnic & Immigrant Centers

P85 Homeless Centers

P86 Blind & Visually Impaired

Centers

P87 Deaf & Hearing Impaired Centers

P88 LGBT Centers

P99 Human Services N.E.C.

International, Foreign Affairs &

National Security

Code

Q01 Alliances & Advocacy

Q02 Management & Technical

Assistance

Q03 Professional Societies &

Associations

Q05 Research Institutes & Public

Policy Analysis

Q11 Single Organization Support

Q12 Fundraising & Fund Distribution

Q19 Support N.E.C.

Q20 Promotion of International

Understanding

Q21 International Cultural Exchange

Q22 International Academic

Exchange

Q23 International Exchange N.E.C.

Q30 International Development

Q31 International Agricultural

Development

Q32 International Economic

Development

Q33 International Relief

Q35 International Democracy & Civil

Society Development

Q40 International Peace & Security

Q41 Arms Control & Peace

Q42 United Nations Associations

Q43 National Security

Q50 International Affairs, Foreign

Policy & Globalization

Q51 International Economic & Trade

Policy

Q70 International Human Rights

Q71 International Migration &

Refugee Issues

Q99 International, Foreign Affairs &

National Security N.E.C.

Civil Rights, Social Action &

Advocacy

code

R01 Alliances & Advocacy

Organizations

R02 Management & Technical

Assistance

R03 Professional Societies &

Associations

R05 Research Institutes & Public

Policy Analysis

R11 Single Organization Support

R12 Fundraising & Fund Distribution

R19 Support N.E.C.

R20 Civil Rights

R22 Minority Rights

R23 Disabled Persons’ Rights

R24 Womens’ Rights

R25 Seniors’ Rights

R26 Lesbian & Gay Rights

R28 Childrens’ Rights

R30 Intergroup & Race Relations

R40 Voter Education & Registration

R60 Civil Liberties

R61 Reproductive Rights

R62 Right to Life

R63 Censorship, Freedom of Speech

& Press

R67 Right to Die & Euthanasia

R99 Civil Rights, Social Action &

Advocacy N.E.C.

Community Improvement &

Capacity Building

Code

S01 Alliances & Advocacy

S02 Management & Technical

Assistance

S03 Professional Societies &

Associations

S05 Research Institutes & Public

Policy Analysis

S11 Single Organization Support

S12 Fund Raising & Fund Distribution

S19 Support N.E.C.

S20 Community & Neighborhood

Development

S21 Community Coalitions

S22 Neighborhood & Block

Associations

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Appendix D: National Taxonomy of Exempt Entities (NTEE) Codes (Continued)

S30

Economic Development

S31 Urban & Community Economic

Development

S32 Rural Economic Development

S40 Business & Industry

S41 Chambers of Commerce &

Business Leagues

S43 Small Business Development

S46 Boards of Trade

S47 Real Estate Associations

S50 Nonprofit Management

S80 Community Service Clubs

S81 Womens’ Service Clubs

S82 Mens’ Service Clubs

S99 Community Improvement &

Capacity Building N.E.C.

Philanthropy, Volunteerism &

Grantmaking Foundations

Code

T01 Alliances & Advocacy

T02 Management & Technical

Assistance

T03 Professional Societies &

Associations

T05 Research Institutes & Public

Policy Analysis

T11 Single Organization Support

T12 Fundraising & Fund Distribution

T19 Support N.E.C.

T20 Private Grantmaking

Foundations

T21 Corporate Foundations

T22 Private Independent Foundations

T23 Private Operating Foundations

T30 Public Foundations

T31 Community Foundations

T40 Volunteerism Promotion

T50 Philanthropy, Charity &

Volunteerism Promotion

T70 Federated Giving Programs

T90 Named Trusts N.E.C.

T99 Philanthropy, Voluntarism &

Grantmaking Foundations N.E.C.

Science & Technology

Code

U01 Alliances & Advocacy

U02 Management & Technical

Assistance

U03 Professional Societies &

Associations

U05 Research Institutes & Public

Policy Analysis

U11 Single Organization Support

U12 Fundraising & Fund Distribution

U19 Support N.E.C.

U20 General Science

U21 Marine Science & Oceanography

U30 Physical & Earth Sciences

U31 Astronomy

U33 Chemistry & Chemical

Engineering

U34 Mathematics

U36 Geology

U40 Engineering & Technology

U41 Computer Science

U42 Engineering

U50 Biological & Life Sciences

Research

U99 Science & Technology N.E.C.

Social Science

Code

V01 Alliances & Advocacy

V02 Management & Technical

Assistance

V03 Professional Societies &

Associations

V05 Research Institutes & Public

Policy Analysis

V11 Single Organization Support

V12 Fund Raising & Fund Distribution

V19 Support N.E.C.

V20 Social Science

V21 Anthropology & Sociology

V22 Economics

V23 Behavioral Science

V24 Political Science

V25 Population Studies

V26 Law & Jurisprudence

V30 Interdisciplinary Research

V31 Black Studies

V32 Women’s Study

V33 Ethnic Studies

V34 Urban Studies

V35 International Studies

V36 Gerontology

V37 Labor Studies

V99 Social Science N.E.C.

Public & Societal Benefit

Code

W01 Alliances & Advocacy

W02 Management & Technical

Assistance

W03 Professional Societies &

Associations

W05 Research Institutes & Public

Policy Analysis

W11 Single Organization Support

W12 Fundraising & Fund Distribution

W19 Support N.E.C.

W20 Government & Public

Administration

W22 Public Finance, Taxation &

Monetary Policy

W24 Citizen Participation

W30 Military & Veterans’

Organizations

W40 Public Transportation Systems

W50 Telecommunications

W60 Financial Institutions

W61 Credit Unions

W70 Leadership Development

W80 Public Utilities

W90 Consumer Protection

W99 Public & Societal Benefit N.E.C.

Religion-Related

Code

X01 Alliances & Advocacy

X02 Management & Technical

Assistance

X03 Professional Societies &

Associations

X05 Research Institutes & Public

Policy Analysis

X11 Single Organization Support

X12 Fundraising & Fund Distribution

X19 Support N.E.C.

X20 Christianity

X21 Protestant

X22 Roman Catholic

X30 Judaism

X40 Islam

X50 Buddhism

X70 Hinduism

X80 Religious Media &

Communications

X81 Religious Film & Video

X82 Religious Television

X83 Religious Printing & Publishing

X84 Religious Radio

X90 Interfaith Coalitions

X99 Religion Related, N.E.C.

Mutual & Membership Benefit

Code

Y01 Alliances & Advocacy

Y02 Management & Technical

Assistance

Y03 Professional Societies &

Associations

Y05 Research Institutes & Public

Policy Analysis

Y11 Single Organization Support

Y12 Fundraising & Fund Distribution

Y19 Support N.E.C.

Y20 Insurance Providers

Y22 Local Benevolent Life Insurance

Associations

Y23 Mutual Insurance Companies &

Associations

Y24 Supplemental Unemployment

Compensation

Y25 State-Sponsored Workers’

Compensation Reinsurance

Organizations

Y30 Pension & Retirement Funds

Y33 Teachers’ Retirement Fund

Associations

Y34 Employee-Funded Pension

Trusts

Y35 Multi-Employer Pension Plans

Y40 Fraternal Societies

Y41 Fraternal Beneficiary Societies

Y42 Domestic Fraternal Societies

Y43 Voluntary Employees Beneficiary

Associations (Non-Government)

Y44 Voluntary Employees Beneficiary

Associations (Government)

Y50 Cemeteries

Y99 Mutual & Membership Benefit

N.E.C.

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Index

Annual filing requirements 4

Annual returns for foreign

organizations 5

Answers 2

Appendix:

Glossary of terms 29

Sample conflict of interest

policy 25

States with statutory

provisions satisfying the

requirements of section

508(e) 27

Application for exemption:

Group exemption 3

Language and currency

requirements 3

Past, present and planned

activities 3

Purpose 3

User fee 3

Application package

assembly 3

Articles of incorporation 6

Assistance 4

Authorized representative 6

Canadian organizations 5

Church 16

Prescribed course of

study 17

Compensation:

Definition 10

Corporation:

Articles of incorporation 6

Definitions:

Authorized

representative 6

Charitable 7

Church 16

Compensation 10

Corporation 6

For-profit organization 22

Hospital 18

Medical research 18

Medical research

organization 18

Distribution of assets at

dissolution 8

EIN (See Employer

identification number)

Employer identification

number 6

Expedite requests 3

Filing assistance 4

Foreign organizations 5

Annual returns 5

Canadian organizations 5

General 5

United States territories and

possessions

organizations 6

Form 2848 4

Form 8821 4

For-profit organization 22

Glossary of terms 29

Group exemption 3

Homes for the elderly or

handicapped 22

Hospital 18

How to answer 2

Language and currency

requirements 3

LLC (See Limited liability

company)

Low-income housing 22

Mailing address 6

Medical research 18

Medical research

organization 18

Month and annual accounting

period 6

NASCO 2

NTEE 37

Operated 2

Qualification 2

Organizational structure 6

Organized 2

Qualification 2

Organizing document 2

Dissolution clause 8

Purpose clause 7

Required provisions 7

Unincorporated

association 7

Past, present and planned

activities 3

Pay.gov 6

Person to contact 6

Political campaign

intervention 2

Predecessor 22

Private foundations 2

processing the application:

Expedite requests 3

Public charities 2

Public charities and private

foundations 2

Public inspection 4

Purpose clause:

Charitable 7

Qualification:

Operated 2

Organized 2

Political campaign

intervention 2

Qualifications 2

Representation 4

Form 2848 4

Form 8821 4

Sample conflict of interest

policy 25

Scholarships, fellowships,

grants, loans 22

School:

Racially nondiscriminatory

policy 17

School 17

Section 501(c)(3) organization:

Eligibility 1

Private foundations 2

Public charities 2

Public charities and private

foundations 2

Qualifications 2

Recognition 1

Signature 4

State registration:

NASCO 2

States with section 508(e)

provisions 27

States with statutory provisions

satisfying the requirements

of section 508(e) 27

Successor 22

Supporting organization 20

Trust 7

Unincorporated association 7

United States territories and

possessions 6

User fee 3

What to file:

Required schedules 3

When to file 4

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