Instructions for F Instructions for Form 1023, Application for Recognition

Instructions for Form 1023

Department of the Treasury
Internal Revenue Service

(Rev. January 2020)

Application for Recognition of Exemption Under Section 501(c)(3) of the Internal
Revenue Code
Section references are to the Internal Revenue
Code unless otherwise noted.

Contents
Future Developments . . . . . . . .
What's New . . . . . . . . . . . . . .
Overview of Organizations
Described in Section 501(c)
(3) . . . . . . . . . . . . . . . . .
General Instructions . . . . . . . . .
Answers . . . . . . . . . . . . . . . .
Purpose of Form . . . . . . . . . . .
What To File . . . . . . . . . . . . .
When To File . . . . . . . . . . . . .
Filing Assistance . . . . . . . . . . .
Signature Requirements . . . . . .
Authorized Representative . . . .
Public Inspection . . . . . . . . . . .
Foreign Organizations . . . . . . .
Specific Instructions . . . . . . . . .
Part I. Identification of Applicant .
Part II. Organizational Structure .
Part III. Required Provisions in
Your Organizing Document .
Part IV. Your Activities . . . . . . .
Part V. Compensation and Other
Financial Arrangements . . .
Part VI. Financial Data . . . . . . .
Part VII. Foundation
Classification . . . . . . . . . .
Part VIII. Effective Date . . . . . . .
Part IX. Annual Filing
Requirement . . . . . . . . . .
Part X. Signature . . . . . . . . . . .
Schedule A. Churches . . . . . . .
Schedule B. Schools, Colleges,
and Universities . . . . . . . .
Schedule C. Hospitals and
Medical Research
Organizations . . . . . . . . . .
Schedule D. Section 509(a)(3)
Supporting Organizations . .
Schedule E. Effective Date . . . .
Schedule F. Low-Income
Housing . . . . . . . . . . . . .
Schedule G. Successors to Other
Organizations . . . . . . . . . .
Schedule H. Organizations
Providing Scholarships,
Fellowships, Educational
Loans, or Other Educational
Grants to Individuals and
Private Foundations
Requesting Advance
Approval of Individual Grant
Procedures . . . . . . . . . . .
Appendix A: Sample Conflict of
Interest Policy . . . . . . . . . .
Appendix B: States With Statutory
Provisions Satisfying the
Requirements of Internal
Feb 03, 2020

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Contents
Revenue Code Section
508(e) . . . . . . . . . . . . . . . .
Appendix C: Glossary of Terms . .
Appendix D: National Taxonomy of
Exempt Entities (NTEE)
Codes . . . . . . . . . . . . . . .
Index . . . . . . . . . . . . . . . . . . .

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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

. . . 22

Page

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.

Cat. No. 17132z

How To Get Forms and
Publications
Internet. You can access the IRS website
24 hours a day, 7 days a week, at IRS.gov
to do the following.
• Download forms, instructions, and
publications.
• Order IRS products online.
• Research your tax questions online.
• Search publications by topic or
keyword.
• Use the online Internal Revenue Code,
regulations, or other official guidance.
• View Internal Revenue Bulletins (IRBs)
published since 1995.
• Sign up at IRS.gov/Charities-NonProfits to receive local and national tax
news by email.
Tax forms and publications. You can
download or print all of the forms and
publications you may need at IRS.gov/
FormsPubs. Otherwise, you can go to
IRS.gov/OrderForms to place an order
and have forms mailed to you. You should
receive your order within 10 business
days.

Overview of Organizations
Described in Section
501(c)(3)
How To Request Recognition of
Tax-Exempt Status Under
Section 501(c)(3)

Section 501(c)(3) describes organizations
organized and operated exclusively for
religious, charitable, scientific, testing for
public safety, literary, or educational
purposes, or to foster national or
international amateur sports competition,
or for the prevention of cruelty to children
or animals. Unless an exception applies,
an organization must file Form 1023 or
Form 1023-EZ (if eligible) to obtain
recognition of exemption from federal
income tax under section 501(c)(3). You
can find information about eligibility to file
Form 1023-EZ at IRS.gov/Charities.
Organizations not required to
obtain recognition of exemption. The
following types of organizations may be
considered tax exempt under section
501(c)(3) without filing Form 1023 (or
Form 1023-EZ).
• Churches, including synagogues,
temples, and mosques.

• Integrated auxiliaries of churches and
conventions or associations of churches.
• Any organization that has gross
receipts in each tax year of normally not
more than $5,000. For more information
on gross receipts exceptions, go to
IRS.gov/Charities.
Even though these organizations aren't
required to seek recognition of exemption,
they may choose to file Form 1023 (or
Form 1023-EZ, if eligible) to receive a
determination letter stating they are
recognized as exempt under section
501(c)(3) status. The determination letter
will also state whether an organization
must file annual information returns or
notices and will specify whether
contributions to that organization are tax
deductible.
Requirements for Tax-Exempt
Status Under Section 501(c)(3)
To qualify for exemption under section
501(c)(3), an organization must be
organized and operated exclusively for
one or more exempt purposes.
Organized. An organization must be
organized as a corporation, a limited
liability company (LLC), an
unincorporated association, or a trust.
Its organizing document (corporate
articles of incorporation, LLC articles of
organization, articles of association or
constitution of an unincorporated
association, or trust agreement or
declaration of trust) must limit the
organization's purpose(s) and
permanently dedicate its assets to exempt
purposes.
Operated. An organization described in
section 501(c)(3) must be operated to
further one or more of the exempt
purposes stated in its organizing
document. Certain other activities are
prohibited or restricted, including, but not
limited to, the following activities. A
section 501(c)(3) organization must:
• Absolutely refrain from participating in
the political campaigns of candidates for
local, state, or federal office;
• Ensure its assets and earnings don’t
unjustly enrich board members, officers,
key management employees, or other
insiders;
• Not further non-exempt purposes (such
as purposes that benefit private interests)
more than insubstantially;
• Not operate for the primary purpose of
conducting a trade or business that isn’t
related to its exempt purpose(s);
• Not engage in activities that are illegal
or violate fundamental public policy; and
• Limit its legislative activities.
Legislative and political campaign intervention. Section 501(c)(3) denies
exemption to an organization if a
substantial part of its activities is

attempting to influence legislation or if it
directly or indirectly participates or
intervenes in any political campaign on
behalf of (or in opposition to) any
candidate for elective public office. These
issues are described in more detail in the
instructions for Part IV, lines 5 and 6.

Public Charities and Private
Foundations
Every organization described in section
501(c)(3) is classified as a private
foundation unless it qualifies for one of
the public charity exceptions. For some
organizations, the primary distinction
between a public charity and a private
foundation is its sources of financial
support.
Public charities. The following section
501(c)(3) organizations are classified as
public charities.
• Organizations that are public charities
based upon their activities (without regard
to their sources of support), such as
churches, schools, hospitals, medical
research organizations, and cooperative
hospital service organizations and
agricultural research organizations
(sections 509(a)(1) and 170(b)(1)(A)(i),
(ii), (iii), and (ix)).
• Organizations that normally receive
substantial support from grants,
governmental units, and/or contributions
from the general public (sections 509(a)(1)
and 170(b)(1)(A)(iv) and (vi)).
• Organizations that normally receive
more than one-third of their support from
contributions, membership fees, and
gross receipts from activities related to
their exempt functions, and not more than
one-third of their support from gross
investment income and net unrelated
business income (section 509(a)(2)).
• Organizations that support other public
charities (supporting organizations)
(section 509(a)(3)).
• Organizations that test for public safety
(section 509(a)(4)).
Private foundations. Section 501(c)(3)
organizations that don’t fit into any of the
foundation classifications above are
private foundations. Private foundations
are further classified as nonoperating
private foundations or private operating
foundations (section 4942(j)(3)).
Nonoperating private foundations.
Nonoperating private foundations
generally accomplish their exempt
purpose by making grants and don’t
otherwise engage directly in charitable
activities.
Private operating foundations. A
private operating foundation actively
conducts exempt programs. Private
operating foundations are subject to more
favorable rules than other private
foundations in terms of charitable
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contribution deductions and attracting
grants from private foundations. In order to
be classified as a private operating
foundation, an organization must meet
certain support tests. Search for “private
operating foundations” at IRS.gov for more
information.
Key distinctions between public charities and private foundations.
Foundation classification is important
because different tax rules apply to the
operations of each entity. For more
information on the different rules, see
IRS.gov/Charities-Non-Profits/EOOperational-Requirements-PrivateFoundations-and-Public-Charities.
Foundation classification has

TIP nothing to do with the name of the

organization. Many organizations
that aren't private foundations include the
word “foundation” in their names.

State Registration Requirements
Tax exemption under section 501(c)(3) is
a matter of federal law. After receiving
federal tax exemption, an organization
may also be required to register with one
or more states where it holds assets or
where it will solicit contributions. The
organization may also need to seek
exemption from state taxes. The National
Association of State Charity Officials
(NASCO) maintains a website that
provides informational links to the various
states for these purposes. It can be
accessed at 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.
Instructions for Form 1023

Your answers must provide
sufficient detail about your past,
CAUTION present, and planned activities to
demonstrate that you're described in
section 501(c)(3). We won't be able to
recognize you as tax exempt based on a
mission statement (such as providing
assistance to the poor) unless you also
describe the activities that further
accomplish your mission. We need to
understand the specific activities you will
undertake to accomplish your section
501(c)(3) exempt purpose(s).

!

Financial data. Financial data, whether
budgeted or actual, should be consistent
with other information presented in your
application.
For example, if you're requesting public
charity classification under one of the
public support tests, your financial data
should show contributions from the public
or receipts from providing exempt
services. Budgeted financial data should
be prepared based upon your current
plans. We recognize that your actual
financial results may vary from the
budgeted amounts.
Past, present, and planned activities.
Many items on Form 1023 are written in
the present tense; however, base your
answers on your past, present, and
planned activities.
Language and currency requirements.
Prepare Form 1023 and attachments in
English. Provide an English translation if
the articles of organization, bylaws, or any
other attachments are in any other
language.
Report financial information in U.S.
dollars (specify the conversion rate used).
Combine amounts from within and outside
the United States and report the total for
each on the financial statements.

Purpose of Form
Completed Form 1023 required to apply for recognition of section 501(c)(3)
exemption. Use Form 1023, including
the appropriate user fee, to apply for
recognition of exemption from federal
income tax under section 501(c)(3). If
approved, we will issue a determination
letter that describes your tax-exempt
status and your qualification to receive
tax-deductible charitable contributions.
The determination letter will also show
your specific foundation classification
(described earlier) and annual filing
requirements.
Form 1023-EZ. You may be
TIP eligible to file Form 1023-EZ,
Streamlined Application for
Recognition of Exemption Under Section
501(c)(3) of the Internal Revenue Code,
which is a streamlined version of Form
1023. Complete the Form 1023-EZ
Instructions for Form 1023

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.
-3-

User fee amounts are listed in Rev.
Proc. 2020-5, updated annually. For the
current Form 1023 user fee, go to Rev.
Proc. 2020-5, 2020-1 I.R.B. 241, at
IRS.gov/Charities-Non-Profits/User-Feesfor-Tax-Exempt-and-Government-EntitiesDivision. You can also call 877-829-5500.

Group Exemption

Don't use Form 1023 to apply for a group
exemption. We may issue to a central
organization a group exemption that
recognizes on a group basis the
exemption of subordinate organizations
on whose behalf the central organization
has applied. See Pub. 557 for information
on how to apply for a group exemption.

What To File

All applicants, unless otherwise noted,
must complete Parts I through X of Form
1023, plus any required schedules and
attachments.
The following organizations must
complete additional schedules to Form
1023.
THEN you
must
complete
Schedule

IF you’re
A church

. . . . . . . . . . .

A school, college, or
university . . . . . . .

. . .

B

. .

C

. . . .

D

A hospital or medical
research organization
A section 509(a)(3)
supporting
organization . . . .

A

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

. . .

G

A successor to other
organizations . . . . .

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.

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.

!

CAUTION

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.
-4-

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/CharitableOrganizations/Exempt-OrganizationSample-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

TIP other returns, such as

employment tax returns or benefit
plan returns, which aren't discussed here.
If a Form 990-series return is due
while your application is pending,
CAUTION complete and submit the return
according to Form 990-series form's
instructions.

!

Public Inspection
Information available for public inspection. If we approve exempt status
under section 501(c)(3), the following
information that will be open for public
inspection includes the following.
• Your complete Form 1023 and any
supporting documents.
• All correspondence between you and
the IRS concerning Form 1023, including
Form 2848.
• Your determination letter.
• Annual information returns (Forms 990,
990-EZ, or 990-PF).
• Schedule A, included with Forms 990 or
990-EZ.
• Schedule B, included with Forms 990 or
990-EZ, excluding the names and
Instructions for Form 1023

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

Instructions for Form 1023

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.

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

TIP foreign organizations generally

aren’t deductible. Tax treaties
between the U.S. and certain foreign
countries provide specific limited
exceptions.

Annual returns for foreign organizations. A foreign organization that obtains
exemption as a public charity must file an
information return annually (Form 990 or
Form 990-EZ). A foreign organization that
is a private foundation must file Form
990-PF annually. However, a foreign
organization, other than a private
foundation or a section 509(a)(3)
supporting organization, may file Form
990-N (e-Postcard) instead of Form 990 or
Form 990-EZ when its gross receipts from
-5-

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).

• 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 Number (EIN). You must have your own EIN.
Enter the 9-digit EIN the IRS assigned to
you. If you don’t have an EIN, you must
apply for one before submitting your
application. You can find out how to apply
for an EIN by visiting IRS.gov and search
for “apply for an EIN.” You may apply for
an EIN online or by fax or mail.
International applicants may call
267-941-1099 (toll call).
Don’t apply for an EIN more than

TIP once. If you’re unsure of your EIN

or whether you have one, call
877-829-5500 for assistance.

!

Don’t use the EIN of a related or
other organization.

CAUTION

Line 3. Month tax year ends. Select the
month your tax year (annual accounting
period) ends. Your tax year (annual
accounting period) is the 12-month period
on which your annual financial records are
based.
Check your bylaws or other rules

TIP of operation for consistency with

the tax year (annual accounting
period) you enter here.

Line 4. Person to contact. Enter the
name and title of the person you want us
to contact if we need more information.
The person to contact may be an officer,
director, trustee, or other individual who is
permitted to speak with us according to
your bylaws or other rules of operation.
Your person to contact may also be an
authorized representative, such as an
attorney, certified public accountant, or
enrolled agent, for whom you’re submitting
a completed Form 2848 with the Form
1023.
Line 5. Provide a daytime telephone
number for the contact listed on line 4.
Line 6. You may provide a fax number for
the contact listed on line 4.
Line 7. Pay.gov will populate this field
with the current user fee for filing Form
1023.
Line 8. Enter your complete website
address if you have one. Also, list any
websites maintained on your behalf. The
information on your website should be
consistent with the information in your
Form 1023.
Line 9. Officers, directors, and trustees. Enter the full names, titles, and
mailing addresses of your officers,
directors, and/or trustees. You may use
the organization’s address for mailing. If
you have more than five officers, directors,
-6-

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
Instructions for Form 1023

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

TIP treated as a disregarded entity by

a tax-exempt member, don’t file
an exemption application.
Unincorporated association. An
unincorporated association formed
under state law must have at least two
members who have signed a written
document that creates an entity with a
specifically defined purpose.

Copy of organizing document
(articles of association or constitution
and any amendments). Your organizing
document must include the name of the
organization, its purpose, the date the
document was adopted, and the
signatures of at least two individuals. If
your copy doesn’t contain the proper
signatures and date of adoption, you may
submit a written declaration that states
your copy is a complete and accurate
copy of the signed and dated original.
Your declaration should clearly indicate
the original date of adoption.
Bylaws may be considered an

TIP organizing document only if they

include the required elements
listed above.

Trust. A trust may be formed by a trust
agreement or declaration of trust. A trust
may also be formed through a will.
Generally, a trust must be funded with
property, such as money, real estate, or
personal property.
Copy of organizing document (trust
agreement/declaration of trust or will
and any amendments). Your trust
agreement (and any amendments) must
be signed by at least one trustee. If your
trust agreement copy isn’t signed, you
may submit a written declaration that
states your copy is a complete and
Instructions for Form 1023

accurate copy of the signed and dated
original. Your declaration should clearly
indicate the original date that it was
signed. For trusts created by a will, include
a copy of the death certificate or a
statement indicating the date of death,
and a copy of the relevant portions of the
will.
If your trust agreement continues
to provide for distributions for
CAUTION non-charitable interests, you won’t
qualify for tax-exempt status.

!

Line 2. Formation date. The date you
enter should be consistent with your
organizing document.
• If you’re a corporation, enter the date
that your articles of incorporation were
filed and approved by the appropriate
authority.
• If you’re an LLC, enter the date that the
appropriate authority filed your articles of
organization or other organizing
document.
• If you’re an unincorporated association,
enter the date that your organizing
document was adopted by the signatures
of at least two individuals.
• If you’re a trust (other than a trust
formed by a will), enter the date your trust
was funded. If your trust agreement
provided for any non-charitable interests,
enter the date that non-charitable interests
expired. If you were formed by a will, enter
the date of death or the date any
non-charitable interests expired.
Line 3. State of formation. Enter the
jurisdiction (for instance, the state or the
federally recognized tribal government)
under the laws of which you were
incorporated or otherwise formed. This
may not be the place in which you’re
physically located. For example, if you’re
physically located in New York, but
incorporated under Massachusetts law,
enter Massachusetts.
For purposes of completing this
application, you’re formed under the laws
of a foreign country if you’re not formed
under the laws of the United States, its
territories and possessions, federally
recognized Indian tribal or Alaska native
governments, or the District of Columbia.
Line 4. “Bylaws” are generally the
internal rules and regulations of an
organization. If you have bylaws, upload a
current copy (including any amendments).
Bylaws don’t need to be signed unless
they are your organizing document as
described in the instructions for line 1
above.
Line 5. Successor organization. You
are a “successor” if you:
• Took over activities previously
conducted by another organization,

-7-

• Took over 25% or more of the fair
market value of the net assets of another
organization, or
• Were established upon the conversion
of an organization from for-profit to
non-profit status.
If you’re a successor organization,
complete Schedule G, Successors to
Other Organizations.
Your predecessor organization

TIP may have been either a

tax-exempt or non-exempt
organization.

Part III. Required
Provisions in Your
Organizing Document
Line 1. Purpose clause. Your
organizing document must limit your
purposes to those described in section
501(c)(3). Those purposes are charitable,
religious, educational, scientific, literary,
testing for public safety, fostering national
or international amateur sports
competition, and preventing cruelty to
children or animals.
The generally accepted legal definition
of “charitable” includes relief of the poor,
the distressed, or the underprivileged;
advancement of religion; advancement of
education or science; erecting or
maintaining public buildings, monuments,
or works; lessening the burdens of
government; lessening neighborhood
tensions; eliminating prejudice and
discrimination; defending human and civil
rights secured by law; and combating
community deterioration and juvenile
delinquency. Therefore, the phrase “relief
of the poor” in your organizing document
properly limits your purposes.
Limiting your purposes by reference to
section 501(c)(3) generally will be
sufficient to meet the organizational test
under section 501(c)(3). Your organizing
document may also sufficiently limit your
purpose by reference to a specific
charitable purpose such as “relief of the
elderly within the meaning of section
501(c)(3).”
However, purposes listed in your
organizing document broader than those
listed in section 501(c)(3) may cause you
to fail the organizational test. In that case,
you will need to amend your organizing
document before applying. A reference to
section 501(c)(3) won’t ensure that your
purposes are limited to those described in
section 501(c)(3) if other provisions
describing your purposes include one or
more non-exempt purposes. The following
is an example of an acceptable purpose
clause.

The organization is organized
exclusively for charitable,
religious, educational, and
scientific purposes under
section 501(c)(3) of the Internal
Revenue Code, or
corresponding sections of any
future federal tax code.
See Pub. 557 for further information
and examples of how to limit your
purposes.
Line 2. Dissolution clause. Your
organizing document must provide for
the permanent dedication of your assets
to a section 501(c)(3) purpose. This
means that if you dissolve your
organization in the future, your assets
must be distributed for an exempt purpose
described in section 501(c)(3), or to the
federal government, or to a state or local
government, for a public purpose. In
certain states, you may rely on state law to
establish the permanent dedication of
assets for exempt purposes. This is based
on Rev. Proc. 82-2, 1982-1 C.B. 367. For
additional information, search “Operation
of state law” at IRS.gov.
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?
-8-

• 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

TIP purposes other than identification

of organizations described in
section 501(c)(3). Therefore, all codes in
the list don't necessarily correspond to a
section 501(c)(3) purpose.

Line 3. If programs are limited to specific
individuals, describe how you select or
identify those individuals. If programs are
available only for members, describe
membership criteria, any membership
dues, any different membership levels,
and the benefit each membership level
receives.
Line 4. Describe any business or family
relationship between individuals who
receive goods, services, or funds through
your programs and any officers, directors,
trustees, or highest compensated
employees or independent contractors.
For purposes of this form, “highest
compensated” employees or independent
contractors are persons to whom you pay
over $100,000 of compensation,
including compensation from related
organizations.
Line 5. You participate in a political
campaign if you promote or oppose the
candidacy of an individual for public office.
Candidate debates and nonpartisan voter
education and registration may be
permitted. See Rev. Rul. 2007-41,
2007-25 I.R.B. 1421 at IRS.gov/irb/
2007-25_I.R.B. 1421 and Pub. 1828 for
more information and examples.
Organizations described in
section 501(c)(3) are prohibited
CAUTION from supporting or opposing
candidates for public office in any political
campaign. If you answer “Yes,” you aren’t
qualified for tax exemption under section
501(c)(3) and should reconsider whether
the filing of application Form 1023 is
appropriate for you. See Pub 557 for a

!

Instructions for Form 1023

description of other code sections under
which you may qualify.
Line 6. You are attempting to influence
legislation if you directly contact or urge
the public to contact members of a
legislative body for the purpose of
proposing, supporting, or opposing
legislation. You are also attempting to
influence legislation if you advocate the
adoption or rejection of legislation. If you
answer “Yes,” your explanation should
include the percentage of your total time
and total funds spent on such legislative
activities.
Organizations described in section
501(c)(3) are prohibited from engaging in
a substantial amount of legislative
activities. Whether you’re engaged in
substantial legislative activities depends
on all of the facts and circumstances.
For this purpose, “legislation” includes
action by Congress, a state legislature, a
local council, or a similar governing body,
with respect to acts, bills, resolutions or
similar items (such as legislative
confirmation of appointive offices).
Legislation also includes action by the
public in a referendum, ballot initiative,
constitutional amendment, or similar
procedure. Legislation generally doesn’t
include actions by executive, judicial, or
administrative bodies.
Organizations may involve themselves
in issues of public policy without being
engaged in legislative activity. For
example, organizations may conduct
educational meetings, prepare and
distribute educational materials, or
otherwise consider public policy issues.
Similarly, an organization may appear
before a governmental body at its request
to offer testimony about a decision that
may affect the organization’s existence.
A private foundation isn’t allowed

TIP to engage in any activities to
influence legislation.

Line 6a. Form 5768. Most public
charities are eligible to elect to make
expenditures to influence legislation by
filing Form 5768, Election/Revocation of
Election by an Eligible Section 501(c)(3)
Organization To Make Expenditures To
Influence Legislation. By filing Form 5768,
your legislative activities will be measured
solely by an expenditure limit under
section 501(h) rather than by whether the
legislative activity is considered
substantial. Form 5768 describes the
types of organizations that are eligible to
make an election. You must file Form
5768 by mailing it to the address on the
form. For a discussion of influencing
legislation and the requirements of section
501(h), see Pub 557.

Instructions for Form 1023

!

CAUTION

Churches and private foundations
aren’t eligible to make this section
501(h) election.

Line 7. Intellectual property includes
the following;
• Patents (for inventions);
• Copyrights (for literary and artistic
works such as novels, poems, plays, films,
musical works, drawings, paintings,
photographs, sculptures, architectural
designs, performances, recordings, film,
and radio or television programs);
• Trade names, trademarks, and service
marks (for symbols, names, images, and
designs); and
• Formulas, know-how, and trade
secrets.
Line 8. These activities involve the
education of the consumer on budgeting,
personal finance, financial literacy,
mortgage foreclosure assistance, or other
consumer credit areas. These activities
may also involve assisting the consumer
in consolidating debt and negotiating
between debtors and creditors to lower
interest rates and waive late and over-limit
fees. If you answer “Yes,” you may be
subject to the requirements of section
501(q). Search “501(q)” on IRS.gov for
information on these requirements and
whether they apply to you.
Line 9. A “relationship” between you
and the recipient organization includes the
following situations.
• You control the recipient organization,
or it controls you through common
officers, directors, or trustees, or through
authority to approve budgets or
expenditures.
• You and the recipient organization were
created at approximately the same time
and by the same persons.
• You and the recipient organization
operated in a coordinated manner with
respect to facilities, programs, employees,
or other activities.
• Persons who exercise substantial
influence over you also exercise
substantial influence over the recipient
organization.
Line 9b. Answer “Yes,” if you make
grants, loans, or other distributions (such
as goods) to a foreign organization.
Line 9g–i. The Office of Foreign Assets
Control (OFAC) of the U.S. Department of
the Treasury administers and enforces
economic and trade sanctions based on
U.S. foreign policy and national security
goals against certain governments,
entities, and individuals, as directed in
Executive Orders. As part of the
comprehensive and sustained campaign
against terrorist financing, all U.S.
persons, including U.S.–based charities,
are prohibited from dealing with persons
(individuals and entities) identified as
-9-

being associated with terrorism on
OFAC’s Specially Designed Nationals and
Blocked Persons List (OFAC SDN List).
Information about OFAC sanction
programs and the OFAC SDN List are
available at www.treasury.gov/ofac.
Line 10. A “foreign country” is a
country other than the U.S., its territories
and possessions, and the District of
Columbia.
Line 10a–c. See instructions for lines 9g–
i.
Line 11. You are a sponsoring
organization of a donor-advised fund if
you establish separate accounts that you
own or control for a donor whereby the
donor or donor-advisor may make
recommendations about the investments
of or distributions from the account. See
Pub. 557 for more information on the
definitions of sponsoring organizations
and donor-advised funds.

!

CAUTION

You can't sponsor a
donor-advised fund if you're a
private foundation.

Line 12. A “school” is an educational
organization whose primary function is the
presentation of formal instruction and
which normally maintains a regular faculty
and curriculum and that normally has a
regularly enrolled body of pupils or
students in attendance at the place where
its educational activities are regularly
carried on. A school may include the
following.
• Primary, secondary, preparatory, or
high school.
• College or university.
• Trade or technical school.
• Nursery or pre-school.
• School that you operate as an activity,
such as a school that is operated as an
activity of a museum, historical society, or
church.
If you're a nursery or pre-school

TIP that doesn't meet the description
line 12.

of a school, answer “No,” to

If you’re a nursery, pre-school, or

TIP child care organization that

doesn’t meet the description of a
school, you may still further an educational
purpose if substantially all the care you
provide is for the purpose of enabling
individuals to be gainfully employed and
your services are available to the general
public (section 501(k)).
If you’re a school, or if you operate a
school as an activity (even if it is a
secondary activity), complete Schedule B.
See Pub. 557 for additional information.
Line 13. “Hospital” or “medical care”
includes the treatment of any physical or

mental disability or condition, whether as
an inpatient or outpatient. A hospital
includes the following.
• Hospitals and rehabilitation institutions,
outpatient clinics, or community mental
health or drug treatment centers if the
principal purpose or function is the
providing of medical or hospital care or
medical education or research.
• Medical research organizations if the
principal purpose or function is the
continuous active conduct of medical
research in conjunction with a hospital.
If you provide “hospital or medical
care,” or you’re a medical research
organization, complete Schedule C.
See Pub. 557 for additional
information.
Line 14. “Low-income housing” refers
to rental or ownership housing provided to
persons based on financial need. If you
provide low-income housing, complete
Schedule F.
Line 15. Answer “Yes,” if you pay money
to an individual as a scholarship,
fellowship, or education loan; for travel,
study, or other similar purposes. Also,
answer “Yes,” if you pay such amounts on
behalf of an individual to a school or a
tuition or educational savings program.
Complete Schedule H—Section I.
Travel, study, or other similar purposes
include payments made to enhance a
literary, artistic, musical, scientific,
teaching or other similar capacity, skill, or
talent of the individual recipient. These
payments include, for example, amounts
paid to:
• Vocational high school students to be
used to purchase basic tools;
• Teachers to induce them to teach in a
public school system in an economically
depressed area; and
• A scientific researcher to underwrite
that individual’s research project.
Educational grants don’t include
amounts you pay to an individual as
compensation, such as payments made to
a consultant for personal services or to
produce a report for you.
Educational grants don’t include
amounts paid to another organization that
distributes your funds as a scholarship to
an individual if you have no role in the
selection process.
If you're a “private foundation”
as described in Part VII, you must
CAUTION obtain advance approval of your
grant-making procedures. You can use
Schedule H—Section II, to request
advance approval as part of this
application process. You can complete
Section II when you complete Part VII.
Foundation Classification.

!

Line 16. “Fundraising”includes efforts
to raise funds through appeals for financial

support. Fundraising may be conducted
by your employees or volunteers, through
an agent, or through an independent
contractor. Check all the boxes that apply.
For purposes of this application,
“bingo” is a game of chance played with
cards that generally are printed with five
rows of five squares each on which
participants place markers to form a
pre-selected pattern to win the game.
“Other (non-bingo) gaming activities”
include pull-tabs, raffles, keno,
split-the-pot, and other games of chance.
Gaming doesn’t further an

TIP exempt purpose under section

501(c)(3). Except to the extent
that an exception may apply, your revenue
from gaming activities will be subject to
unrelated business income tax. See
Pub. 3079 for further information about
gaming.

Part V. Compensation and
Other Financial
Arrangements
Reminder. Answer all questions in this
part as they pertain to your past, present,
and future activities.
For purposes of Part V, compensation
includes:
• Salary or wages;
• Deferred compensation;
• Retirement benefits, whether in the
form of a qualified or non-qualified
employee plan (pensions or annuities);
• Fringe benefits (personal vehicle,
meals, lodging, personal and family
educational benefits, low-interest loans,
payment of personal travel, entertainment,
or other expense, athletic or country club
membership, and personal use of your
property); and
• Bonuses.
Example. An organization could
compensate a director as follows:
Wages
Director
Compensation . . .
Salary as Chief Executive
Officer . . . . . . . . . . . . . . .
Deferred retirement . . . . . .
Health insurance policy . . .
Use of a vehicle . . . . . . . .
Total Compensation

$2,500

40,000
2,000
5,000
5,000
$54,500

Make sure the information you provide in
Part V is consistent with the information
you enter in Part VI. Financial Data.
Line 1. Compensation. Check “Yes,” if
you do or you will compensate your
officers, directors, or trustees. Also, check
-10-

“Yes,” if you will or you do have highest
compensated employees or highest
compensated independent contractors.
For purposes of this form, “highest
compensated” employees or independent
contractors are persons to whom you pay
over $100,000 of compensation,
including compensation from related
organizations.
For information on determining if an
individual is an employee or an
independent contractor, see Pub. 15-A,
Employer’s Supplemental Tax Guide.
Line 1e. “Similarly situated
organizations” means tax-exempt or
taxable organizations of comparable size,
purpose, and resources. Adjustments due
to geographic area and other specified
conditions are appropriate, but you should
document the adjustments. You should
document the sources(s) of comparable
compensation data, both taxable and
non-taxable, and retain copies in your
permanent records.
Line 1g. “Reasonable compensation”
is the amount that would ordinarily be paid
for like services by like organizations
under like circumstance as of the date the
compensation arrangement is made.
Establishing and documenting your
decisions about compensation is
important because excess compensation
(including cash and other benefits that
aren’t accounted for as reasonable
compensation for services) may result in
excise taxes on both the individual and
you, and may jeopardize your tax
exemption.
Line 2. A conflict of interest arises when a
person in a position of authority over an
organization, such as a director, officer, or
manager, may benefit personally from a
decision he or she could make. A sample
Conflict of Interest Policy is included as
Appendix A. This sample conflict of
interest policy doesn’t prescribe any
specific requirements. Therefore,
organizations should use a conflict of
interest policy that best fits their
organizations.
Adoption of a conflict of interest policy
isn’t required to obtain tax-exempt status.
However, by adopting the sample policy or
a similar policy, you will be choosing to put
in place procedures that will help your
officers, directors, and trustees recognize
situations that could present potential or
actual conflicts of interest so that you can
take steps to reduce the risk that those in
positions of authority over you may
receive an inappropriate benefit.
The sample conflict of interest

TIP policy in Appendix A includes

items marked “Hospital insert–for
hospitals that complete Schedule C” that
are intended to be adopted by hospitals.
Instructions for Form 1023

Line 3. A fixed payment means a
payment that is either a set dollar amount
or fixed through a specific formula where
the amount doesn’t depend on discretion.
For example, a salary of $200,000 that is
adjusted annually based on the increase
in the Consumer Price Index is a fixed
payment.
A “non-fixed payment” means a
payment that depends on discretion. For
example, a bonus of up to $100,000 that is
based on an evaluation of performance by
the governing board is a non-fixed
payment because the governing body has
discretion over whether the bonus is paid
and on the amount of the bonus.
Line 4. Don’t include purchases or sales
of goods and services in your normal
course of operations that are available to
the general public under similar terms and
conditions.
Answer “Yes,” if any of your officers,
directors, or trustees:
• Is an officer, director, or trustee of
another organization (other than a section
501(c)(3) organization) that you will
purchase or sell goods, services, or
assets from or to; or
• Possesses more than 35% ownership
interest in any organization that you will
purchase or sell goods, services, or
assets from or to.
Arm’s length. An arm’s length
standard exists where the parties have an
adverse (or opposing) interest. For
example, a seller wants to sell his goods
at the highest possible price, while a buyer
wants to buy at the lowest possible price.
These are adverse interests.
In negotiating with a person, an
adverse interest is assumed if that person
is otherwise unrelated to you in the sense
of not being in a position to exercise
substantial influence over you or your
affairs. If the person is in a position to
exercise substantial influence over your
affairs, then an arm’s length standard
requires additional precautions to
eliminate the effect of the relationship.
Using a conflict of interest policy,
information about comparable
transactions between unrelated parties,
and reliable methods for evaluating the
transaction, are examples of precautions
that would help make the negotiation
process equivalent to one between
unrelated persons.
Fair market value. This is the price at
which property or the right to use property
would change hands between a willing
buyer and a willing seller, neither being
under any compulsion to buy, sell, or
transfer property or the right to use
property, and both having reasonable
knowledge of relevant facts.

Instructions for Form 1023

Line 5. Answer “Yes,” if any of your
officers, directors, or trustees:
• Is an officer, director, or trustee in
another organization (other than a section
501(c)(3) organization) that has a lease,
contract, loan, or other agreement with
you; or
• Possesses more than a 35% ownership
interest in any organization that has a
lease, contract, loan, or other agreement
with you. For example, answer “Yes,” if
one of your directors is an officer for a
section 501(c)(4) organization with whom
you have a lease for office space, or if one
of your directors owns more than 35% of
the voting stock of a corporation to which
you made a loan.
Line 6. “Develop” means the planning,
financing, construction, or provision of
similar services involved in the acquisition
of real property, such as land or a building.
For example, you should provide
information regarding the services of a
consultant who arranges your acquisition
of a facility through the issuance of
tax-exempt bonds.
Line 7. “Manage” means to direct or
administer. For example, you would
provide information about an organization
hired to administer a museum gift shop.
Line 8. A “joint venture” is a legal
agreement in which the persons jointly
undertake a transaction for mutual profit.
Generally, each person contributes assets
and shares risks. Like a partnership, joint
ventures can involve any type of business
transaction and the persons involved can
be individuals, groups of individuals,
companies, or corporations.

Part VI. Financial Data
Line 1. Select the option that best
describes you to determine the years of
revenues and expenses you need to
provide.
Completed less than 1 year. If
you’ve existed for less than 1 year,
provide projections of your likely income
and expenses for your current year and
projections of your likely income and
expenses for the next 2 years based on a
reasonable and good faith estimate of
your future finances for a total of 3 years of
financial information. Place financial
information for the year you’re filing this
application in the column marked Current
tax year.
Completed more than 1 year, fewer
than 5 years. If you’ve existed for more
than 1 year but fewer than 5 years,
provide your actual income and expenses
for each completed year you’ve existed
and projections of your likely income and
expenses based on a reasonable and
good faith estimate of your future finances
for your current year and each year you
-11-

haven’t existed, for a total of 4 years of
financial information. Place financial
information for the year you’re filing this
application in the column marked Current
tax year.
Completed 5 years or more. If
you’ve existed for 5 years or more, provide
your actual income and expenses for your
5 most recently completed tax years.
Place financial information for your most
recently completed tax year in the column
marked Current tax year.

!

We may request financial
information for more than 5 years.

CAUTION

A. Statement of Revenue and
Expenses
Preparing the statement. Prepare the
statement using the method of accounting
you use in keeping your books and
records.
Prepare the statement using the
accounting period entered on Part I, line 3.
Enter “0” if a particular revenue or
expense doesn’t apply to you.
Your financial information should reflect
your activities described in this
application.
Line 1. Enter the total gifts, grants, and
contributions you receive (other than
membership dues reported on line 2 and
described below). Include items of value
that you receive as gifts, grants, or
contributions. For example, if one of your
activities is a food drive, include the value
of the donated food on this line. Also
include on this line payments a
governmental unit makes to enable you to
both accomplish your exempt purpose(s)
and to provide a service or facility directly
to the general public.
See the instructions for line 9 if you’re
uncertain whether revenue should be
included as a grant on line 1 or as gross
receipts on line 9. Include unusual
grants on line 12 and not on line 1.
Examples.
1. A city pays the symphony orchestra
to provide free music programs in the
public schools. The programs are open to
the public. This income received from a
governmental unit accomplishes the
orchestra's exempt purpose and directly
provides a service to the general public.
This income is a grant to the symphony
orchestra that should be listed on line 1.
2. The symphony orchestra sells
tickets to the public for its fall season.
Such income is gross receipts received
from the general public in performance of
the symphony orchestra’s exempt function
and should be listed on line 9.
3. The public school system pays the
orchestra to create several musical pieces

Figure 2. Net Gain or Loss On Sales of Capital Assets
Categories
(A) Real Estate

(B) Securities

(C) Other

1. Gross sales price of
assets (other than
inventory) by category.

Line 10. Lines 8 and 9 will be added for
you.

2. Less: Cost or other
basis and sales
expenses.

Line 11. Enter any net gain or loss on the
sale of capital assets. Provide an itemized
list by asset category (for example, real
estate or securities) showing gross sales,
cost or other basis/sales expenses, and
gain or loss by asset category in line 25.
You may use the format in Figure 2.

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.

suitable for the school system’s
elementary music curriculum. This
payment by a governmental unit for the
music compositions is primarily for the
school system’s own use, not for the direct
benefit of the public. Therefore, this
income is gross receipts received from a
governmental unit in performance of the
orchestra’s exempt function that should be
listed on line 9.
Line 2. Enter the amount you receive
from members to provide support to the
organization. Don’t include payments from
members or on behalf of members to
purchase admissions, merchandise,
services, or use of facilities.
Line 3. Enter your gross income from
dividends, interest, payments received on
securities, loans, rents, and royalties you
hold for investment purposes.
See Pub. 598 for additional information
regarding royalties treated as unrelated
business income.
Line 4. Enter your net income from
unrelated business activities. “Unrelated
business income” generally is income
from any trade or business activity that is
regularly carried on, and not related to
your exempt purpose. Certain exceptions
and exclusions may apply.
Report on line 9 income from activities
that aren’t related to the accomplishment
of your exempt purposes, but aren’t
considered unrelated business activities.
For example, report income from the sale
of merchandise by volunteers that isn’t
treated as an unrelated trade or business
on line 9.
See Pub. 598 for additional information
regarding unrelated business income.
Line 5. Enter amounts any local tax
authority collects from the public on your
behalf.
Line 6. Enter the value of services or
facilities a governmental unit furnishes to
you. Use the fair market value of the
services or facilities. Don’t include the
value of services or facilities generally

Provide an itemized list of your gross
receipts in line 25, describing the sources
and amounts of income. For payments by
a governmental unit, list the payer, the
purpose of the payment, and the payment
amount.

provided by the governmental unit to the
public without charge.
Line 7. Enter your total income from all
sources not reported on lines 1 through 6,
or lines 9, 11, and 12. Provide an itemized
list in line 25, showing each type and
amount of income included, and a brief
description of each type of income.
Line 8. Lines 1 through 7 will be added
for you.
Line 9. Enter income from activities that
you conduct to further your exempt
purposes (excluding amounts listed on
other lines). Also, include as gross
receipts the income from activities
conducted:
• Intermittently (not regularly carried on),
such as an occasional auction;
• With substantially all (at least 85%)
volunteer labor, such as a car wash;
• For the convenience of members,
students, patients, officers, or employees,
such as a parking lot for a school’s
students and employees; or
• With substantially all contributed
merchandise, such as a thrift store.
See Pub. 598 for additional information
regarding income that isn’t from an
unrelated trade or business.
“Gross receipts” also includes
payment by a governmental unit that may
be called a “grant” but is actually payment
for a service or facility for the use of the
government payer, rather than for the
direct benefit of the public.
Example. The state government gives
a conservation group a grant to study the
effects of a new sewage treatment plant
on an ecologically significant woodland
area. Although the payment is called a
grant, it is actually gross receipts that
should be included on line 9. The payment
is by a governmental unit (state) for a
study for its own use, not for the direct
benefit of the general public. A for-profit
consulting company could’ve done the
study rather than by the tax-exempt
conservation group.

-12-

Line 12. Enter any “unusual grants,”
which generally are any substantial
contributions and bequests you received
from disinterested persons that, by their
size, adversely affect your classification as
a public charity. “Unusual grants” are
unusual, unexpected, and received from
an unrelated party. Provide an itemized list
of any unusual grants, including the
amount in line 25, and explain how it was
unusual, unexpected, and from an
unrelated party.
For additional information about
unusual grants and a description of public
charity classifications, see Pub. 557.
Line 13. Lines 10 through 12 will be
added for you.
Lines 14. Enter the total expenses you
incur for soliciting gifts, grants, and
contributions included on line 1. Include
fees paid to professional fundraisers for
soliciting gifts, grants, and contributions.
Line 15. Enter the total amount you pay
out to both individuals and organizations.
Provide an itemized list in line 25,
identifying recipients (using letter
designations such as A, B, C, etc.), a brief
description of the purposes or conditions
of payments, and the amounts paid.
Colleges, universities, and other
educational institutions and agencies
subject to the Family Educational Rights
and Privacy Act (20 U.S.C. 1232g) don’t
need to list the names of individuals to
whom they provided scholarships or other
financial assistance where such
disclosure would violate the privacy
provisions of the law. Instead, group each
type of financial aid provided, indicate the
number of individuals who received the
aid, and specify the aggregate dollar
amount.
Maintain (but don’t submit) a list
showing the names of recipients
associated with each letter designation.
Line 16. Enter total payments you make
to or for the benefit of your members (not
including any amounts listed on line 15).
Provide an itemized list in line 25,
identifying recipients (using letter
Instructions for Form 1023

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.

Instructions for Form 1023

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
-13-

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.

You can only select one

TIP foundation classification.
Line 1. Select the foundation
classification you’re requesting from the
list below. The form will then take you to
additional lines or parts of the application
that you must complete based on your
response.
509(a)(1) and 170(b)(1)(A)(vi). Select
this classification if you normally receive a
substantial part of your support from
grants from governmental units or from
contributions from the general public, or a
combination of these sources. Typically,
you would show a substantial part of your
income on Part VI-A. Statement of
Revenue and Expenses, lines 1 and 2.
Under this public charity
classification, you must meet the one-third
public support test or 10% facts and
circumstances test. See Pub. 557 for more
information.
Public support test. An organization
must receive either:
1. At least one-third of its total support
from governmental agencies,
contributions from the general public, and
contributions or grants from other public
charities; or
2. At least 10% of its total support
from governmental agencies,
contributions from the general public, and
contributions or grants from other public
charities; and also satisfy a facts and
circumstances test.
Facts and circumstances test. Facts
and circumstances include:
1. The amount of support you
received from the general public,
governmental units, or public charities;
2. Whether you have a continuous
and bona fide program for solicitation of
funds from the general public,
governmental units, or public charities, or
carry on activities designed to attract
support from organizations or other
governmental units, and
3. All other facts and circumstances,
including the public nature of your
governing board, the extent to which your
facilities or programs are publicly
available, the extent to which nature your
dues encourage membership, and
whether your activities are likely to appeal
to persons having a broad common
interest or purpose. For additional
information about the 10% facts and
circumstances test, see Pub. 557 and
Reg. 1.170A-9(f)(3).
509(a)(2). Select this classification if you
normally receive more than one-third of
your support from contributions,
membership fees, and gross receipts
from activities related to your exempt

functions, or a combination of these
sources, and not more than one-third of
your support from gross investment
income and net unrelated business
income. Typically, you would show a
substantial part of your income on Part
VI-A. Statement of Revenues and
Expenses, lines 1, 2, and 9.
Under this public charity
classification, you must meet both the
“one-third public support test ” and the
“not-more-than-one-third investment
income and net unrelated business
income test,” lines 1 through 13. See Pub.
557 for additional information about these
tests.
509(a)(1) and 170(b)(1)(A)(i). Select
this classification if your primary purpose
is operating a church or convention or
association of churches. The term
“church” includes mosques, temples,
synagogues, etc. If you select this box,
complete Schedule A.
509(a)(1) and 170(b)(1)(A)(ii). Select
this classification if your primary purpose
is operating a school. If you select this
box, complete Schedule B.
If you operate a school but it isn’t your
primary purpose, don’t select this
classification. However, you must still
complete Schedule B. See Part IV, line 12.
509(a)(1) and 170(b)(1)(A)(iii). Select
this classification if your primary purpose
is providing medical or hospital care or
medical eduction or research (performed
in association with a hospital). If you select
this box, complete Schedule C.
A hospital includes a rehabilitation
institute, outpatient clinic, community
mental health clinic, drug treatment
center, or skilled nursing facility. A hospital
doesn’t include convalescent homes,
homes for children or the aged, or
institutions whose principal purpose or
function is to train handicapped individuals
to pursue some vocation.
Cooperative hospital service
organizations described in section
501(e) should also check this box and
complete Schedule C.
509(a)(1) and 170(b)(1)(A)(iv). Select
this classification if you’re organized and
operated exclusively to benefit a college
or university owned or operated by a
governmental unit. You must also normally
receive a substantial part of your support
from a governmental unit or from
contributions from the general public.
509(a)(1) and 170(b)(1)(A)(ix). Select
this classification if you’re an agricultural
research organization described in section
170(b)(1)(A)(ix) operated in conjunction
with a land grant college or university or a
non-land grant college of agriculture.

-14-

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.

Instructions for Form 1023

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.

Instructions for Form 1023

Line 2a(i). 509(a)(2). Check “Yes,” if you
received amounts listed on lines 1, 2, and
9 of Part VI-A, Statement of Revenue and
Expenses, from any disqualified
persons and identify those disqualified
persons by letter (A, B, C, etc.) and list the
amounts contributed by each. Keep, but
don’t submit, a list of the names of your
donors with the associated letter
designations.
Line 2a(ii). Check “Yes,” if you received
amounts paid by an individual or
organization greater than the larger of 1%
of line 10, of Part VI-A, Statement of
Revenues and Expenses, or $5,000 for
any completed tax year, and identify those
individuals or organizations by letter and
list the amount(s) received from each.
Keep, but don’t submit, a list of the names
of your donors with the associated letter
designations.
Don’t include disqualified persons
in this list. Disqualified persons
CAUTION should be listed in line 2(a)(i). For
purposes of this application, a
“disqualified person” is any individual or
organization that is any of the following.
1. A “substantial contributor” to you
(defined below).
2. An officer, director, trustee, or any
other individual who has similar powers or
responsibilities.
3. An individual who owns more than
20% of the total combined voting power of
a corporation that is a substantial
contributor.
4. An individual who owns more than
20% of the profits interest of a partnership
that is a substantial contributor.
5. An individual who owns more than
20% of the beneficiary interest of a trust or
estate that is a substantial contributor.
6. A member of the family of any
individual described in 1, 2, 3, 4, or 5
above.
7. A corporation in which any
individuals described 1, 2, 3, 4, 5, or 6
above hold more than 35% of the total
combined voting power.
8. A trust or estate in which any
individuals described in 1, 2, 3, 4, 5, or 6
above hold more than 35% of the
beneficial interests.
9. A partnership in which any
individuals described in 1, 2, 3, 4, 5, or 6
above hold more than 35% of the profits
interest.

!

Substantial contributor. A substantial
contributor is any individual or
organization that gave more than $5,000
to you from the date you were formed or
other date that your exemption would be
effective, to the end of the year in which
the contributions were received. This total
-15-

amount contributed must also be more
than 2% of all the contributions you
received. A creator of a trust is treated as
a substantial contributor regardless of the
amount contributed. For more information
regarding substantial contributors, go to
IRS.gov/Charities-Non-Profits/PrivateFoundations/Substantial-ContributorPrivate-Foundation.
Family members. A “member of the
family” includes the spouse, ancestors,
children, grandchildren,
great-grandchildren, and their spouses.
For additional information concerning
members of the family, go to IRS.gov/
Charities-Non-Profits/CharitableOrganizations/Member-of-the-Family.
Further information about disqualified
persons, can be obtained at IRS.gov/
Charities-Non-Profits/IRC-Setion-4946Definition-of-Disqualified-Person.
Line 2a(iii). Use Schedule A (Form 990
or 990-EZ), Public Charity Status and
Public Support, Part III, Support Schedule
for Organizations Described in Section
509(a)(2), and its instructions to determine
if you meet the public support test for your
most recent 5-year period.

Part VIII. Effective Date
Line 1. Use the formation date you listed
in Part II, line 2, and the date you will
submit this electronic form and required
user fee payment to determine whether
you’re submitting this application within 27
months from the month in which you were
formed. If you’re not submitting this
application within 27 months from your
formation, complete Schedule E.

Part IX. Annual Filing
Requirement

Most organizations must file an annual
return (Form 990, 990-EZ, or Form
990-PF) or notice (Form 990-N, Electronic
Notice (e-Postcard)). Exceptions to this
rule include churches, certain church
affiliated organizations, and certain
affiliates of a governmental unit. You can
find more detailed information about filing
requirements and exceptions from the
requirement to file in the Instructions for
Form 990.
The following are some general rules.

• A private foundation must file Form

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

If you fail to file a required
information return or notice for 3
CAUTION consecutive years, your exempt
status will be automatically revoked.

!

Line 1. Check “Yes,” if you’re claiming
you are excepted from filing a Form
990-series return or notice and indicate
the reason you believe you’re excepted
from filing. See Pub. 557 and the
Instructions for Form 8940, Request for
Miscellaneous Determination, for more
information on the requirements for the
various filing exceptions. Provide
information regarding how you meet your
requested exception in your narrative
description of activities or as part of an
uploaded supplemental response.

Part X. Signature
Signature requirements. An officer,
director, trustee, or other official who is
authorized to sign for the organization
must sign Form 1023. The signature must
be accompanied by the title or authority of
the signer and the date.
The person signing Form 1023

TIP must be listed as an officer,

director, or trustee within the first
five entries of Part I, line 9.

Upload Checklist
Documents to upload. Check the boxes
to indicate which documents are included
in the file you upload with your application.
You must upload a copy of your
organizing document and any
amendments to it along with a copy of
your bylaws, if adopted. The other listed
documents are not required.
Put your name and EIN on each page
of your supplemental response and
identify the part and line number to which
the information relates.
Pay.gov can accommodate only one
uploaded file. Consolidate your
attachments into a single PDF file, which
cannot exceed 15MB.
If your PDF file exceeds the 15MB limit,
remove any items over the limit and
contact IRS Customer Accounts Services
at 877-829-5500 for assistance on how to
submit the removed items.

Schedule A. Churches

There is no single definition of the word
“church” for tax purposes. When
determining whether a section 501(c)(3)
religious organization is described as a
church (described in section 509(a)(1) and
170(b)(1)(A)(i)), we will consider
characteristics generally attributed to
churches and the facts and circumstances
of each organization applying for public
charity classification as a “church.”

The characteristics generally attributed to
churches are:
• A distinct legal existence,
• A recognized creed and form of
worship,
• A definite and distinct ecclesiastical
government,
• A formal code of doctrine and
discipline,
• A distinct religious history,
• A membership not associated with any
other church or denomination,
• Ordained ministers ministering to the
congregation,
• Ordained ministers selected after
completing prescribed courses of study,
• A literature of its own,
• Established places of worship,
• Regular congregations,
• Regular religious services,
• Sunday schools for the religious
instruction of the young, and
• Schools for the preparation of ministers.
Although you don’t need to meet each of
the above criteria to be classified as a
church, you’re generally required to have
a congregation or other religious
membership group. For purposes of
foundation classification under section
509(a)(1) and 170(b)(1)(A)(i), the term
“church” includes, without limitation,
mosques, temples, and synagogues, and
certain other forms of religious
organizations. For more information, see
Pub. 1828.
The practices and rituals associated with
your religious beliefs or creed must not be
illegal or contrary to public policy.

Specific Line Items
Line 1. Describe your written creed,
statement of faith, or summary of beliefs.
Line 2. Your literature includes any
writings about your beliefs, rules, or
history.
Line 3. A “code of doctrine and discipline”
refers to a body of laws or rules that
govern behavior.
Line 4. A “religious hierarchy or
ecclesiastical government” refers to
people or institutions that exercise
significant influence or authority over your
church.
Line 5. Answer “Yes,” if you’re part of a
group of churches with similar beliefs and
structures, such as a convention,
association, or union of churches.
Line 6. A “form of worship” refers to
religious practices that express your
devotion to your creed, faith, or beliefs.
Line 7. Indicate the regular days and
times of your religious services. Describe
the order of events during your regular
worship service and explain how the
-16-

activities conducted as part of your
services further your religious purposes.
Line 7a. Enter the average number of
members and non-members who attend
your regularly scheduled religious
services.
Line 8. An “established place of worship”
is a place where you hold regularly
scheduled religious services. It may be a
place that you own, rent, or that is
provided free for your use.
Line 9. An “established congregation” or
“other religious membership group”
includes individuals who regularly attend
and take part in the religious services of
your organization at an established
location. An established congregation
generally doesn’t include members of only
one family. If you answer “No,” because
you don’t have an established
congregation or other religious
membership, you may be a religious
organization that doesn’t qualify as a
church. If you don’t qualify as a church,
you will need to go back to Part VII, line 1,
to reconsider your public charity
classification.
You may request classification as

TIP a church at a later date after you

establish a congregation or other
religious membership group. For
information about this option, see Form
8940, Request for Miscellaneous
Determination Under Section 507, 509(a),
4940, 4942, 4945, and 6033 of the Internal
Revenue Code, or contact our customer
account service representatives at
877-829-5500 (toll-free).
Line 9a. Enter the total number of your
current members. If you have no
members, enter zero (0).
Line 9b. Answer “Yes,” if you have a
prescribed way to become a member.
Answer “Yes,” even if you just keep
records of who is currently a member.
Describe 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
Instructions for Form 1023

Line 12. A “prescribed course of study”
refers to formal or informal training. It
doesn’t include self-ordination or paying a
fee for an ordination certificate without
completing a course of study. Describe
the course of study completed by your
religious leaders.
Line 15. Provide any additional
information you would like us to consider
that would help us classify you as a
church.

Schedule B. Schools,
Colleges, and Universities
An organization qualifies as a school (for
purposes of classification under sections
509(a)(1) and 170(b)(1)(A)(ii)) if all the
following applies. It:

• Presents formal instruction as its
primary function,
• Has a regularly scheduled curriculum,
• Has a regular faculty of qualified
teachers,
• Has a regularly enrolled student body,
and
• Has a place where educational
activities are regularly carried on.

The term “school” includes primary,
secondary, preparatory, high schools,
colleges, and universities. An organization
won’t be described as a school under
sections 509(a)(1) and 170(b)(1)(A)(ii) if it
engages in both educational and
non-educational activities, unless the latter
are merely incidental to the educational
activities. Non-traditional schools such as
an outdoor survival school or a yoga
school may qualify. However, an
organization may further an educational
purpose without satisfying all the
conditions listed above that describe a
school. Such organizations may qualify as
public charities based upon their sources
of support as organizations described in
sections 509(a)(1) and 170(B)(1)(A)(vi) or
section 509(a)(2).
Specific Line Items
Line 1. Answer “Yes,” if you have a
regularly scheduled curriculum, a regular
faculty of qualified teachers, a regularly
enrolled student body, and facilities where
your educational activities are regularly
carried on.
If you answer “Yes,”you should

TIP maintain in your records evidence
as:

that you meet these factors, such

• A list of required courses of study,
dates and times courses are offered, and
other information about how to complete
required courses;

• Certification by the appropriate state
authority or successful completion of
required training for qualified teachers;
• Records of regular attendance by
students at your facility; and
• A lease agreement or deed for your
facility.

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.

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.

!

CAUTION

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 nondiscriminatory policy. A section 501(c)(3)
organization that is a private school must
publish a notice of its racially

-17-

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:
.

regularly scheduled religious, educational
activities for youth.

The M school admits students of any
race, color, and national or ethnic
origin.

Line 8a. If you answered “No” to Line 8,
check the box on line 8a if you agree that
all future printed materials, including
website content, will contain a statement
of nondiscriminatory policy as to students
similar to the one provided above.
Line 9. You must make your
nondiscriminatory policy known to all
segments of the general community
served by the school. One way to meet
this requirement is to publish your

nondiscriminatory policy annually in a
newspaper or over broadcast media. Rev.
Proc. 2019-22 now allows this publication
requirement to be satisfied by
continuously displaying your
nondiscrimination statement on your
Internet site, as described below.
Check “Yes,” if you make your racially
nondiscriminatory policy known to all
segments of the general community you
serve by:
• Publishing a notice of your policy in a
newspaper of general circulation that
serves all racial segments of the
community;
• publicizing your policy over broadcast
media in a way that is reasonably
expected to be effective; or
• display a notice of your policy at all
times on your primary, publicly accessible
Internet 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

TIP notices section or classified

advertisements of your local
newspaper generally is not acceptable.
Line 9a. If you answered “No,” to line 9,
check the box on line 9a if you agree that
you will publicize your nondiscriminatory
policy in a way that meets the
requirements of Revenue Procedure 75–
50, as modified by Revenue Procedure
2019-22.
Line 11. Enter the racial composition of
your student body, faculty, and
administrative staff in the spaces
provided. Enter actual numbers, rather
than percentages, for the current year and
projected numbers for the next academic
year. If the number is zero, then enter “0.”
If you’re not operational, submit an
estimate based on the best information
available (such as the racial composition
of the community you serve).

!

Don’t identify students, faculty,
and staff by name.

CAUTION

Line 12. Enter the racial composition of
students to whom you award loans and
scholarships in the spaces provided. Enter
actual numbers, rather than percentages,
for the current year and projected
numbers for the next academic year. If the
number is zero, then enter “0.” If you won’t
provide any loans or scholarships, check
the box provided.

!

CAUTION

Don’t identify students by name.

If you complete line 12 indicating

TIP you do or will provide loans or

scholarships, be sure your
response to Part IV, line 15 is consistent
with your response here.
Line 13. Identify each of your
incorporators, founders, board members,
donors of land, and donors of buildings by
name (whether individuals or
organizations).
Line 14. Answer “Yes,” if any individuals
or organizations on your list have an
objective to keep public or private school
education segregated by race and explain
how these individuals or organizations
promote segregation in public or private
schools.
Line 15. Answer “Yes,” if on a continuing
basis, you will maintain for a minimum
period of 3 years the following records.
• Your racial composition (similar to the
information requested on Schedule B,
line 11).
• Evidence that your scholarships and
loans are awarded on a racially
nondiscriminatory basis (similar to the
information requested on Schedule B,
line 12).
• Copies of all materials used by you or
on your behalf to solicit contributions.
• Copies of brochures, application forms,
advertisements, and catalogues dealing
with student admissions, programs, and
financial aid.
Answer “No,” if you don’t maintain
records and explain how you meet the
recordkeeping requirements under Rev.
Proc. 75-50.
Failure to maintain these records
or produce them upon the proper
CAUTION request will create a presumption
that you haven’t complied with the
requirements of Rev. Proc. 75-50.

!

Schedule C. Hospitals and
Medical Research
Organizations
An organization qualifies as a hospital for
purposes of classification under sections
509(a)(1) and 170(b)(1)(iii) if it is a:
• Hospital,
• Medical research organization
operated in conjunction with a hospital, or
• Cooperative hospital service
organization.
Hospital. An organization is a “hospital”
if its principal purpose or function is
providing medical or hospital care or
medical education or research. Medical
care includes treatment of any physical or
mental disability or condition, on an
inpatient or outpatient basis. Thus, if an
organization is a rehabilitation institution,
outpatient clinic, or community mental
health or drug treatment center, it is a
-18-

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.

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
Instructions for Form 1023

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
-19-

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

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.

• 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.”

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.

Before you file your application,
TIP 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.

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);

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).

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
-20-

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

TIP 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 disqualified 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

TIP managers who otherwise are

disqualified persons only because
they are foundation managers aren't
disqualified persons for this purpose.

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

TIP 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 requirement. 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

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

TIP 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
-21-

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;

• 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

TIP 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
CAUTION 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.

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

-22-

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
CAUTION 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.

Instructions for Form 1023

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/

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charities-non-profit/private-foundations/
advance-approval-of-grant-makingprocedures.
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

TIP 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.

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

-24-

Instructions for Form 1023

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 Addressing 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.

-25-

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.

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.

-26-

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.

Appendix B: States With Statutory Provisions Satisfying the Requirements of
Internal Revenue Code Section 508(e)
The following states have adopted legislation satisfying the requirements of Section 508(e) relating to
private foundation governing instruments. Information derived from Revenue Ruling 75-38, 1975-1
C.B. 161.
ALABAMA — except where otherwise provided by a decree of a court of competent jurisdiction or by a provision in the
private foundation's governing instrument, which in either case has been entered or made after October 1, 1971, and
expressly limits the applicability of state law.
ALASKA — except for such private foundations that expressly provide in their governing instruments that the applicable
sections of Alaska law don't apply to them.
ARKANSAS — except for such private foundations which expressly provide in their governing instruments that the
applicable sections of Arkansas law don't apply to them and except in the case of trusts where otherwise provided by decree
of a court of competent jurisdiction.
CALIFORNIA — except where otherwise provided by a court of competent jurisdiction.
COLORADO — with respect to trusts that are private foundations except where otherwise provided by a court of competent
jurisdiction.
CONNECTICUT — except where otherwise provided by a court of competent jurisdiction.
DELAWARE — except for such private foundations, which expressly provide in their governing instruments that the
applicable sections of Delaware law don't apply to them.
DISTRICT OF COLUMBIA — except for such corporations, which expressly provide in their governing instruments that the
applicable sections of District of Columbia law don't apply to them and except in the case of trusts where otherwise provided
by a court of competent jurisdiction. (For purposes of this statute, corporations include corporations organized under any Act
of Congress applicable to the District of Columbia as well as corporations organized under the laws of the District of
Columbia.)
FLORIDA — except for such trusts that file a proper election not to be subject to the applicable provisions of Florida law and
for such corporations as to which a court of competent jurisdiction has otherwise determined.
GEORGIA — except for such private foundations that file a proper election not to be subject to such law.
HAWAII — no exceptions.
IDAHO — except for such private foundations that expressly provide in their governing instruments that the applicable
sections of Idaho law don't apply to them.
ILLINOIS — except for such corporations that have express provisions to the contrary in their articles of incorporation and
except for trusts where it is otherwise provided by a court of competent jurisdiction.
INDIANA — except where otherwise determined by a court of competent jurisdiction with respect to private foundations
organized before January 1, 1970.
IOWA — except for such private foundations which expressly provide in their governing instruments that the applicable
sections of Iowa law don't apply to them.
KANSAS — except where otherwise provided by a court of competent jurisdiction.
KENTUCKY — except, with respect to corporations in existence on July 1, 1972, to the extent that such a corporation
provides to the contrary by amendment to its articles of incorporation adopted after July 1, 1972, and, with respect to trusts in
existence on July 1, 1972, where action is properly commenced on or before December 31, 1972, in a court of competent
jurisdiction to excuse the trust from compliance with the requirements of section 508(e) of the Code.
LOUISIANA — except for such private foundations that expressly provide in their governing instruments that the applicable
sections of Louisiana law don't apply to them.
MAINE — except where otherwise provided by a court of competent jurisdiction.
MARYLAND — except where otherwise provided by a court of competent jurisdiction.
MASSACHUSETTS — except where otherwise provided by a court of competent jurisdiction.
MICHIGAN — with respect to trusts that are private foundations except for such private foundations which file a notice of
inconsistency under Michigan law.

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

-28-

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.

-29-

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.

-30-

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.

-31-

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.

-32-

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.

-33-

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.

-34-

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.

-35-

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.

-36-

Appendix D: National Taxonomy of
Exempt Entities (NTEE) Codes
Arts, Culture & Humanities
Code
A01
A02
A03
A05
A11
A12
A19
A20
A23
A24
A25
A26
A27
A30
A31
A32
A33
A34
A40
A50
A51
A52
A54
A56
A57
A60
A61
A62
A63
A65
A68
A69
A6A
A6B
A6C
A6E
A70
A80
A82
A84
A90
A99

Alliances & Advocacy
Management & Technical
Assistance
Professional Societies &
Associations
Research Institutes & Public
Policy Analysis
Single Organization Support
Fund Raising & Fund Distribution
Support N.E.C.
Arts & Culture
Cultural & Ethnic Awareness
Folk Arts
Art Education
Arts & Humanities Councils &
Agencies
Community Celebrations
Media & Communications
Film & Video
Television
Printing & Publishing
Radio
Visual Arts
Museums
Art Museums
Children’s Museums
History Museums
Natural History & Natural
Science Museums
Science & Technology Museums
Performing Art
Performing Arts Centers
Dance
Ballet
Theater
Music
Symphony Orchestras
Opera
Singing & Choral Groups
Bands & Ensembles
Performing Arts Schools
Humanities Organizations
Historical Organizations
Historical Societies & Historic
Preservation
Commemorative Events
Arts Service
Arts, Culture & Humanities
N.E.C.

Education
Code
B01
B02
B03
B05
B11
B12
B19
B20
B21
B24
B25
B28
B29
B30
B40
B41
B42
B43
B50
B60
B70
B80
B82
B83
B84
B90

Alliances & Advocacy
Organizations
Management & Technical
Assistance
Professional Society &
Associations
Research Institutes & Public
Policy Analysis
Single Organization Support
Fundraising & Fund Distribution
Support N.E.C.
Elementary & Secondary
Schools
Preschools
Primary & Elementary Schools
Secondary & High Schools
Special Education
Charter Schools
Vocational & Technical Schools
Higher Education Institutions
Two-Year Colleges
Two-Year Colleges
Undergraduate Colleges
Graduate & Professional Schools
Adult Education
Libraries
Student Services
Scholarships & Student Financial
Aid
Student Sororities & Fraternities
Alumni Associations
Educational Services

B92
B94
B99

Remedial Reading &
Encouragement
Parent & Teacher Groups
Education N.E.C.

Environment
Code
C01
C02
C03
C05
C11
C12
C19
C20
C27
C30
C32
C34
C35
C36
C40
C41
C42
C50
C60
C99

Alliances & Advocacy
Management & Technical
Assistance
Professional Societies &
Associations
Research Institutes & Public
Policy Analysis
Single Organization Support
Fundraising & Fund Distribution
Support N.E.C.
Pollution Abatement & Control
Recycling
Natural Resources Conservation
& Protection
Water Resources, Wetland
Conservation & Management
Land Resources Conservation
Energy Resources Conservation
& Development
Forest Conservation
Botanical, Horticultural &
Landscape Services
Botanical Gardens & Arboreta
Garden Clubs
Environmental Beautification
Environmental Education
Environmental N.E.C.

Animal-Related
Code
D01
D02
D03
D05
D11
D12
D19
D20
D30
D31
D32
D33
D34
D40
D50
D60
D61
D99

Alliance & Advocacy
Management & Technical
Assistance
Professional Societies &
Associations
Research Institutes & Public
Policy Analysis
Single Organization Support
Fundraising & Fund Distribution
Support N.E.C.
Animal Protection & Welfare
Wildlife Preservation &
Protection
Protection of Endangered
Species
Bird Sanctuaries
Fisheries Resources
Wildlife Sanctuaries
Veterinary Services
Zoos & Aquariums
Animal Services N.E.C.
Animal Training
Animal Related N.E.C.

Health Care
Code
E01
E02
E03
E05
E11
E12
E19
E20
E21
E22
E24
E30
E31
E32
E40
E42
E50
E60
E61
E62

Alliances & Advocacy
Management & Technical
Assistance
Professional Societies &
Associations
Research Institutes & Public
Policy Analysis
Single Organization Support
Fundraising & Fund Distribution
Support N.E.C.
Hospitals
Community Health Systems
General Hospitals
Specialty Hospitals
Ambulatory & Primary Health
Care
Group Health Practices
Community Clinics
Reproductive Health Care
Family Planning
Rehabilitative Care
Health Support
Blood Banks
Emergency Medical Services &
Transport

E65
E6A
E70
E80
E86
E90
E91
E92
E99

Organ & Tissue Banks
Pharmacies & Drugstores
Public Health
Health (General & Financing)
Patient & Family Support
Nursing
Nursing Facilities
Home Health Care
Health Care N.E.C.

Mental Health & Crisis
Intervention
Code
F01
F02
F03
F05
F11
F12
F19
F20
F21
F22
F30
F31
F32
F33
F40
F42
F50
F52
F53
F54
F60
F70
F80
F99

Alliances & Advocacy
Management & Technical
Assistance
Professional Societies &
Associations
Research Institutes & Public
Policy Analysis
Single Organization Support
Fundraising & Fund Distribution
Support N.E.C.
Substance Abuse Dependency,
Prevention & Treatment
Substance Abuse Prevention
Substance Abuse Treatment
Mental Health Treatment
Psychiatric Hospitals
Community Mental Health
Centers
Residential Mental Health
Treatment
Hot Line & Crisis Intervention
Sexual Assault Services
Addictive Disorders N.E.C.
Smoking Addiction
Eating Disorders & Addictions
Gambling Addiction
Counseling
Mental Health Disorders
Mental Health Associations
Mental Health & Crisis
Intervention N.E.C.

Volutary Health Associations &
Medical Disciplines
Code
G01
G02
G03
G05
G11
G12
G19
G20
G25
G30
G32
G40
G41
G42
G43
G44
G45
G48
G50
G51
G54
G60
G61
G70
G80
G81
G83
G84
G90
G92
G94
G96
G98

-37-

Alliances & Advocacy
Management & Technical
Assistance
Professional Societies &
Associations
Research Institute & Public
Policy Analysis
Single Organization Support
Fundraising & Fund Distribution
Support N.E.C.
Birth Defects & Genetic Diseases
Down Syndrome
Cancer
Breast Cancer
Diseases of Specific Organs
Eye Diseases, Blindness &
Vision Impairments
Ear & Throat Diseases
Heart & Circulator System
Diseases & Disorders
Kidney Diseases
Lung Diseases
Brain Disorder
Nerve, Muscle, & Bone Diseases
Arthritis
Epilepsy
Allergy Related Diseases
Asthma
Digestive Diseases & Disorders
Specific Named Disorders
AIDS
Alzheimer’s Diseases
Autism
Medical Disciplines
Biomedicine & Bioengineering
Geriatrics
Neurology & Neuroscience
Pediatrics

G99
G9B

Voluntary Health Associations,
Medical Disciplines N.E.C.
Surgical Specialties

Medical Research
Code
H01
H02
H03
H05
H11
H12
H19
H20
H25
H30
H32
H40
H41
H42
H43
H44
H45
H48
H50
H51
H54
H60
H61
H70
H80
H81
H83
H84
H90
H92
H94
H96
H98
H99
H9B

Alliances & Advocacy
Management & Technical
Assistance
Professional Societies &
Associations
Research Institute & Public
Policy Analysis
Single Organization Support
Fundraising & Fund Distribution
Support N.E.C.
Birth Defects & Genetic Diseases
Research
Down Syndrome Research
Cancer Research
Breast Cancer Research
Diseases of Specific Organs
Research
Eye Diseases, Blindness &
Vision Impairments Research
Ear & Throat Diseases Research
Heart & Circulatory System
Diseases & Disorders Research
Kidney Diseases Research
Lung Diseases Research
Brain Disorders Research
Nerve, Muscle & Bone Diseases
Research
Arthritis Research
Epilepsy Research
Allergy-Related Diseases
Research
Asthma Research
Digestive Diseases & Disorders
Research
Specifically Named Diseases
Research
AIDS Research
Alzheimer’s Disease Research
Autism Research
Medical Disciplines Research
Biomedicine & Bioengineering
Research
Geriatrics Research
Neurology & Neuroscience
Research
Pediatrics Research
Medical Research N.E.C.
Surgical Specialties Research

Crime & Legal-Related
Code
I01
I02
I03
I05
I11
I12
I19
I20
I21
I23
I30
I31
I40
I43
I44
I50
I51
I60
I70
I71
I72
I73
I80
I83
I99

Alliances & Advocacy
Management & Technical
Assistance
Professional Societies &
Associations
Research Institutes & Public
Policy Analysis
Single Organization Support
Fundraising & Fund Distribution
Support N.E.C.
Crime Prevention
Youth Violence Prevention
Drunk Driving-Related
Correctional Facilities
Half-Way Houses for Offenders
& Ex-Offenders
Rehabilitation Services for
Offenders
Inmate Support
Prison Alternatives
Administration of Justice
Dispute Resolution & Mediation
Law Enforcement
Protection Against Abuse
Spouse Abuse Prevention
Child Abuse Prevention
Sexual Abuse Prevention
Legal Services
Public Interest Law
Crime & Legal-Related N.E.C.

Appendix D: National Taxonomy of Exempt Entities (NTEE) Codes (Continued)
Employment
Code
J01
J02
J03
J05
J11
J12
J19
J20
J21
J22
J30
J32
J33
J40
J99

Alliances & Advocacy
Management & Technical
Assistance
Professional Societies &
Associations
Single Organization Support
Consumer Lending
Fundraising & Fund Distribution
Support N.E.C.
Employment Preparation &
Procurement
Vocational Counseling
Job Training
Vocational Rehabilitation
Goodwill Industries
Sheltered Employment
Labor Unions
Employment N.E.C.

Food, Agriculture & Nutrition
Code
K01
K02
K03
K05
K11
K12
K19
K20
K25
K26
K28
K2A
K2B
K2C
K30
K31
K34
K35
K36
K40
K50
K6A
K6B
K6C
K6D
K6E
K6F
K90
K91
K92
K93
K94
K95
K96
K97
K98
K99

Alliances & Advocacy
Management & Technical
Assistance
Professional Societies &
Associations
Research Institutes & Public
Policy Analysis
Single Organization Support
Fundraising & Fund Distribution
Support N.E.C.
Agricultural Programs
Farmland Preservation
Animal Husbandry
Farm Bureaus & Granges
Other Vegetable (except Potato)
& Melon Farming
Soil Preparation, Planting, &
Cultivating
Wineries
Food Programs
Food Banks & Pantries
Congregate Meals
Soup Kitchens
Meals on Wheels
Nutrition
Home Economics
Meat Markets
Confectionery & Nut Stores
Caterers
Mobile Food Services
Drinking Places
Snack Nonalcoholic Beverage
Bars
Limited-Service Restaurants
Supermarkets & Other Grocery
(except Convenience) Stores
Convenience Stores
Fruit & Vegetable Markets
All Other Specialty Food Stores
Food (Health) Supplement
Stores
Warehouse Clubs &
Supercenters
Food Service Contractors
Full-Service Restaurants
Food, Agriculture & Nutrition
N.E.C.

Housing & Shelter
Code
L01
L02
L03
L05
L11
L12
L19
L20
L21
L22
L24

Alliances & Advocacy
Management & Technical
Assistance
Professional Societies &
Associations
Research Institutes & Public
Policy Analysis
Single Organization Support
Fundraising & Fund Distribution
Support N.E.C.
Housing Development,
Construction & Management
Low-Income & Subsidized Rental
Housing
Senior Citizens’ Housing &
Retirement Communities
Independent Housing for People
with Disabilities

L25
L30
L40
L41
L4A
L4B
L50
L80
L81
L82
L99

Housing Rehabilitation
Housing Search Assistance
Temporary Housing
Homeless Shelters
Hotels (except Casino Hotels) &
Motels
Bed and Breakfast Inns
Homeowners & Tenants
Associations
Housing Support
Home Improvement & Repairs
Housing Expense Reduction
Support
Housing & Shelter N.E.C.

Public Safety, Disaster
Preparedness & Relief
Code
M01
M02
M03
M05
M11
M12
M19
M20
M23
M24
M40
M41
M42
M60
M99

Alliances & Advocacy
Management & Technical
Assistance
Professional Societies &
Associations
Research Institutes & Public
Policy Analysis
Single Organization Support
Fundraising & Fund Distribution
Support N.E.C.
Disaster Preparedness & Relief
Services
Search & Rescue Squads
Fire Prevention
Safety Education
First Aid
Automotive Safety
Public Safety Benevolent
Associations
Public Safety, Disaster
Preparedness & Relief N.E.C.

N05
N11
N12
N19
N20
N2A
N2B
N30
N31
N32
N40
N50
N52
N60
N61
N62
N63
N64
N65
N66
N67
N68
N69
N6A
N70
N71
N72
N80
N99

Code
O01
O02
O03
O05
O11

Alliances & Advocacy
Management & Technical
Assistance
Professional Societies &
Associations
Research Institutes & Public
Policy Analysis
Single Organization Support

Fundraising & Fund Distribution
Support N.E.C.
Youth Centers & Clubs
Boys Clubs
Girls Clubs
Boys & Girls Clubs
Adult & Child - Matching
Programs
Big Brothers & Big Sisters
Scouting
Boy Scouts of America
Girl Scouts of the U.S.A.
Camp Fire
Youth Development Programs
Youth Community Service Clubs
Youth Development - Agricultural
Youth Development - Business
Youth Development - Citizenship
Youth Development - Religious
Leadership
Youth Development N.E.C.

Human Services
Code
P01
P02
P03
P05
P11
P12
P19
P20
P21
P22
P24
P26
P27

Alliances & Advocacy
Employment Services
Professional Societies &
Associations
Research Institutes & Public
Policy Analysis
Single Organization Support
Fundraising & Fund Distribution
Support N.E.C.
Camps
RV (Recreational Vehicle) Parks
& Campgrounds
Recreational and Vacation
Camps (Except Campgrounds)
Physical Fitness & Community
Recreational Facilities
Community Recreational Centers
Parks & Playgrounds
Sports Training Facilities,
Agencies
Recreational Clubs
Fairs
Amateur Sports
Fishing & Hunting
Basketball
Baseball & Softball
Soccer
Football
Racquet Sports
Swimming & Other Water
Recreation
Winter Sports
Equestrian
Golf
Amateur Sports Competitions
Olympics
Special Olympics
Professional Athletic Leagues
Recreation & Sports N.E.C.

Youth Development

O31
O40
O41
O42
O43
O50
O51
O52
O53
O54
O55
O99

Recreation & Sports
Code
N01
N02
N03

O12
O19
O20
O21
O22
O23
O30

P28
P29
P30
P31
P32
P33
P40
P42
P43
P44
P45
P46
P47
P50
P51
P52
P58
P60
P61
P62
P70
P71
P73
P74
P75
P76
P7A

P80
P81
P82
P83
P84
P85
P86
P87
P88
P99

-38-

Alliances & Advocacy
Management & Technical
Assistance
Professional Societies &
Associations
Research Institutes & Public
Policy Analysis
Single Organization Support
Fundraising & Fund Distribution
Support N.E.C.
Human Service Organizations
American Red Cross
Urban League
Salvation Army
Volunteers of America
Young Men’s or Women
Associations
Neighborhood Centers
Thrift Shops
Children & Youth Services
Adoption
Foster Care
Child Day Care
Family Services
Single Parent Agencies
Family Violence Shelters,
Services
In-Home Assistance
Family Services for Adolescent
Parents
Family Counseling
Pregnancy Centers
Personal Social Services
Financial Counseling
Transportation Assistance
Gift Distribution
Emergency Assistance
Travelers’ Aid
Victims’ Services
Residential Care & Adult Day
Programs
Adult Day Care
Group Homes
Hospices
Supportive Housing for Older
Adults
Homes for Children &
Adolescents
Residential Intellectual &
Developmental Disability
Facilities (Group Homes,
Intermediate Care Facilities &
Hospitals)
Centers to Support the
Independence of Specific
Populations
Senior Centers
Developmentally Disabled
Centers
Womens’ Centers
Ethnic & Immigrant Centers
Homeless Centers
Blind & Visually Impaired
Centers
Deaf & Hearing Impaired Centers
LGBT Centers
Human Services N.E.C.

International, Foreign Affairs &
National Security
Code
Q01
Q02
Q03
Q05
Q11
Q12
Q19
Q20
Q21
Q22
Q23
Q30
Q31
Q32
Q33
Q35
Q40
Q41
Q42
Q43
Q50
Q51
Q70
Q71
Q99

Alliances & Advocacy
Management & Technical
Assistance
Professional Societies &
Associations
Research Institutes & Public
Policy Analysis
Single Organization Support
Fundraising & Fund Distribution
Support N.E.C.
Promotion of International
Understanding
International Cultural Exchange
International Academic
Exchange
International Exchange N.E.C.
International Development
International Agricultural
Development
International Economic
Development
International Relief
International Democracy & Civil
Society Development
International Peace & Security
Arms Control & Peace
United Nations Associations
National Security
International Affairs, Foreign
Policy & Globalization
International Economic & Trade
Policy
International Human Rights
International Migration &
Refugee Issues
International, Foreign Affairs &
National Security N.E.C.

Civil Rights, Social Action &
Advocacy
code
R01
R02
R03
R05
R11
R12
R19
R20
R22
R23
R24
R25
R26
R28
R30
R40
R60
R61
R62
R63
R67
R99

Alliances & Advocacy
Organizations
Management & Technical
Assistance
Professional Societies &
Associations
Research Institutes & Public
Policy Analysis
Single Organization Support
Fundraising & Fund Distribution
Support N.E.C.
Civil Rights
Minority Rights
Disabled Persons’ Rights
Womens’ Rights
Seniors’ Rights
Lesbian & Gay Rights
Childrens’ Rights
Intergroup & Race Relations
Voter Education & Registration
Civil Liberties
Reproductive Rights
Right to Life
Censorship, Freedom of Speech
& Press
Right to Die & Euthanasia
Civil Rights, Social Action &
Advocacy N.E.C.

Community Improvement &
Capacity Building
Code
S01
S02
S03
S05
S11
S12
S19
S20
S21
S22

Alliances & Advocacy
Management & Technical
Assistance
Professional Societies &
Associations
Research Institutes & Public
Policy Analysis
Single Organization Support
Fund Raising & Fund Distribution
Support N.E.C.
Community & Neighborhood
Development
Community Coalitions
Neighborhood & Block
Associations

Appendix D: National Taxonomy of Exempt Entities (NTEE) Codes (Continued)
S30
S31
S32
S40
S41
S43
S46
S47
S50
S80
S81
S82
S99

Economic Development
Urban & Community Economic
Development
Rural Economic Development
Business & Industry
Chambers of Commerce &
Business Leagues
Small Business Development
Boards of Trade
Real Estate Associations
Nonprofit Management
Community Service Clubs
Womens’ Service Clubs
Mens’ Service Clubs
Community Improvement &
Capacity Building N.E.C.

Philanthropy, Volunteerism &
Grantmaking Foundations
Code
T01
T02
T03
T05
T11
T12
T19
T20
T21
T22
T23
T30
T31
T40
T50
T70
T90
T99

Alliances & Advocacy
Management & Technical
Assistance
Professional Societies &
Associations
Research Institutes & Public
Policy Analysis
Single Organization Support
Fundraising & Fund Distribution
Support N.E.C.
Private Grantmaking
Foundations
Corporate Foundations
Private Independent Foundations
Private Operating Foundations
Public Foundations
Community Foundations
Volunteerism Promotion
Philanthropy, Charity &
Volunteerism Promotion
Federated Giving Programs
Named Trusts N.E.C.
Philanthropy, Voluntarism &
Grantmaking Foundations N.E.C.

Science & Technology
Code
U01
U02

Alliances & Advocacy
Management & Technical
Assistance

U03
U05
U11
U12
U19
U20
U21
U30
U31
U33
U34
U36
U40
U41
U42
U50
U99

Professional Societies &
Associations
Research Institutes & Public
Policy Analysis
Single Organization Support
Fundraising & Fund Distribution
Support N.E.C.
General Science
Marine Science & Oceanography
Physical & Earth Sciences
Astronomy
Chemistry & Chemical
Engineering
Mathematics
Geology
Engineering & Technology
Computer Science
Engineering
Biological & Life Sciences
Research
Science & Technology N.E.C.

Social Science
Code
V01
V02
V03
V05
V11
V12
V19
V20
V21
V22
V23
V24
V25
V26
V30
V31
V32
V33
V34
V35
V36

Alliances & Advocacy
Management & Technical
Assistance
Professional Societies &
Associations
Research Institutes & Public
Policy Analysis
Single Organization Support
Fund Raising & Fund Distribution
Support N.E.C.
Social Science
Anthropology & Sociology
Economics
Behavioral Science
Political Science
Population Studies
Law & Jurisprudence
Interdisciplinary Research
Black Studies
Women’s Study
Ethnic Studies
Urban Studies
International Studies
Gerontology

V37
V99

Labor Studies
Social Science N.E.C.

Public & Societal Benefit
Code
W01
W02
W03
W05
W11
W12
W19
W20
W22
W24
W30
W40
W50
W60
W61
W70
W80
W90
W99

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Assistance
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Associations
Research Institutes & Public
Policy Analysis
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Administration
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Monetary Policy
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Organizations
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Telecommunications
Financial Institutions
Credit Unions
Leadership Development
Public Utilities
Consumer Protection
Public & Societal Benefit N.E.C.

Religion-Related
Code
X01
X02
X03
X05
X11
X12
X19
X20
X21
X22
X30
X40
X50

-39-

Alliances & Advocacy
Management & Technical
Assistance
Professional Societies &
Associations
Research Institutes & Public
Policy Analysis
Single Organization Support
Fundraising & Fund Distribution
Support N.E.C.
Christianity
Protestant
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Judaism
Islam
Buddhism

X70
X80
X81
X82
X83
X84
X90
X99

Hinduism
Religious Media &
Communications
Religious Film & Video
Religious Television
Religious Printing & Publishing
Religious Radio
Interfaith Coalitions
Religion Related, N.E.C.

Mutual & Membership Benefit
Code
Y01
Y02
Y03
Y05
Y11
Y12
Y19
Y20
Y22
Y23
Y24
Y25
Y30
Y33
Y34
Y35
Y40
Y41
Y42
Y43
Y44
Y50
Y99

Alliances & Advocacy
Management & Technical
Assistance
Professional Societies &
Associations
Research Institutes & Public
Policy Analysis
Single Organization Support
Fundraising & Fund Distribution
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Insurance Providers
Local Benevolent Life Insurance
Associations
Mutual Insurance Companies &
Associations
Supplemental Unemployment
Compensation
State-Sponsored Workers’
Compensation Reinsurance
Organizations
Pension & Retirement Funds
Teachers’ Retirement Fund
Associations
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Trusts
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Fraternal Societies
Fraternal Beneficiary Societies
Domestic Fraternal Societies
Voluntary Employees Beneficiary
Associations (Non-Government)
Voluntary Employees Beneficiary
Associations (Government)
Cemeteries
Mutual & Membership Benefit
N.E.C.

Index
A
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
C
Canadian organizations 5
Church 16
Prescribed course of
study 17
Compensation:
Definition 10
Corporation:
Articles of incorporation 6
D
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

N
NASCO 2
NTEE 37

E
EIN (See Employer
identification number)
Employer identification
number 6
Expedite requests 3
F
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
G
Glossary of terms 29
Group exemption 3
H
Homes for the elderly or
handicapped 22
Hospital 18
How to answer 2
L
Language and currency
requirements 3
LLC (See Limited liability
company)
Low-income housing 22
M
Mailing address 6
Medical research 18
Medical research
organization 18
Month and annual accounting
period 6

O
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
P
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
Q
Qualification:
Operated 2
Organized 2
Political campaign
intervention 2
Qualifications 2
R
Representation 4
Form 2848 4
Form 8821 4

-40-

S
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
T
Trust 7
U
Unincorporated association 7
United States territories and
possessions 6
User fee 3
W
What to file:
Required schedules 3
When to file 4