1024 Instructions for Form 1024

Instructions for Form 1024

Department of the Treasury
Internal Revenue Service

(Rev. January 2022)

Application for Recognition of Exemption Under Section 501(a) or Section 521 of
the Internal Revenue Code
Section references are to the Internal Revenue
Code unless otherwise noted.

Note. Keep a copy of the completed Form
1024 in the organization’s permanent
records.

Future Developments

For the latest information about
developments related to Form 1024 and
its instructions, such as legislation
enacted after they were published, go to
IRS.gov/Form1024.

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 1024, 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. The IRS sends subscribers
periodic updates regarding exempt
organization tax law and regulations,
available services, and other information.
To subscribe, visit IRS.gov/Charities.

How To Get Forms and
Publications
Internet. You can access the IRS
website 24 hours a day, 7 days a week, at
IRS.gov to do the following:
• Download forms, instructions, and
publications.
• Order IRS products online.
• Research your tax questions online.
• Search publications by topic or
keyword.
• Use the online Internal Revenue Code,
regulations, or other official guidance.
• View Internal Revenue Bulletins (IRBs)
published since 1995.
• Sign up at IRS.gov/Charities to receive
local and national tax news by email.
Mar 03, 2022

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.

What's New

Organizations filing Form 1024,
Application for Recognition of Exemption
Under Section 501(a) or Section 521 of
the Internal Revenue Code, must
complete and submit their Form 1024
application electronically (including paying
the correct user fee) using Pay.gov.
Organizations requesting
determinations under subsections 501(c)
(11), (14), (16), (18), (21), (22), (23), (26),
(27), (28), (29) or section 501(d)
previously submitted letter applications,
but now are required to submit the
electronic Form 1024. Organizations
requesting determination under section
521 may also submit the electronic Form
1024 instead of Form 1028, Application for
Recognition of Exemption Under Section
521 of the Internal Revenue Code. Form
1024 has been revised accordingly.

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 1024, 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.

Answers

Form 1024 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 the
subsection you applied. Answer questions
completely. If an explanation provided for
an earlier question also applies to a later
question, your response to the later
question may simply refer to your previous
answer.
Cat. No. 47909G

Your answers must provide sufficient
detail about your past, present, and
planned activities to demonstrate that
you're described in the subsection of
501(c), 501(d), or section 521 under which
you are seeking recognition of exemption.
We won't be able to recognize you as tax
exempt based on a mission statement
unless you also describe the activities that
further accomplish your mission. We need
to understand the specific activities you
undertake to accomplish your exempt
purpose(s).
Financial data. Financial data, whether
budgets or actual, should be consistent
with other information presented in your
application. Budgeted financial data
should be prepared based on 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 1024 are written in
the present tense; however, base your
answers on your past, present, and
planned activities.
Language and currency requirements.
Complete Form 1024 and attachments in
English. Provide an English translation if
your organizational document, bylaws, or
any other attachments are in any other
language.
Report financial information in United
States dollars (specify the conversion rate
used). Combine amounts from within and
outside the United States and report the
totals on the financial statements.

Purpose of Form
Don't use Form 1024 if you are
applying under Section 501(c)(3)
CAUTION or Section 501(c)(4). Instead, use
Form 1023-EZ, Form 1023, or Form
1024-A.

!

Form 1024 is used by most types of
organizations to apply for recognition of
exemption under section 501(a) or section
521.
Certain organizations aren't required to
apply for tax-exempt status; however, they
may wish to file Form 1024 to receive a
determination letter of IRS recognition of
their section 501(c) status in order to
obtain certain incidental benefits such as:
• Public recognition of tax-exempt status,
• Possible exemption from certain state
taxes,

• Advance assurance to donors of
deductibility of contributions (in certain
cases), and
• Nonprofit mailing privileges, etc.

victims of emergencies such as floods and
hurricanes.
• An IRS error has caused delays in
review of the application.

Group exemption. Don't use Form 1024
to apply for a group exemption. We may
issue a group exemption to a central
organization recognizing, 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.

User Fee

Leaving a group exemption. A
subordinate organization under a group
exemption can use Form 1024 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 intent to
leave the group ruling before filing Form
1024.

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 for 3 consecutive years,
you must apply to have your tax-exempt
status reinstated. You must complete and
submit Form 1024 and pay the appropriate
user fee, even if you did not previously
choose to apply for recognition of
exemption.
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,
2014-3 I.R.B. 411 at IRS.gov/IRB2014-3
for details, including additional
requirements for retroactive reinstatement.

Requesting Expedited Review

We generally review applications for
exemption in the order we receive them.
We expedite processing of an application
only where a written request presents a
compelling reason for processing the
application ahead of others. Even if your
request for expedited processing is
approved, this does not mean your
application will be immediately approved
or denied. Expedited processing means
that it will be assigned to a specialist for
review ahead of applications received
earlier in time. 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

The law requires payment of a user fee
with each application. You must pay this
fee through Pay.gov when you file Form
1024.
Payments can be made directly from
your bank account or by credit or debit
card. You won't be able to submit Form
1024 without paying the correct fee.
User fee amounts are listed in Rev.
Proc. 2022-5, updated annually. For the
current Form 1024 user fee, go to
IRS.gov/Charities-Non-Profits/User-Feesfor-Tax-Exempt-and-Government-EntitiesDivision. You can also call 877-829-5500.

What To File

All applicants must complete Parts I
through VIII of Form 1024 and must
provide any required attachments.

Attachments to Form 1024

A complete application will include one or
more documents in addition to Form 1024.
Pay.gov can accommodate only one
uploaded file. Before submitting Form
1024, 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 1024 within 27
months after the month in which you were
legally formed, and we approve your
application, the effective date of
recognition of your exempt status will be
your legal date of formation.
If you otherwise meet the requirements
for tax exempt status but don't meet the
requirements for recognition from your
date of formation, the effective date of
-2-

recognition of your exempt status will be
the date you submitted Form 1024.
For exceptions and special rules,
including automatic extensions, see Pub.
557.

How To File

As of January 3, 2022, the IRS requires
that Form 1024 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 1024 (and letter
applications from organizations previously
required to submit in that format). To
submit Form 1024, you must:
1. Register or have previously
registered for an account on Pay.gov.
2. Enter “Form 1024” or “1024” in the
search box and select Form 1024.
3. Complete the form.

Filing Assistance

For help in completing this form or general
questions relating to exempt
organizations, you may access
information on our website at IRS.gov/EO.

You may find the following publications
available on IRS.gov.helpful.
• Pub. 557, Tax-Exempt Status for Your
Organization.
• Pub. 598, Tax on Unrelated Business
Income of Exempt Organizations.
• Pub. 3079, Tax-Exempt Organizations
and Gaming.
• Pub. 4221-NC, Compliance Guide for
Tax Exempt Organizations (Other than
501(c)(3) Public Charities and Private
Foundations).

Signature Requirements

An officer, director, trustee, or other official
who is authorized to sign for the
organization must digitally sign Form 1024
at the end of Part VIII. The signature must
be accompanied by the title or authority of
the signer and the date.

Authorized Representative
Form 2848. Upload a completed Form
2848 if you want to authorize a
representative to represent you regarding
your application. An individual authorized
by Form 2848 may not sign the application
unless that person is also an officer,
director, trustee, or other official who is
authorized to sign the application.
A Centralized Authorization File

TIP (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.

Instructions for Form 1024

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.

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.

After You Submit Form 1024

Information available for public inspection. If we approve exempt status
under section 501(a) or section 521, the
information that will be open for public
inspection includes the following.
• Your complete Form 1024 and any
supporting documents.
• All correspondence between you and
the IRS concerning Form 1024, including
Form 2848.
• Your determination letter.
• Annual information returns (Form 990,
990-EZ, or 990-N) including schedules,
except for the names and addresses of
contributors and other identifying
information about contributors.

Unless we approve a request for
expedited processing, we'll 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, we'll
send you a determination letter stating that
you're exempt.
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 you
may be asked 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
either section 501(a) or section 521. If we
determine that you don't qualify for
exemption, we'll 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 began as
soon as you were formed. If you have an
annual information return or tax return due
while your Form 1024 is pending,
complete the return checking 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.
You may also be required to file

TIP other returns, such as

employment tax returns or benefit
plan returns, which aren't discussed here.

Instructions for Form 1024

!

Public Inspection

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 other identifying information about
contributors included with Form 990 or
990-EZ.
• Form 990-T.
When applying for tax-exempt status,
you must clearly identify any information
that isn't open to 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 the organization 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 delete only the information that
isn't open for public inspection.
-3-

If you post the documents on your
website, you can give any person
requesting copies the website where the
documents may be found, but you don't
need to provide copies of the information.
However, even if these documents are
posted on your website, you must still
allow public inspection without charge at
your main office during regular business
hours.
Documents aren't considered available
for public inspection on a website if the
otherwise disclosable information is edited
or subject to editing by a third party when
posted. To date, the IRS hasn't approved
any third-party websites for posting.
See Pub. 557 for additional information
on public inspection requirements.

Foreign Organizations

Foreign organizations are those that were
created in countries other than the United
States, its territories, or its possessions.
Foreign organizations may apply for
tax-exempt status on income earned in the
United States in the same way that
domestic organizations apply for exempt
status. See Language and currency
requirements, earlier.
Contributions by U.S. residents to
foreign organizations generally
CAUTION aren't deductible. Tax treaties
between the United States and certain
foreign countries provide specific limited
exceptions.

!

Annual returns for foreign organizations. A foreign organization that obtains
exemption must file an information return
annually (Form 990 or Form 990-EZ).
However, a foreign organization may file
Form 990-N (e-Postcard) instead of Form
990 or Form 990-EZ when its gross
receipts from U.S. source income 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 for further information. A
foreign organization that is subject to
unrelated business income tax must file
Form 990-T.
Organizations created in U.S. territories and possessions. Organizations
created in possessions and territories of
the United States 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 1024 to apply for recognition of
exempt status.
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).

Specific Instructions
Part I. Identification of
Applicant
Line 1. Enter your complete name exactly
as it appears in your organizing document,
including amendments.
Line 2. If you have an “in care of” name,
enter it here; otherwise, leave this space
blank.
Lines 3–9. Enter your complete address
where all correspondence will be sent. If
mail isn't delivered to your street address
and you have a P.O. Box, list your P.O.
Box information instead of your street
address. For a foreign address, enter your
province or state and foreign postal code
where indicated.
Line 10. Employer Identification Number (EIN). You must have your own EIN.
Enter the 9-digit EIN the IRS assigned to
you. If you don't have an EIN, you must
apply for one before submitting your
application. You can find out how to apply
for an EIN by visiting IRS.gov and
searching for “apply for an EIN.” You may
apply for an EIN online or by fax or mail.
International applicants may call
267-941-1099 (toll call).
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 11. Month tax year ends. Select
the month your tax year (annual
accounting period) ends. Your tax year is
the 12-month period on which your annual
financial records are based.
Line 12. Person to contact. Enter the
name and title of the person you want us
to contact if we need more information.
The person to contact may be an officer,
director, trustee, or other individual who is
permitted to speak with us according to
your bylaws or other rules of operation.
Your person to contact may also be an
authorized representative, such as an
attorney, certified public accountant, or
enrolled agent, for whom you're submitting
a completed Form 2848 with Form 1024.
Line 13. Provide a daytime telephone
number for the contact listed on line 12.
Line 14. You may provide a fax number
for the contact listed on line 12.
Line 15. Pay.gov will populate this field
with the current user fee for filing Form
1024.
Line 16. If you have a website, enter the
complete web address. Also, list any
websites maintained on your behalf. The

information on your website should be
consistent with the information in your
Form 1024.
Line 17. Officers, directors, and trustees. Enter the full names, titles, and
mailing addresses of your officers,
directors, and/or trustees. You may use
the organization's address for mailing. If
you have more than five, check the box
provided to add more officer, director,
and/or trustee information.
The person who is signing Form 1024
must be listed within the first five entries of
line 17.

Part II. Organizational Structure

You must be a corporation, limited liability
company, unincorporated association, or
trust to be tax exempt. 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 statute of a federally recognized
Indian tribal or Alaskan native
government.
Copy of organizing document (articles
of incorporation and any amendments). A corporation's organizing
document is its articles of incorporation.
If you formed under state statute, your
articles of incorporation (and any
amendments) must show certification of
filing. This means your articles show
evidence that on a specific date they were
filed with and approved by an appropriate
state authority. The document must be an
exact copy of what is on file with your
state.
If you don't have a copy of your articles
of incorporation showing evidence of
having been filed and approved by an
appropriate state official, you may submit
a substitute copy of your articles of
incorporation. This substitute copy may be
handwritten, typed, printed, or otherwise
reproduced. It must be accompanied by a
declaration, signed by an officer
authorized to sign for you, that it is a
complete and correct copy of the articles
of incorporation and that it contains all the
powers, principles, purposes, functions,
and other provisions by which you
currently govern yourself.
Limited liability company. A limited
liability company (LLC) that files its own
exemption application and is recognized
as exempt under either section 501(a) or
-4-

section 521 is automatically treated as a
corporation rather than a partnership.
Copy of organizing document (articles
of organization and operating agreement (if adopted) and any amendments). Instead of articles of
incorporation, an LLC's organizing
document is its state-approved articles of
organization.
If it has adopted an operating
agreement, then this document is also part
of its organizing document. If you formed
under state statute, your articles of
organization (and any amendments) must
show certification of filing. This means
your articles show evidence that on a
specific date they were filed with and
approved by an appropriate state
authority. The document must be an exact
copy of what is on file with your state.
If you don't have a copy of your articles
of organization showing evidence of
having been filed and approved by an
appropriate state official, you may submit
a substitute copy of your articles of
organization. This substitute copy may be
handwritten, typed, printed, or otherwise
reproduced. It must be accompanied by a
declaration, signed by an officer
authorized to sign for you, that it is a
complete and correct copy of the articles
of organization and that it contains all the
powers, principles, purposes, functions,
and other provisions by which you
currently govern yourself.
If you're an LLC with a tax-exempt

TIP organization as its sole member

and you want to be treated as a
disregarded entity, 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.

Instructions for Form 1024

Trust. A trust may be formed by a trust
agreement or declaration of trust. A trust
may also be formed through a will.
Generally, a trust must be funded with
property, such as money, real estate, or
personal property.
Copy of organizing document (trust
agreement/declaration of trust or will
and any amendments). Your trust
agreement (and any amendments) must
be signed by at least one trustee.
If your trust agreement copy isn't
signed, you may submit a written
declaration that states your copy is a
complete and accurate copy of the signed
and dated original. Your declaration
should clearly indicate the original date
that it was signed.
For trusts created by a will, include a
copy of the death certificate or a statement
indicating the date of death, and a copy of
the relevant portions of the will.
If your trust agreement continues
to provide for distributions for
CAUTION non-charitable interests, you won't
qualify for tax-exempt status.

!

Line 2. Formation date. The date you
enter should be consistent with your
organizing document.
• If you're a corporation, enter the date
that your articles of incorporation were
filed and approved by the appropriate
authority.
• If you're an LLC, enter the date that the
appropriate authority filed your articles of
organization or other organizing
document.
• If you're an unincorporated association,
enter the date that your organizing
document was adopted by the signatures
of at least two individuals.

• If you're a trust (other than a trust
formed by a will), enter the date your trust
was funded. If your trust agreement
provided for any non-charitable interests,
enter the date that non-charitable interests
expired. If you were formed by a will, enter
the date of death or the date any
non-charitable interests expired.
Line 3. State of formation. Enter the
jurisdiction (for instance, the state or the
federally recognized tribal government)
under the laws of which you were
incorporated or otherwise formed. This
may not be the place in which you're
physically located. For example, if you're
physically located in New York, but
incorporated under Massachusetts law,
enter Massachusetts.
For purposes of completing this
application, you're formed under the laws
of a foreign country if you aren't formed
under the laws of the Unites 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.

Part III. Your Activities
Reminder. Answer all questions in this
part as they pertain to your past, present,
and planned activities.
Line 1. Describe completely and in detail
your past, present, and planned activities.
Your narrative description of activities
should be thorough and accurate because

501(c)(15) - Mutual Insurance Companies or Associations. If you are applying
under section 501(c)(15), provide the
following in addition to your narrative
description of activities:
• Whether you're a member of a
controlled group of corporations as
defined in section 831(c)(2)(C)(ii).
(Disregard section 1563(b)(2)(B) in
determining whether the organization is a
member of a controlled group.)
Note. You would be considered a
member of a controlled group of
corporations if you were not exempt from
tax under section 501(a). In applying
section 1563(a), use a “more than 50%”
stock ownership test to determine whether
the applicant or any other corporation is a
member of a controlled group.
• If you are a such a member, include in
the following table the total amount
received by you and all other members of
the controlled group. If not, include only
the amounts that relate to you.

3 Prior Tax Years

(a) Current Year
From __________
To __________

we determine whether you qualify for
exempt status based on the information in
your application.
For each past, present, or planned
activity, include information that answers
the following questions:
• What is the activity?
• Who conducts the activity?
• What percentage of your total time is
allocated to the activity? (Combined time
percentages should add up to 100%)
• How is the activity funded (for example,
donations, fees, etc.) and what
percentage of your overall expenses is
allocated to this activity?
• How does the activity further your
exempt purposes?

(b)
__________

(c)
__________

(d)
__________

1. Direct written premiums *
2. Reinsurance assumed **
3. Reinsurance ceded **
4. Net written premiums
((line 1 plus line 2) minus line 3)
*1. In addition to other direct written premiums, include on line 1 the full amount of any prepaid or advance premium in the year the prepayment is received.
For example, if a $5,000 premium for a 3-year policy was received in the current year, include the full $5,000 amount in the Current Year column.
**2 and **3. If you entered an amount on line 2 or 3, upload a copy of the reinsurance agreement into which you have entered.

501(c)(29) - CO-OP Health Insurance
Issuers. If you are applying under section
501(c)(29) as a qualified nonprofit health
insurance issuer (QNHII), provide the
following in addition to your narrative
description of activities:
1. Upload a copy of both the Notice of
Award issued by Centers for Medicare
Instructions for Form 1024

and Medicaid Services (CMS) and the
fully executed Loan Agreement with CMS.
2. The following representations:
• Except to the extent allowed by section
1322(c)(4) of the Patient Protection and
Affordable Care Act, no part of your net
earnings inures to the benefit of any
private shareholder or individual, or has so
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inured since the later of your date of
formation or March 23, 2010;
• No substantial part of your activities
constitutes, or has constituted since the
later of your date of formation or March 23,
2010, carrying on propaganda, or
otherwise attempting to influence
legislation; and

• You do not participate or intervene in
(including the publishing or distributing of
statements) any political campaign on
behalf of (or in opposition to) any
candidate for public office, nor have you
so participated or intervened since the
later of your date of formation or March 23,
2010.
Line 2. National Taxonomy of Exempt
Entities (NTEE) code. An NTEE code is
a three-character series of letters and
numbers that generally describe a type of
organization. Enter the code from the list
of NTEE codes, located in Appendix A,
that best describes you. For more
information and more detailed definitions
of these codes developed by the National
Center for Charitable Statistics (NCCS),
visit the Urban Institute, NCCS website at
nccs.urba.org.
NTEE codes are also used for

TIP purposes other than identification

of organizations described in
section 501(a) or section 521. Therefore,
all codes in the list don't necessarily
correspond to a section 501(a) or section
521 purpose.

Line 3. Describe any money or time
(whether volunteer or paid) you spent or
will spend attempting to influence the
selection, nomination, election, or
appointment of any person to any federal,
state, or local public office or to an office in
a political organization.
Line 4. You are a successor to another
organization if you:
• Took or will take over activities
previously conducted by another
organization,
• Took or will take over 25% or more of
the fair market value of the net assets of
another organization, or
• Were established upon the conversion
of an organization from for-profit to
nonprofit status.
Line 4a. 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.
Line 5. Answer “Yes” if you have
members and enter the requested
information.
Line 6. Indicate if you distribute, or plan
to distribute, any of your property or funds
(such as a distribution of profits) to your
shareholders or members.
Line 7. Answer “Yes” if you have or will
issue stock as a means of indicating
ownership by your members or others.
Enter the requested information.

Line 8. If you should cease operations as
a tax-exempt organization, explain to
whom your assets will be distributed.
Line 9. Answer “Yes” if you provide or will
provide insurance through a third party or
provide the insurance yourself.
Line 10. Answer “Yes” if you make
grants, loans, or other distributions (such
as goods) to a foreign organization. A
relationship between you and the recipient
organization includes the following
situations.
• You control the recipient organization,
or it controls you through common
officers, directors, or trustees, or through
authority to approve budgets or
expenditures.
• You and the recipient organization were
created at approximately the same time
and by the same persons.
• You and the recipient organization
operate in a coordinated manner with
respect to facilities, programs, employees,
or other activities.
Persons who exercise substantial
influence over you also exercise
substantial influence over the recipient
organization.
Lines 10d–10f. The Office of Foreign
Assets Control (OFAC) of the U.S.
Department of the Treasury administers
and enforces economic and trade
sanctions based on U.S. foreign policy
and national security goals against certain
governments, entities, and individuals, as
directed in Executive Orders. As part of
the comprehensive and sustained
campaign against terrorist financing, all
U.S. persons, including U.S.-based
charities, are prohibited from dealing with
persons (individuals and entities)
identified as being associated with
terrorism on OFAC's Specially Designated
Nationals and Blocked Persons List
(OFAC SDN List). Information about
OFAC sanction programs and the OFAC
SDN List are available at treasury.gov/
ofac. If you make grants, loans,
distributions, or you provide goods or
services to a foreign organization or
engage in activities in a foreign country,
you are responsible to know whether an
OFAC sanctions program applies and
whether your activities require a license
from OFAC to engage in a transaction that
otherwise would be prohibited.
Line 11. A foreign country is a country
other than the United States, its territories
and possessions, and the District of
Columbia.
Lines 11a–11c. 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
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directed in Executive Orders. As part of
the comprehensive and sustained
campaign against terrorist financing, all
U.S. persons, including U.S.-based
charities, are prohibited from dealing with
persons (individuals and entities)
identified as being associated with
terrorism on OFAC's Specially Designated
Nationals and Blocked Persons List
(OFAC SDN List). Information about
OFAC sanction programs and the OFAC
SDN List are available at treasury.gov/
ofac. If you make grants, loans,
distributions, or you provide goods or
services to a foreign organization or
engage in activities in a foreign country,
you are responsible to know whether an
OFAC sanctions program applies and
whether your activities require a license
from OFAC to engage in a transaction that
otherwise would be prohibited.

Part IV. Compensation and
Other Financial Arrangements
Line 1. Answer “Yes” if you pay or will
pay compensation to your officers,
directors, trustees, employees, members,
or independent contractors.
Line 1a. A conflict of interest arises when
a person in a position of authority over an
organization, such as a director, officer, or
manager, may benefit personally from a
decision he or she could make. Adoption
of a conflict of interest policy is not
required to obtain tax-exempt status.
However, by adopting a policy, you will be
choosing to put in place procedures that
will help you avoid the possibility that
those in positions of authority may receive
an inappropriate benefit.
Reasonable compensation is the
amount that would ordinarily be paid for
like services by like organizations under
like circumstances as of the date the
compensation arrangement is made.
Establishing and documenting reasonable
compensation is important because
excessive compensation may result in
excise taxes on both the individual and
you. In addition, excessive compensation
may jeopardize your tax-exempt status.
Line 1b. A fixed payment means a
payment that is either a set dollar amount
or fixed through a specific formula where
the amount doesn't depend on discretion.
For example, a base salary of $200,000
that is adjusted annually based on the
increase in the Consumer Price Index is a
fixed payment.
A nonfixed payment means a payment
that depends on discretion. For example,
a bonus of up to $100,000 that is based on
an evaluation of performance by the
governing board is a nonfixed payment
because the governing body has
discretion over whether the bonus is paid
and the amount of the bonus.
Instructions for Form 1024

Line 2. Don't include purchases or sales
of goods and services in your normal
course of operations that are available to
the general public under similar terms and
conditions. Answer “Yes” if any of your
officers, directors, or trustees:
• Is an officer, director, or trustee in
another organization from or to which you
will purchase or sell goods, services, or
assets; or
• Possesses more than 35% ownership
interest in any organization to which you
will purchase or sell goods, services, or
assets.
An arm's length standard exists where
the parties have an adverse (or opposing)
interest. For example, a seller wants to sell
his goods at the highest possible price,
while a buyer wants to buy at the lowest
possible price. These are adverse
interests.
In negotiating with a person, an
adverse interest is assumed if that person
is otherwise unrelated to you in the sense
of not being in a position to exercise
substantial influence over you or your
affairs. If the person is in a position to
exercise substantial influence over your
affairs, then an arm's length standard
requires additional precautions to
eliminate the effect of the relationship.
Using a conflict of interest policy,
information about comparable
transactions between unrelated parties,
and reliable methods for evaluating the
transaction, are examples of precautions
that would help make the negotiation
process equivalent to one between
unrelated persons.
Fair market value is the price at which
property or the right to use property would
change hands between a willing buyer
and a willing seller, neither being under
any compulsion to buy, sell, or transfer
property or the right to use property, and
both having reasonable knowledge of
relevant facts.
Line 3. Answer “Yes” if any of your
officers, directors, or trustees:
• Is an officer, director, or trustee in
another organization that has a lease,
contract, loan, or other agreement with
you; or
• Possesses more than a 35% ownership
interest in any organization that has a
lease, contract, loan, or other agreement
with you.
For example, answer “Yes,” if one of
your directors is an officer for a section
501(c)(3) organization with whom you
have a lease for office space or if one of
your directors owns more than 35% of the
voting stock of a corporation to which you
made a loan.
Line 4. Indicate if you perform any
services for any other organization or
individual for which you receive a fee.
Instructions for Form 1024

Line 5. A joint venture is a legal
agreement in which the persons jointly
undertake a transaction for mutual profit.
Generally, each person contributes assets
and shares risks. Like a partnership, joint
ventures can involve any type of business
transaction and the persons involved can
be individuals, groups of individuals,
companies, or corporations.

Part V. Financial Data
A. Statement of Revenue and
Expenses
You must complete the Statement of
Revenue and Expenses for a total of 3
years including the current year.
Completed less than 1 year. If you
existed less than 1 year, provide
projections of your likely income and
expenses for your current year and next 2
years based on a reasonable and good
faith estimate of your finances for a total of
3 years financial information.
Completed at least 1 year but fewer
than 3. If you've existed for more than 1
year but fewer than 3 years, provide your
actual income and expenses for the
current year and 1 year prior and
projected income and expenses for next
year for a total of 3 years financial
information.
Completed more than 3 years. If
you've existed more than 3 years, provide
your actual income and expenses for the
current year and 2 years prior for a total of
3 years financial information.

!

We may request financial data for
more than 3 years.

CAUTION

Preparing the statement. Prepare the
statement using the method of accounting
you use in keeping your books and
records. Place financial information for the
year you're filing this form in the column
marked Current tax year.
Prepare the statement using the
accounting period you entered on Part I,
line 11. Enter “0” if a particular revenue or
expense doesn't apply to you.
Your financial information should reflect
your activities described in this
application.
Line 1. Enter the total gifts, grants, and
contributions you receive. Include items of
value that you receive as gifts, grants, or
contributions. Do not include membership
dues reported on line 2.
Line 2. Enter the amount you receive
from members to provide support to the
organization. Do not include payments
from members or on behalf of members to
purchase admissions, merchandise,
services, or use of facilities.

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Line 3. Enter your gross income from
dividends, interest, payments received on
securities, loans, rents, and royalties that
are held for investment purposes.
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, not conducted with
substantially all (at least 85%) volunteer
labor, and not related to your exempt
purposes. Special rules apply to
organizations described in section 501(c)
(7), (9), or (17). In addition, unrelated
business income can be generated by
assets you acquire with debt
(“debt-financed income”). (You can take
this amount from Form 990-T, if filed.)
See Pub. 598 for additional information
regarding unrelated business income.
Line 5. Enter amounts any local tax
authority collects from the public on your
behalf.
Line 6. Enter the value of services or
facilities a governmental unit furnishes to
you. Use the fair market value of the
services or facilities. Don't include the
value of services or facilities generally
provided to the public without charge.
Line 7. Enter the total income from all
sources not reported on lines 1 through 6,
or lines 9, and line 11. Provide an itemized
list showing each type and amount of
income included on this line. Also, briefly
describe each type of income.
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.
Note. The state government gives a
conservation group a grant to study the
effects of a new sewage treatment plant
on an ecologically significant woodland
area. Although the payment is called a

grant, it is actually gross receipts that
should be included on Line 9.
The payment is by a governmental unit
(state) for a study for its own use, not for
the direct benefit of the general public. A
for-profit consulting company could have
done the study rather than by the
tax-exempt conservation group.

Provide an itemized list of your gross
receipts on line 24, describing the sources
and amounts of income. For payments by
a governmental unit, list the payer, the
purpose of the payment, and the payment
amount.

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 on line 24.
You may use the format in Figure 2.

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

(B) Securities

(C) Other

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

Line 13. Enter the total expenses you
incur for soliciting gifts, grants, and
contributions included on line 1. Include
fees paid to professional fundraisers for
soliciting gifts, grants, and contributions.
Line 14. Enter the total amounts you pay
out to both individuals and organizations.
Provide an itemized list on line 24,
identifying recipients (using letter
designations such as A, B, C, etc., for
individuals) a brief description of the
purposes or conditions of payments, and
the amounts paid.
Maintain (but don't submit) a list
showing the names of recipients
associated with each letter designation.
Line 15. Enter total payments you make
to or for the benefit of your members.
Provide an itemized list on line 24,
identifying recipients (using letter
designations), a brief description of the
purposes or conditions of payment, and
the amounts paid. Do not include any
amounts reported on line 14.
Maintain (but don't submit) a list
showing the names of recipients
associated with each letter designation.
Line 16. Enter the total amount of
compensation you pay to your officers,
directors, and trustees.
Line 17. Enter the total amount of
salaries you pay to employees (not
reported on line 16 above).
Line 18. Enter your total interest expense
for the year. Don't include mortgage
interest treated as an occupancy expense
on line 19.
Line 19. Enter the amount you pay for the
use of office space or other facilities, heat,
light, power, and other utilities, outside

janitorial services, mortgage interest, real
estate taxes, and similar expenses.
Line 20. Enter the total depreciation,
depletion, and similar expenses you incur.
Line 21. Enter the total professional fees
you pay. Professional fees are amounts
charged by individuals and entities that
aren't your employees. They include fees
for professional fundraisers (other than
fees included on line 13, above),
accounting services, legal counsel,
consulting services, contract
management, or any independent
contractors.
Line 22. Enter any expenses you didn't
include in the lines above, such as for
program services. Provide an itemized list
on line 24, showing the type and amount
of each significant expense.

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 the total interest and noninterest-bearing 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), change funds,
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.

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Line 3. Enter the amount of materials,
goods, and supplies you purchased or
manufactured and held to be sold or used
in some future period.
Line 4. Enter the total amount of bonds or
notes you issued that will be repaid to you.
Provide an itemized list on line 19 that
shows the name of the borrower (using a
letter designation), the borrower's
relationship to you, a brief description of
the obligation, the rate of return, the due
date, and the amount due.
Maintain (but don't submit) a list
showing the names of borrowers
associated with each letter designation.
Line 5. Enter the total fair market value of
corporate stocks you hold. Provide an
itemized list of your corporate stock
holdings on line 19.
For stock traded on an organized
exchange or in substantial quantities over
the counter, the schedule should show the
name of the corporation, a description of
the stock and the principal exchange on
which it is traded, the number of shares
held, and their value as carried on the
organization's books.
Line 6. Enter your total amount of loans
(personal and mortgage loans) receivable.
Provide an itemized list on line 19 that
identifies each borrower name (using a
letter designation), the borrower's
relationship to you, purpose of loan,
repayment terms, interest rate, and
original amount of loan. Report each loan
separately, even if more than one loan
was made to the same person.
Maintain (but don't submit) a list
showing the names of borrowers
associated with each letter designation.

Instructions for Form 1024

Line 7. Enter the total book value of your
other investments. Include the total book
value of governmental securities (federal,
state, and municipal), buildings, and
equipment held for investment purposes.
Provide an itemized list on 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 listing on line 19 of
these assets held at the end of the current
tax year/period, including the cost or other
basis.
Line 9. Enter the total book value of land
not held for investment purposes.
Line 10. Enter the total book value of any
other category of your assets not reported
on lines 1 through 9, for example, patents,
copyrights, or other intangible assets.
Provide an itemized list of each asset on
line 19.
Line 12. Enter the total 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 year/period. Provide
an itemized list on line 19 showing each
note separately and 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 on
line 19 of these liabilities, including the
amounts you owe.
If the organization doesn’t use fund
accounting, report only the “net assets”
account balances, such as capital stock,
paid-in capital, and retained earnings or
accumulated income.
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.

Instructions for Form 1024

Part VI. Reinstatement After
Automatic Revocation
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,
provides procedures for seeking
reinstatement of 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 have been
automatically revoked pursuant to Section
6033(j)(1); and
• You're submitting this application not
later than 15 months after the later of the
date of your Revocation Letter or the date
on which the IRS posted your name on the
Auto-Revocation List at
apps.irs.gov/app/eos/.
By selecting Section 4, you're also
attesting that your failure to file was not
intentional and you have put in place
procedures to file required returns or
notices in the future.
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 are ineligible to file for

reinstatement under Section 4; and
• You're submitting this application not
later than 15 months after the later of the
date of your Revocation Letter or the date
on which the IRS posted your name on the
Auto-Revocation List at
apps.irs.gov/app/eos/.
By selecting Section 5, you're also
attesting that you have filed the required
annual returns, your failure to file was not
intentional, and you have put in place
procedures to file required returns or
notices in the future.
Describe how you exercised ordinary
business care and prudence in
determining and attempting to comply with
your filing requirements in at least 1 of the
3 years of revocation. Include a detailed
explanation of all the facts and
-9-

circumstances that led to the failure, the
discovery of the failure, and the steps you
have taken or will take to avoid or mitigate
future failures to file timely returns or
notices.
Section 6. Select this section if:

• You're applying for reinstatement of

your tax-exempt status more than 15
months from the later of the date of the
Revocation Letter or the date on which the
IRS posted your name on
Auto-Revocation List at
apps.irs.gov/app/eos/.
By selecting Section 6, you're also
attesting that you have filed the required
annual returns, your failure to file was not
intentional, and you have put in place
procedures to file required returns or
notices in the future.
Describe how you exercised ordinary
business care and prudence in
determining and attempting to comply with
your filing requirements in each of the 3
years of revocation. Include a detailed
explanation of all the facts and
circumstances that led to the failure, the
discovery of the failure, and the steps you
have taken or will take to avoid or mitigate
future failures to file timely returns or
notices.
Section 7. Select this section if you're
seeking reinstatement with an effective
date of reinstatement of the date of
submission of this application.

Part VII. Annual Filing
Requirements

Most organizations must file an annual
information return (Form 990 or 990-EZ) or
notice (Form 990-N, Electronic Notice
(e-Postcard)). Exceptions to this rule
include certain affiliates of a governmental
unit. You can find more detailed
information about filing requirements and
exceptions from the requirement to file in
the Instructions for Form 990.
Unless specifically required to file Form
990 or Form 990-EZ (see the Instructions
for Form 990), most organizations that
normally have gross receipts of $50,000 or
less may satisfy their filing obligation with
the Form 990-N, Electronic Notice
(e-Postcard).
Note. Organizations exempt under
section 501(d) use Form 1065, U.S.
Return of Partnership Income, to satisfy
their annual filing requirement.
Organizations exempt under section 521
use Form 1120-C, U.S. Income Tax
Return for Cooperative Associations, to
satisfy their annual filing requirements.
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. Answer “Yes” if you're claiming
you are excepted from filing a Form
990-series return or notice and indicate
the reason you believe you're excepted
from filing. See Pub. 557 and Instructions
for Form 8940, Request for Miscellaneous
Determination, for more information on the
requirements for the various filing
exceptions.
Provide information regarding how you
meet your requested exception in your
narrative description of activities or as part
of an uploaded supplemental response.
For example, if you're claiming exception
as an affiliate of a governmental unit
based on Rev. Proc. 95-48, you must
demonstrate that your bylaws or other
organizational documents state that your
board members were appointed by a
governmental unit, an affiliate of a
governmental unit, a public official acting
in an official capacity, or elected by the
public at large, pursuant to local statute or
ordinance. Also include information
demonstrating that you meet at least two
(2) of the affiliation factors listed in Rev.
Proc. 95-48, Section 4.03 and how you
meet all of the facts and circumstances
detailed in Rev. Proc. 95-48, Section 4.04.

Part VIII. Signature
Signature Requirements
An officer, director, trustee, or other official
who is authorized to sign for the

organization must sign Form 1024. The
signature must be accompanied by the
title or authority of the signer and the date.
The person signing Form 1024

TIP must be listed as an officer,

director, or trustee within the first
five entries of Part I, Line 17.

Upload Checklist
Documents to upload. Check the boxes
to indicate which documents are included
in the file you upload with your application.
For your application to be complete,
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 documents in the
upload checklist are optional unless
required for a complete response to a
question.
Put your name and EIN on each page
of your supplemental response and
identify the Part and Line number to which
the information relates.
Pay.gov can accommodate only one
uploaded file. Consolidate your
attachments into a single PDF file not to
exceed 15MB.

organization to be recognized as tax
exempt by the IRS, you are required to
give us this information. We need it to
determine whether the organization meets
the legal requirements for tax-exempt
status.
The organization isn’t 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. The rules
governing the confidentiality of the Form
1024 application are covered in section
6104.
The time needed to complete and file
this form will vary depending on individual
circumstances.
The estimated average times are:

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

Taxpayer Burden for Exempt Organizations

Form 1024
Parts I–III
Part IV
Sch. A
Sch. C
Sch. D
Sch. E
Sch. F
Sch. G
Sch. H
Sch. I
Sch. J
Sch. K

Comments and suggestions. If you
have comments concerning the accuracy
of these time estimates or suggestions for
making Form 1024 simpler, we would be
happy to hear from you.
You can send us comments from
IRS.gov/FormComments.
Or you can write to the
Internal Revenue Service
Tax Forms and Publications Division
1111 Constitution Ave. NW, IR-6526
Washington, DC 20224

Learning about
the law or the
form
3 hr., 2 min.
47 min.
18 min.
12 min.
18 min.
18 min.
6 min.
6 min.
6 min.
30 min.
6 min.
6 min.

Recordkeeping
26 hr., 1 min.
1 hr., 40 min.
2 hr., 52 min.
57 min.
4 hr., 4 min.
1 hr., 40 min.
2 hr., 23 min.
1 hr., 54 min.
1 hr., 40 min.
5 hr., 30 min.
2 hr., 23 min.
3 hr., 21 min.

Preparing and
sending the form
to the IRS
5 hr., 35 min.
51 min.
21 min.
13 min.
22 min.
20 min.
8 min.
7 min.
7 min.
36 min.
8 min.
9 min.

Don’t send Form 1024 to this address.
Instead, see Where To File, earlier.

Line 2. Describe the property to which
you hold or will hold title.

Schedule A

Line 3. Answer “Yes” if you turn over the
entire amount of your income, less
expenses, to your parent organization.
The type of distribution is immaterial. It
could be termed a dividend on stock or
given some other description. What is
important is that the income must be
distributed to the exempt organization. A
mere obligation to use the income for the
parent's benefit doesn't satisfy this
requirement.

Organizations described in
section 501(c)(2) or 501(c)
(25) --Title holding corporations
or trusts
Line 1. Provide the requested information
on each organization for which you hold
title to property. Also indicate the number
and types of shares of your stock that are
held by each.
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Instructions for Form 1024

Often, an exempt parent occupies
realty that the title-holding company owns.
The exempt parent generally doesn't pay
rent. In this situation, the statutory
requirement that income be paid over to
the parent is satisfied if the title-holding
company turns over whatever income is
available.
If you answer “No,” state the purpose
for which the excess is or will be retained.
Line 4. Answer “Yes” if you engage or will
engage in any activities other than holding
title to property and collecting income
therefrom. Describe the activities in detail.
Line 5. Check the appropriate box below
to indicate the section under which you
are applying.
Line 5a. Answer “Yes” if your
shareholders or beneficiaries are
permitted to dismiss your investment
adviser upon a majority vote.
If you answer “No,” explain why your
shareholders or beneficiaries aren't
permitted to dismiss your investment
adviser upon a majority vote of your
shareholders or beneficiaries.
Line 5b. Answer “Yes” if your
shareholders or beneficiaries are
permitted to terminate their interest in you
by selling or exchanging their stock to any
organization described in section 501(c)
(25)(C) so long as the sale or exchange
does not increase the number of your
shareholders or beneficiaries above 35, or
by having their stock or interest redeemed
by you after they provide you 90 days
notice.
If you answer “No,” explain why your
shareholders or beneficiaries aren't
permitted to terminate their interest in you
in such a way.
Line 5c. Answer “Yes” if you hold or will
hold interests in partnerships or real estate
trusts. Describe the interests in detail.
Line 5d. Answer “Yes” if you make or will
make mortgage loans. Describe the loans
in detail.
Line 5e. Answer “Yes” if you hold
property through a corporation,
partnership, or trust. Identify the
corporation, partnership, or trust and
describe the property held.

Schedule B.
Organizations described in
section 501(c)(5) --Labor,
agricultural, or horticultural
organizations
Line 1. Select your type of organization
from the list.
A labor organization is an association
of workers who have combined to protect
and promote the interests of their
Instructions for Form 1024

members by bargaining collectively with
their employers to secure better working
conditions, wages, and similar benefits.
Agricultural and horticultural
organizations are connected with raising
livestock, cultivating land, raising and
harvesting crops or aquatic resources,
cultivating useful or ornamental plants,
and similar pursuits.

Schedule C.
Organizations described in
section 501(c)(6) --Business
leagues, chambers of
commerce, etc.
Line 1. Select your type of organization
from the list.
A business league, in general, is an
association of persons having some
common business interest, the purpose of
which is to promote that common interest
and not to engage in a regular business of
a kind ordinarily carried on for profit. Trade
associations and professional
associations are considered business
leagues.
A chamber of commerce is usually
composed of the merchants and traders of
a city.
A board of trade often consists of
persons engaged in similar lines of
business. For example, a nonprofit
organization formed to regulate the sale of
a specified agricultural commodity to
assure equal treatment of producers,
warehouse workers, and buyers is a board
of trade.
Chambers of commerce and boards of
trade usually promote the common
economic interests of all the commercial
enterprises in a given trade community.
A real estate board consists of
members interested in improving the
business conditions in the real estate field.
It isn't organized for profit and no part of
the net earnings inures to the benefit of
any private shareholder or individual.
The Internal Revenue Code specifically
defines professional football leagues as
exempt organizations under section
501(c)(6). They are exempt whether or not
they administer a pension fund for football
players.
Line 2. Describe your members' common
business interests.
Line 3. Describe any services you
perform or will perform for members or
others. You must show that your purpose
is the improvement of business conditions.
This isn't established by evidence of
particular services that provide a
convenience or economy to individual
members in their businesses, such as
advertising that carries the name of
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members, interest-free loans, assigning
exclusive franchise areas, operation of a
real estate multiple listing system, or
operation of a credit reporting agency.
Line 4. Answer “Yes” if you restrict or will
restrict your membership to individuals,
firms, associations, and/or corporations,
each representing a different trade,
business, occupation, or profession, and
organized for the purpose of exchanging
information on business prospects.
Explain in detail.
Line 5. Answer “Yes” if you market or will
market a specific product(s) and/or
brand(s) within an industry. Identify the
specific product(s) and/or brand(s) and
explain in detail how you market them.
Line 6. Answer “Yes” if you limit or will
limit your activities to users of a specific
product within an industry. Explain in
detail.
Line 7. Answer “Yes” if you operate or will
operate a listing or referral system. Explain
in detail.

Schedule D
Organizations described in
section 501(c)(7) --Social clubs
Line 1. Answer “Yes” if personal contact,
commingling, and fellowship exist among
members. If not, explain.
Line 2. Answer “Yes” if you conduct
activities such as take-out food sales,
liquor sales, operation of a gas station,
parking garage, barber shop, etc.
Describe these activities and indicate the
percentage of your time and resources
devoted to them.
Line 3. Answer “Yes” if you have entered
or will enter into any contract or agreement
for the management or operation of your
property and/or activities, such as
restaurants, pro shops, lodges. Describe
any written or oral arrangements that you
made or intend to make, with whom you
have or will have such arrangements, how
the terms are or will be negotiated at arm's
length, and how you determine you pay no
more than fair market value or you are
paid at least fair market value.
Line 4. Answer “Yes” if gross receipts
from your activities will include amounts
paid by non-members for goods and
services. Explain in detail.
Line 5. Answer “Yes” if non-members,
other than guests of members, are
permitted or will be permitted to use the
club facilities or participate in or attend any
functions or activities conducted by you.
Describe the functions or activities in
which there has been or will be
non-member participation or admittance.

Line 6. Enter the figure for the current
year and each of the prior tax years.
Line 7. Enter the figure for the current
year and each of the prior tax years.
Line 8. Answer “Yes” if your charter,
bylaws, other governing instrument, or any
written policy statement contain any
provision that provides for discrimination
against any person on the basis of race,
color, or religion. Identify where this
provision is located; whether or not it will
be kept; and if you have such a provision
that will be repealed, deleted, or otherwise
stricken from your requirements, state
when this will be done.
Line 9. Answer “Yes” if you restrict or will
restrict your membership to members of a
particular religion. Explain in detail.
Line 9a. Answer “Yes” if you are an
auxiliary of a section 501(c)(8) fraternal
beneficiary society. Provide the name and
EIN of the organization.
Line 9b. Answer “Yes” if you, in good
faith, limit your membership to the
members of a particular religion in order to
further the teachings or principles of that
religion and not to exclude individuals of a
particular race or color.

Schedule E
Organizations described in
section 501(c)(8) or 501(c)
(10) --Fraternal beneficiary
societies, orders, or
associations.

Unlike organizations exempt under section
501(c)(8), organizations exempt under
section 501(c)(10) are not “beneficiary”
societies; that is, they may not provide for
the payment of life, sick, accident or other
benefits to their members. Ensure your
selection in Part II is consistent with your
operations.

Line 1. Operating under the lodge system
means carrying on activities under a form
of organization that is composed of local
branches, chartered by a parent
organization, largely self-governing, and
called lodges, chapters, or the like.
Line 2. Answer “Yes” if you operate or will
operate for the exclusive benefit of the
members of an organization operating
under the lodge system. Explain in detail.
Line 3. Answer “Yes” if you are a
subordinate or local lodge, etc. List the
name, address, and EIN of your parent
organization.
Line 4. Answer “Yes” if you are a parent
or grand lodge. List the name, address,
and EIN of each subordinate lodge in
active operation.

Schedule F
Organizations described in
section 501(c)(9) --Voluntary
employees' beneficiary
associations
Line 1. Describe in detail the benefits you
provide or will provide. For each benefit
include the account, duration, eligibility
requirements, and the circumstances that
will entitle a recipient to payment of the
benefit.
Line 2. Answer “Yes” if you provide or will
provide deferred compensation benefits,
property or malpractice insurance, loans
(other than loans at times of disaster or
whole life insurance policy loans), savings
plans, reimbursement of commuting
expenses, or benefits similar to those
provided by a pension, stock bonus or
profit sharing plan. Describe these
benefits in detail.
Line 3. Provide the requested information
for each plan as of the last day of the most
recent plan year. If you have more than
one plan, at the end of this form, upload a
separate schedule.
Line 4. State the number of persons, if
any, other than employees and their
dependents (for example, the proprietor of
a business whose employees are
members of the association) who are
entitled to receive benefits.
Line 5. Answer “Yes” if any employees or
classes of employees are entitled to
benefits to which other employees or
classes of employees are not entitled.
Explain in detail.
Line 6. Answer “Yes” if you are organized
under the terms of a collective bargaining
agreement. At the end of this form, upload
a current copy.
Line 7. 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.
Line 7a. Generally, if you didn't file Form
1024 within 27 months of formation, the
effective date of your exempt status will be
the date you filed Form 1024 (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. See Rev. Proc. 2021-5
(updated annually) for more information.
Select the appropriate box to indicate
whether you accept the submission date
as the effective date of your exempt status

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or whether you are requesting an earlier
effective date.
Line 7b. You may be eligible for
consideration for relief from the
requirement that you file Form 1024 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 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 1024.
• You filed the required Form 990 series
returns consistent with your requested
status.

Schedule G
Organizations described in
section 501(c)(12)—Benevolent
life insurance associations,
mutual ditch or irrigation
companies, mutual or
cooperative telephone
companies, or like
organizations
Line 1. Select your type of organization
from the list.
A benevolent life insurance association
of a purely local character is one that
confines its business activities to a
particular community, place, or district,
irrespective of political subdivisions.
Ditch and irrigation companies,
telephone companies, electric companies,
and “like organizations” that seek
exemption under section 501(c)(12) must
be organized and operated as mutual or
cooperative organizations.
Line 2. Answer “Yes” if your business
activities will be confined to a particular

Instructions for Form 1024

community, place, or district. If “No,”
explain in detail.
Line 3. List the counties or geographical
region from which your members are or
will be accepted.
Line 4. Answer “Yes” if members have
democratic control. If “No,” explain in
detail.
Democratic Control means you
periodically hold democratically
conducted meetings with members.
Election of officers must be on a one
member, one vote basis. Meetings must
have a quorum of members in attendance
or voting by proxy.
Line 5 Answer “Yes” if the rights and
interests of members in your annual
savings are determined in proportion to
their business with you.
Line 6. Answer “Yes” if you keep the
records necessary to determine at any
time each member’s rights and interests in
such savings, including assets acquired
with the savings.
Line 7. Answer “Yes” if the rights and
interests of members are forfeited upon
termination of membership. Explain in
detail.
Line 8. Answer “Yes” if you receive or will
receive at least 85% of your income from
amounts collected from members for the
sole purposes of meeting losses and
expenses. If “No,” explain in detail.

Schedule H
Organizations described in
section 501(c)
(13)—Cemeteries, crematoria,
and like corporations
Line 1. Answer “Yes” if you are claiming
exemption as a perpetual care fund for an
organization described in section 501(c)
(13).
Line 1a. Answer “Yes” if the cemetery
organization, for which funds are held, has
established exemption under section
501(c)(13). If “No,” explain in detail.
Line 1b. Answer “Yes” if your funds are
devoted exclusively to the perpetual care
and maintenance of the non-profit
cemetery as a whole. If “No,” explain in
detail.
Line 2. Answer “Yes” if you operate or will
operate a mortuary. Explain in detail.
Line 3. Answer “Yes” if you engage or will
engage in land sale agreements,
percentage-of-sales land sale
agreements, or other similar financial
arrangements. Describe in detail any
written or oral arrangements that you
made or intend to make, with whom you
have or will have such arrangements, how
Instructions for Form 1024

the terms are or will be negotiated at arm's
length, and how you determine you pay no
more than fair market value or you are
paid at least fair market value.
Line 4. Answer “Yes” if you currently, or
will, own, operate, or maintain a cemetery
for pets. Explain in detail.

Schedule I
Organizations described in
section 501(c)(14)—Credit
Unions
Line 1. Answer “Yes” if you are formed
under a state credit union law.
Line 2. Select the state credit union law
under which you are organized and
operated from the drop down menu.
Line 3. Answer “Yes” if you are being
operated under uniform bylaws adopted
by the state you selected on Line 3a.
If you answer “No,” explain in detail the
rules and regulations under which you are
operated.
Line 4. Answer “Yes” if you comply or will
comply with the state credit union law
requirements, including their purposes,
security, and rate of interest charged
thereon, in making loans.
If you answer “No,” explain in detail
why you do not or will not comply with
state credit union law requirements.
Line 5. Answer “Yes” if you limit or will
limit your investments to securities which
are legal investments for credit unions
under the state credit union law.
If you answer “No,” explain in detail
why you do not or will not comply with
state credit union law requirements.
Line 6. Answer “Yes” if you distribute or
will distribute dividends on shares, if any,
as prescribed by the state credit union
law.
If you answer “No,” explain in detail
why you do not or will not comply with
state credit union law requirements.
Line 7. Answer “Yes” if you are operated
for the mutual benefit of your members.
Line 8. Answer “Yes” if your members
share a common bond such as
association, occupation, or residence.
Describe the common bond in detail.
Line 9. 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.
Line 10. Answer “Yes” if you issue or will
issue stock as a means of indicating
ownership by your members or others.
Describe the provisions for the issuance of
stock to shareholders that would take
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ownership in the corporation and share in
the earnings.
Line 11. Answer “Yes” if you allow or will
allow individuals who aren’t members to
be shareholders. Explain in detail.
Line 12. If you answer “No,” explain in
detail why you do not or will not ensure
that loans to members benefit the
borrower and meet their needs.
Line 13. Answer “Yes” if you make or will
make loans to individuals who aren’t
members. Explain in detail.
Line 14. Answer “Yes” if you advertise or
will advertise to individuals who aren’t
members. Explain in detail.
Line 15. Answer “Yes” if you are a mutual
fund organized before September 1, 1957.
Line 15a. Answer “Yes” if you provide
reserve funds for-- and insurance of
shares or deposits in-- a domestic building
and loan association, cooperative bank
without capital stock organized and
operated for mutual purposes and without
profit, mutual savings bank not having
capital stock represented by shares, or a
mutual savings bank described in section
591(b).
Line 15b. Select the type of organization
for which you provide reserve funds and
insurance of shares or deposits.
Line 15c. Provide the name of the
organization for which you provide reserve
funds and insurance of shares or deposits.
Line 15d. Answer “Yes” if 85% or more of
your income is attributable to providing
reserve funds and to investments.
If you answer “No,” specify the
percentage of your income that is
attributable to providing reserve funds and
to investments.

Schedule J
Organizations described in
section 501(c)(17)—Trusts
providing for the payment of
supplemental unemployment
compensation benefits
Line 1. A full description of the
supplemental unemployment benefits
available to the participants must
accompany your application, showing the
amount, duration, eligibility requirements,
and the circumstances that will entitle a
recipient to payment of the benefit.
A copy of your plan documents that
describe such benefits and the terms and
conditions of eligibility for each benefit
should be uploaded at the end of the form.
Line 2. Answer “Yes” if you provide or will
provide benefits for individual proprietors,
partners, or self-employed persons under
the plan. Explain in detail.

Line 3. Provide the requested information
for each plan as of the last day of the most
recent plan year and enter that date in the
space provided. If you have more than
one plan, at the end of this form, upload a
separate schedule.
Line 4. Answer “Yes” if the creator of the
trust or a contributor to the trust; a brother
or sister (whole or half-blood), a spouse,
an ancestor, or a lineal descendant of
such a creator or contributor; or a
corporation controlled directly or indirectly
by such a creator or contributor has or will
(a) borrow or receive any part of the trust’s
income or corpus, (b) receive any
compensation for personal services, (c)
obtain any part of the trust’s services, or
(d) sell or purchase any securities or other
properties from or to the trust.
Line 5. 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.
Line 5a. Generally, if you didn’t file Form
1024 within 27 months of formation, the
effective date of your exempt status will be
the date you filed Form 1024 (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. See Rev. Proc. 2021-5
(updated annually) for more information.
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 5b. You may be eligible for
consideration for relief from the
requirement that you file Form 1024 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 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 1024.
• You filed the required Form 990 series
returns consistent with your requested
status.

Schedule K
Organizations described in
section 501(c)(19)—A post,
organization, auxiliary unit,
etc., of past or present
members of the Armed Forces
of the United States
Line 1. Answer “Yes” if you are a post or
organization of past or present members
of the Armed Forces of the United States.
Line 1a. Enter the total number of your
members.
Line 1b. Enter the number of your
members that are present or former
members of the U.S. Armed forces.
Line 1c. Enter the total number of your
members that are cadets (include
students in college or university ROTC
programs or at armed services academies
only), or spouses, widows, or widowers of
cadets or past or present members of the
U.S. Armed Forces.
Line 1d. Answer “Yes” if you have a
membership category other than the ones
asked about above. Describe other
membership categories and state the
number of members in each category.
Line 1e. Answer “Yes” if you wish to
apply for a determination that
contributions to your organization are
deductible by donors.
Line 1f. Enter the number of your
members from line 1b that are war
veterans. (A war veteran is a person who
served in the Armed Forces of the United
States during the following periods of war:
April 21, 1898, through July 4, 1902; April
6, 1917, through November 11, 1918;
December 7, 1941, through December 31,
1946; June 27, 1950, through January 31,
1955; August 5, 1964, through May 7,
1975; and August 2, 1990, through a
future date to be set by law or Presidential
Proclamation.)
Line 2. Answer “Yes” if you are an
auxiliary unit or society of a post or
organization of past or present members
of the Armed Forces of the United States.

-14-

Enter the name, address, and EIN of the
post or organization.
Line 2a. Answer “Yes” if you are affiliated
with and organized according to the
bylaws and regulations formulated by
such an exempt post or organization. A
copy of such bylaws or regulations should
be uploaded at the end of this form.
Line 2b. Enter the total number of your
members.
Line 2c. Enter the number of your
members that are themselves past or
present members of the Armed Forces of
the United States, or are their spouses, or
persons related to them within two
degrees of blood relationship.
(Grandparents, brothers, sisters, and
grandchildren are the most distant
relationships allowable.)
Line 2d. Answer “Yes” if all of your
members are themselves members of a
post or organization, past or present
members of the Armed Forces of the
United States, spouses of members of
such a post or organization, or related to
members of such a post or organization
within two degrees of blood relationship.
Line 3. Answer “Yes” if you are a trust or
foundation organized for the benefit of an
exempt post or organization of past or
present members of the Armed Forces of
the United States.
Line 3a. Answer “Yes” if your corpus or
income be used solely for the funding of
such an exempt organization (including
necessary related expenses). If not,
answer “No” and explain.
Line 3b. Answer “Yes” if you are formed
for charitable purposes and your
organizational document contain a proper
dissolution provision as described in
section 1.501(c)(3)-1(b)(4) of the Income
Tax Regulations.
Line 4. Answer “Yes” if you currently, or
will, (a) rent your facilities to the general
public; (b) make your facilities, such as bar
and dining facilities, open to the general
public; (c) sell liquor and/or food to
members and/or the general public for
consumption off premises; or (d) conduct
gaming activities with the general public.
Explain in detail, including the percentage
of your time and resources devoted to
such activities.

Schedule L
Organizations described in
section 501(d)—Religious and
apostolic organizations
Line 1. Answer “Yes” if you are organized
for the purpose of operating a communal
religious community where members live a
communal life following your tenets and
teachings.
Instructions for Form 1024

Line 2. Answer “Yes” if you maintain a
common or community treasury.
Line 3. Answer “Yes” if all your members
live in a communal manner.
Line 4. Answer “Yes” if your members are
permitted to own, in their own names, any
real or personal property.
Line 5. Answer “Yes” if your members are
required to furnish their own support (food,
clothing, and shelter).
Line 6. State your membership
requirements, the method of member
admission, members’ right to property
owned at the time they’re admitted and
terminating members’ rights to share in
the organization’s property, or to a return
of any property contributed.

Schedule M
Organizations described in
section 521 – Farmers'
Cooperative Associations
Line 1. Complete the table. Show the
number of shares of each class of capital
stock currently outstanding, if any, the
value of the consideration for which it was
issued, and the rate of dividend paid.
Line 2. Complete the table. Show the
number of shares of capital stock (other
than non-voting preferred) owned by
current and active producers, inactive
producers, and non-producers.
The term “producer” means an
individual or corporation engaged in
farming as a business receiving income
based on farm production rather than fixed
compensation. For example, a corporation
leases its land to a tenant farmer who
agrees to pay a rental fee based on a
percentage of the farm crops produced.
Both the landowner and the tenant farmer
qualify as producers.
“Current and active” producers are
patrons of a cooperative who market more
than 50% of their products or purchase
more than 50% of their supplies and
equipment through the cooperative during
the cooperative's tax year.
Line 3. Answer “Yes” if you issue or will
issue non-voting preferred stock. Explain
in detail whether the owners, upon
dissolution or liquidation, may share in the
profits of the association beyond fixed
dividends.
Line 4. Answer “Yes” if you make or will
make any provisions for retiring the voting
stock held by a non-producer. Explain in
detail.
Line 5. Enter the legal rate of interest in
the state where you are located. If the
state in which you are located differs from

Instructions for Form 1024

the state in which you are incorporated,
enter the legal rate of interest in the state
of your incorporation.
Line 6. Answer “Yes” if you are required
by state law to accumulate and maintain
reserves. State the names and purposes
of the reserves and specify the amounts of
each.
Line 7. Answer “Yes” if you maintain or
will maintain any reserves other than those
required by state law. State the names
and purposes of the reserves and specify
the amounts of each.
Line 8. Describe who is accorded voting
rights in the cooperative and how many
votes one person may have. If a person
may be entitled to more than one vote,
explain in detail how voting rights are
acquired.
Line 9. Answer “Yes” if you are a
federated cooperative.
Line 10. Answer “Yes” if all your member
cooperatives are exempt under section
521.
Line 11. Answer “Yes” if the nonexempt
member cooperatives have the same
annual accounting period as you. If “No,”
describe the method that you use or will
use to provide a common or comparable
unit of time for analyzing and evaluating
your operations and those of your
members.
Line 12. Answer “Yes” if you do business
with or will do business with both
members and non-members. Explain in
detail.
Line 13. Answer “Yes” if you pay or will
pay patronage dividends. Explain in detail
whether they will be paid to members and
non-members on the same basis.
Line 14. Answer “Yes” if you allocate or
will allocate patronage dividends based on
an obligation in existence before you
received the amounts allocated. Explain
the obligation in detail.
Line 15. Explain how distribution is or will
be made of the proceeds of products
marketed for members and non-members.
Also, if you operate on a basis of allocated
units (i.e., functional, departmental, etc.),
explain how losses are or will be treated.
Line 16. Explain how you charge for
supplies and equipment purchased for
members and non-members.
Line 17 – 19. The information requested
on lines 17 through 19 must be completed
for the current year and each of the 2
immediately preceding years (or for the
time you have existed if less than 3 years).
The requested information for the current
year must cover the period beginning on
the first day of your established annual

-15-

accounting period and ending on any day
which is within 60 days of the date of the
application. If the date of the application is
less than 60 days after the first day of the
current accounting period, no information
is required for the current year.
Requested information is required for
the 2 preceding years regardless of the
current year requirement. Please note that
if no information is required for the current
year, the preceding years information
period can end on any day which is within
60 days of the date of the application.
Line 17. Enter the value of agricultural
products marketed or handled for
members and non-members below:
Line 17a. Members – Note: If it is
necessary to own one or more shares of
stock in order to become a member,
include only the amount of business
transacted with persons actually owning
the required number of shares.
Line 17a.1 List the amount actually
produced by members.
Line 17a.2 List the amount not actually
produced by members but marketed by
them through you
Line 17b.1 Non-members
Line 17b.2 List the amount not actually
produced by non-members but marketed
by them through you
Line 17c. List the amount by
nonproducers (purchased from
nonproducers for marketing by you)
Line 18. Enter the value of supplies and
equipment purchased for or sold to
members and non-members below:
Line 18a. List the amount from members
who were producers Note: If it is
necessary to own one or more shares of
stock in order to become a member,
include only the amount of business
transacted with persons actually owning
the required number of shares.
Line 18b. List the amount from
non-members who were producers
Line 18c. List the amount from members
and non-members who were not
producers
Line 19. List the amount of business
done with the United States Government
or any of its agencies
Line 20. Answer “Yes” if all the net
earnings (after payment of dividends, if
any, on capital stock) for the years shown
on lines 17-19 were distributed as
patronage dividends. If your net earnings
were not distributed as patronage
dividends, also indicate whether they were
apportioned on the records to all patrons
on a patronage basis.

Appendix A: 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

-16-

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 A: 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

-17-

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
Children’s 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 A: 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
Women’s Service Clubs
Men’s 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
Voluntaryism Promotion
Philanthropy, Charity &
Voluntaryism Promotion
Federated Giving Programs
Named Trusts N.E.C.
Philanthropy, Voluntaryism &
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

Alliances & Advocacy
Management & Technical
Assistance
Professional Societies &
Associations
Research Institutes & Public
Policy Analysis
Single Organization Support
Fundraising & Fund Distribution
Support N.E.C.
Government & Public
Administration
Public Finance, Taxation &
Monetary Policy
Citizen Participation
Military & Veterans’
Organizations
Public Transportation Systems
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

-18-

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
Roman Catholic
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
Support N.E.C.
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
Employee-Funded Pension
Trusts
Multi-Employer Pension Plans
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.