Fillable Texas Application For Exemption (Page 2 of 2) in pdf

*AP20420W041509*

AP-204-2

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CLEAR FIELDS

(Rev.4-15/9)

*AP20420W041509*

Texas Application for Exemption

– Federal and All Others

• Remove All Staples

• TYPE OR PRINT

• Do NOT write in shaded areas.

1. Organizations applying for exemption under one of the categories listed below should check the appropriate box and complete this application.

Our publication, Guidelines to Texas Tax Exemptions (96-1045), includes a description of the additional documentation required for each category of

exemption. For the category you select, be sure to read the requirements listed in the publication. If you send in an application without including the

documentation described in the publication, we will return the application to you with a request for additional information. We are unable to

process incomplete applications.

Federal Exemption under qualifying Internal Revenue Code

Credit Unions - Federal

Section 501(c)

Credit Unions - State

Development Corporations

Cemetery Corporations

Electric Cooperatives

Certain Insurance Corporations for Farm Mutuals, Local Mutual Aid

Associations and Burial Associations

Emergency Medical Service Corporations

Certain Insurance Corporations Licensed as Title Insurance

Farmers Cooperative Societies

Companies and Title Insurance Agents

Health Facility Development Corporations

Certain Corporations Subject to the Insurance Code

Hospital Laundry Cooperative Associations

Housing Finance Corporations

Chambers of Commerce

Local Organizing Committees

Convention and Tourist Promotional Agencies

Cooperative Associations

Lodges

Cooperative Credit Associations

Marketing Associations

Corporations Exempted by Another Law

Nonproﬁt Water Supply Corporations

Open-End Investment Companies

Corporations with Business Interest In Solar Energy Devices

Corporations Organized to Promote County, City or Another Area

Corporations Organized for Agricultural Purposes

(Public Interest Organizations)

Corporations Organized for Conservation Purposes

Corporations Involved with City Natural Gas Facility

Railway Terminal Corporations

Corporations Organized to Provide Cooperative Housing

Recycling Operations

Corporations Organized to Provide Convalescent Homes for

Telephone Cooperatives

Elderly

Volunteer Fire Departments

Corporations Organized for Student Loan Funds or Student

Youth Athletic Organizations

Scholarship Purposes

2. ORGANIZATION NAME

(Legal name as provided on Articles of Incorporation, or if unincorporated, the governing document.)

3. ORGANIZATION MAILING ADDRESS

Street number, P.O. Box or rural route and box number

City

State/Province

ZIP Code

County (or country, if outside the U.S.)

4. Texas taxpayer number (if applicable) ............................................................................................................................

5. Federal Employer Identiﬁ cation Number

(EIN)

(Required if applying for exemption on the basis of a federal exemption) ......................

6. a) Enter ﬁling information issued by the Texas Secretary of State:

Month

Day

Year

File Number .............................................................

File Date ................................................

Check this box if this organization is not registered with the Texas Secretary of State.

7. Contact information of the person submitting this application

Name