Form St-119.2-I - 2013 - Application For An Exempt Organization Certificate Page 4
Download a blank fillable Form St-119.2-I - 2013 - Application For An Exempt Organization Certificate in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form St-119.2-I - 2013 - Application For An Exempt Organization Certificate with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3
4ST-119.2 (9/11) (back)
6 If you marked box 1a, has the organization ever participated or intervened, directly or indirectly, in any
political campaign or endorsed or opposed any candidate for public office? ................................................ Yes
No
7 If you marked box 1a and the organization fosters national or international amateur sports competition,
does it provide any facilities or equipment, either directly or indirectly, to anyone? ....................................... Yes
No
8 Has the organization received an exemption from federal income tax under IRC section 501(c)(3)? ................. Yes
No
(If Yes, you must attach a copy of the federal determination letter confirming your IRC section 501(c)(3)
exemption.)
9 If you are a branch or chapter, has your parent organization received an exemption from federal income
tax under IRC section 501(c)(3) that applies to subordinate branches or chapters (see instructions)? ........... Yes
No
(If Yes, you must attach a copy of the federal determination letter confirming your IRC section 501(c)(3)
exemption.)
10 Mark an X in the appropriate box to indicate your type of organization
.
(see instructions)
Corporation
(attach a copy of articles of incorporation, including filing receipt, and bylaws and any amendments to either of them)
Trust or foundation
(attach a copy of Declaration of Trust and bylaws and any amendments to either of them)
Limited liability company (LLC)
(attach a copy of articles of organization and operating agreement and any amendments to
either of them)
Credit union
(attach a copy of federal or New York State charter)
Other
(attach a copy of constitution and bylaws and any amendments to either of them)
11 Attach the following to this application
:
(see instructions)
• Statement of activities fully describing all current and proposed activities.
• Statement of receipts and expenditures for your most recent fiscal year of operation, clearly reflecting the nature and
amount of receipts and the purpose and amount of expenditures. (If you have been in existence less than a year, submit a
statement of your receipts and expenditures to date, and a proposed budget for the rest of the year.)
• Statement of assets and liabilities as of the end of your most recent fiscal year. (If you have been in existence less than a
year, your statement should be as of the date of this application).
• Note: Do not attach federal Form 1023, Application for Recognition of Exemption.
• Note: The Tax Department may require the applicant to submit additional documents and information.
Certification: I certify that the above statements are true, complete, and correct, and that no material information has been omitted. I
make these statements with the knowledge that willfully providing false or fraudulent information with this document may constitute a
felony or other crime under New York State Law, punishable by a substantial fine and possible jail sentence. I also understand that the
Tax Department is authorized to investigate the validity of any information entered on this document.
Signature of officer or trustee
Date
Name and title of officer or trustee
(please print)
Email address of officer or trustee
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form St-119.2-i - Instructions For Form St-119.2 - Application For An Exempt Organization Certificate
Financial
Application For Certificate Of Exemption For An Exempt Organization From The Rhode Island Sales And Use Tax
Financial
Form Exo-app - Sales & Use Exemption For An Exempt Organization - State Of Rhode Island And Providence Plantations
Legal
Related Categories
Parent category: Financial