Federal Group Exemption Form
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1FEDERAL GROUP EXEMPTION FORM
(Must be completed by an association officer.)
Association Information
Contact Person Information
________________________________________
________________________________________
Association Name
Name
________________________________________
________________________________________
Mailing Address
Title
________________________________________
________________________________________
Street Address (if different)
Address
________________________________________
________________________________________
City
State
Zip
City
State
Zip
________________________________________
________________________________________
Telephone Number
Telephone Number
________________________________________
________________________________________
Employer Identification Number (EIN)
E-mail Address
(Must use the EIN of one of the merging associations. Do NOT apply for a new EIN.)
It is our understanding that the United States Bowling Congress, Inc. (USBC) has obtained a Section
501(c)(3) group tax exemption ruling on behalf of its state and local associations. The above-named
association hereby authorizes and directs USBC to include this association in that group ruling.
We further understand that, as a condition of such Section 501(c)(3) status, if the association is
incorporated, the Articles of Incorporation of associations to be covered by the group ruling must
contain certain provisions specifying the association’s amateur sports organization and international
competition status and indicating the disposition of their assets in the event of dissolution.
On behalf of the above-named association, I hereby certify that the Articles of Incorporation (if
applicable) of the above-named association includes such provisions, and such articles have been
duly filed with the appropriate state and/or local authorities.
For Office Use Only
_________________________________
Date Received: _____________________________
Signature of Officer
Assn Number: _____________________________
_________________________________
Title
Date
Assn Name: _______________________________
Title
Date
USBC/Chartering/MergeCharter/FederalGroupExemptionRequestForm
Rev. 10/06
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