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Form Rp-420-A-Org - Application For Real Property Tax Exemption For Nonprofit Organizations - Mandatory Class I-Organization Purpose - 2008 Page 2

RP-420-a-Org (9/08)

3. Is the organization currently exempt from Federal income tax?

Yes

If no, skip to question 4. If yes, answer a. through d.

a. Under which section, subsection and paragraph of the Internal Revenue Code? _______________

b. Did the Internal Revenue Service recognize the exemption on the basis of an application form or a

written request or statement?

Yes

If yes:

(1) Was the exemption recognized by a (check one)

Group exemption letter

Separate exemption letter

(2) If exemption was recognized by a group exemption letter, give name and address of

organization receiving group exemption.

(3) If the exemption was recognized by an advanced ruling, when does the ruling expire?

(month/day/year)

ATTACH COPY OF DETERMINATION OR RULING LETTER

If no:

(4) Please explain how the organization is exempt from Federal income tax (attach additional

sheets if needed).

c. Is the organization required to file annual returns with the Internal Revenue Service?

Yes

If yes, attach form number(s).

ATTACH COPY OF EACH RETURN FILED FOR THE ORGANIZATION’S LAST FISCAL YEAR

d. For the last fiscal year, did the organization file Internal Revenue Form 990-T (Exempt Organization

Business Income Tax Return)?

Yes

IF YES ATTACH COPY OF FORM 990-T AND SKIP TO QUESTION 5

4. Has the organization applied for recognition of exemption from Federal income tax?

Yes

a. Under which section, subsection and paragraph of the Internal Revenue Code?

b. Date of application

ATTACH COPY OF APPLICATION, REQUEST OR STATEMENT AND ATTACHMENTS

IF NO, COMPLETE AND ATTACH SCHEDULE A (RP-420-a/b-Org) (obtain Sch. A from assessor)

5. Is the organization incorporated?

Yes

If yes, answer a through c. If no, answer d through f.

Form Rp-420-A-Org - Application For Real Property Tax Exemption For Nonprofit Organizations - Mandatory Class I-Organization Purpose - 2008 Page 2