Form 5768 - Election/revocation Of Election By An Eligible Section 501(C)(3) Organization To Make Expenditures To Influence Legislation
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15768
Election/Revocation of Election by an Eligible
Form
Section 501(c)(3) Organization To Make
Expenditures To Influence Legislation
(Rev. September 2016)
For IRS
(Under Section 501(h) of the Internal Revenue Code)
Department of the Treasury
Use Only
▶
Internal Revenue Service
Information about Form 5768 and its instructions is at
▶
Employer identification number
Name of organization
Number and street (or P.O. box no., if mail is not delivered to street address)
Room/suite
City, town or post office, and state
ZIP + 4
1 Election— As an eligible organization, we hereby elect to have the provisions of section 501(h) of the Code, relating to
expenditures to influence legislation, apply to our tax year ending
and all
subsequent tax years until revoked.
(Month, day, and year)
Note: This election must be signed and postmarked within the first taxable year to which it applies.
2 Revocation— As an eligible organization, we hereby revoke our election to have the provisions of section 501(h) of the Code,
relating to expenditures to influence legislation, apply to our tax year ending
and
all subsequent tax years (until a new election is made).
(Month, day, and year)
Note: This revocation must be signed and postmarked before the first day of the tax year to which it applies.
election
revocation
Under penalties of perjury, I declare that I am authorized to make this (check applicable box)
▶
on behalf of the above named organization.
(Signature of officer or trustee)
(Type or print name and title)
(Date)
General Instructions
the election or revocation applies in item
b. An integrated auxiliary of a church or
1 or 2, as applicable, and sign and date
of a convention or association of
Section references are to the Internal
the form in the spaces provided.
churches, or
Revenue Code.
c. A member of an affiliated group of
Eligible organizations. A section
Section 501(c)(3) states that an
501(c)(3) organization is permitted to
organizations if one or more members
organization exempt under that section
of such group is described in a or b of
make the election if it is not a
will lose its tax-exempt status and its
disqualified organization (see below) and
this paragraph.
qualification to receive deductible
is described in:
Affiliated organizations. Organizations
charitable contributions if a substantial
1. Section 170(b)(1)(A)(ii) (relating to
are members of an affiliated group of
part of its activities are carried on to
educational institutions),
organizations only if (1) the governing
influence legislation. Section 501(h),
instrument of one such organization
2. Section 170(b)(1)(A)(iii) (relating to
however, permits certain eligible section
requires it to be bound by the decisions
hospitals and medical research
501(c)(3) organizations to elect to make
of the other organization on legislative
organizations),
limited expenditures to influence
issues, or (2) the governing board of one
3. Section 170(b)(1)(A)(iv) (relating to
legislation. An organization making the
such organization includes persons (i)
organizations supporting government
election will, however, be subject to an
who are specifically designated
schools),
excise tax under section 4911 if it
representatives of another such
spends more than the amounts
4. Section 170(b)(1)(A)(vi) (relating to
organization or are members of the
permitted by that section. Also, the
organizations publicly supported by
governing board, officers, or paid
organization may lose its exempt status
charitable contributions),
executive staff members of such other
if its lobbying expenditures exceed the
5. Section 170(b)(1)(A)(ix) (relating to
organization, and (ii) who, by aggregating
permitted amounts by more than 50%
agricultural research organizations),
their votes, have sufficient voting power
over a 4-year period. For any tax year in
6. Section 509(a)(2) (relating to
to cause or prevent action on legislative
which an election under section 501(h) is
organizations publicly supported by
issues by the first such organization.
in effect, an electing organization must
admissions, sales, etc.), or
For more details, see section 4911 and
report the actual and permitted amounts
7. Section 509(a)(3) (relating to
section 501(h).
of its lobbying expenditures and grass
organizations supporting certain types
Note: A private foundation (including a
roots expenditures (as defined in section
of public charities other than those
private operating foundation) is not an
4911(c)) on its annual return required
section 509(a)(3) organizations that
eligible organization.
under section 6033. See Part II-A of
support section 501(c)(4), (5), or (6)
Schedule C (Form 990 or Form 990-EZ).
Where to file. Mail Form 5768 to:
organizations).
Each electing member of an affiliated
Department of the Treasury
Disqualified organizations. The
group must report these amounts for
Internal Revenue Service Center
following types of organizations are not
both itself and the affiliated group as a
Ogden, UT 84201-0027
permitted to make the election:
whole.
a. Section 170(b)(1)(A)(i) organizations
To make or revoke the election, enter
(relating to churches),
the ending date of the tax year to which
5768
Form
(Rev. 9-2016)
Cat. No. 12125M
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