Form Fae 183 - Franchise And Excise Tax Annual Exemption Renewal Page 2
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1
2EXEMPTION PERIOD
ACCOUNT NO. or FEIN
TAXPAYER NAME
COMPLETE ONLY THE SCHEDULE FOR THE ENTITY'S EXEMPTION TYPE
Check all that apply
SCHEDULE A - Family-Owned Non-Corporate Entity - T.C.A. § 67-4-2008(a)(11)
Entity is an LLC, LP, or LLP.
At least 95% of the ownership units of the entity are owned by members of the family or the estate or trust of a deceased individual who,
while living, was a member of the family.
At least 66.67% of the entity's activity is either 1) the production of passive investment income; or 2) the combination of passive investment
income and farming.
Completed Disclosure of Activity form is attached.
ALL REQUIREMENTS MUST BE MET IN ORDER TO BE EXEMPT.
Check all that apply
SCHEDULE B - Farming/Personal Residence - T.C.A. § 67-4-2008(a)(6)
Entity is an LLC, LP, or LLP.
1) At least 66.67% of the activity is in farming and 66.67% of assets are used by the owner or the owner's lessee for farming; or 2) at least
66.67% of the activity is the holding of one or more personal residences where one or more of the members/partners reside.
At least 95% of the voting rights, capital interest or profits are owned by natural persons who are relatives or by trusts for their benefit.
Completed Disclosure of Activity form is attached.
ALL REQUIREMENTS MUST BE MET IN ORDER TO BE EXEMPT.
SCHEDULE C - Affordable Housing - T.C.A. § 67-4-2008(a)(8)
Check all that apply
Entity is an LLC, or LP.
Entity was formed exclusively to provide affordable housing.
Entity has received an allocation of low-income housing tax credits pursuant to I.R.C. §42.
Each residential building has an É e xtended low-income housing commitmentÉ as defined in I.R.C. § 42(h)(6)(B).
Certification of LP or LLC Providing Affordable Housing is attached.
Form can be found at
ALL REQUIREMENTS MUST BE MET IN ORDER TO BE EXEMPT.
Check all that apply
SCHEDULE D - Venture Capital Fund - T.C.A. § 67-4-2008(a)(5)
Entity is an LLC, LP, LLP, or business trust.
Entity is operated for the exclusive purpose of buying, holding and/or selling securities and more than 50% of securities are in non-publicly
traded companies. Entity buys, sells, and/or holds securities on its own behalf and not as a broker.
More than 50% of capital is from investments neither related to nor affiliated with the fund.
ALL REQUIREMENTS MUST BE MET IN ORDER TO BE EXEMPT.
Check all that apply
SCHEDULE E - Diversified Investment Fund - T.C.A. § 67-4-2008(a)(12)
Entity is an LLC, LP, LLP, or business trust.
At least 90% of the cost of total assets consists of qualifying investment securities, bank deposits, and office space and equipment.
At least 90% of gross income consists of interest, dividends, and gains from the sale or exchange of qualifying investment securities.
Primary purpose of entity is buying, holding, and selling qualified securities on its own behalf and not as a broker.
Capital is primarily derived from investments by entities or individuals not affiliated with the fund.
ALL REQUIREMENTS MUST BE MET IN ORDER TO BE EXEMPT.
Check all that apply
SCHEDULE F - Obligated Member Entity - T.C.A. § 67-4-2008(a)(9)
Entity is an LLC, LP, or LLP.
All members or partners are fully liable for the debts, obligations, and liabilities of the entity.
Required documentation has been filed with the Tennessee Secretary of State.
ALL REQUIREMENTS MUST BE MET IN ORDER TO BE EXEMPT.
Check all that apply
SCHEDULE G - Asset-Backed Securitization (REMIC/FASIT) - T.C.A. § 67-4-2008(a)(10)
Entity is classified as one of the following: 1) a partnership or trust for federal tax purposes; 2) a REMIC; 3) a FASIT; 4) a business trust; 5) a
trust that is disregarded for federal tax purposes and whose trustee is domiciled outside Tennessee.
The entity's sole purpose, except for foreclosures, is the asset-backed securitization of debt obligations.
ALL REQUIREMENTS MUST BE MET IN ORDER TO BE EXEMPT.
Check all that apply
SCHEDULE H - Security 3rd Party Indebtedness - T.C.A. § 67-4-2008(a)(7)
LLC, LP, LLP or business trust existing on May 1, 1999.
At least 98% owned by corporate members of an affiliated group and was formed exclusively to acquire notes from affiliated group
members.
Assets serve as security for third-party borrowings or securitized indebtedness acquired by third parties.
At least 80% of income from assets is included in the income of a corporation doing business in Tennessee and subject to applicable
allocation and apportionment rules.
ALL REQUIREMENTS MUST BE MET IN ORDER TO BE EXEMPT.
SCHEDULE I - Facilities Owned by the Armed Forces - T.C.A. § 67-4-2008(a)(16)
Entity is owned, in whole or in part, directly by a branch of the armed forces of the United States.
Entity derives more than 50% of its gross income from the operation of facilities that are located on property owned or leased
by the federal government and operated primarily for the benefit of members of the armed forces of the United States.
ALL REQUIREMENTS MUST BE MET IN ORDER TO BE EXEMPT.
Page Two
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