Form 3605 - Application For Recognition Of Exemption From Georgia Income Tax Page 2
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2FORM 3605
DEPARTMENTOF REVENUE
(rev.11/09)
Taxpayer Services Division
THIS FORM WILL NO LONGER BE REQUIRED FOR TAX YEARS BEGINNING ON OR AFTER JANUARY 1, 2008.
APPLICATION FOR RECOGNITION OF EXEMPTION
FROM GEORGIA INCOME TAX
UNDER GEORGIA CODE SECTION 48-7-25
1. FULL NAME OF ORGANIZATION
2. FEDERAL EMPLOYER ID. NO.
3(a). ADDRESS (Number and Street)
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8. IS THE ORGANIZATION A PRIVATE FOUNDATION
FOR FEDERAL PURPOSES?
9. DATE EXEMPTION GRANTED BY IRS (See instructions)
ORGANIZATIONAL DOCUMENTS (See Instructions)
1. Attach a copy of the organization’s creating instruments (articles of incorporation, constitution, articles of association, deed of trust, etc.)
2. Attach a copy of the organization’s bylaws or other rules for its operation.
3. Attach a copy of the determination letter received from IRS granting an exempt status.
4. Attach a copy of certificate of registration, certificate of incorporation or certificate of authority from Georgia’s Secretary of State’s Office
(If corporation).
ACTIVITIES AND OPERATIONAL INFORMATION
Give a narrative description of the activities presently carried on by the organization, and also those that will be carried on by it in Georgia. The
narrative should specifically identify the services performed or to be performed by the organization. (Do not state the purpose of the organization in
general terms or repeat the language of the organization documents.) (Attach additional sheets if necessary)
I declare under the penalties of perjury that I am authorized to sign this application on behalf of the above organization and I have examined this
application, including the accompanying statements, and to the best of my knowledge it is true, correct and complete.
(Signature)
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