Form 1028 - Application For Recognition Of Exemption Page 2
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Form 1028 (Rev. 9-2006)
Page
Part III
Activities and Operational Information (Continued)
6
If the association issues any nonvoting preferred stock, explain whether the owners, upon dissolution or liquidation, may
participate in the profits of the association beyond fixed dividends.
7a
Does state law require the accumulation and maintenance of reserves?
Yes
No
Amount
b
If “Yes,” state the names and purposes of the reserves and enter the amount of each:
8a Does the association maintain or plan to maintain any reserve or reserves other than those required by
state law?
Yes
No
Amount
b
If “Yes,” state the names and purposes of the reserves and enter the amount of each:
9
Does the association deal or plan to deal with both members and nonmembers?
Yes
No
10a Does the association pay or plan to pay patronage dividends?
Yes
No
b
If “Yes,” are they paid or will they be paid to all patrons, both member and nonmember, on the same basis?
Yes
No
11a Is the allocation of patronage dividends based on an obligation in existence before the cooperative
received the amounts allocated?
Yes
No
b
If “Yes,” is the obligation in:
Organizing document (specify)
Bylaws
12
Explain all of the activities in which the association is or will be engaged.
13
Explain how distribution is or will be made of the proceeds of products marketed for members and nonmembers. Also, if
the organization operates on a basis of allocated units (i.e., functional, departmental, etc.), explain how losses are or will
be treated.
14
Explain how the association charges for supplies and equipment bought for members and nonmembers.
1028
Form
(Rev. 9-2006)
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