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FORM G-6A

PAGE 3

(REV. 2012)

The affidavit must be accompanied

SCHEDULE INSTRUCTIONS

SCHEDULE C — COMPARATIVE

by a dated declaration, signed by an

BALANCE SHEET FOR HAWAII AC-

NOTE: SCHEDULES A, B, C, and D

authorized representative of the orga-

TIVITIES:

MUST BE COMPLETED.

nization, which states “Under penal-

The comparative balance sheet

SCHEDULE A — STATEMENT OF

ties provided by section 231-36, HRS,

must show your Hawaii assets, liabili-

ORGANIZATION:

I declare that I have examined this re-

ties, and net worth for your last two

Date of Inception. Enter the date

quest, including accompanying docu-

completed tax years. If your organi-

(month, day, year) the organization

ments, and, to the best of my knowl-

zation was recently formed and has

was legally created. This date should

edge and belief, the request contains

not completed a full tax year, enter

be consistent with your organizing

all the relevant facts relating to the re-

the most current information available

document.

quest, and such facts are true, correct,

in column (B). Be sure to enter the

and complete.”

The individual who

Under the Laws of. Enter the state or

date(s) for the information provided. If

signs for the organization must have

foreign country where the organization

the organization was recently formed

personal knowledge of the facts and

was legally created.

and has not acquired any assets or in-

circumstances at issue.

curred any liabilities, please state this

Name of the Central Organization.

on Schedule C.

D. Form BB-1 — In certain circum-

If part of a central (national) organiza-

stances (as explained below), you

tion, indicate the name of the central

If you are engaging in activities both

are required to obtain a GET license

organization.

within and without of Hawaii, including

and file GET returns even if you qual-

a central (national) organization that

Organization’s Accounting Year End.

ify for a GET exemption. Failure to do

is opening or establishing a Hawaii

Enter the month and day the organiza-

so may result in the loss of all or part

chapter, the organization must provide

tion’s annual accounting period ends.

of your GET tax benefits pursuant to

a comparative balance sheet from Ha-

Character of Organization. Indicate

HRS §237-9.3. See Tax Information

waii activities only. If no assets or li-

the character of the organization, for

Release Nos. 2010-05 and 2011-04

abilities are from Hawaii activities, you

example: educational, scientific, busi-

for more information. You must sub-

should state this on Schedule C.

ness league, civic league, or an or-

mit Form BB-1, State of Hawaii Basic

ganization for the promotion of social

If you are a church that operates a

Business Application, to obtain a GET

welfare.

preschool or day-care center, a com-

license and file GET returns if:

parative balance sheet for the pre-

Purpose for Which Organized. Fully

(1) you are/will engage in any “fun-

school or day-care center must be

describe the purpose for which the or-

draising activities” (i.e., activities con-

provided in addition to and separate

ganization was formed. When describ-

ducted with the primary purpose of

from the comparative balance sheet

ing the organization’s purpose and ac-

generating income, and that are out-

for the church.

tual activities in Hawaii, do not merely

side of your stated exempt purpose).

repeat the purpose clause from the

SCHEDULE D — COMPARATIVE

The gross receipts from “fundrais-

articles of organization.

STATEMENT OF RECEIPTS AND

ing activities” (e.g., golf tournaments,

DISBURSEMENTS FOR HAWAII AC-

Actual Activities in Hawaii. Fully

bake sales, car washes, silent auc-

TIVITIES:

describe the organization’s activities,

tions, etc.) are subject to the GET;

including fundraising activities, who

The comparative statement of re-

and/or

conducts the activities, when and

ceipts and disbursements must show

(2) you have unrelated trade or

where they take place, how it relates

an itemized statement of receipts and

business income; and/or

to its purpose, and how it is funded.

disbursements for your Hawaii ac-

tivities for the last two completed tax

Types of Income. Fully describe

(3) you are required to file federal

years. If you recently started your ac-

the types of income (e.g., donations,

Form 990, 990-EZ, or 990-T.

tivity in Hawaii or were recently formed

grants, program fees) that the organi-

(less than two complete years of activ-

zation receives and the Hawaii activity

COMPLETING FORM G-6

ity in Hawaii), prepare a projected bud-

(e.g., donation solicitation, education-

get of anticipated income and related

In addition to completing lines 1 -

al activities, charitable programs) that

expenses for your Hawaii activities for

12D, line 12 items E, F, and G MUST

generates each type of income.

2 years. The statement should be a

be submitted with your application:

Disposition of Income. Fully describe

compilation of receipts and expenses

E. and F. Articles of Organization &

how the organization uses its income.

for the year, not a listing of checks and

Amendments — Submit an executed

Date of Last Amendment to Bylaws.

deposits.

copy of your articles of incorporation,

Enter the date of the last amendment

articles of association, constitution,

If you are engaging in business

to the bylaws (if any).

trust instrument, or any other written

both within and without Hawaii, in-

SCHEDULE B — LIST OF OFFI-

instrument including any amendments

cluding a central (national) organiza-

CERS, DIRECTORS OR TRUSTEES:

by which the organization is created

tion that is opening or establishing a

and sets forth the purposes of the or-

List the full name, address, daytime

Hawaii chapter, you must provide a

ganization. A subordinate organization

telephone number (including the area

comparative statement of receipts and

may or may not be incorporated, but

code), office held, salary, and time de-

disbursements from Hawaii activities

it must have an organizing document.

voted to duties for each officer, director,

only. If no receipts and disbursements

or trustee, as applicable. Attach a sep-

are from Hawaii activities, you should

G. Bylaws and amendments — Sub-

arate sheet if more space is needed.

state this on Schedule D.

mit an executed copy of your bylaws

and any amendments to the bylaws. If

If you are a church that operates

you do not have any bylaws, provide a

a preschool or day-care center, a

written statement to this effect.

comparative statement of receipts

Instructions For Form G-6 And Form G-6s - Application For Exemption From General Excise Taxes Page 3

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