Form 1024-A - Application For Recognition Of Exemption

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1024-A
Application for Recognition of Exemption
OMB No.1545-0057
Form
Note: If exempt status
Under Section 501(c)(4) of the Internal Revenue Code
(January 2018)
is approved, this
application will be open
Department of the Treasury
Go to for instructions and the latest information.
for public inspection.
Internal Revenue Service
Complete Parts I–IX and submit Form 8718 (with payment of the appropriate user fee). Attach additional sheets if you need more
space to answer fully. Use the instructions to complete this application and for definitions of terms used in this form. For additional
help, call IRS Exempt Organizations Customer Account Services toll-free at 877-829-5500, or visit our website at If you
don’t submit the required information, we may return the application to you. A request for a determination under section 501(c)(4) is
optional. See instructions for additional information.
Don't include social security numbers on this form as it may be made public.
Part I
Identification of Applicant
1
2 c/o Name (if applicable)
Full name of organization (exactly as it appears in your organizing document)
3
Mailing address (Number and street) (see instructions)
4 Employer Identification Number (EIN)
5 Month the annual accounting period ends
City or town, state or country, and ZIP + 4
6
Primary contact (officer, director, trustee, or authorized representative)
b Phone:
a Name:
c Fax: (optional)
7
Organization’s website:
Part II
Organizational Structure
You must be a corporation (including a limited liability company), an unincorporated association, or a trust to be tax exempt. See
instructions. Don't file this form unless you can check “Yes” on lines 1, 2, 3, or 4.
Yes
No
1
Are you a corporation? If “Yes,” attach a copy of your articles of incorporation showing certification of
filing with the appropriate state agency. Include copies of any amendments to your articles and be sure
they also show state filing certification.
Yes
No
2
Are you a limited liability company (LLC)? If “Yes,” attach a copy of your articles of organization
showing certification of filing with the appropriate state agency. Include copies of any amendments to
your articles and be sure they show state filing certification. Also, if you adopted an operating agreement,
attach a copy, along with any amendments.
Yes
No
3
Are you an unincorporated association? If “Yes,” attach a copy of your articles of association,
constitution, or other similar organizing document that is dated and includes at least two signatures.
Include signed and dated copies of any amendments.
Yes
No
4
Are you a trust? If “Yes,” attach a signed and dated copy of your trust agreement. Include signed and
dated copies of any amendments. If you are a trust, enter the date the trust was funded. (MM/DD/YYYY)
/
/
5
Have you adopted bylaws? If “Yes,” attach a current copy showing date of adoption. If “No,” explain in
Yes
No
an attachment how your officers, directors, or trustees are selected.
Part III
Narrative Description of Your Activities
Use an attachment to describe all of your past, present, and planned activities in a narrative (including the percentage of time and funds
spent on these activities). You may attach representative copies of newsletters, brochures, or similar documents for supporting details to
this narrative. Refer to the instructions for information that must be included in your description. Check this box to confirm that you
submitted a narrative attachment describing your activities.
1024-A
For Paperwork Reduction Act Notice, see instructions.
Form
(1-2018)
Cat. No. 69155Y

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