Form 8940 (Rev. June 2011) F8940
User Manual: 8940
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8940 Form (Rev. June 2011) Department of the Treasury Internal Revenue Service Request for Miscellaneous Determination Under Section 507, 509(a), 4940, 4942, 4945, and 6033 of the Internal Revenue Code OMB No. 1545-2211 Use the instructions to complete this form. A User Fee must be attached to this form, if required. For user fee information or additional help, visit our website at www.irs.gov/eo or call IRS Exempt Organizations Customer Account Services toll-free at 1-877-829-5500. If the required information and documents are not submitted with payment of the appropriate user fee, the form may be returned to you. Part I 1a Identification of Organization Full Name of Organization b Address (number, street and room/suite) If a P.O. Box, see instructions. c City 2 Employer Identification Number 5 Contact Telephone Number Part II 8 3 Month Tax Year Ends (MM) d State e Zip Code + 4 4 Person to Contact if More Information is Needed 6 Fax Number (optional) 7 User Fee Submitted Type of Request Please select the item(s) below that best describe your request. Using an attachment, provide a detailed explanation of your request. Be sure to include the organization's name and EIN on each additional sheet. a Advance approval of certain set-asides described in section 4942(g)(2) b Advance approval of voter registration activities described in section 4945(f) c Advance approval of scholarship procedures described in section 4945(g) d Exemption from Form 990 filing requirements e Advance approval that a potential grant or contribution constitutes an “unusual grant” f Change in Type (or initial determination of Type) of a section 509(a)(3) organization g Reclassification of foundation status, including a voluntary request from a public charity for private foundation status h Termination of private foundation status under section 507(b)(1)(B)—advance ruling request i Termination of private foundation status under section 507(b)(1)(B)—60-month period ended Under penalties of perjury, I declare that I have examined this application, including accompanying statements and schedules, and to the best of my knowledge and belief, it is true, correct, and complete. ▲ Please Sign Here (Signature of Officer, Director, Trustee or other authorized official.) (Type or print name of signer) For Paperwork Reduction Act Notice, see separate instructions. (Date) (Type or print title or authority of signer) Cat. No. 37756H Form 8940 (Rev. 6-2011)
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