Package 1024 (Rev. September 1998) K1024

User Manual: 1024

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Department of the Treasury
Internal Revenue Service

Application for
Recognition of
Exemption Under
Section 501(a)*
*For organizations
described in sections:
501(c)(2), (4), (5), (6), (7),
(8), (9), (10), (12), (13),
(15), (17), (19), and (25)
of the Internal Revenue
Code

Note: For the addresses for filing
For m 1024, see Form 8718, User
Fee for Exempt Organization
Determination Letter Request.
For obtaining an Employer
Identification Number (EIN), see
Form SS-4, Application for Employer
Identification Number.

Note: Organizations
described in section
501(c)(3) must use
application Form 1023.

Contents:
Form 1024
Instructions

Package 1024
(Rev. September 1998)
Cat. No. 47201P

Department of the Treasury
Internal Revenue Service

Instructions for Form 1024
(Rev. September 1998)
Application for Recognition of Exemption Under
Section 501(a)
Note: Keep a copy of the completed Form
1024 in the organization’s permanent records.

General Instructions
Section references are to the Internal
Revenue Code unless otherwise noted.
User fee.—Submit with the Form 1024
application for a determination letter, a
Form 8718, User Fee for Exempt Organization
Determination Letter Request, and the user fee
called for in the Form 8718. You may obtain
Form 8718, and additional forms and
publications, through your local IRS office or by
calling 1-800-829-3676 (1-800-TAX-FORM).
User fees are subject to change on an annual
basis. Therefore, be sure that you use the most
current Form 8718.
Helpful information.—For additional
information, see:
● Pub. 557, Tax-Exempt Status for Your
Organization
● Pub. 598, Tax on Unrelated Business
Income of Exempt Organizations
● Pub. 578, Tax Information for Private
Foundations and Foundation Managers
● Internet site:
www.irs.ustreas.gov/bus_info/eo/

Purpose of Form
Form 1024 is used by most types of
organizations to apply for recognition of
exemption under section 501(a). See Part I of
the application.
Even if these organizations are not required
to file Form 1024 to be tax-exempt, they may
wish to file Form 1024 to receive a
determination letter of IRS recognition of their
section 501(c) status in order to obtain certain
incidental benefits such as:
● Public recognition of tax-exempt status
● Exemption from certain state taxes
● Advance assurance to donors of
deductibility of contributions (in certain cases)
● Nonprofit mailing privileges, etc.
Note: Generally, Form 1024 is NOT used to
apply for a group exemption letter. For
information on how to apply for a group
exemption letter, see Pub. 557.
Note: Tax benefits for certain homeowners
associations under section 528 are available
to organizations that are not exempt from
Federal income tax. To elect these benefits,
file a properly completed and timely filed
(including extensions) Form 1120-H, U.S.
Income Tax Return for Homeowners
Associations. DO NOT file Form 1024.

What To File
Do not submit any blank schedules that do
not apply to your type of organization.

Most organizations applying for exemption
under section 501(a) must complete Parts I
through III.
Section 501(c)(9), Voluntary Employees’
Beneficiary Associations, and section
501(c)(17), Supplemental Unemployment
Benefit Trusts, applicants should also
complete Part IV.
See Special Rule for Certain Canadian
Organizations on the following page.
In addition, each organization must
complete the schedule indicated on page 1 of
the application for the section of the Code
under which it seeks recognition of
exemption. (For example, a social welfare
organization seeking recognition under
section 501(c)(4) must complete Parts I
through III and Schedule B.)

Attachments
For any attachments submitted with Form
1024.—
● Show the organization’s name, address,
and employer identification number (EIN).
● Identify the Part and line item number to
which the attachment relates.
● Use 8-1/2 x 11 inch paper for any
attachments.
● Include any court decisions, rulings,
opinions, etc., that will expedite processing of
the application. Generally, attachments in the
form of tape recordings are not acceptable
unless accompanied by a transcript.

When To File (Section 501(c)(9)
or (17) Organization)
An organization must file Form 1024 to be
recognized as an organization described in
section 501(c)(9) or 501(c)(17). Generally, if an
organization files its application within 15
months after the end of the month in which it
was formed, and if the IRS approves the
application, the effective date of the
organization’s section 501(c)(9) or (17) status
will be the date it was organized.
Generally, if an organization does not file its
application (Form 1024) within 15 months
after the end of the month in which it was
formed, it will not qualify for exempt status as
a section 501(c)(9) or (17) organization during
the period before the date of its application.
For exceptions and special rules, including
automatic extensions in some cases, see Part
IV of Form 1024.
The date of receipt is the date of the U.S.
postmark on the cover in which an exemption
application is mailed or, if no postmark
appears on the cover, the date the
application is stamped as received by the
IRS.
Private delivery services.—See the
instructions for your income tax return for

information on certain private delivery
services designated by the IRS to meet the
“timely mailing as timely filing/paying rule.”
The private delivery service can tell you
how to get written proof of the mailing date.
Caution: Private delivery services cannot
deliver items to P.O. boxes. You must use the
U. S. Postal Service to mail any item to an
IRS P.O. box address. See the Form 8718 for
the P.O. box address as well as the express
mail or a delivery service address.

Where To File
File the completed Form 1024 application,
and all required information, at the address
shown in Form 8718.
The IRS will determine the organization’s
tax-exempt status and whether any annual
returns must be filed.

Signature Requirements
An officer, a trustee who is authorized to sign,
or another person authorized by a power of
attorney, must sign the Form 1024
application. Attach a power of attorney to the
application. You may use Form 2848, Power
of Attorney and Declaration of
Representative, for this purpose.

Appeal Procedures
Your organization’s application will be
considered by the IRS which will either:
1. Issue a favorable determination letter;
2. Issue a proposed adverse determination
letter denying the exempt status requested;
or
3. Refer the case to the National Office.
If we send your organization a proposed
adverse determination, we will advise it of its
appeal rights at that time.

Language and Currency
Requirements
Language requirements.—Prepare the Form
1024 and attachments in English. Provide an
English translation if the organizational
document or bylaws are in any other
language. See the conformed copy
requirements in the line 8 instructions under
Part I.
You may be asked to provide English
translations of foreign language publications
that the organization produces or distributes
and that are submitted with the application.
Financial requirements.—Report all financial
information in U.S. dollars (specify the
conversion rate used). Combine amounts
from within and outside the United States and
report the total for each item on the financial
statements.

For example:
Gross Investment Income
From U.S. sources
From non-U.S. sources
Amount to report on income
statement

$4,000
1,000
$5,000

Annual Information Return
If an annual information return is due while
the organization’s application for recognition
of exempt status is pending with the IRS
(including any appeal of a proposed adverse
determination), the organization should file:
Form 990, Return of Organization Exempt
From Income Tax, or Form 990-EZ, Short
Form Return of Organization Exempt From
Income Tax, at the following address: Internal
Revenue Service, Ogden Service Center,
Ogden, UT 84201-0027
Indicate that an application is pending.
If an organization has unrelated business
income of more than $1,000, file Form 990-T,
Exempt Organization Business Income Tax
Return.
Applicants under sections 501(c)(5), (9), and
(17) should see the Form 990 (or Form
990-EZ) instructions for special provisions
regarding substitutions for certain parts of
that form.

Public Inspection of Form 1024
Caution: Note the discussion below for the
potential effect of the Taxpayer Bill of Rights
2 (TBOR2) on these instructions.
IRS responsibilities for public inspection.—
If the organization’s application for section
501(c) status is approved, the following items
will be open to public inspection in any
District office and at the National Office of the
IRS (section 6104):
1. The organization’s application and any
supporting documents.
2. Any letter or other document issued by
the IRS with regard to the application.
Note that the following items are not
available for public inspection:
1. Any information relating to a trade
secret, patent, style of work, or apparatus
that, if released, would adversely affect the
organization, or
2. Any other information that would
adversely affect the national defense.
IMPORTANT: Applicants must identify this
information by clearly marking it, “NOT
SUBJECT TO PUBLIC INSPECTION,” and
must attach a statement to explain why the
organization asks that the information be
withheld. If the IRS agrees, the information
will be withheld.
Organization’s responsibilities for public
inspection.—The organization must make
available a copy of its approved application
and supporting documents, along with any
document or letter issued by the IRS, for
public inspection.
These documents must be available during
regular business hours at the organization’s
principal office and at each of its regional or
district offices having at least three paid
employees. See Notice 88-120, 1988-2 C.B.
454.
A penalty of $20 a day will be imposed on
any person under a duty to comply with the
public inspection requirements for each day a
failure to comply continues.

Furnishing copies of documents under
TBOR2.—The Taxpayer Bill of Rights 2
(TBOR2), enacted July 30, 1996, modified
prospectively the section 6685 penalty and
the rules for the public inspection of returns
and exemption applications. An organization
must furnish a copy of its Form 990, Form
990-EZ, or exemption application, and certain
related documents, if a request is made in
writing or in person.
For a request made in person, the
organization must make an immediate
response.
For a response to a written request, the
organization must provide the requested
copies within 30 days.
The organization must furnish copies of its
Forms 990, or Forms 990-EZ, for any of its 3
most recent taxable years. No charge is to be
made other than charging a reasonable fee
for reproduction and actual postage costs.
An organization need not provide copies if:
1. The organization has made the
requested documents widely available in a
manner provided in Treasury regulations, or
2. The Secretary of the Treasury
determined, upon application by the
organization, that the organization was
subject to a harassment campaign such that
a waiver of the obligation to provide copies
would be in the public interest.
Penalty for failure to allow public
inspection or provide copies.—The section
6685 penalty for willful failure to allow public
inspections or provide copies is increased
from the present-law level of $1,000 to
$5,000 by TBOR2.
Effective date of TBOR2.—These public
inspection provisions governing tax-exempt
organizations under TBOR2 generally apply to
requests made no earlier than 60 days after
the date on which the Treasury Department
publishes the regulations required under the
provisions. However, Congress, in the
legislative history of TBOR2, indicated that
organizations would comply voluntarily with
the public inspection provisions prior to the
issuance of such regulations.

Special Rule for Certain
Canadian Organizations
A religious, scientific, literary, educational, or
charitable organization formed in Canada that
has received a Form T2051, Notification of
Registration, from Revenue Canada
(Department of National Revenue, Taxation)
and whose registration has not been revoked
may apply for recognition of exemption as a
social welfare organization under section
501(c)(4) without completing all parts of Form
1024 that would otherwise be required. Such
an organization must complete only Part I and
the signature portion of Form 1024.
To indicate that this special rule applies,
the organization should write “Registered
Canadian Organization” across the top of
page 1 of Form 1024.
The organization must also attach a copy
of its current Form T2051 and a copy of
Application for Registration, Form T2050,
together with all required attachments that it
submitted to Revenue Canada.
If any of the attachments to Form T2050
were prepared in French, an English
translation must be furnished with Form 1024.

In the case of organizing documents and
bylaws, see the line 8 instructions under
Part I.
An organization that wants recognition of
exemption under section 501(c)(3) must
complete Form 1023, Application for
Recognition of Exemption Under Section
501(c)(3) of the Internal Revenue Code.
Exemption under section 501(c)(3) is
needed to establish eligibility to receive
contributions that are deductible by U.S.
residents to the extent provided by the U.S.–
Canada tax treaty.

Specific Instructions
The following instructions are keyed to the
line items on the application form:

Part I. Identification of
Applicant
Line 1. Full name and address of
organization.—Enter the organization’s name
exactly as it appears in its creating
documents, including amendments. If the
organization will be operating under another
name, show the other name in parentheses.
For a foreign address, enter the information
in the following order: city, province or state,
and country. Follow the country’s practice in
placing the postal code in the address. Do
not abbreviate the country name.
Line 2. Employer identification number
(EIN).—All organizations must have an EIN.
Enter the nine-digit EIN the IRS assigned to
the organization. See Form SS-4, Application
for Employer Identification Number, for
information on how to obtain an EIN
immediately by telephone, if the organization
does not have an EIN. Enter, “applied for,” if
the organization has applied for an EIN
number previously. Attach a statement giving
the date of the application and the office
where it was filed. Do not apply for an EIN
more than once.
Line 3. Person to contact.—Enter the name
and telephone number of the person to be
contacted during business hours if more
information is needed. The contact person
should be an officer, director, or a person
with power of attorney who is familiar with
the organization’s activities and who is
authorized to act on its behalf. Attach Form
2848 or other power of attorney.
Line 4. Month the annual accounting period
ends.—Enter the month the organization’s
annual accounting period ends. The
organization’s accounting period is usually the
12-month period that is the organization’s tax
year. The organization’s first tax year depends
on the accounting period it chooses. The first
tax year could be less than 12 months.
Line 5. Date incorporated or formed.—Enter
the date the organization became a legal
entity. For corporations this is the date that
the articles of incorporation were approved by
the appropriate state official. For
unincorporated organizations, it is the date its
constitution or articles of association were
adopted.
Line 6.—Indicate if the organization has ever
filed Form 1023, Form 1024, or other
exemption application with the IRS.
Line 7.—Indicate if the organization has ever
filed Federal income tax returns as a taxable
organization or filed returns as an exempt
organization (e.g., Forms 990, 990-EZ,
990-PF, and 990-T).

Page 2

Line 8. Type of organization and
organizational documents.—
Organizing instrument.—Submit a
conformed copy of the organizing instrument.
If the organization does not have an
organizing instrument, it will not qualify for
exempt status.
● A conformed copy is one that agrees with
the original and all amendments to it. The
conformed copy may be:
● A photocopy of the original signed and
dated organizing document, OR
● A copy of the organizing document that is
unsigned but is sent with a written
declaration, signed by an authorized
individual, that states that the copy is a
complete and accurate copy of the original
signed and dated document.
Corporation.—In the case of a corporation, a
copy of the articles of incorporation,
approved and dated by an appropriate state
official, is sufficient by itself.
If an unsigned copy of the articles of
incorporation is submitted, it must be
accompanied by the written declaration
discussed above.
Signed or unsigned copies of the articles of
incorporation must be accompanied by a
declaration stating that the original copy of
the articles was filed with and approved by
the state. The date filed must be specified.
Unincorporated association.—In the case of
an unincorporated association, the conformed
copy of the constitution, articles of
association, or other organizing document
must indicate in the document itself, or in a
written declaration, that the organization was
formed by the adoption of the document by
two or more persons.
Bylaws.—If the organization has adopted
bylaws, include a current copy. The bylaws
need not be signed if submitted as an
attachment to the Form 1024 application. The
bylaws of an organization alone are not an
organizing instrument. They are merely the
internal rules and regulations of the
organization.
Trust.—In the case of a trust, a copy of the
signed and dated trust instrument must be
furnished.

Part II. Activities and
Operational Information
Line 1.—It is important that you report all
activities carried on by the organization to
enable the IRS to make a proper
determination of the organization’s exempt
status.
It is also important that you provide
detailed information about the nature and
purpose of each of the activities. The
organization will be contacted for such
information if it is not furnished.
Line 2.— If it is anticipated that the
organization’s principal sources of support
will increase or decrease substantially in
relation to the organization’s total support,
attach a statement describing anticipated
changes and explaining the basis for the
expectation.
Line 3a.—Furnish the mailing addresses of
the organization’s principal officers, directors,
or trustees. Do not give the address of the
organization.

Page 3

Line 3b.—The annual compensation includes
salary, bonus, and any other form of payment
to the individual for services performed for
the organization.
Line 4.—If your organization’s activities were
formerly performed under another name or if
your organization was a part of another
organization (tax-exempt or nonexempt),
furnish the requested information. Otherwise,
indicate “N/A.”
Line 5.—Indicate your organization’s current
or planned connection with any tax-exempt
or nonexempt organization.
Line 6.—If your organization has issued stock
as a means of indicating ownership by its
members or others, furnish the requested
information. Otherwise, indicate “N/A.”
Line 7.—If your organization is a membership
organization, furnish the requested
information. Otherwise, indicate “N/A.”
Line 8.—If your organization should cease
operations as a tax-exempt organization,
explain to whom its assets will be distributed.
Line 9.—Indicate if the organization
distributes, or plans to distribute, any of its
property or funds (such as a distribution of
profits) to its shareholders or members.
Line 10.—Indicate if the organization
performs any services for any other
organization or individual for which it is paid a
fee.
Line 11.—Do not include the normal salary of
officers or employees.
Line 12.—Answer “Yes,” if the organization
either provides insurance through a third
party or provides the insurance itself.
Line 13.—Examples of public regulatory
bodies are: HUD, HHS, Public Utilities
Commission, Housing Commission, and a
state insurance commission.
Line 14.—Provide the specified information
about leased property whether it is used for
exempt functions or for other purposes.
Line 15.—Provide the specified information
about political expenditures whether they
were made to support or to oppose particular
candidates.
Line 16.—This includes any printed material
that may be used to publicize the
organization’s activities, or as an informational
item to members or potential members.

Part III. Financial Data
The Statement of Revenue and Expenses
must be completed for the current year and
each of the 3 years immediately before it (or
the years the organization has existed, if less
than 4).
Any applicant that has existed for less
than 1 year must give financial data for the
current year and proposed budgets for the
following 2 years.
Any applicant that has been in existence
more than 1 year but seeks recognition of
exemption only for the current year and future
years (rather than from the date of its
formation), should give financial data for the
current year and proposed budgets for the
following 2 years.
We may request financial data for more
than 4 years if necessary.
All financial information for the current year
must cover the period beginning on the first
day of the organization’s established annual
accounting period and ending on any day
that is within 60 days of the date of this
application.

If the date of this application is less than 60
days after the first day of the current
accounting period, no financial information is
required for the current year.
Financial information is required for the 3
preceding years regardless of the current year
requirements.
Note that if no financial information is
required for the current year, the preceding
year’s financial information can end on any
day that is within 60 days of the date of this
application.
Prepare the statements using the method
of accounting and the accounting period the
organization uses in keeping its books and
records.
If the organization uses a method other
than the cash receipts and disbursements
method, attach a statement explaining the
method used.

A. Statement of Revenue and
Expenses
Line 1.—Include amounts received from the
members that represent the annual dues and
any special assessments or initiation fees.
Line 2.—Do not include amounts received
from the general public or a governmental
unit for the exercise or performance of the
organization’s exempt function.
Line 3.—Examples of such income include:
the income derived by a social club from the
sale of food or beverage to its members; the
sale of burial lots by a cemetery association;
and fees charged by a social welfare
organization or trade association for an
educational seminar it conducted.
Line 4.—Enter the organization’s gross
income from activities that are regularly
carried on and not related to the
organization’s exempt purposes.
Examples of such income include: fees
from the commercial testing of products;
income from renting office equipment or other
personal property; and income from the sale
of advertising in an exempt organization
periodical. See Pub. 598 for information about
unrelated business income and activities.
Line 5.—Attach a schedule showing the
description of each asset, the name of the
person to whom sold, and the amount
received. In the case of publicly traded
securities sold through a broker, the name of
the purchaser is not required.
Line 6.—Include on this line the income
received from dividends, interest, payments
received on securities loans (as defined in
section 512(a)(5)), rents, and royalties.
Line 7.—Enter the total income from all
sources that is not reported on lines 1
through 6. Include, for example, income from
special events such as raffles and dances
that is not taxable as unrelated business
income. Attach a schedule that lists each
type of revenue source and the amount
derived from each.
Line 9.—Enter the expenses directly related
to the income sources reported on line 3 of
this part.
Line 10.—Enter the expenses directly related
to the income sources reported on line 4 of
this part.
Line 11.—Attach a schedule showing the
name of the recipient, a brief description of
the purposes or conditions of payment, and
the amount paid.

Line 12.—Attach a schedule showing the
total amount paid for each benefit category,
such as disability, death, sickness,
hospitalization, unemployment compensation,
or strike benefits.
Lines 13–18.—Use lines 13 through 18 to
report expenses that are not directly related to
the expense categories listed on lines 9 and
10.
For example, salaries attributable to the
organization’s exempt purpose activities
should be included with any other expenses
reportable on line 9 rather than being
reported separately on line 14.
Salaries reportable on line 14 include, for
example, those attributable to special events;
to the solicitation of contributions; and to the
overall management and operation of the
organization.
Line 13.—Attach a schedule that shows the
name of the person compensated; the office
or position; the average amount of time
devoted to business per week, month, etc.;
and the amount of annual compensation.
Line 14.—Enter the total of employees’
salaries not reported on line 13.
Line 15.—Enter the total interest expense for
the year, excluding mortgage interest treated
as occupancy expense on line 16.
Line 16.—Enter the amount paid for the use
of office space or other facilities; heat; light;
power; and other utilities; outside janitorial
services; mortgage interest; real estate taxes;
and similar expenses.
Line 17.—If your organization records
depreciation, depletion, and similar expenses,
enter the total.
Line 18.—Attach a statement listing the type
and amount of each significant expense for
which a separate line is not provided. Report
other miscellaneous expenses as a single
total if not substantial in amount.

B. Balance Sheet
Line 1.—Enter the total interest- and noninterest-bearing cash in checking and savings
accounts, temporary cash investments
(money market funds, CDs, treasury bills, or
other obligations that mature in less than 1
year), change funds, and petty cash funds.
Line 2.—Enter the total accounts receivable
that arose from the sale of goods and/or
performance of services.
Line 3.—Enter the amount of materials,
goods, and supplies purchased or
manufactured by the organization and held to
be sold or used in some future period.
Line 4.—Attach a schedule that shows the
name of the borrower, a brief description of
the obligation, the rate of return on the
principal indebtedness, the due date, and the
amount due.
Line 5.—Attach a schedule listing the
organization’s corporate stock holdings.
For stock of closely held corporations, the
schedule should show the name of the
corporation, a brief summary of the
corporation’s capital structure, the number of
shares held, and their value as carried on the
organization’s books. If such valuation does
not reflect current fair market value, also
include fair market value.
For stock traded on an organized exchange
or in substantial quantities over the counter,
the schedule should show the name of the
corporation, a description of the stock and

the principal exchange on which it is traded,
the number of shares held, and their value as
carried on the organization’s books.
Line 6.—Attach a schedule that shows the
borrower’s name, purpose of loan, repayment
terms, interest rate, and original amount of
loan.
Report each loan separately, even if more
than one loan was made to the same person.
Line 7.—Enter the book value of securities
held of the U.S., state, or municipal
governments. Also enter the book value of
buildings and equipment held for investment
purposes. Attach a schedule identifying each.
Line 8.—Enter the book value of buildings
and equipment not held for investment. This
includes plant and equipment used by the
organization in conducting its exempt
activities. Attach a schedule listing these
assets held at the end of the current tax-year
period and the cost or other basis.
Line 9.—Enter the book value of land not
held for investment.
Line 10.—Enter the book value of each
category of assets not reported on lines 1
through 9. Attach a schedule listing each.
Line 12.—Enter the total of accounts payable
to suppliers and others, such as salaries
payable, accrued payroll taxes, and interest
payable.
Line 13.—Enter the unpaid portion of grants
and contributions that the organization has
made a commitment to pay to other
organizations or individuals.
Line 14.—Enter the total of mortgages and
other notes payable at the end of the year.
Attach a schedule that shows each item
separately and the lender’s name, purpose of
loan, repayment terms, interest rate, and
original amount.
Line 15.—Enter the amount of each liability
not reported on lines 12 through 14. Attach a
separate schedule.
Line 17.—Under fund accounting, an
organization segregates its assets, liabilities,
and net assets into separate funds according
to restrictions on the use of certain assets.
Each fund is like a separate entity in that it
has a self-balancing set of accounts showing
assets, liabilities, equity (fund balance),
income, and expenses.
If the organization uses fund accounting,
report the total of all fund balances on line
17. If the organization does not use fund
accounting, report only the “net assets”
account balances, such as capital stock,
paid-in capital, and retained earnings or
accumulated income.

Part IV. Notice Requirements
Part IV only applies to section 501(c)(9) and
(17) organizations. Organizations applying for
tax-exempt status under other sections of the
Code should not fill in Part IV.
Line 1.—If you answer “Yes,” do not answer
questions 2 through 4. If you answer “No,”
proceed to line 2.
Line 2.—Relief from the 15-month filing
requirement is granted automatically if the
organization submits a completed Form 1024
within 12 months from the end of the
15-month period.
To get this extension, an organization must
add the following statement at the top of its
application: “Filed Pursuant to Section
301.9100-2.” No request for a letter ruling is
required to obtain an automatic extension.

Line 3.—See Regulation sections 301.9100-1
and 301.9100-3 for information about a
discretionary extension beyond the 27-month
period. Under this regulation, the IRS will
allow an organization a reasonable extension
of time to file a Form 1024 if it submits
evidence to establish that:
(a) It acted reasonably and in good faith,
and
(b) Granting relief will not prejudice the
interests of the government.
Showing reasonable action and good
faith.—An organization acted reasonably and
showed good faith if at least one of the
following is true.
1. The organization filed its application
before the IRS discovered its failure to file.
2. The organization failed to file because of
intervening events beyond its control.
3. The organization exercised reasonable
diligence but was not aware of the filing
requirement.
To determine whether the organization
exercised reasonable diligence, it is
necessary to take into account the complexity
of filing and the organization’s experience in
these matters.
4. The organization reasonably relied upon
the written advice of the IRS.
5. The organization reasonably relied upon
the advice of a qualified tax professional who
failed to file or advise the organization to file
Form 1024. An organization cannot rely on the
advice of a qualified tax professional if it
knows or should know that he or she is not
competent to render advice on filing
exemption applications or is not aware of all
the relevant facts.
Not acting reasonably and in good faith.—
An organization has not acted reasonably and
in good faith if it chose not to file after being
informed of the requirement to file and the
consequences of failure to do so.
Furthermore, an organization has not acted
reasonably and in good faith if it used
hindsight to request an extension of time to
file. That is, if after the original deadline to file
passes, specific facts have changed so that
filing an application becomes advantageous
to an organization, the IRS will not ordinarily
grant an extension. To qualify for an
extension in this situation, the organization
must prove that its decision to file did not
involve hindsight.
No prejudice to the interest of the
government.—Prejudice to the interest of the
government results if granting an extension of
time to file to an organization results in a
lower total tax liability for the years to which
the filing applies than would have been the
case if the organization had applied on time.
Before granting an extension, the IRS may
require the organization requesting it to
submit a statement from an independent
auditor certifying that no prejudice will result
if the extension is granted.
Procedure for requesting extension.—To
request a discretionary extension, an
organization must submit the following with
its Form 1024.
● A statement showing the date Form 1024
should have been filed and the date it was
actually filed.
● An affidavit describing in detail the events
that led to the failure to apply and to the
discovery of that failure. If the organization

Page 4

relied on a qualified tax professional’s advice,
the affidavit must describe the engagement
and responsibilities of the professional and
the extent to which the organization relied on
him or her.
● All documents relevant to the election
application.
● A dated declaration, signed by an individual
authorized to act for the organization, that
includes the following statement: “Under
penalties of perjury, I declare that I have
examined this request, including
accompanying documents, and, to the best
of my knowledge and belief, the request
contains all the relevant facts relating to the
request, and such facts are true, correct, and
complete.” The individual who signs for the
organization must have personal knowledge
of the facts and circumstances at issue.
● A detailed affidavit from individuals having
knowledge or information about the events
that led to the failure to make the application
and to the discovery of that failure. These
individuals include accountants or attorneys
knowledgeable in tax matters who advised
the organization concerning the application.
Any affidavit from a tax professional must
describe the engagement and responsibilities
of the professional as well as the advice that
the professional provided to the organization.
The affidavit must also include the name,
current address, and taxpayer identification
number of the individual making the affidavit
(the affiant). The affiant must also forward
with the affidavit a dated and signed
declaration that states: “Under penalties of
perjury, I declare that I have examined this
request, including accompanying documents,
and, to the best of my knowledge and belief,
the request contains all the relevant facts
relating to the request, and such facts are
true, correct, and complete.”
The reasons for late filing should be
specific to your particular organization and
situation. Regulation section 301.9100-3 (see
above) lists the factors the IRS will consider
to determine if good cause exists for granting
a discretionary extension of time to file the
application. To address these factors your
response on line 3 should provide the
following information:

Page 5

1. Whether the organization consulted an
attorney or accountant knowledgeable in tax
matters, or communicated with a responsible
IRS employee (before or after the organization
was created), to ascertain the organization’s
Federal filing requirements and, if so, the
names and occupations or titles of the
persons contacted, the approximate dates,
and the substance of the information
obtained;
2. How and when the organization learned
about the 15-month deadline for filing Form
1024;
3. Whether any significant intervening
circumstances beyond the organization’s
control prevented it from submitting the
application timely or within a reasonable
period of time after it learned of the
requirement to file the application within the
15-month period; and

4. Any other information that you believe
may establish reasonable action and good
faith and no prejudice to the interest of the
government for not filing timely or otherwise
justify granting the relief sought.
A request for relief under this section is
treated as part of the request for the
exemption determination letter and is covered
by the user fee submitted with Form 8718.
Line 4.—If you answer “No,” the organization
may receive an adverse letter limiting the
effective date of its exempt status to the date
its application was received.

Paperwork Reduction Act Notice.—We ask for the information on this form to carry out the
Internal Revenue laws of the United States. If you want your organization to be recognized as
tax exempt by the IRS, you are required to give us this information. We need it to determine
whether the organization meets the legal requirements for tax-exempt status.
The organization is not required to provide the information requested on a form that is
subject to the Paperwork Reduction Act unless the form displays a valid OMB control number.
Books or records relating to a form or its instructions must be retained as long as their
contents may become material in the administration of any Internal Revenue law. The rules
governing the confidentiality of the Form 1024 application are covered in Code section 6104.
The time needed to complete and file this form will vary depending on individual
circumstances. The estimated average times are:

Form
1024, Parts I–III
Part IV
Sch. A
Sch. B
Sch. C
Sch. D
Sch. E
Sch. F
Sch. G
Sch. H
Sch. I
Sch. J
Sch. K

Recordkeeping
53
1
2
1

hr.,
hr.,
hr.,
hr.,

4
1
2
1
1
5
2
3

hr.,
hr.,
hr.,
hr.,
hr.,
hr.,
hr.,
hr.,

5
12
52
40
58
4
40
23
55
40
30
23
21

min.
min.
min.
min.
min.
min.
min.
min.
min.
min.
min.
min.
min.

Learning about
the law or the
form
2 hr., 17
35
18
18
12
18
18
6
6
6
30
6
6

min.
min.
min.
min.
min.
min.
min.
min.
min.
min.
min.
min.
min.

Preparing and
sending the form
to the IRS
3 hr., 15
52
21
20
13
22
20
8
8
8
37
8
10

min.
min.
min.
min.
min.
min.
min.
min.
min.
min.
min.
min.
min.

If you have comments concerning the accuracy of these time estimates or suggestions for
making this form simpler, we would be happy to hear from you. You can write to the Tax
Forms Committee, Western Area Distribution Center, Rancho Cordova, CA 95743-0001. DO
NOT send the application to this address. Instead, see Where To File on page 1.

Procedural Checklist
Make sure the application is complete.
If you do not complete all applicable parts or do not provide all required attachments, we may
return the incomplete application for the organization to resubmit with the missing information
or attachments. This will delay the processing of the application and may delay the effective
date of your organization’s exempt status. The organization may also incur additional user fees.

Have you . . .
Attached Form 8718 (User Fee for Exempt Organization Determination Letter Request) and the
appropriate fee?
Prepared the application for mailing? (See Where To File addresses in Form 8718.)
Completed all Parts and Schedules that apply to the organization?
Shown your organization’s Employer Identification Number (EIN)?
a. If your organization has an EIN, write it in the space provided.
b. If this is a newly formed organization and does not have an Employer Identification Number, obtain an
EIN by telephone. (See Specific Instructions, Part I, Line 2, on page 2.)
If applicable, described your organization’s specific activities as directed in Part II, question 1 of the
application?
Included a conformed copy of the complete organizing instrument? (Part I, question 8 of the
application.)
Had the application signed by one of the following:
a. An officer or trustee who is authorized to sign (e.g., president, treasurer); or
b. A person authorized by a power of attorney (submit Form 2848 or other power of attorney)?
If applicable, enclosed financial statements (Part III)?
a. Current year (must include period up to within 60 days of the date the application is filed) and 3
preceding years.
b. Detailed breakdown of revenue and expenses (no lump sums).
c. If the organization has been in existence less than 1 year, it must also submit proposed budgets for 2
years showing the amounts and types of receipts and expenditures anticipated.

Note: Dur ing the technical review of a completed application, it may be necessary to contact
the organization for more specific or additional information.

Do not send this checklist with the application.

Page 6

Form

1024

Application for Recognition of Exemption
Under Section 501(a)

(Rev. September 1998)

OMB No. 1545-0057
If exempt status is approved,
this application will be open
for public inspection.

Department of the Treasury
Internal Revenue Service

Read the instructions for each Part carefully. A User Fee must be attached to this application.
If the required information and appropriate documents are not submitted along with Form 8718 (with payment
of the appropriate user fee), the application may be returned to the organization.
Complete the Procedural Checklist on page 6 of the instructions.
Part I. Identification of Applicant (Must be completed by all applicants; also complete appropriate schedule.)
Submit only the schedule that applies to your organization. Do not submit blank schedules.
Check the appropriate box below to indicate the section under which the organization is applying:
a

Section 501(c)(2)—Title holding corporations (Schedule A, page 7)

Section 501(c)(4)—Civic leagues, social welfare organizations (including certain war veterans’ organizations), or local associations of
employees (Schedule B, page 8)

Section 501(c)(5)—Labor, agricultural, or horticultural organizations (Schedule C, page 9)

Section 501(c)(6)—Business leagues, chambers of commerce, etc. (Schedule C, page 9)

Section 501(c)(7)—Social clubs (Schedule D, page 11)

Section 501(c)(8)—Fraternal beneficiary societies, etc., providing life, sick, accident, or other benefits to members (Schedule E, page 13)

Section 501(c)(9)—Voluntary employees’ beneficiary associations (Parts I through IV and Schedule F, page 14)

Section 501(c)(10)—Domestic fraternal societies, orders, etc., not providing life, sick, accident, or other benefits (Schedule E, page 13)

Section 501(c)(12)—Benevolent life insurance associations, mutual ditch or irrigation companies, mutual or cooperative telephone
companies, or like organizations (Schedule G, page 15)

Section 501(c)(13)—Cemeteries, crematoria, and like corporations (Schedule H, page 16)

Section 501(c)(15)—Mutual insurance companies or associations, other than life or marine (Schedule I, page 17)

Section 501(c)(17)—Trusts providing for the payment of supplemental unemployment compensation benefits (Parts I through IV and Schedule J, page 18)

m
Section 501(c)(19)—A post, organization, auxiliary unit, etc., of past or present members of the Armed Forces of the United States (Schedule K, page 19)
n
Section 501(c)(25)—Title holding corporations or trusts (Schedule A, page 7)
1a Full name of organization (as shown in organizing document)
2 Employer identification number (EIN) (if
none, see Specific Instructions on page 2)
3 Name and telephone number of person to be
contacted if additional information is needed

c/o Name (if applicable)

Address (number and street)

City, town or post office, state, and ZIP + 4
Instructions for Part I, page 2.

Room/Suite
If you have a foreign address, see Specific

(
1e Web site address

Month the annual accounting period ends

)
Date incorporated or formed

Did the organization previously apply for recognition of exemption under this Code section or under any other section of the Code?
If “Yes,” attach an explanation.

Yes

Has the organization filed Federal income tax returns or exempt organization information returns?
If “Yes,” state the form numbers, years filed, and Internal Revenue office where filed.

Yes

Check the box for the type of organization. ATTACH A CONFORMED COPY OF THE CORRESPONDING ORGANIZING DOCUMENTS TO
THE APPLICATION BEFORE MAILING.
a

Corporation— Attach a copy of the Articles of Incorporation (including amendments and restatements) showing approval by the
appropriate state official; also attach a copy of the bylaws.

b
c

Trust—

Attach a copy of the Trust Indenture or Agreement, including all appropriate signatures and dates.

Association—

Attach a copy of the Articles of Association, Constitution, or other creating document, with a declaration (see instructions) or
other evidence that the organization was formed by adoption of the document by more than one person. Also include a copy
of the bylaws.
©
If this is a corporation or an unincorporated association that has not yet adopted bylaws, check here
I declare under the penalties of perjury that I am authorized to sign this application on behalf of the above organization, and that I have examined
this application, including the accompanying schedules and attachments, and to the best of my knowledge it is true, correct, and complete.

PLEASE
SIGN
HERE

(Signature)

For Paperwork Reduction Act Notice, see page 5 of the instructions.

(Type or print name and title or authority of signer)

(Date)

Form 1024 (Rev. 9-98)

Page

Part II. Activities and Operational Information (Must be completed by all applicants)
1

Provide a detailed narrative description of all the activities of the organization—past, present, and planned. Do not merely refer to or
repeat the language in the organizational document. List each activity separately in the order of importance based on the relative time and
other resources devoted to the activity. Indicate the percentage of time for each activity. Each description should include, as a minimum,
the following: (a) a detailed description of the activity including its purpose and how each activity furthers your exempt purpose; (b) when
the activity was or will be initiated; and (c) where and by whom the activity will be conducted.

List the organization’s present and future sources of financial support, beginning with the largest source first.

Form 1024 (Rev. 9-98)

Page

Part II. Activities and Operational Information (continued)
3

Give the following information about the organization’s governing body:
a

Names, addresses, and titles of officers, directors, trustees, etc.

b Annual compensation

If the organization is the outgrowth or continuation of any form of predecessor, state the name of each predecessor, the period during
which it was in existence, and the reasons for its termination. Submit copies of all papers by which any transfer of assets was effected.

If the applicant organization is now, or plans to be, connected in any way with any other organization, describe the other organization and
explain the relationship (e.g., financial support on a continuing basis; shared facilities or employees; same officers, directors, or trustees).

If the organization has capital stock issued and outstanding, state: (1) class or classes of the stock; (2) number and par value of the
shares; (3) consideration for which they were issued; and (4) if any dividends have been paid or whether your organization’s creating instrument authorizes dividend payments on any class of capital stock.

State the qualifications necessary for membership in the organization; the classes of membership (with the number of members in each
class); and the voting rights and privileges received. If any group or class of persons is required to join, describe the requirement and
explain the relationship between those members and members who join voluntarily. Submit copies of any membership solicitation material.
Attach sample copies of all types of membership certificates issued.

Explain how your organization’s assets will be distributed on dissolution.

Form 1024 (Rev. 9-98)

Page

Part II. Activities and Operational Information (continued)
9

Has the organization made or does it plan to make any distribution of its property or surplus funds to shareholders or
members?

Yes

If “Yes,” state the full details, including: (1) amounts or value; (2) source of funds or property distributed or to be
distributed; and (3) basis of, and authority for, distribution or planned distribution.

Does, or will, any part of your organization’s receipts represent payments for services performed or to be performed?
If “Yes,” state in detail the amount received and the character of the services performed or to be performed.

Has the organization made, or does it plan to make, any payments to members or shareholders for services performed
or to be performed?
If “Yes,” state in detail the amount paid, the character of the services, and to whom the payments have been, or will
be, made.

Does the organization have any arrangement to provide insurance for members, their dependents, or others (including
provisions for the payment of sick or death benefits, pensions, or annuities)?
If “Yes,” describe and explain the arrangement’s eligibility rules and attach a sample copy of each plan document and
each type of policy issued.

Is the organization under the supervisory jurisdiction of any public regulatory body, such as a social welfare agency,
etc.?
If “Yes,” submit copies of all administrative opinions or court decisions regarding this supervision, as well as copies of
applications or requests for the opinions or decisions.

Does the organization now lease or does it plan to lease any property?
If “Yes,” explain in detail. Include the amount of rent, a description of the property, and any relationship between the
applicant organization and the other party. Also, attach a copy of any rental or lease agreement. (If the organization is
a party, as a lessor, to multiple leases of rental real property under similar lease agreements, please attach a single
representative copy of the leases.)

Has the organization spent or does it plan to spend any money attempting to influence the selection, nomination, election,
or appointment of any person to any Federal, state, or local public office or to an office in a political organization?
If “Yes,” explain in detail and list the amounts spent or to be spent in each case.

Does the organization publish pamphlets, brochures, newsletters, journals, or similar printed material?
If “Yes,” attach a recent copy of each.

Form 1024 (Rev. 9-98)

Page

Part III. Financial Data (Must be completed by all applicants)
Complete the financial statements for the current year and for each of the 3 years immediately before it. If in existence less than 4 years, complete the
statements for each year in existence. If in existence less than 1 year, also provide proposed budgets for the 2 years following the current year.

A. Statement of Revenue and Expenses
(a) Current Tax Year

Revenue

From
To

Gross dues and assessments of members

Gross contributions, gifts, etc.

Gross amounts derived from activities related to
the organization’s exempt purpose (attach
schedule) (Include related cost of sales on line 9.)

Gross amounts from unrelated business activities (attach schedule)

Gain from sale of assets, excluding inventory items
(attach schedule)

Investment income (see page 3 of the instructions)

Other revenue (attach schedule)

Total revenue (add lines 1 through 7)

Expenses attributable to activities related to the
organization’s exempt purposes

Expenses attributable to unrelated business activities

Contributions, gifts, grants, and similar amounts
paid (attach schedule)

Disbursements to or for the benefit of members (attach schedule)

Compensation of officers, directors, and trustees (attach schedule)

Other salaries and wages

Interest

Occupancy

Depreciation and depletion

Other expenses (attach schedule)

Total expenses (add lines 9 through 18)

Excess of revenue over expenses (line 8 minus
line 19)

3 Prior Tax Years or Proposed Budget for Next 2 Years

(b)

(c)

(d)

(e) Total

Expenses

B. Balance Sheet (at the end of the period shown)
Current Tax Year

Assets

as of

Cash

Accounts receivable, net

Inventories

Bonds and notes receivable (attach schedule)

Corporate stocks (attach schedule)

Mortgage loans (attach schedule)

Other investments (attach schedule)

Depreciable and depletable assets (attach schedule)

Land

Other assets (attach schedule)

10
11

Total assets

Liabilities
12

Accounts payable

Contributions, gifts, grants, etc., payable

Mortgages and notes payable (attach schedule)

Other liabilities (attach schedule)

Total liabilities

Fund Balances or Net Assets
17
18

Total fund balances or net assets
Total liabilities and fund balances or net assets (add line 16 and line 17)

17
18

If there has been any substantial change in any aspect of the organization’s financial activities since the end of the period shown above,
©
check the box and attach a detailed explanation

Form 1024 (Rev. 9-98)

Page

Part IV. Notice Requirements (Sections 501(c)(9) and 501(c)(17) Organizations Only)
1

Section 501(c)(9) and 501(c)(17) organizations:
Are you filing Form 1024 within 15 months from the end of the month in which the organization was created or formed
as required by section 505(c)?

Yes

If “Yes,” skip the rest of this Part.
If “No,” answer question 2.
2

If you answer “No” to question 1, are you filing Form 1024 within 27 months from the end of the month in which the
organization was created or formed?
If “Yes,” your organization qualifies under Regulation section 301.9100-2 for an automatic 12-month extension
of the 15-month filing requirement. Do not answer questions 3 and 4.
If “No,” answer question 3.

If you answer “No” to question 2, does the organization wish to request an extension of time to apply under the “reasonable
action and good faith” and the “no prejudice to the interest of the government” requirements of Regulations section
301.9100-3?
If “Yes,” give the reasons for not filing this application within the 27-month period described in question 2. See Specific
Instructions, Part IV, Line 3, page 4, before completing this item. Do not answer question 4.
If “No,” answer question 4.

If you answer “No” to question 3, your organization’s qualification as a section 501(c)(9) or 501(c)(17) organization can
be recognized only from the date this application is filed. Therefore, does the organization want us to consider its
application as a request for recognition of exemption as a section 501(c)(9) or 501(c)(17) organization from the date the
application is received and not retroactively to the date the organization was created or formed?

Form 1024 (Rev. 9-98)

Schedule A

Page 7
Organizations described in section 501(c)(2) or 501(c)(25) (Title holding corporations or trusts)

State the complete name, address, and EIN of each organization for which title to property is held and the number and type of the
applicant organization’s stock held by each organization.

If the annual excess of revenue over expenses has not been or will not be turned over to the organization for which title to property is
held, state the purpose for which the excess is or will be retained by the title holding organization.

In the case of a corporation described in section 501(c)(2), state the purpose of the organization for which title to property is held (as
shown in its governing instrument) and the Code sections under which it is classified as exempt from tax. If the organization has received
a determination or ruling letter recognizing it as exempt from taxation, please attach a copy of the letter.

In the case of a corporation or trust described in section 501(c)(25), state the basis whereby each shareholder is described in section
501(c)(25)(C). For each organization described that has received a determination or ruling letter recognizing that organization as exempt
from taxation, please attach a copy of the letter.

With respect to the activities of the organization.
a

Is any rent received attributable to personal property leased with real property?

Yes

If “Yes,” what percentage of the total rent, as reported on the financial statements in Part III, is attributable to
personal property?

Will the organization receive income which is incidentally derived from the holding of real property, such as
income from operation of a parking lot or from vending machines?
If “Yes,” what percentage of the organization’s gross income, as reported on the financial statements in Part III, is
incidentally derived from the holding of real property?

Will the organization receive income other than rent from real property or personal property leased with real
property or income which is incidentally derived from the holding of real property?
If “Yes,” describe the source of the income.

Instructions
Line 1.—Provide the requested information on each organization for
which the applicant organization holds title to property. Also indicate
the number and types of shares of the applicant organization’s stock
that are held by each.
Line 2.—For purposes of this question, “excess of revenue over
expenses” is all of the organization’s income for a particular tax year
less operating expenses.
Line 3.—Give the exempt purpose of each organization that is the
basis for its exempt status and the Internal Revenue Code section

that describes the organization (as shown in its IRS determination
letter).
Line 4.—Indicate if the shareholder is one of the following:
1. A qualified pension, profit-sharing, or stock bonus plan that
meets the requirements of the Code;
2. A government plan;
3. An organization described in section 501(c)(3); or
4. An organization described in section 501(c)(25).

Form 1024 (Rev. 9-98)

Schedule B

Page

Organizations Described in Section 501(c)(4) (Civic leagues, social welfare organizations
(including posts, councils, etc., of veterans’ organizations not qualifying or applying for
exemption under section 501(c)(19)) or local associations of employees.)

Has the Internal Revenue Service previously issued a ruling or determination letter recognizing the applicant organization
(or any predecessor organization listed in question 4, Part II of the application) to be exempt under section 501(c)(3) and
later revoked that recognition of exemption on the basis that the applicant organization (or its predecessor) was carrying
on propaganda or otherwise attempting to influence legislation or on the basis that it engaged in political activity?

Yes

If “Yes,” indicate the earliest tax year for which recognition of exemption under section 501(c)(3) was revoked and the
IRS district office that issued the revocation.

Does the organization perform or plan to perform (for members, shareholders, or others) services, such as maintaining
the common areas of a condominium; buying food or other items on a cooperative basis; or providing recreational facilities
or transportation services, job placement, or other similar undertakings?
If “Yes,” explain the activities in detail, including income realized and expenses incurred. Also, explain in detail the nature
of the benefits to the general public from these activities. (If the answer to this question is explained in Part II of the
application (pages 2, 3, and 4), enter the page and item number here.)

If the organization is claiming exemption as a homeowners’ association, is access to any property or facilities it owns
or maintains restricted in any way?
If “Yes,” explain.

If the organization is claiming exemption as a local association of employees, state the name and address of each employer whose employees
are eligible for membership in the association. If employees of more than one plant or office of the same employer are eligible for membership,
give the address of each plant or office.

Form 1024 (Rev. 9-98)

Schedule C

Page

Organizations described in section 501(c)(5) (Labor, agricultural, including fishermen’s
organizations, or horticultural organizations) or section 501(c)(6) (business leagues, chambers
of commerce, etc.)

Describe any services the organization performs for members or others. (If the description of the services is
contained in Part II of the application, enter the page and item number here.)

Fishermen’s organizations only.—What kinds of aquatic resources (not including mineral) are cultivated or harvested
by those eligible for membership in the organization?

Labor organizations only.—Is the organization organized under the terms of a collective bargaining agreement?
If “Yes,” attach a copy of the latest agreement.

Yes

Form 1024 (Rev. 9-98)

Schedule D
1

Page

Organizations described in section 501(c)(7) (Social clubs)

Has the organization entered or does it plan to enter into any contract or agreement for the management or operation
of its property and/or activities, such as restaurants, pro shops, lodges, etc.?

Yes

If “Yes,” attach a copy of the contract or agreement. If one has not yet been drawn up, please explain the organization’s
plans.

Does the organization seek or plan to seek public patronage of its facilities or activities by advertisement or otherwise?
If “Yes,” attach sample copies of the advertisements or other requests.
If the organization plans to seek public patronage, please explain the plans.

3a Are nonmembers, other than guests of members, permitted or will they be permitted to use the club facilities or participate
in or attend any functions or activities conducted by the organization?
If “Yes,” describe the functions or activities in which there has been or will be nonmember participation or admittance.
(Submit a copy of the house rules, if any.)

b State the amount of nonmember income included in Part III of the application, lines 3 and 4, column (a)
c Enter the percent of gross receipts from nonmembers for the use of club facilities
d Enter the percent of gross receipts received from investment income and nonmember use of the club’s facilities
4a Does the organization’s charter, bylaws, other governing instrument, or any written policy statement of the organization
contain any provision that provides for discrimination against any person on the basis of race, color, or religion?
b If “Yes,” state whether or not its provision will be kept.

c If the organization has such a provision that will be repealed, deleted, or otherwise stricken from its requirements, state
when this will be done
d If the organization formerly had such a requirement and it no longer applies, give the date it ceased to apply
e If the organization restricts its membership to members of a particular religion, check here and attach the explanation
specified in the instructions
See reverse side for instructions

%
%
Yes

Form 1024 (Rev. 9-98)

Page

Instructions
Line 1.—Answer “Yes,” if any of the organization’s
property or activities will be managed by another
organization or company.
Lines 3b, c, and d.—Enter the figures for the current
year. On an attached schedule, furnish the same
information for each of the prior tax years for which
you completed Part III of the application.
Line 4e.—If the organization restricts its membership
to members of a particular religion, the organization
must be:
1. An auxiliary of a fraternal beneficiary society that:

a. Is described in section 501(c)(8) and exempt from
tax under section 501(a), and
b. Limits its membership to members of a particular
religion; or
2. A club that, in good faith, limits its membership to
the members of a particular religion in order to further
the teachings or principles of that religion and not to
exclude individuals of a particular race or color.
If you checked 4e, your explanation must show how
the organization meets one of these two requirements.

Form 1024 (Rev. 9-98)

Schedule E
1

Page

Organizations described in section 501(c)(8) or 501(c)(10) (Fraternal societies, orders, or
associations)

Is the organization a college fraternity or sorority, or chapter of a college fraternity or sorority?

Yes

Does or will your organization operate under the lodge system?

Yes

If “No,” does or will it operate for the exclusive benefit of the members of an organization operating under the lodge
system?

Yes

Is the organization a subordinate or local lodge, etc.?

Yes

If “Yes,” read the instructions for Line 1, below, before completing this schedule.
2

If “Yes,” attach a certificate signed by the secretary of the parent organization, under the seal of the organization,
certifying that the subordinate lodge is a duly constituted body operating under the jurisdiction of the parent body.

Is the organization a parent or grand lodge?
If “Yes,” attach a schedule for each subordinate lodge in active operation showing: (a) its name and address; (b)
the number of members in it; and (c) how often it holds periodic meetings.

Instructions
Line 1.—To the extent that they qualify for exemption
from Federal income tax, college fraternities and
sororities generally qualify as organizations described
in section 501(c)(7). Therefore, if the organization is a
college fraternity or sorority, refer to the discussion of
section 501(c)(7) organizations in Pub. 557. If section
501(c)(7) appears to apply to your organization,
complete Schedule D instead of this schedule.

Line 2.—Operating under the lodge system means
carrying on activities under a form of organization that
is composed of local branches, chartered by a parent
organization, largely self-governing, and called lodges,
chapters, or the like.

Form 1024 (Rev. 9-98)

Schedule F

Page

Organizations described in section 501(c)(9) (Voluntary employees’ beneficiary associations)

Describe the benefits available to members. Include copies of any plan documents that describe such benefits and the
terms and conditions of eligibility for each benefit.

Are any employees or classes of employees entitled to benefits to which other employees or classes of employees are
not entitled?

Yes

If “Yes,” explain.

Give the following information for each plan as of the last day of the most recent plan year and enter that date here. If
there is more than one plan, attach a separate schedule

/
(mo.) (day)

/
(yr.)

a Total number of persons covered by the plan who are highly compensated individuals (See instructions below.)
b Number of other employees covered by the plan
c Number of employees not covered by the plan
d Total number employed*
* Should equal the total of a, b, and c—if not, explain any difference. Describe the eligibility requirements that prevent
those employees not covered by the plan from participating.
4

State the number of persons, if any, other than employees and their dependents (e.g., the proprietor of a business whose
©
employees are members of the association) who are entitled to receive benefits

Instructions
Line 3a.—A “highly compensated individual” is one
who:
(a) Owned 5% or more of the employer at any time
during the current year or the preceding year.

(b) Received more than $80,000 (adjusted for
inflation) in compensation from the employer for the
preceding year, and
(c) Was among the top 20% of employees by
compensation for the preceding year. However, the
employer can choose not to have (c) apply.

Page 15
Schedule G Organizations described in section 501(c)(12) (Benevolent life insurance associations, mutual ditch
or irrigation companies, mutual or cooperative telephone companies, or like organizations)

Form 1024 (Rev. 9-98)

Attach a schedule in columnar form for each tax year for which the organization is claiming exempt status. On each schedule:
a Show the total gross income received from members or shareholders.

b List, by source, the total amounts of gross income received from other sources.
2

If the organization is claiming exemption as a local benevolent insurance association, state:
a The counties from which members are accepted or will be accepted.

b Whether stipulated premiums are or will be charged in advance, or whether losses are or will be paid solely through assessments.

If the organization is claiming exemption as a “like organization,” explain how it is similar to a mutual ditch or irrigation company, or a mutual
or cooperative telephone company.

Are the rights and interests of members in the organization’s annual savings determined in proportion to their business
with it?

Yes

If “Yes,” does the organization keep the records necessary to determine at any time each member’s rights and interests
in such savings, including assets acquired with the savings?

Yes

If the organization is a mutual or cooperative telephone company and has contracts with other systems for long-distance telephone services,
attach copies of the contracts.

Instructions
Mutual or cooperative electric or telephone companies
should show income received from qualified pole
rentals separately. Mutual or cooperative telephone
companies should also show separately the gross
amount of income received from nonmember
telephone companies for performing services that

involve their members and the gross amount of income
received from the sale of display advertising in a
directory furnished to their members.
Do not net amounts due or paid to other sources
against amounts due or received from those sources.

Form 1024 (Rev. 9-98)

Schedule H
1

Page 16
Organizations described in section 501(c)(13) (Cemeteries, crematoria, and like corporations)

Attach the following documents:
a Complete copy of sales contracts or other documents, including any “debt” certificates, involved in acquiring cemetery
or crematorium property.

b Complete copy of any contract your organization has that designates an agent to sell its cemetery lots.
c A copy of the appraisal (obtained from a disinterested and qualified party) of the cemetery property as of the date
acquired.
2

Does your organization have, or does it plan to have, a perpetual care fund?

Yes

If “Yes,” attach a copy of the fund agreement and explain the nature of the fund (cash, securities, unsold land, etc.)

If your organization is claiming exemption as a perpetual care fund for an organization described in section 501(c)(13),
has the cemetery organization, for which funds are held, established exemption under that section?
If “No,” explain.

Form 1024 (Rev. 9-98)

Schedule I
1

Page

Organizations described in section 501(c)(15) (Small insurance companies or associations)

Is the organization a member of a controlled group of corporations as defined in section 831(b)(2)(B)(ii)? (Disregard section
1563(b)(2)(B) in determining whether the organization is a member of a controlled group.)

Yes

If “Yes,” include on lines 2 through 5 the total amount received by the organization and all other members of the
controlled group.
If “No,” include on lines 2 through 5 only the amounts that relate to the applicant organization.
(a) Current Year
From
To

Direct written premiums

Reinsurance assumed

Reinsurance ceded

Net written premiums ((line 2 plus line 3) minus line 4)

If you entered an amount on line 3 or line 4, attach a copy of the
reinsurance agreements the organization has entered into.

3 Prior Tax Years
(b)

(c)

(d)

Instructions
Line 1.—Answer “Yes,” if the organization would be
considered a member of a controlled group of
corporations if it were not exempt from tax under
section 501(a). In applying section 1563(a), use a
“more than 50%” stock ownership test to determine
whether the applicant or any other corporation is a
member of a controlled group.

Line 2.— In addition to other direct written premiums,
include on line 2 the full amount of any prepaid or
advance premium in the year the prepayment is
received. For example, if a $5,000 premium for a
3-year policy was received in the current year, include
the full $5,000 amount in the Current Year column.

Form 1024 (Rev. 9-98)

Schedule J

Page

If benefits are provided for individual proprietors, partners, or self-employed persons under the plan, explain in detail.

If the plan provides other benefits in addition to the supplemental unemployment compensation benefits, explain in detail and state
whether the other benefits are subordinate to the unemployment benefits.

Organizations described in section 501(c)(17) (Trusts providing for the payment of
supplemental unemployment compensation benefits)

Give the following information as of the last day of the most recent plan year and enter that date here
a Total number of employees covered by the plan who are shareholders, officers, self-employed persons, or highly
compensated (See Schedule F instructions for line 3a on page 14.)

b Number of other employees covered by the plan
c Number of employees not covered by the plan
d Total number employed*

* Should equal the total of a, b, and c—if not, explain the difference. Describe the eligibility requirements that prevent
those employees not covered by the plan from participating.
4

At any time after December 31, 1959, did any of the following persons engage in any of the transactions listed below with the trust: the
creator of the trust or a contributor to the trust; a brother or sister (whole or half blood), a spouse, an ancestor, or a lineal descendant of
such a creator or contributor; or a corporation controlled directly or indirectly by such a creator or contributor?

Note: If you know that the organization will be, or is considering being, a party to any of the transactions (or activities) listed below, check the
“Planned” box. Give a detailed explanation of any “Yes” or “Planned” answer in the space below.
a Borrow any part of the trust’s income or corpus?

Yes

Planned

b Receive any compensation for personal services?

Yes

Planned

c Obtain any part of the trust’s services?

Yes

Planned

d Purchase any securities or other properties from the trust?

Yes

Planned

e Sell any securities or other property to the trust?

Yes

Planned

f Receive any of the trust’s income or corpus in any other transaction?

Yes

Planned

Attach a copy of the Supplemental Unemployment Benefit Plan and related agreements.

Form 1024 (Rev. 9-98)

Schedule K

Page

Organizations described in section 501(c)(19)—A post or organization of past or present
members of the Armed Forces of the United States, auxiliary units or societies for such a
post or organization, and trusts or foundations formed for the benefit of such posts or
organizations.

To be completed by a post or organization of past or present members of the Armed Forces of the United States.
a Total membership of the post or organization

b Number of members who are present or former members of the U.S. Armed Forces
c Number of members who are cadets (include students in college or university ROTC programs or at armed services
academies only), or spouses, widows, or widowers of cadets or past or present members of the U.S. Armed Forces
d Does the organization have a membership category other than the ones set out above?

Yes

If “Yes,” please explain in full. Enter number of members in this category

e If you wish to apply for a determination that contributions to your organization are deductible by donors, enter the number
of members from line 1b who are war veterans, as defined below
A war veteran is a person who served in the Armed Forces of the United States during the following periods of war:
April 21, 1898, through July 4, 1902; April 6, 1917, through November 11, 1918; December 7, 1941, through December
31, 1946; June 27, 1950, through January 31, 1955; and August 5, 1964, through May 7, 1975.
2

To be completed by an auxiliary unit or society of a post or organization of past or present members of the Armed Forces
of the United States.
a Is the organization affiliated with and organized according to the bylaws and regulations formulated by such an exempt
post or organization?
If “Yes,” submit a copy of such bylaws or regulations.

b How many members does your organization have?
c How many are themselves past or present members of the Armed Forces of the United States, or are their spouses, or
persons related to them within two degrees of blood relationship? (Grandparents, brothers, sisters, and grandchildren
are the most distant relationships allowable.)
d Are all of the members themselves members of a post or organization, past or present members of the Armed Forces
of the United States, spouses of members of such a post or organization, or related to members of such a post or
organization within two degrees of blood relationship?
3

To be completed by a trust or foundation organized for the benefit of an exempt post or organization of past or present
members of the Armed Forces of the United States.
a Will the corpus or income be used solely for the funding of such an exempt organization (including necessary related
expenses)?
If “No,” please explain.

b If the trust or foundation is formed for charitable purposes, does the organizational document contain a proper dissolution
provision as described in section 1.501(c)(3)-1(b)(4) of the Income Tax Regulations?

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Title                           : Package 1024 (Rev. September 1998)
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Description                     : Application for Recognition of Exemption Under Section 501(a) for Determination Under Section 120 of the Internal Revenue Code
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Subject                         : Application for Recognition of Exemption Under Section 501(a) for Determination Under Section 120 of the Internal Revenue Code

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Package 1024 (Rev. September 1998) K1024

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