Fillable F8871 Accessible Form 8871 (Rev. 7-2003)

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F8871 Accessible Form 8871 (Rev. 7-2003)

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The F8871 Accessible Form 8871 (Rev. 7-2003) form is 2 pages long and contains:

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  • 89 other fields

Country of origin: US
File type: PDF

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The Internal Revenue Service (IRS) is a government agency responsible for collecting taxes and administering the federal statutory tax laws of the United States. The IRS provide tax assistance to taxpayers and pursue and resolve fraudulent tax filings.

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INSTRUCTIONS TO PRINTERS
Form 8871, PAGE 1 of 4
MARGINS: TOP 13 mm (
1
⁄2"), CENTER SIDES. PRINTS: HEAD to HEAD
PAPER: WHITE, WRITING, SUB. 20 INK: BLACK
FLAT SIZE: 203 mm (8") � 279 mm (11")
PERFORATE: ON FOLD
2
I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT
TLS, have you
transmitted all R
text files for this
cycle update?
Date
Action
Revised proofs
requested
Date Signature
O.K. to print
Form
8871
Political Organization
Notice of Section 527 Status
(Rev. July 2003)
OMB No. 1545-1693
Cat. No. 30405V
Department of the Treasury
Internal Revenue Service
For Paperwork Reduction Act Notice, see the separate Instructions for Form 8871.
Part I General Information
1 Name of organization
Employer identification number
2 Mailing address (P.O. box or number, street, and room or suite number)
City or town, state, and ZIP code
3 Check applicable box: Initial notice Amended notice Final notice
4a Date established 4b Date of material change
5 Email address of organization
6a Name of custodian of records 6b Custodian’s address
7a Name of contact person 7b Contact person’s address
8 Business address of organization (if different from mailing address shown above). Number, street, and room or suite number
City or town, state, and ZIP code
9a Election authority 9b Election authority identification number
Part II
Notification of Claim of Exemption From Filing Certain Forms (see instructions)
10a
Is this organization claiming exemption from filing Form 8872, Political Organization Report of Contributions and Expenditures, as a qualified
state or local political organization?
Yes No
10b
If “Yes,” list the state where the organization files reports
11 Is this organization claiming exemption from filing Form 990 (or 990-EZ), Return of Organization Exempt from Income Tax, as a caucus or
association of state or local officials?
Yes No
Part III
Purpose
12 Describe the purpose of the organization
Part IV
List of All Related Entities (see instructions)
13
Check if the organization has no related entities
�
14a Name of related entity 14b Relationship 14c Address
Form 8871 (Rev. 7-2003)
INSTRUCTIONS TO PRINTERS
FORM 8871, PAGE 2 of 4
MARGINS: TOP 13mm (
1
⁄2"), CENTER SIDES. PRINTS: HEAD TO HEAD
PAPER: WHITE, WRITING, SUB. 20. INK: BLACK
FLAT SIZE: 203mm (8") x 279mm (11")
PERFORATE: ON FOLD
2
I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT
Form 8871 (Rev. 7-2003) Page 2
Part V
List of All Officers, Directors, and Highly Compensated Employees (see instructions)
15a Name 15b Title 15c Address
Sign
Here
Under penalties of perjury, I declare that the organization named in Part I is to be treated as a tax-exempt organization described in section 527 of the
Internal Revenue Code, and that I have examined this notice, including accompanying schedules and statements, and to the best of my knowledge
and belief, it is true, correct, and complete. I further declare that I am the official authorized to sign this report, and I am signing by entering my name
below.
Name of authorized official Date
� �
Printed on recycled paper Form 8871 (Rev. 7-2003)
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F8871 Accessible Form 8871 (Rev. 7-2003)

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Completed 20 June 2020

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