Form 1023 Checklist
(Revised December 2017)
Application for Recognition of Exemption under Section 501(c)(3) of the
Internal Revenue Code
Note: Retain a copy of the completed Form 1023 in your permanent records. Refer to the General Instructions regarding
Public Inspection of approved applications.
Check each box to finish your application (Form 1023). Send this completed Checklist with your filled-in
application. If you have not answered all the items below, your application may be returned to you as
Assemble the application and materials in this order.
• Form 1023 Checklist
• Form 2848, Power of Attorney and Declaration of Representative (if filing)
• Form 8821, Tax Information Authorization (if filing)
• Expedite request (if requesting)
• Application (Form 1023 and Schedules A through H, as required)
• Articles of organization
• Amendments to articles of organization in chronological order
• Bylaws or other rules of operation and amendments
• Documentation of nondiscriminatory policy for schools, as required by Schedule B
Form 5768, Election/Revocation of Election by an Eligible Section 501(c)(3) Organization To Make
Expenditures To Influence Legislation (if filing)
• All other attachments, including explanations, financial data, and printed materials or publications.
Label each page with name and EIN.
User fee payment placed in envelope on top of checklist. DO NOT STAPLE or otherwise attach your
check or money order to your application. Instead, just place it in the envelope.
Employer Identification Number (EIN)
Completed Parts I through XI of the application, including any requested information and any
required Schedules A through H.
• You must provide specific details about your past, present, and planned activities.
Generalizations or failure to answer questions in the Form 1023 application will prevent us from
recognizing you as tax exempt.
• Describe your purposes and proposed activities in specific easily understood terms.
• Financial information should correspond with proposed activities.
Schedules. Submit only those schedules that apply to you and check either “Yes” or “No” below.
Schedule A
Schedule B Yes No
Schedule C Yes No
Schedule D Yes No
Schedule E Yes No
Schedule F Yes No
Schedule G Yes No
Schedule H Yes No
An exact copy of your complete articles of organization (creating document). Absence of the proper purpose
and dissolution clauses is the number one reason for delays in the issuance of determination letters.
• Location of Purpose Clause from Part III, line 1 (Page, Article and Paragraph Number)
• Location of Dissolution Clause from Part III, line 2b or 2c (Page, Article and Paragraph Number) or by
operation of state law
Signature of an officer, director, trustee, or other official who is authorized to sign the application.
• Signature at Part XI of Form 1023.
Your name on the application must be the same as your legal name as it appears in your articles of
Send completed Form 1023, user fee payment, and all other required information, to:
Internal Revenue Service
Attention: EO Determination Letters
Stop 31
P.O. Box 12192
Covington, KY 41012-0192
If you are using express mail or a delivery service, send Form 1023, user fee payment, and attachments to:
Internal Revenue Service
Attention: EO Determination Letters
Stop 31
201 West Rivercenter Boulevard
Covington, KY 41011