Form 1024
(Rev. January 2018)
Department of the Treasury
Internal Revenue Service
Application for Recognition of Exemption
Under Section 501(a)
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Go to www.irs.gov/Form1024 for instructions and the latest information.
OMB No. 1545-0057
If exempt status is approved,
this application will be open
for public inspection.
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 that follows the form.
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)
b
Reserved for future use
c
Section 501(c)(5)—Labor, agricultural, or horticultural organizations (Schedule C)
d
Section 501(c)(6)—Business leagues, chambers of commerce, etc. (Schedule C)
e
Section 501(c)(7)—Social clubs (Schedule D)
f
Section 501(c)(8)—Fraternal beneficiary societies, etc., providing life, sick, accident, or other benefits to members (Schedule E)
g
Section 501(c)(9)—Voluntary employees’ beneficiary associations (Parts I through IV and Schedule F)
h
Section 501(c)(10)—Domestic fraternal societies, orders, etc., not providing life, sick, accident, or other benefits (Schedule E)
i
Section 501(c)(12)—Benevolent life insurance associations, mutual ditch or irrigation companies, mutual or cooperative telephone
companies, or like organizations (Schedule G)
j
Section 501(c)(13)—Cemeteries, crematoria, and like corporations (Schedule H)
k
Section 501(c)(15)—Mutual insurance companies or associations, other than life or marine (Schedule I)
l
Section 501(c)(17)—Trusts providing for the payment of supplemental unemployment compensation benefits (Parts I through IV and Schedule J)
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)
n Section 501(c)(25)—Title holding corporations or trusts (Schedule A)
1a Full name of organization (as shown in organizing document)
1b c/o Name (if applicable)
1c Address (number and street) Room/Suite
1d City, town or post office, state, and ZIP + 4. If you have a foreign address, see Specific
Instructions for Part I.
1e Web site address
2 Employer identification number (EIN) (if
none, see Specific Instructions)
3
Name and telephone number of person to be
contacted if additional information is needed
( )
4 Month the annual accounting period ends 5 Date incorporated or formed
6
Did the organization previously apply for recognition of exemption under this Code section or under any other section of the Code?
Yes No
If “Yes,” attach an explanation.
7 Has the organization filed Federal income tax returns or exempt organization information returns? . . . . . . . .
Yes No
If “Yes,” state the form numbers, years filed, and Internal Revenue office where filed.
8
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
Trust— Attach a copy of the Trust Indenture or Agreement, including all appropriate signatures and dates.
c
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 . . . . . . . .
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PLEASE
SIGN
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.
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(Signature) (Type or print name and title or authority of signer) (Date)
For Paperwork Reduction Act Notice, see instructions.
Catalog No. 12343K
Form 1024 (Rev. 1-2018)