Fillable form to request exemption from the two laws (Michigan)

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form to request exemption from the two laws (Michigan)

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State of Michigan
Department of Attorney General
REQUEST FOR EXEMPTION
Charitable Organizations and Solicitations Act (COSA)
Supervision of Trustees for Charitable Purposes Act (STCPA)
Complete this
form to request exemption from the two laws listed above. Some exemptions apply to both laws.
Although you may be exempt from registration under COSA, registration may be required under STCPA and vice
versa.
PLEASE TYPE OR PRINT IN INK – Attach additional pages if more space is needed.
Legal Name of Organization Attorney General File # (CS/CT/T) if applicable
Address of Organization
City County State Zip Area Code Telephone Number
Organization Email Address Website Organization Fax Number
Other names used by organization Employer I
dentification Number (EIN)
GENERAL INFORMATION
A. Type of Organization
– Check one.
Nonprofit corporation – State of incorporation ________ Date incorporated _______________
If incorporated in Michigan, enter your Corporate Identification Number: __________________
Provide copies of your articles of incorporation, bylaws and, if applicable, Mich. Certificate of Authority.
Trust – Provide a copy of the trust instrument.
Unincorporated Association – Provide a copy of your Articles of Association, Constitution and Bylaws, or other organizing document.
Other – explain and provide a copy of the relevant document:
B. Organization's Federal Tax Exempt Status
– Check one.
Applied, or will apply, for tax exempt status under section 501(c)___. Date of application. ________________
If you checked either box above, indicate the form used to apply for exempt status. Form 1023
Form 1023-EZ
Exempt under another section: Section 501(c) ____ Provide a copy of your determination letter.
The organization is not tax exempt and will not apply for tax exempt status. Explain:_____________________________
C. Summarize the organization's purpose in 50 words or less. Do not simply refer to articles of incorporation or quote required
IRS language.
CTS - 03
AUTHORITY 1975 PA 169
1961 PA 101
PENALTY: civil, criminal
1
Exempt under 501(c)(3) - Provide a copy of your determination letter.
MICHIGAN DEPARTMENT OF ATTORNEY GENERAL
REQUEST FOR EXEMPTION
D.
Required Documentation
1.
An organization that requests contributions only for the relief
or benefit of a named individual or family with all fundraising
conducted by persons who are unpaid for their service.
Enter the name, address, and telephone number of the
beneficiary:
2.
A Michigan educational institution approved by the Michigan
Board of Education. Michigan approval is separate from
accreditation or other certifications.
Provide appropriate documentation from the Michigan
Department of Education.
3.
A veterans organization incorporated under federal law.
Submit proof of federal charter.
4.
A licensed hospital. Health systems and other affiliates are
not exempt even if they include a licensed hospital.
Provide a copy of the hospital license.
5.
A school booster organization operating with the knowledge
and approval of an educational institution for the support or
promotion of educational, artistic, musical, or athletic
programs or events.
The school booster organization must serve only one school
which must be an approved school in Michigan. Provide the
name of the school and attach documentation of its knowledge
and approval.
6.
A governmental unit or instrumentality.
Provide explanation and copies of appropriate documentation.
If you merely receive government funding, or you intend to
become a governmental instrumentality in the future, the
exemption does not apply to you.
7.
An advocacy or lobbying organization, or an organization
associated with an advocacy organization, political party,
candidate or committee, that does not
have 501(c)(3) status.
Provide explanation, articles of incorporation, and a copy of
the IRS determination letter.
8.
A duly constituted religious organization or group affiliated
with and forming an integral part of a religious organization.
Provide explanation and appropriate documentation, including
a copy of the IRS determination letter that states that filing
Form 990 is not required.
9.
An organization that will not have 501(c)(3) status and whose
principal purpose is not charitable but that solicits from time to
time for a charitable purpose.
All fundraising must be performed by members of the
organization who are not paid for their services.
All funds must be wholly used for the purposes for which they
were solicited.
10.
An organization that confines solicitations to drives solely
among members, directors and their immediate families,
where the general public is not invited to become a member.
This includes a private foundation for IRS tax purposes that
receives contributions solely from incorporators, directors,
stockholders or their families, or from a sponsoring business.
Provide an explanation of your membership requirements,
your solicitation activities, and/or your relationship with
expected contributors.
11.
An organization whose sole source of contributions is a
charitable organization registered with this office to solicit
contributions.
Enter the name and registration number of the registered
organization:
Section I
The exemptions in the following section apply to both COSA and STCPA.
Section II
The exemptions in the following section apply only to COSA.
Specific exemptions. Check all that apply to the organization. Additional information and required documentation is listed in the
right column.
Exemption
If the organization annually files a Form 990 or 990-EZ with
the IRS, provide a copy.
·
·
Note - To qualify for this exemption:
Note - If the organization's IRS 501(c)(3) determination letter
requires it to file a Form 990, 990-EZ, or 990-N, the
organization likely does not qualify for this exemption.
See the Key at the end to determine if any additional forms must be filed.
The organization must not have, or intend to receive,
501(c)(3) status.
·
Provide the IRS determination of tax-exempt status that is not
501(c)(3).
2
MICHIGAN DEPARTMENT OF ATTORNEY GENERAL
REQUEST FOR EXEMPTION
Required Documentation
Exemption
12.
A hospital-based foundation or auxiliary that solicits
contributions solely for 1 or more licensed hospitals.
See instructions.
Enter the name of the parent hospital:
13.
An organization that does not intend to solicit and receive,
and does not actually receive, contributions in excess of
$25,000.00 during any 12-month period.
Do not include grants from governmental agencies or restricted grants from
foundations when calculating contributions. See instructions.
All fundraising functions must be conducted by persons,
whether staff or contractors, who are not paid for their
services.
The organization must make a financial statement of its
activities of its most recent fiscal year available to its members
and the public.
14.
A nonprofit corporation whose purpose is the owning and
operating of facilities for the aged and chronically ill that is
under the sole control of a religious or fraternal society.
Provide proof of sole control by a religious or fraternal society.
15.
An organization at least 50% of whose activities are licensed
by the Michigan Department of Health and Human Services to
serve children and families.
Enter the name of the specific state licensing agency and your
license number:
16.
An organization incorporated or organized in a state other
than Michigan that will never hold assets in Michigan,
including cash, savings accounts, investment accounts, land,
building, equipment, etc.
17.
An organization that receives operating funds from United
Way.
Identify the specific United Way office:
18.
An amateur theater, band, orchestra, chorale or dance
or
ganization.
Forms to provide
(available at www.mi.gov/charity)
CTS-01, Initial Solicitation Form.
CTS-03, Request for Exemption form.
CTS-03, Request for Exemption form and
CTS-05, Registration and Inventory Forms for Corporations
and Unincorporated Associations.
CTS-03, Request for Exemption form and
CTS-01, Initial Solicitation Form.
Type or print name (must be legible)
Title Date
If you checked a box in Section I, or
if you checked boxes in more than one section:
If you checked a box in Section II and did not check a box in
Sections I or III:
If you checked a box in Section III and did not check a box in Sections I
or II:
Section III
The following section applies only to the STCPA.
This is a public record, copies of which are sent, upon request, to any interested person.
Key:
If you did not check a box:
CERTIFICATION
I certify that I am an authorized represtentative of the organization and that to the best of my knowledge and belief the
information provided, including all accompanying documents, is true, correct, and complete. False statements are
prohibited by MCL 400.288(1)(u) and MCL 400.293(2)(c) and are punishable by civil and criminal penalties.
Note
-
To
q
ualif
y
for this exem
p
tion:
·
Provide a schedule of all governmental grants and restricted
grants from foundations received during the year of your
financial report.
Y
ou will be notified in writing after your request for exemption has
been reviewed and a determination has been made.
3
This exemption also applies if the organization or trust does not
solicit or receive any contributions.
Provide a copy of your latest IRS 990, 990-EZ, or 990-PF.
(We do not accept Form 990-N.) If you have not prepared
an IRS return, provide a financial statement or treasurer's
report. If you are a newly created organization in your first
fiscal period, you do not have to provide a financial
statement at this time.
·
REQUEST FOR EXEMPTION
INSTRUCTIONS
GENERAL INFORMATION
Who should file this form?
• Organizations that are exempt from solicitation
registration under COSA; and/or
• Organizations that are exempt from registration
under the STCPA.
Notification
– You will be notified in writing if your
request for exemption has been approved or not.
Fees – There is no fee required to file this form.
Filing the form – You may submit the form by email,
fax, or mail. For faster processing, use email.
Email – The form and all required documents should be
attached in PDF form. Send it to: ct_email@mi.gov.
Mail – Send the completed form with all additional
required documentation to:
Department of Attorney General
Charitable Trust Section
PO Box 30214
Lansing, MI 48909
Telephone: 517-335-7571
Fax: 517-241-7074
SPECIFIC INSTRUCTIONS
Name - Enter your exact legal name on the form. This
will be the same name as is currently on your articles of
incorporation or other organizing document. If you use
any name other than your legal name, enter it on the
form in the space Other names used by organization.
Item C. Organization's purpose – Provide a summary
of the organization's purpose in 50 words or less. This
will be used on our database and will be provided to
persons who inquire. Do not simply quote your articles
of incorporation or provide the IRS required 501(c)(3)
language.
Item D. Exemptions – This form applies to 2 different
laws. The exemption area is divided into 3 parts:
Section I applies to both laws and Sections II and III
apply separately to COSA and the STCPA. If you
check any box for an exemption that applies to the
organization, see the Key, which will tell you if any
additional forms should be filed.
Exemption 2 – If checked, include any documentation
you hold that indicates the organization is recognized
by the Michigan Department of Education as a school
or educational institution. This is separate from
accreditations or other certifications.
Exemption 3 – If the organization is a chapter of a
federally chartered veterans organization, provide
verification of the parent organization's federal charter
and also verification of your status as a chapter of the
parent.
Exemption 9 – If you later enter into a contract with a
professional fundraiser, provide a copy of the contract
and submit the Initial Solicitation Form.
Exemption 12 - A hospital-based foundation or
auxiliary does not qualify for the exemption if it solicits
contributions for other organizations even if they are
related to, or controlled by, the hospital.
Exemption 13 - If any person involved in fundraising is
compensated, you do not qualify for this exemption. If
you anticipate receiving contributions in excess of
$25,000 during a fiscal year, you do not qualify for this
exemption. Do not count governmental grants or
restricted grants from foundations in the $25,000.
A restricted grant from a foundation is one that the
organization applies for and includes all of the following
components:
• The foundation is organized and operated
primarily as a grant making foundation;
• The gift should be restricted for purposes or
programs narrower or more limited than the
organization's general charitable mission or
operations; i.e., it is not a gift to be used for
general operating funds;
• The restriction should be in writing and include
reporting and accountability requirements back
to the grant making foundation.
If you are providing a financial statement for a period in
which you received governmental grants or restricted
grants from foundations, provide a schedule of such
grants. The schedule should include the name and
address of the granting foundation or governmental
agency, and dollar amount of the grant, and the
restricted purpose of the grant.
Key – Other forms are available at our website:
www.mi.gov/charity.
CHECKLIST
Have you:
Provided copies of the organizing documents,
including amendments?
Provided a copy of the IRS determination letter
or, if none, provided an explanation?
Provided supporting documentation for each
exemption checked?
Provided additional forms required by the Key?
Certified the form and included your contact
information?
Checked a box on pages 2 or 3? Do not submit
this form if no box is checked.
Revised 7/12/16
4
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form to request exemption from the two laws (Michigan)

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Completed 9 February 2022

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