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									           Sample 1023, Application for Recognition of Exemption
                         FILING INSTRUCTIONS

      Remember, on all attachments to have a heading with your
      PTA’s corporation name and EIN (Employer ID Number).

      Form 1023 (Rev. 6-2006)       Name: Sample PTA 1.1.1       EIN: 91-0000000

      Note, you must have applied for and received your Employer Identification
      Number (EIN) prior to filing a Form 1023. If your PTA has not received an EIN,
      obtain a Form SS-4, complete it, and wait for the IRS to assign you a number
      before mailing your Form 1023. A ready to be completed Form SS-4 can be found
      at http://www.irs.gov/formspubs/index.html or call WSPTA Office for help.

      The IRS charges a user fee for processing the Form 1023. See Part XI of the
      Form1023, and the related instructions for the correct fee amount. A check for the
      user fee must accompany the application and is generally non-refundable.

      Furthermore, you must complete and attach the Form 1023 Checklist (is two
      pages) before submitting the Form 1023. The user fee check should be placed
      AND NOT STAPLED on top of the checklist and would be mailed to:

      Internal Revenue Service
      PO Box 12192
      Covington, KY 41012-0192

      Or

      If you are using express mail or a delivery service, send the completed Form
      1023 application, with all required information and user fee to:

      Internal Revenue Service
      201 West Rivercenter Blvd.
      Attention: Extracting Stop 312
      Covington, KY 41011




Updated March 2009
      Part 1: Identification of Application
      Line 1: Full name of Organization
      Enter your corporation name

      Line 2: c/o Name
      Enter Washington State PTA if you want us to be your registered agent.

      Line 3: Mailing address
      Enter 2003 65th Ave. W, Tacoma WA 98466-6215 if you want WSPTA to be your registered
      agent.

      Line 4: Employer Identification Number
      Enter the nine-digit EIN assigned to you. Please call Pat Nelson at (800) 562-3804, if you are not
      sure about your EIN or if you need help in finding it.

      Line 5: Month the annual accounting period ends
      Enter 06 because the fiscal year for PTAs in the State of Washington is July 1st to June 30th.

      Line 6: Primary Contact
      On 6a Put the name of the person completing this form.
      On 6b Put their phone number.
      On 6 Put a fax number for the PTA.

      Line 7: Representation by an authorized representative
      Normally, a PTA would answer NO.

      Line 8: Listing of persons other than officers whom you paid to help organize and develop
      your PTA.
      Normally, a PTA would answer NO.

      Line 9: Organization’s website
      Enter your PTA’s website address if you have one. Do not enter the school’s website address.

      Line 9b: Email
      Enter your PTA’s email address.

      Line 10: Is the PTA excused from filing 990/990EZ?
      Check: NO

      Line 11: Date of Incorporation
      Enter the date that you were legally created by month, day, and year.

      Line 12: Foreign Organization
      Check: NO



      Part II: Organizational Structure
      Line 1: Corporation
      Check: YES. (Attach a copy of your PTA’s Articles of Incorporation & Certificate of
      Incorporation and any Amendments.)

      Line 2: “Limited Liability Company”


Updated March 2009
      Check: NO.

      Line 3: “Unincorporated Association”
      Check: NO.

      Line 4: Are you a trust?
      Check: NO.

      Line 5: Have you adopted bylaws?
      Check: YES. (Attach a copy of WSPTA Bylaws.)



      Part III: Required Provisions in Your Organizing
      Document
      Attach a copy of your PTA’s Articles of Incorporation and any Amendments in order to answer
      questions 1 through 2c.

      Line 1: Purpose Clause
      Your Articles of Incorporation need to state “organized exclusively for charitable and
      educational purposes”. Please check the box and most PTA’s would write on the line: page 1,
      Article III, first paragraph.

      Line 2a: Dissolution Clause
      On page 8 of the IRS 1023 Instruction is the IRS language that needs to be in your Articles of
      Incorporation. If your PTA’s Articles of Incorporation have the correct languages then check the
      2a box.

      Line 2b: Most PTAs would put Page 2, Article V, paragraph 1 if they check box on 2a.

      Line 2c: Operation of State Law. Do not check the box.

      Part IV: Narrative Description of Your Activities
      This is the most important part of your 1023 Application because this is your contract with the
      IRS. You may refer to other parts of your application rather than repeat information provided
      elsewhere.
       Describe completely and in detail your past, present, or planned activities. Include information
      that answers the following questions.

      If your PTA is currently a 501 (c) (4) organization, then you need
      to include that information and the date of your Letter of
      Determination in your narrative. Please also include a copy of
      your 501 (c) (4) Letter of Determination with this application.
              What is the activity? Give a detailed description of all activities.
              Who conducts the activity? PTA
              When is the activity conducted? Samples would be every spring or every November.
              Where is the activity conducted? In our school community or off site
              How does the activity further your exempt purposes?



Updated March 2009
      The answer to this question is the most important answer to any of these questions. You will be
      asking the Government to be organized as a 501(c) (3) charity with an exempt function of
      supporting and promoting education and benefiting children and youth. Each and every past,
      present, or planned activity should have a statement on how this activity furthers your exempt
      purpose.

      The IRS will be concerned that your activities are geared towards your exempt function. For
      example, they will not grant you 501(c) (3) status if you tell them you want to support education
      and benefiting children, yet you raise funds and spend them on, promoting wildlife preservation.
      Both are worthy activities, but remember you are being organized to support and promote
      education, children and youth and nothing else.

      The answers and documentation provided to answer this question is likely why the IRS either
      rejects applications, or requests more information from the applicant. Be a salesperson by
      explaining your activities to the IRS, providing written promotional materials advertising the
      event, how much was raised for the activity, and how those funds raised were (or will be) spent,
      and what criteria was used to select any individuals (as opposed to a whole group, like the 3rd
      grade) who received funds, especially if those funds are in the nature of scholarships.

              What percentage of your total time is allocated to the activity?
              How is the activity funded?

      List any alternate names under which you operate, including any “aka” (also known as) or “dba”
      (doing business as) names. Please look at your corporation name; you would put other name
      (s) that your PTA goes by or uses.

      If a PTA has a website, you may attach paper copies of relevant materials to support your narrative
      description of activities. Providing examples of past newsletters, brochures or other written
      examples of what activities your PTA chapter has supported (e.g. library reading materials) and
      how you raised funds for them can go a long way in getting your application approved.

      Anything you can add by written example will show to the IRS that your application is from a
      group of parents and teachers trying to help the children learn better and faster. Showing the
      human element in how you raise funds and how those funds were spent, gives the IRS a little
      better understanding of your chapter. This understanding makes them feel more comfortable that
      your exemption request qualifies as a 501(c) (3) type charity under the Internal Revenue Code.



      Part V: Compensation and Other Financial
      Arrangements With Your Officers, Directors, Trustees,
      Employees, and Independent Contractors
      Line 1a: List the names, titles, mailing addresses and compensation for your Board of
      Directors
      The Board of Directors consists of the executive committee and committee chairmen (Committee
      Chairmen who are on the Board of Directors should be listed in the PTA’s Standing Rules). Enter
      “None” if no compensation is or will be paid. Please refer to question 3a so that you may add
      three more items that need to be addressed on your list of the Board of Directors. A sample
      heading might be:
      Duties       Name         Address                                     Qualifications     Hours
      Compensation

      President    Jane Doe      123 N Doe, Tacoma WA 98400             Volunteer            10-+/month
      None

Updated March 2009
      Line 1b: Five Top Employees of $50,000 or more
      Most PTAs would enter N/A on the first line in section 1b.

      Line 1c: Five Top Independent Contractors of $50,000 or more
      Most PTAs would enter N/A on the first line in section 1c.

      The following “Yes” and “No” questions relate to past, present, or planned relationships,
      transactions of agreements with your officers, directors, highest compensated employees, and
      highest compensated independent contractors listed in lines 1a, 1b & 1c.

      Line 2: Family or business relationships with your officers and directors
      2a. Are any of the Board of Directors related to each other? Most PTA’s would check NO.
      2b. Is there a family or business relationship between your PTA and Board of Directors? Most
      PTA’s would check NO.
      2c. Are the Board of Directors related to any of the employees listed on line 1b or independent
      contractors listed on line 1c.? Most PTA’s would check NO.

      Line 3a: Average Hours Worked and Duties for All Names Listed on 1a, 1b, and 1c
      This information is included on question 1a if you use the sample heading that was provided for
      question 1a. You need to have an attachment that says: 3a. See attachment 1a.

      Line 3b: Common Control of All Names Listed on Lines 1a, 1b, and 1c
      A PTA would normally check NO.

      4. Compensation-Setting Practices
      Line 4a: Would normally check YES.
      On an attachment there would be this statement: “4a. See the WSPTA Bylaws on page 4, Article
      2 Section 1 (d).”
      Line 4b: Would normally check YES.
      Line 4c: Would normally check YES.
      Line 4d: Would normally check YES. On an attachment there would be this statement: 4d.
      Decisions are made by consensus and documented in our meeting minutes.
      Line 4e: Would normally check YES.
      Line 4f: Would normally check YES.

      5. “Conflict of Interest” Policy
      Line 5a: Check NO (If your PTA does not have a conflict of interest policy that is consistent with
      the sample the IRS provides on Pages 25 and 26 of IRS Instructions.) On an attachment there
      would be this statement: 5a See enclosed WSPTA Bylaws, Article 2, Section 1 (d) on page 4.
      Line 5b: On an attachment there would be this statement: 5b Affected parties must fully
      disclose their interest or conflict and must not participate in the board discussion or voting
      on the issue.
      Line 5c: On an attachment there would be this statement: 5c Affected parties must fully
      disclose their interest or conflict and must not participate in the board discussion or voting
      on the issue.

      6. Compensation to All Names Listed on Lines 1a, 1b and 1c
      Line 6a: Would normally check NO.
      Line 6b: Would normally check NO.

      7.  Purchase or Sell Goods, Services and Assets From Individuals Listed on Lines 1a, 1b,
          and 1c
      Line 7a: Would normally check NO.
      Line 7b: Would normally check NO.


Updated March 2009
      8.   Leases, Contracts, Loans, Other Agreements with Individuals Listed On Lines 1a, 1b
           and 1c
      Line 8a: Would normally check NO.
      If yes then you need to answer questions 8 b, c, d, e, and f.

      9. Leases, Contracts, Loans, Other Agreements with an Insider’s Business
      Line 9a: Would normally check NO.
      If yes then you need to answer questions 9 b, c, d, e, and f.




      Part VI: Your Members and Other Individuals, and
      Organizations That Receive Benefits from You
      Line 1a: Benefits to Individuals
      Describe any programs where you provide goods, services, or funds to individuals. This would
      include a scholarship program. Please refer to Part IV Narrative Description Of Your
      Activities in answering this question on your program that benefits children.

      Line 1b: Benefits to Organizations
      Describe any programs where you provide goods and services, or funds to organizations. An
      example would be donations for disaster relief organizations or help starting a new PTA. You
      would also list your “Restricted Donations” (we in the past were referring to the Grant
      Agreement Form) to your school district. Please refer to Part IV Narrative Description of Your
      Activities in answering this question on your program that benefits children.

      Line 2: Describe Your Membership Program
      Most PTAs would answer NO. If you answer YES, then you need to describe any benefits that
      only members receive. Send a list of your different membership levels and the benefits each
      membership level receives. Also include a sample membership flyer and a sample of membership
      envelope and a schedule of membership dues.

      Line 3: Related Parties to Individuals Listed on Part V, Lines 1a, 1b and, 1c
      A PTA would normally check NO.
      This would not include the children of the Board of Directors because all children of your school
      community would receive the same benefit form your PTA.

      Part VII: Your History
      Line 1: Successor Organization
      Most PTA’s would check NO

      Line 2: Late Filing
      Newer PTAs (incorporated less than 27 months) would answer NO to this question.
      PTAs changing from a 501 (c) (4) to a 501 (c) (3) organization would answer NO.

      A first time filing and have been incorporated more than 27 months would check YES. If this is
      your answer to Line 2, you need to complete Schedule E.

      Part VIII: Your Specific Activities

Updated March 2009
      Line 1: Support or Oppose a Candidate in Political Campaigns
      A PTA would check NO.
      If you answer YES, then your PTA may not be a 501(c) (3) organization because a 501 (c) (3)
      organization may NOT support or oppose a candidate for public office. This is also against the
      Washington State PTA Bylaws.

      Line 2a: Influence Legislation or Lobbying
      Check YES, if your PTA donates to a levy or bond fund or if your PTA has supported a bill or an
      initiative or sent a delegate to WSPTA Legislative Assembly in the past or plans to send a delegate
      in the future. It is best to check YES to this question because you might want to support a levy or
      bond issue in the future. On an attachment you will need to make a statement as this sample:
      Sample PTA’s attempts to influence legislation are not substantial part of our activities or budget.
      We have spent approximately _____% (if your percentage is higher than 5%, please call Pat
      Nelson at WSPTA office) of our volunteer time and our budget over the last four years in our
      efforts to influence legislation. Another sample statement might be: Our legislative activity has
      always been insubstantial. Less than 1%, 2%, 3%, 4%, or 5% of our volunteer time and expenses
      goes towards legislative activity.

      Line 2b: Election 501(h) by Filing Form 5768
      Check NO, if your legislative activity is insubstantial which is 5% or less of your volunteer time
      and expenses.
      If you check YES, then please call Pat Nelson at WSPTA Office for help with Form 5768.

      Line 3a: Gaming Activities (Gambling)
      Check Yes, if you do a raffle or a bingo. A raffle is a gambling activity. Describe these
      activities, including how often your bingo or other gaming activities are conducted, where they are
      conducted, and who conducts them. An example would be: Our PTA has a bingo at our carnival
      in October in the school gym. The workers are not compensated. You will also need to include a
      schedule of revenues received and expenses paid for the year. Include in expenses the dollar value
      of any prizes given to winners. This data will also need to be disclosed in Part IX, financial data.

      Line 3b: Contracts with Individuals or Organizations to Conduct Bingo or Gaming
      Most PTAs would answer NO.
      If you Answer YES, please follow IRS instructions on Page 5 of the 1023 Application.

      Line 3c: List the States and Local Jurisdictions
      You would answer Washington State and your local city or town.

      Line 4a: Fundraising
      Check YES and check the appropriate boxes that pertain to your PTA’s fundraising program. You
      would check the other box for fundraising activities like selling cookie dough or catalog sales.
      You need to attach a description of each fundraising program. Please refer back to Part IV,
      your Narrative Description of Your Activities; to make sure you cover each activity listed in Part
      IV.

      Line 4b: Contracts for Fundraising
      A PTA would normally check NO. If you check YES, please call Pat Nelson at the WSPTA
      office.

      Line 4c: Fundraising Activities for Another Organization
       A PTA would normally answer NO.

      Line 4d: Location of Fundraising Activities
      You would list Washington State and the name of your town or area. An example would be
      Tacoma in Pierce County.


Updated March 2009
      Line 4e: A Donor-Advised Fund
      A PTA would normally check NO. If you check YES, please call Pat Nelson at the WSPTA
      office.

      Line 5: Affiliated With a Governmental Unit
      A PTA would check NO.

      Line 6a: Economic Development
      Check NO.

      Line 7a: Develop
      Check NO.

      Line 7b: Manage
      Check NO.

      Line 7 c: Relationship Between Any Manager or Developer and Your PTA Board
      N/A

      Line 8: Joint Ventures
       A PTA would normally check NO. If you check YES, please call Pat Nelson at the WSPTA
      office.

      Line 9a: Childcare Organization
      Check NO and you do not answer questions 9b through 9d.


      Line 10: Intellectual Property
      Check NO. f you check YES then you need follow IRS instructions.

      Line 11: Non-cash Donations
      A PTA would normally check NO. If you check YES, please call Pat Nelson at the WSPTA
      office. If your PTA received non-cash donation for raffle, auction or door prizes.

      Line 12a: Foreign Country Operation
      Check NO and go to line 13a.

      Line 13a: Grants, Loans, or Other Distributions to Organization(s)
      A PTA would normally answer NO. If NO, go to line 14a.

      If you answer YES to 13a, because you have a judging and application process for your grant and
      scholarship programs for other organizations and answer questions 13b through 13g.

      Line 14a: Do you or will you make grants, loans other distributions to foreign organizations?
      Check NO and do not answer questions 14b through 14f.

      Line 15: A PTA would normally answer NO

      Line 16: Check NO.

      Line 17: Check NO.

      Line 18: Check NO.

      Line 19: Check NO.


Updated March 2009
      Line 20: Check NO.

      Line 21: Check NO.

      Line 22: Do or will you provide scholarships, fellowships, educational loans, or other grants
      to individuals? A PTA would normally answer NO because the monies given to a local school
      district are in the nature of a restricted donation not a grant according to IRS definition. (If you
      have questions or are not sure about your program, please call Pat Nelson at the WSPTA Office.)

      You would answer YES to Line22 if your PTA’s scholarship and grant programs have a judging
      and application process.

      If you checked YES, then you need to complete Schedule H, Section 1, lines 1a through 7 on
      page 25 of the 1023 Form. Do not complete Section II, of Schedule H lines 1a through 3
      because you are a Public Charity.



      Part IX: Financial Data
      A PTA would do cash accounting.
      A. Statement of Revenue and Expenses

      For purpose of this schedule, years in existence refer to completed tax years.

      1.   If in existence less than 5 years, complete the statement for each year in existence and provide
           projections of your likely revenues and expenses based on a reasonable and good faith
           estimate of your future finances for a total of :
           a. Three years of financial information if you have not completed one tax year, or
           b. Four years of financial information if you have completed one tax year.
      2.   If in existence 5 or more years, complete the schedule for the most recent 5 tax years. You
           will to provide a separate statement that includes information about the most recent t tax
           years because the data table in Part IX, has not been updated to provide for a 5th year.

      Line 1: Gifts, Grants and Contributions Received
      All donations and contributions and grants from other organizations and the “fair market value” of
      all donated items for your auction and door prizes

      Line 2: Membership Fees Received
      Enter the total amount that your PTA received in membership service fees. This includes the
      WSPTA portion and National PTA portion and council portion (if the PTA belongs to a council).

      Line 3: Gross Investment Income
      Enter all interest from your checking accounts, savings accounts and CDs.

      Line 4: Net Unrelated Business Income
      If your PTA has NO employees, then you would not have anything on this line.

      Line 5: Taxes Levied for Your Benefit
      A PTA would not have anything on this line.

      Line 6: Value of Services of Facilities Furnished by a Governmental Unit
      A PTA would not have anything on this line.

      Line 7: Any Revenue Not Otherwise Listed Above or in Lines 9-12
      A PTA would not have anything on this line.


Updated March 2009
      Line 8: Total of Lines 1 Through 7
      Add lines 1 through 7.

      Line 9: Gross Receipts from Admissions, Merchandise Sold or Services Performed in any
      Activity That Is Related to Your Exempt Purpose
      A PTA would enter income from the sale of yearbooks, book fairs, emergency preparedness
      supplies, cookie dough, catalog sales, and coupon books. As you can see, this line is just about
      all of your income for your PTA.

      Line 10: Total Lines 8 and 9

      Line 11: Gain or Loss on Sale of Capital Assets
      A PTA would not have anything on this line.

      Line 12: Unusual Grants
      A PTA would normally not have anything on this line.

      Line 13: Total Revenue. Add lines 10 through 12

      Line 14: Fundraising Expenses
      A PTA would enter the expenses for cookie dough and catalog sales and such events. You would
      list the cost of printing your flyer for your fundraising event and other fundraising expenses.

      Line 15: Contributions, Gifts, Grants (Scholarships) and Similar Amounts Paid
      If the PTA has a scholarship program (if you completed Schedule H) and gave to a disaster relief
      fund, these amounts would go on this line.

      Line 16: Disbursement to or for the Benefit of Members
      A PTA would not have anything on this line.

      Line 17: Compensation of Officers, Directors and Trustees
      A PTA would normally not have anything on this line.

      Line 18: Other Salaries and Wages
      A PTA would normally not have anything on this line.

      Line 19: Interest Expense
      A PTA would not have anything on this line.

      Line 20: Occupancy (Rent, Utilities, etc)
      A PTA would not have anything on this line.

      Line 21: Depreciation and Depletion.
      A PTA would only have depreciation on items of value of $1000 or more (popcorn machine) and
      depreciate 20% a year.

      Line 22: Professional Fees
      A PTA would enter the amount that they paid an independent contractor.

      Line 23: Any Expense not Otherwise Classified Such as Program Services. (Attach Itemized
      List)
      A PTA would enter all expenses that were for the benefit of children and your purpose,
      membership fees, and administrative expenses (insurance, incorporation renewal and charitable
      solicitation renewal). This would be grants to the school district, camps, book fairs, items to
      enhance the classroom and hospitality. Attach itemized list and this could be your year-to-


Updated March 2009
      date treasurer’s report from Column A of the Financial Data and yearend reports for
      columns B, C, and D.

      Line 24: Total Expenses.
      Add lines 14 through 23.

      B. Balance Sheet
      Complete the following for your current tax year’s information that is in column (a) of Statement
      of Revenues and Expenses on page 9 of this form. A PTA in the State of Washington has a fiscal
      year from July 1st to June 30th. Be sure to enter the year-end date of June 30, 20__ for the
      information provided.

      Line 1: Cash
      Enter all balances from your checking and savings accounts and petty cash and CDs.

      Line 2: Accounts Receivable
      Enter any payments from any individual or business. Most PTAs would have Zero on this line.

      Line 3: Inventories
      A sample would be your inventory for a school store.

      Lines 4, 5, and 7: Investment
      Most PTAs would enter Zero on these lines. Please refer to IRS Instructions on Pages 13 and 14
      for your determination.

      Line 6: Loans Receivable
      This would be personal or mortgage loans and most PTAs would have Zero.

      Line 8: Building and Equipment (Depreciable Assets).
      A PTA would enter any asset that has a value of $1000 or more. A sample might be a popcorn
      machine. A recommendation is to depreciate over a five year period at 20% a year. (Please call
      Pat Nelson at the WSPTA Off ice if you have any questions.)

      Line 9: Land
      A PTA would normally put Zero to this question.

      Line 10: Other Assets
      List any other assets that are not listed on line 1 through 9.

      Line 11: Total Assets
      (Add line 1 through 10.)

      Line 12: Accounts Payable
      A PTA would normally enter Zero.

      Line 13: Grants Payable
      Enter the total of any unpaid amount of grants and contributions that the PTA has made a
      commitment to pay to individuals or organizations. (An example would be any unpaid
      scholarships.)

      Line 14: Mortgages and Notes Payable
      A PTA would normally enter Zero.

      Line 15: Other Liabilities
      Enter the total amount of any other liabilities that are not reported on lines 12 through 14. A PTA
      would normally put Zero to this question.

Updated March 2009
      Line 16: Total Liabilities
      (Add lines 12 through 15.)

      Line 17: Total Fund Balances or Net Assets
      You would subtract line 16 from line 11.

      Line 18: Total Liabilities and Fund Balances or Net Assets
      (You would add lines 16 and 17.)

      Line 19: Substantial Changes in Assets or Liabilities
      Have there been any substantial changes in your PTA’s assets or liabilities since the end of the
      period shown in the Balance Sheet. A PTA would normally enter Zero.



      Part X: Public Charity Status
      This section is designed to determine if your PTA is a private foundation. Generally, if you
      receive broad financial support from the general public, you will not be considered to be a private
      foundation. It is in your best interest NOT to be classified as a private foundation.

      Part X, specific line instructions
      Line 1a: Typically, unless you don’t receive more than one-third of your revenues from the
      general public and your investment income is less than one-third of your total revenues, you
      should check line 1a “No” and proceed to line 5 g, h, or i.

      Line 5:
      Your choices here are between line 5, choices (g), (h) or (i).
      Select choice (g) if at least one-third of your support is from governmental agencies, the general
      public, or from other public charities. Does your PTA receive the majority of your income from
      donations and an auction? If this is how your PTA receives the majority of your income then you
      would check 5g.

      Alternatively, also select choice (g) if at least 10% of your total support is from governmental
      agencies, the general public, or from other public charities, AND you can meet the fact and
      circumstances test. See the instructions to Form 1023, Publication 557 and Treasury Regulations
      1.170A-9(e) (3) for more information on the facts and circumstances test.

      Select choice (h) if you normally receive more than one-third of your support from contributions,
      membership fees and gross receipts related to your exempt function (sale of year books and book
      fairs and sale of merchandise such as cookie dough sale and catalog sales), or a combination of
      these sources. You may not select choice (h) if more than one-third of your support is from gross
      investment income and net unrelated business income.

      If either choice (g) or (h) appears to apply, and you cannot decide which one is a good fit for your
      PTA, you may select choice (i) to have the IRS make the determination for you. A word of
      warning, however, letting the IRS make this choice may not be in your best interest. If you
      otherwise qualify, choice (h) appears to be your best choice.

      Line 6:
      In General: If your PTA/PTSA has been in existence less than 5 years do not answer 6b and 7.
      A PTA/PTSA will not complete question 6a.

      Because you are most likely to have selected choice (g), (h) or (i) to question 5, you must
      complete line 6b and 7 if you have been in existence for five or more years.

Updated March 2009
      A tax year is from July 1st to June 30th.

      Line 6b: Request for Definitive Ruling
      You will need to answer 6b (i) if you checked box 5g. Answer line 6 b (ii) if you checked box 5h.

      5g: If you check this box, then answer 6b (i) (a) and (b).
      6b (i) (a): Enter 2% of line 8, column (3) Part IX-A, Statement of Revenues and Expenses.
      6b (i) (b): Attach a list showing the name and amount contributed by each person, company, or
      organization whose gifts totaled more than the 2% amount. If the answer is “None,” check the
      box.

      5h: If you check this box, then answer 6b (ii) (a) and (b).
      6b (ii) (a): You will need to attach a list with the names of Board of Directors (elected positions
      and committee chairmen listed in your PTA’s Standing Rules) and their family members (who
      have paid membership fees). You would include the amount they paid for membership fees and
      any donations for all individuals you have listed for all the years listed on Part IX-A, statement of
      Revenues on page 9 of 1023 Form.
      6b (ii) (b): Most PTAs would check the box because they have not received $5000 or more from
      any individual or business.

      Line 7: Unusual Grants
      Normally, a PTA would answer NO.


      Part XI User Fee Information
      A check, payable to the United States Treasury, for the correct user fee, must
      accompany your application. The correct user fee is determined by your average annual gross
      receipts over a four year period. To determine how much this is, divide Part IX, line 10, column
      (e) by four.

          •    If this amount is $10,000 or under, then the User Fee is $300.00 and you would check the
               YES box. You would check the #2 box.
          •    If this amount is over $10,000, then the fee is $750.00 and you would check the NO box.
               You would check the #3 box.



This application must be signed and dated.

Reminder: send the completed Form 1023 Checklist (of two
pages) with your filled in application. Please, enclose Washington State
PTA Bylaws and Articles of Incorporation and Amendments with you Form 1023.



                          If you have questions or need additional help,
                            contact Pat Nelson at the State PTA Office
                             800-562-3804 or pnelson@wastatepta.org



Updated March 2009
      Schedule E. Organizations Not Filing Form 1023 Within
      27 Months of Formation

      A PTA who is currently a 501(c)(4) and changing to a
      501(c)(3) organization would complete the Schedule E.
      Line 1: NO

      Line 2a: Answer YES, if your gross receipts are $5000 or less and stop here.
               Answer NO, if your gross receipts are $5000 or more.

      Line 2b: Answer YES, if your gross receipts are $5000 or more and you are filing within 90 days
      of June 30th of the first year that the PTA grossed more than $5000. If “Yes”, stop here.
               Answer NO, if your gross receipts have been over $5000.00 and this filing is after
      September 30th of the first year that the PTA grossed more than $5000.

      Line 3a: NO, Washington State PTA does not have a group exemption.

      Line 4: Answer YES, if you were incorporated on or before October 9, 1969. Stop Here.
              Answer NO, if your PTA was incorporated after October 9, 1969.

      Line 5: Answer YES, for an extension of time and attach a statement with the below phrases that
      pertains to your PTA situation. You need to always include statement number 5. By answering
      yes to Line 5, you are asking for a Definitive Ruling and please refer to Part X, Line 6b.
               1. All volunteer organization
               2. No paid staff
               3. Officers change each year.
               4. Our Board was unaware that our PTA had not applied for 501(c) (3) status but once
                    the Board became aware of this oversight we have submitted this application.
               5. Our PTA has never supported a candidate for public office.
               6. Our legislative activity has always been insubstantial of less than ____% of our
                    volunteer time and expenses. Please refer to Part VIII, Line 2a. For the percentage
                    of your volunteer time and expenses.
               7. The only difference in our activities is that we will now be able to tell individuals
                    and businesses that their donations will be tax-deductible donations.
               If the answer was YES to Line 5 then do NOT answer lines 6, 7, or 8.
               Answer NO, if your PTA does not feel that they can ask for an extension of time of the
               27 months and that there will be significant change in your financial activity from your
               past financial history. Please answer lines 6, 7, and 8.

      Line 6a: Answer YES, if you answered NO to Line 5. By answering yes to Line 6, you will be
      asking for an Advance Ruling and please refer to Part X, Line 6a. If your PTA receives an
      Advance Ruling, then at the end of this period your PTA will need to complete the “Support
      Schedule for Advance Ruling Period” on your income from the advance ruling period. You are
      eligible for an advance ruling to be classified as a public charity from the postmark of your 1023
      application.

      Line 6b: Answer YES, if you anticipate significant changes in your sources of support in the
      future and you would answer Line 7.



Updated March 2009
      Line 7: Complete this item only if you answered “Yes” to line 6b. Include projected revenue for
      the first two full years following the current tax year. Call Pat Nelson if you have any questions
      or need help with Line 7.

      Line 8: If your PTA is already a 501(c) (4) organization, do not check this box. If your PTA is
      not a 501 (c) (4) organization and have been in existence for more than 27 months, then you
      would check this box and complete Page 1 of Form 1024, Application for Recognition of
      Exemption under Section 501(a). Attach the first page of the 1024 to this application.




Updated March 2009
                Schedule H. Organizations Providing Scholarships
                 A PTA would complete this schedule if their scholarship program has an application
                process, criteria that need to be meet and a judging process.

                Generally, distributions made to individuals may advance educational purposes if
                selection is made:
                    •   Scholarships are made in a non-discriminatory fashion in terms of racial
                        preference.
                    •   Scholarships are based on need and /or merit.
                    •    Scholarships are paid to a charitable class (children and youth are a charitable
                         class) in terms of being available to an open-ended group, rather than to pre-
                         selected individuals.
                Section 1: You need to answer questions 1a through 7 with very detailed
                description and documentation about your scholarship program.

                Line 2: You would answer YES. If you answer NO, explain how your will be able to
                demonstrate that your distributions serve exempt purpose.

                Section 2: Do not answer this section because your PTA is a Public
Charity.
If you need help with questions 1a through 7, please call Pat Nelson, at the WSPTA Office at (800)
562-3804.




Updated March 2009

								
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