Part VIII. Signature

Signature Requirements

An officer, director, trustee, or other official who is authorized to sign for the

organization must sign Form 1024. The signature must be accompanied by the title or authority of the signer and the date.

The person signing Form 1024

TIP must be listed as an officer,

director, or trustee within the first five entries of Part I, Line 17.

Upload Checklist

Documents to upload. Check the boxes to indicate which documents are included in the file you upload with your application.

For your application to be complete, you must upload a copy of your organizing document and any amendments to it along with a copy of your bylaws, if adopted. The other documents in the upload checklist are optional unless required for a complete response to a question.

Put your name and EIN on each page of your supplemental response and identify the Part and Line number to which the information relates.

Pay.gov can accommodate only one uploaded file. Consolidate your attachments into a single PDF file not to exceed 15MB.

Paperwork Reduction Act Notice. We ask for the information on this form to carry out the Internal Revenue laws of the United States. If you want your

Taxpayer Burden for Exempt Organizations

Learning about Preparing and the law or the sending the form Form 1024 Recordkeeping form to the IRS Parts I–III 26 hr., 1 min. 3 hr., 2 min. 5 hr., 35 min. Part IV 1 hr., 40 min. 47 min. 51 min. Sch. A 2 hr., 52 min. 18 min. 21 min. Sch. C 57 min. 12 min. 13 min. Sch. D 4 hr., 4 min. 18 min. 22 min. Sch. E 1 hr., 40 min. 18 min. 20 min. Sch. F 2 hr., 23 min. 6 min. 8 min. Sch. G 1 hr., 54 min. 6 min. 7 min. Sch. H 1 hr., 40 min. 6 min. 7 min. Sch. I 5 hr., 30 min. 30 min. 36 min. Sch. J 2 hr., 23 min. 6 min. 8 min. Sch. K 3 hr., 21 min. 6 min. 9 min.

Comments and suggestions. If you have comments concerning the accuracy of these time estimates or suggestions for making Form 1024 simpler, we would be happy to hear from you.

You can send us comments from IRS.gov/FormComments .

Or you can write to the

Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave. NW, IR-6526 Washington, DC 20224

Don’t send Form 1024 to this address. Instead, see Where To File, earlier.

Organizations described in section 501(c)(2) or 501(c) (25) --Title holding corporations or trusts

Line 1. Provide the requested information on each organization for which you hold title to property. Also indicate the number and types of shares of your stock that are held by each.

Line 2. Describe the property to which you hold or will hold title.

Line 3. Answer “Yes” if you turn over the entire amount of your income, less expenses, to your parent organization. The type of distribution is immaterial. It could be termed a dividend on stock or given some other description. What is important is that the income must be distributed to the exempt organization. A mere obligation to use the income for the parent's benefit doesn't satisfy this requirement.

-10- Instructions for Form 1024

members, interest-free loans, assigning exclusive franchise areas, operation of a real estate multiple listing system, or operation of a credit reporting agency.

Line 4. Answer “Yes” if you restrict or will restrict your membership to individuals, firms, associations, and/or corporations, each representing a different trade, business, occupation, or profession, and organized for the purpose of exchanging information on business prospects. Explain in detail.

Line 5. Answer “Yes” if you market or will market a specific product(s) and/or brand(s) within an industry. Identify the specific product(s) and/or brand(s) and explain in detail how you market them.

Line 6. Answer “Yes” if you limit or will limit your activities to users of a specific product within an industry. Explain in detail.

Line 7. Answer “Yes” if you operate or will operate a listing or referral system. Explain in detail.

Organizations described in section 501(c)(7) --Social clubs

Line 1. Answer “Yes” if personal contact, commingling, and fellowship exist among members. If not, explain.

Line 2. Answer “Yes” if you conduct activities such as take-out food sales, liquor sales, operation of a gas station, parking garage, barber shop, etc. Describe these activities and indicate the percentage of your time and resources devoted to them.

Line 3. Answer “Yes” if you have entered or will enter into any contract or agreement for the management or operation of your property and/or activities, such as restaurants, pro shops, lodges. Describe any written or oral arrangements that you made or intend to make, with whom you have or will have such arrangements, how the terms are or will be negotiated at arm's length, and how you determine you pay no more than fair market value or you are paid at least fair market value.

Line 4. Answer “Yes” if gross receipts from your activities will include amounts paid by non-members for goods and services. Explain in detail.

Line 5. Answer “Yes” if non-members, other than guests of members, are permitted or will be permitted to use the club facilities or participate in or attend any functions or activities conducted by you. Describe the functions or activities in which there has been or will be non-member participation or admittance.

Often, an exempt parent occupies realty that the title-holding company owns. The exempt parent generally doesn't pay rent. In this situation, the statutory requirement that income be paid over to the parent is satisfied if the title-holding company turns over whatever income is available.

If you answer “No,” state the purpose for which the excess is or will be retained.

Line 4. Answer “Yes” if you engage or will engage in any activities other than holding title to property and collecting income therefrom. Describe the activities in detail.

Line 5. Check the appropriate box below to indicate the section under which you are applying.

Line 5a. Answer “Yes” if your shareholders or beneficiaries are permitted to dismiss your investment adviser upon a majority vote. If you answer “No,” explain why your shareholders or beneficiaries aren't permitted to dismiss your investment adviser upon a majority vote of your shareholders or beneficiaries.

Line 5b. Answer “Yes” if your shareholders or beneficiaries are permitted to terminate their interest in you by selling or exchanging their stock to any organization described in section 501(c) (25)(C) so long as the sale or exchange does not increase the number of your shareholders or beneficiaries above 35, or by having their stock or interest redeemed by you after they provide you 90 days notice.

If you answer “No,” explain why your shareholders or beneficiaries aren't permitted to terminate their interest in you in such a way.

Line 5c. Answer “Yes” if you hold or will hold interests in partnerships or real estate trusts. Describe the interests in detail.

Line 5d. Answer “Yes” if you make or will make mortgage loans. Describe the loans in detail.

Line 5e. Answer “Yes” if you hold property through a corporation, partnership, or trust. Identify the corporation, partnership, or trust and describe the property held.

Organizations described in section 501(c)(5) --Labor, agricultural, or horticultural organizations

Line 1. Select your type of organization from the list.

A labor organization is an association of workers who have combined to protect and promote the interests of their

members by bargaining collectively with their employers to secure better working conditions, wages, and similar benefits.

Agricultural and horticultural organizations are connected with raising livestock, cultivating land, raising and harvesting crops or aquatic resources, cultivating useful or ornamental plants, and similar pursuits.

Organizations described in section 501(c)(6) --Business leagues, chambers of commerce, etc.

Line 1. Select your type of organization from the list.

A business league, in general, is an association of persons having some common business interest, the purpose of which is to promote that common interest and not to engage in a regular business of a kind ordinarily carried on for profit. Trade associations and professional associations are considered business leagues.

A chamber of commerce is usually composed of the merchants and traders of a city.

A board of trade often consists of persons engaged in similar lines of business. For example, a nonprofit organization formed to regulate the sale of a specified agricultural commodity to assure equal treatment of producers, warehouse workers, and buyers is a board of trade.

Chambers of commerce and boards of trade usually promote the common economic interests of all the commercial enterprises in a given trade community.

A real estate board consists of members interested in improving the business conditions in the real estate field. It isn't organized for profit and no part of the net earnings inures to the benefit of any private shareholder or individual.

The Internal Revenue Code specifically defines professional football leagues as exempt organizations under section 501(c)(6). They are exempt whether or not they administer a pension fund for football players.

Line 2. Describe your members' common business interests.

Line 3. Describe any services you perform or will perform for members or others. You must show that your purpose is the improvement of business conditions. This isn't established by evidence of particular services that provide a convenience or economy to individual members in their businesses, such as advertising that carries the name of

Instructions for Form 1024 -11-

or whether you are requesting an earlier effective date.

Line 7b. You may be eligible for consideration for relief from the requirement that you file Form 1024 within 27 months of formation if you can establish that you acted reasonably and in good faith, and that granting an extension won’t prejudice the interests of the government

Describe in detail your reasons for filing late, how you discovered your failure to file, any reliance on professional advice or advice from the IRS, and any other information you believe will support your request for relief. Also, you may want to provide a comparison of (1) what your aggregate tax liability would be if you had filed this application within the 27-month period with (2) what your aggregate liability would be if you were exempt as of your formation date.

We may consider the following factors.

• You failed to file because of intervening events beyond your control.

• You exercised reasonable diligence, but you weren’t aware of the filing requirements. (The complexity of your filing and experience in these matters may be taken into consideration.)

• You reasonably relied on written advice from us.

• You reasonably relied on the advice of a qualified tax professional who failed to file or advise you to file Form 1024.

• You filed the required Form 990 series returns consistent with your requested status.

Organizations described in section 501(c)(12)—Benevolent life insurance associations, mutual ditch or irrigation companies, mutual or cooperative telephone companies, or like organizations

Line 1. Select your type of organization from the list.

A benevolent life insurance association of a purely local character is one that confines its business activities to a particular community, place, or district, irrespective of political subdivisions.

Ditch and irrigation companies, telephone companies, electric companies, and “like organizations” that seek exemption under section 501(c)(12) must be organized and operated as mutual or cooperative organizations.

Line 2. Answer “Yes” if your business activities will be confined to a particular

Line 6. Enter the figure for the current year and each of the prior tax years.

Line 7. Enter the figure for the current year and each of the prior tax years.

Line 8. Answer “Yes” if your charter, bylaws, other governing instrument, or any written policy statement contain any provision that provides for discrimination against any person on the basis of race, color, or religion. Identify where this provision is located; whether or not it will be kept; and if you have such a provision that will be repealed, deleted, or otherwise stricken from your requirements, state when this will be done.

Line 9. Answer “Yes” if you restrict or will restrict your membership to members of a particular religion. Explain in detail.

Line 9a. Answer “Yes” if you are an auxiliary of a section 501(c)(8) fraternal beneficiary society. Provide the name and EIN of the organization.

Line 9b. Answer “Yes” if you, in good faith, limit your membership to the members of a particular religion in order to further the teachings or principles of that religion and not to exclude individuals of a particular race or color.

Organizations described in section 501(c)(8) or 501(c) (10) --Fraternal beneficiary societies, orders, or associations. Unlike organizations exempt under section 501(c)(8), organizations exempt under section 501(c)(10) are not “beneficiary” societies; that is, they may not provide for the payment of life, sick, accident or other benefits to their members. Ensure your selection in Part II is consistent with your operations.

Line 1. Operating under the lodge system means carrying on activities under a form of organization that is composed of local branches, chartered by a parent organization, largely self-governing, and called lodges, chapters, or the like.

Line 2. Answer “Yes” if you operate or will operate for the exclusive benefit of the members of an organization operating under the lodge system. Explain in detail.

Line 3. Answer “Yes” if you are a subordinate or local lodge, etc. List the name, address, and EIN of your parent organization.

Line 4. Answer “Yes” if you are a parent or grand lodge. List the name, address, and EIN of each subordinate lodge in active operation.

Organizations described in section 501(c)(9) --Voluntary employees' beneficiary associations

Line 1. Describe in detail the benefits you provide or will provide. For each benefit include the account, duration, eligibility requirements, and the circumstances that will entitle a recipient to payment of the benefit.

Line 2. Answer “Yes” if you provide or will provide deferred compensation benefits, property or malpractice insurance, loans (other than loans at times of disaster or whole life insurance policy loans), savings plans, reimbursement of commuting expenses, or benefits similar to those provided by a pension, stock bonus or profit sharing plan. Describe these benefits in detail.

Line 3. Provide the requested information for each plan as of the last day of the most recent plan year. If you have more than one plan, at the end of this form, upload a separate schedule.

Line 4. State the number of persons, if any, other than employees and their dependents (for example, the proprietor of a business whose employees are members of the association) who are entitled to receive benefits.

Line 5. Answer “Yes” if any employees or classes of employees are entitled to benefits to which other employees or classes of employees are not entitled. Explain in detail.

Line 6. Answer “Yes” if you are organized under the terms of a collective bargaining agreement. At the end of this form, upload a current copy.

Line 7. Use the formation date you listed in Part II, line 2, and the date you will submit this electronic form and required user fee payment to determine whether you’re submitting this application within 27 months from the month in which you were formed.

Line 7a. Generally, if you didn't file Form 1024 within 27 months of formation, the effective date of your exempt status will be the date you filed Form 1024 (submission date). We may grant requests for an earlier effective date when there's evidence to establish you acted reasonably and in good faith, and the grant of relief won't prejudice the interests of the government. See Rev. Proc. 2021-5 (updated annually) for more information.

Select the appropriate box to indicate whether you accept the submission date as the effective date of your exempt status

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ownership in the corporation and share in the earnings.

Line 11. Answer “Yes” if you allow or will allow individuals who aren’t members to be shareholders. Explain in detail.

Line 12. If you answer “No,” explain in detail why you do not or will not ensure that loans to members benefit the borrower and meet their needs.

Line 13. Answer “Yes” if you make or will make loans to individuals who aren’t members. Explain in detail.

Line 14. Answer “Yes” if you advertise or will advertise to individuals who aren’t members. Explain in detail.

Line 15. Answer “Yes” if you are a mutual fund organized before September 1, 1957.

Line 15a. Answer “Yes” if you provide reserve funds for-- and insurance of shares or deposits in-- a domestic building and loan association, cooperative bank without capital stock organized and operated for mutual purposes and without profit, mutual savings bank not having capital stock represented by shares, or a mutual savings bank described in section 591(b).

Line 15b. Select the type of organization for which you provide reserve funds and insurance of shares or deposits.

Line 15c. Provide the name of the organization for which you provide reserve funds and insurance of shares or deposits.

Line 15d. Answer “Yes” if 85% or more of your income is attributable to providing reserve funds and to investments.

If you answer “No,” specify the percentage of your income that is attributable to providing reserve funds and to investments.

Organizations described in section 501(c)(17)—Trusts providing for the payment of supplemental unemployment compensation benefits

Line 1. A full description of the supplemental unemployment benefits available to the participants must accompany your application, showing the amount, duration, eligibility requirements, and the circumstances that will entitle a recipient to payment of the benefit.

A copy of your plan documents that describe such benefits and the terms and conditions of eligibility for each benefit should be uploaded at the end of the form.

Line 2. Answer “Yes” if you provide or will provide benefits for individual proprietors, partners, or self-employed persons under the plan. Explain in detail.

community, place, or district. If “No,” explain in detail.

Line 3. List the counties or geographical region from which your members are or will be accepted.

Line 4. Answer “Yes” if members have democratic control. If “No,” explain in detail.

Democratic Control means you periodically hold democratically conducted meetings with members. Election of officers must be on a one member, one vote basis. Meetings must have a quorum of members in attendance or voting by proxy.

Line 5 Answer “Yes” if the rights and interests of members in your annual savings are determined in proportion to their business with you.

Line 6. Answer “Yes” if you keep the records necessary to determine at any time each member’s rights and interests in such savings, including assets acquired with the savings.

Line 7. Answer “Yes” if the rights and interests of members are forfeited upon termination of membership. Explain in detail.

Line 8. Answer “Yes” if you receive or will receive at least 85% of your income from amounts collected from members for the sole purposes of meeting losses and expenses. If “No,” explain in detail.

Organizations described in section 501(c) (13)—Cemeteries, crematoria, and like corporations

Line 1. Answer “Yes” if you are claiming exemption as a perpetual care fund for an organization described in section 501(c) (13).

Line 1a. Answer “Yes” if the cemetery organization, for which funds are held, has established exemption under section 501(c)(13). If “No,” explain in detail.

Line 1b. Answer “Yes” if your funds are devoted exclusively to the perpetual care and maintenance of the non-profit cemetery as a whole. If “No,” explain in detail.

Line 2. Answer “Yes” if you operate or will operate a mortuary. Explain in detail.

Line 3. Answer “Yes” if you engage or will engage in land sale agreements, percentage-of-sales land sale agreements, or other similar financial arrangements. Describe in detail any written or oral arrangements that you made or intend to make, with whom you have or will have such arrangements, how

the terms are or will be negotiated at arm's length, and how you determine you pay no more than fair market value or you are paid at least fair market value.

Line 4. Answer “Yes” if you currently, or will, own, operate, or maintain a cemetery for pets. Explain in detail.

Organizations described in section 501(c)(14)—Credit Unions

Line 1. Answer “Yes” if you are formed under a state credit union law.

Line 2. Select the state credit union law under which you are organized and operated from the drop down menu.

Line 3. Answer “Yes” if you are being operated under uniform bylaws adopted by the state you selected on Line 3a.

If you answer “No,” explain in detail the rules and regulations under which you are operated.

Line 4. Answer “Yes” if you comply or will comply with the state credit union law requirements, including their purposes, security, and rate of interest charged thereon, in making loans.

If you answer “No,” explain in detail why you do not or will not comply with state credit union law requirements.

Line 5. Answer “Yes” if you limit or will limit your investments to securities which are legal investments for credit unions under the state credit union law.

If you answer “No,” explain in detail why you do not or will not comply with state credit union law requirements.

Line 6. Answer “Yes” if you distribute or will distribute dividends on shares, if any, as prescribed by the state credit union law.

If you answer “No,” explain in detail why you do not or will not comply with state credit union law requirements.

Line 7. Answer “Yes” if you are operated for the mutual benefit of your members.

Line 8. Answer “Yes” if your members share a common bond such as association, occupation, or residence. Describe the common bond in detail.

Line 9. Describe how your governing board and officers are selected, including where (if applicable) this information is in your governing document, bylaws, or other internal rules and regulations.

Line 10. Answer “Yes” if you issue or will issue stock as a means of indicating ownership by your members or others. Describe the provisions for the issuance of stock to shareholders that would take

Instructions for Form 1024 -13-

Enter the name, address, and EIN of the post or organization.

Line 2a. Answer “Yes” if you are affiliated with and organized according to the bylaws and regulations formulated by such an exempt post or organization. A copy of such bylaws or regulations should be uploaded at the end of this form.

Line 2b. Enter the total number of your members.

Line 2c. Enter the number of your members that are themselves past or present members of the Armed Forces of the United States, or are their spouses, or persons related to them within two degrees of blood relationship. (Grandparents, brothers, sisters, and grandchildren are the most distant relationships allowable.)

Line 2d. Answer “Yes” if all of your members are themselves members of a post or organization, past or present members of the Armed Forces of the United States, spouses of members of such a post or organization, or related to members of such a post or organization within two degrees of blood relationship.

Line 3. Answer “Yes” if you are a trust or foundation organized for the benefit of an exempt post or organization of past or present members of the Armed Forces of the United States.

Line 3a. Answer “Yes” if your corpus or income be used solely for the funding of such an exempt organization (including necessary related expenses). If not, answer “No” and explain.

Line 3b. Answer “Yes” if you are formed for charitable purposes and your organizational document contain a proper dissolution provision as described in section 1.501(c)(3)-1(b)(4) of the Income Tax Regulations.

Line 4. Answer “Yes” if you currently, or will, (a) rent your facilities to the general public; (b) make your facilities, such as bar and dining facilities, open to the general public; (c) sell liquor and/or food to members and/or the general public for consumption off premises; or (d) conduct gaming activities with the general public. Explain in detail, including the percentage of your time and resources devoted to such activities.

Organizations described in section 501(d)—Religious and apostolic organizations

Line 1. Answer “Yes” if you are organized for the purpose of operating a communal religious community where members live a communal life following your tenets and teachings.

Line 3. Provide the requested information for each plan as of the last day of the most recent plan year and enter that date in the space provided. If you have more than one plan, at the end of this form, upload a separate schedule.

Line 4. Answer “Yes” if the creator of the trust or a contributor to the trust; a brother or sister (whole or half-blood), a spouse, an ancestor, or a lineal descendant of such a creator or contributor; or a corporation controlled directly or indirectly by such a creator or contributor has or will (a) borrow or receive any part of the trust’s income or corpus, (b) receive any compensation for personal services, (c) obtain any part of the trust’s services, or (d) sell or purchase any securities or other properties from or to the trust.

Line 5. Use the formation date you listed in Part II, line 2, and the date you will submit this electronic form and required user fee payment to determine whether you’re submitting this application within 27 months from the month in which you were formed.

Line 5a. Generally, if you didn’t file Form 1024 within 27 months of formation, the effective date of your exempt status will be the date you filed Form 1024 (submission date). We may grant requests for an earlier effective date when there’s evidence to establish you acted reasonably and in good faith, and the grant of relief won’t prejudice the interests of the government. See Rev. Proc. 2021-5 (updated annually) for more information.

Select the appropriate box to indicate whether you accept the submission date as the effective date of your exempt status or whether you are requesting an earlier effective date.

Line 5b. You may be eligible for consideration for relief from the requirement that you file Form 1024 within 27 months of formation if you can establish that you acted reasonably and in good faith, and that granting an extension won’t prejudice the interests of the government. Describe in detail your reasons for filing late, how you discovered your failure to file, any reliance on professional advice or advice from the IRS, and any other information you believe will support your request for relief. Also, you may want to provide a comparison of

1. What your aggregate tax liability would be if you had filed this application within the 27-month period with

2. What your aggregate liability would be if you were exempt as of your formation date.

We may consider the following factors.

• You failed to file because of intervening events beyond your control.

• You exercised reasonable diligence, but you weren’t aware of the filing requirements. (The complexity of your filing and experience in these matters may be taken into consideration.)

• You reasonably relied on written advice from us.

• You reasonably relied on the advice of a qualified tax professional who failed to file or advise you to file Form 1024.

• You filed the required Form 990 series returns consistent with your requested status.

Organizations described in section 501(c)(19)—A post, organization, auxiliary unit, etc., of past or present members of the Armed Forces of the United States

Line 1. Answer “Yes” if you are a post or organization of past or present members of the Armed Forces of the United States.

Line 1a. Enter the total number of your members.

Line 1b. Enter the number of your members that are present or former members of the U.S. Armed forces.

Line 1c. Enter the total number of your members that are cadets (include students in college or university ROTC programs or at armed services academies only), or spouses, widows, or widowers of cadets or past or present members of the U.S. Armed Forces.

Line 1d. Answer “Yes” if you have a membership category other than the ones asked about above. Describe other membership categories and state the number of members in each category.

Line 1e. Answer “Yes” if you wish to apply for a determination that contributions to your organization are deductible by donors.

Line 1f. Enter the number of your members from line 1b that are war veterans. (A war veteran is a person who served in the Armed Forces of the United States during the following periods of war: April 21, 1898, through July 4, 1902; April 6, 1917, through November 11, 1918; December 7, 1941, through December 31, 1946; June 27, 1950, through January 31, 1955; August 5, 1964, through May 7, 1975; and August 2, 1990, through a future date to be set by law or Presidential Proclamation.)

Line 2. Answer “Yes” if you are an auxiliary unit or society of a post or organization of past or present members of the Armed Forces of the United States.

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accounting period and ending on any day which is within 60 days of the date of the application. If the date of the application is less than 60 days after the first day of the current accounting period, no information is required for the current year.

Requested information is required for the 2 preceding years regardless of the current year requirement. Please note that if no information is required for the current year, the preceding years information period can end on any day which is within 60 days of the date of the application.

Line 17. Enter the value of agricultural products marketed or handled for members and non-members below:

Line 17a. Members – Note: If it is necessary to own one or more shares of stock in order to become a member, include only the amount of business transacted with persons actually owning the required number of shares.

Line 17a.1 List the amount actually produced by members.

Line 17a.2 List the amount not actually produced by members but marketed by them through you

Line 17b.1 Non-members

Line 17b.2 List the amount not actually produced by non-members but marketed by them through you

Line 17c. List the amount by nonproducers (purchased from nonproducers for marketing by you)

Line 18. Enter the value of supplies and equipment purchased for or sold to members and non-members below:

Line 18a. List the amount from members who were producers Note: If it is necessary to own one or more shares of stock in order to become a member, include only the amount of business transacted with persons actually owning the required number of shares.

Line 18b. List the amount from non-members who were producers

Line 18c. List the amount from members and non-members who were not producers

Line 19. List the amount of business done with the United States Government or any of its agencies

Line 20. Answer “Yes” if all the net earnings (after payment of dividends, if any, on capital stock) for the years shown on lines 17-19 were distributed as patronage dividends. If your net earnings were not distributed as patronage dividends, also indicate whether they were apportioned on the records to all patrons on a patronage basis.

Line 2. Answer “Yes” if you maintain a common or community treasury.

Line 3. Answer “Yes” if all your members live in a communal manner.

Line 4. Answer “Yes” if your members are permitted to own, in their own names, any real or personal property.

Line 5. Answer “Yes” if your members are required to furnish their own support (food, clothing, and shelter).

Line 6. State your membership requirements, the method of member admission, members’ right to property owned at the time they’re admitted and terminating members’ rights to share in the organization’s property, or to a return of any property contributed.

Organizations described in section 521 – Farmers' Cooperative Associations

Line 1. Complete the table. Show the number of shares of each class of capital stock currently outstanding, if any, the value of the consideration for which it was issued, and the rate of dividend paid.

Line 2. Complete the table. Show the number of shares of capital stock (other than non-voting preferred) owned by current and active producers, inactive producers, and non-producers.

The term “producer” means an individual or corporation engaged in farming as a business receiving income based on farm production rather than fixed compensation. For example, a corporation leases its land to a tenant farmer who agrees to pay a rental fee based on a percentage of the farm crops produced. Both the landowner and the tenant farmer qualify as producers.

“Current and active” producers are patrons of a cooperative who market more than 50% of their products or purchase more than 50% of their supplies and equipment through the cooperative during the cooperative's tax year.

Line 3. Answer “Yes” if you issue or will issue non-voting preferred stock. Explain in detail whether the owners, upon dissolution or liquidation, may share in the profits of the association beyond fixed dividends.

Line 4. Answer “Yes” if you make or will make any provisions for retiring the voting stock held by a non-producer. Explain in detail.

Line 5. Enter the legal rate of interest in the state where you are located. If the state in which you are located differs from

the state in which you are incorporated, enter the legal rate of interest in the state of your incorporation.

Line 6. Answer “Yes” if you are required by state law to accumulate and maintain reserves. State the names and purposes of the reserves and specify the amounts of each.

Line 7. Answer “Yes” if you maintain or will maintain any reserves other than those required by state law. State the names and purposes of the reserves and specify the amounts of each.

Line 8. Describe who is accorded voting rights in the cooperative and how many votes one person may have. If a person may be entitled to more than one vote, explain in detail how voting rights are acquired.

Line 9. Answer “Yes” if you are a federated cooperative.

Line 10. Answer “Yes” if all your member cooperatives are exempt under section 521.

Line 11. Answer “Yes” if the nonexempt member cooperatives have the same annual accounting period as you. If “No,” describe the method that you use or will use to provide a common or comparable unit of time for analyzing and evaluating your operations and those of your members.

Line 12. Answer “Yes” if you do business with or will do business with both members and non-members. Explain in detail.

Line 13. Answer “Yes” if you pay or will pay patronage dividends. Explain in detail whether they will be paid to members and non-members on the same basis.

Line 14. Answer “Yes” if you allocate or will allocate patronage dividends based on an obligation in existence before you received the amounts allocated. Explain the obligation in detail.

Line 15. Explain how distribution is or will be made of the proceeds of products marketed for members and non-members. Also, if you operate on a basis of allocated units (i.e., functional, departmental, etc.), explain how losses are or will be treated.

Line 16. Explain how you charge for supplies and equipment purchased for members and non-members.

Line 17 – 19. The information requested on lines 17 through 19 must be completed for the current year and each of the 2 immediately preceding years (or for the time you have existed if less than 3 years). The requested information for the current year must cover the period beginning on the first day of your established annual

Instructions for Form 1024 -15-

Appendix A: National Taxonomy of
Exempt Entities (NTEE) Codes

Appendix A: National Taxonomy of
Exempt Entities (NTEE) Codes

Appendix A: National Taxonomy of
Exempt Entities (NTEE) Codes

Appendix A: National Taxonomy of
Exempt Entities (NTEE) Codes

Appendix A: National Taxonomy of
Exempt Entities (NTEE) Codes

Appendix A: National Taxonomy of
Exempt Entities (NTEE) Codes

Appendix A: National Taxonomy of
Exempt Entities (NTEE) Codes

-16-

Appendix A: National Taxonomy of Exempt Entities (NTEE) Codes (Continued)

Human Services
Code
P01
Alliances & Advocacy
P02
Management & Technical
Assistance
P03
Professional Societies &
Associations
P05
Research Institutes & Public
Policy Analysis
P11
Single Organization Support
P12
Fundraising & Fund Distribution
P19
Support N.E.C.
P20
Human Service Organizations
P21
American Red Cross
P22
Urban League
P24
Salvation Army
P26
Volunteers of America
P27
Young Men’s or Women
Associations
P28
Neighborhood Centers
P29
Thrift Shops
P30
Children & Youth Services
P31
Adoption
P32
Foster Care
P33
Child Day Care
P40
Family Services
P42
Single Parent Agencies
P43
Family Violence Shelters,
Services
P44
In-Home Assistance
P45
Family Services for Adolescent
Parents
P46
Family Counseling
P47
Pregnancy Centers
P50
Personal Social Services
P51
Financial Counseling
P52
Transportation Assistance
P58
Gift Distribution
P60
Emergency Assistance
P61
Travelers’ Aid
P62
Victims’ Services
P70
Residential Care & Adult Day
Programs
P71
Adult Day Care
P73
Group Homes
P74
Hospices
P75
Supportive Housing for Older
Adults
P76
Homes for Children &
Adolescents
P7A
Residential Intellectual &
Developmental Disability
Facilities (Group Homes,
Intermediate Care Facilities &
Hospitals)
P80
Centers to Support the
Independence of Specific
Populations
P81
Senior Centers
P82
Developmentally Disabled
Centers
P83
Womens’ Centers
P84
Ethnic & Immigrant Centers
P85
Homeless Centers
P86
Blind & Visually Impaired
Centers
P87
Deaf & Hearing Impaired Centers
P88
LGBT Centers
P99
Human Services N.E.C.

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Appendix A: National Taxonomy of Exempt Entities (NTEE) Codes (Continued)

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