Part I — 0121 Inst 1024-A (PDF)

Part I, Line	Part I, Identification of Applicant
1	Enter your complete name exactly as it appears in your organizing document, including amendments.
2	If you have an "in care of" name, enter it here; otherwise, leave this space blank.
3–9	Enter your complete address where all correspondence will be sent. If mail isn't delivered to your street address and you have a P.O. Box, list your P.O. Box information instead of your street address. For a foreign address, enter your province or state and foreign postal code where indicated.
10	Employer Identification Number. You must have your own EIN. Enter the 9-digit EIN the IRS assigned to you. If you don't have an EIN, you must apply for one before submitting your application. You can find out how to apply for an EIN by visiting IRS.gov and searching for “apply for an EIN.” You may apply for an EIN online or by fax or mail. International applicants may call 267-941-1099 (toll call). TIP Don't apply for an EIN more than once. If you’re unsure of your EIN or whether you have one, call 877-829-5500 for assistance. CAUTION! Don’t use the EIN of a related or other organization.
11	Month Tax Year Ends. Select the month your tax year (annual accounting period) ends. Your tax year is the 12-month period on which your annual financial records are based. TIP Check your bylaws or other rules of operation for consistency with the tax year you enter here.
12	Person to Contact. Enter the name and title of the person you want us to contact if we need more information. The person to contact may be an officer, director, trustee, or other individual who is permitted to speak with us according to your bylaws or other rules of operation. Your person to contact may also be an authorized representative, such as an attorney, certified public accountant, or enrolled agent, for whom you’re submitting a completed Form 2848 with Form 1024-A.
13	Provide a daytime telephone number for the contact listed on Line 12.
14	You may provide a fax number for the contact listed on Line 12.
15	Pay.gov will populate this field with the current user fee for filing Form 1024-A.
16	If you have a website, enter its complete web address. Also, list any websites maintained on your behalf. The information on your website should be consistent with the information in your Form 1024-A.
17	Officers, directors, and trustees. Enter the full names, titles, and mailing addresses of your officers, directors, and/or trustees. You may use the organization's address for mailing. If you have more than five, check the box provided to add more officer, director, and/or trustee information. The person who is signing Form 1024-A must be listed within the first five entries of Line 17.

-6- Instructions for Form 1024-A