We Need Help with the IRS 501c3 Application (Form 1023) 501c3 Tax-Exempt Status This is for groups who have already formed a state nonprofit corporation and have an EIN. Please advise if you need help drafting bylaws and a conflict of interest policy - we'd love to help. General InformationName* First Name Last Name Contact Phone*Email* Full Legal Name of NonprofitThis is the nonprofit corporation's formal, legal name on your organizing document -- the Certificate of Formation with your Secretary of State.What date the nonprofit became a nonprofit corporation or was formed? This is the date file stamped by the Secretary of State.The principal address of the nonprofit Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Mission/Purpose. In a sentence or two, please describe the specific purpose for which your nonprofit is being formed.*Describe the organization’s reason for existing and describe the overall purpose of the organization. It should include things like who it will serve and what it will accomplish. This may be the organization's mission statement. You can learn more about drafting a mission statements here. http://www.cullinanelaw.com/what-is-a-mission-statement/ **WE CAN WORK ON THIS TOGETHER, IF YOU DON'T HAVE A MISSION STATEMENT YET.**What activities will you undertake?What are the goals of the organization and what activities will it undertake? There may be more than one activity. For EACH activity, please be as specific as you can. It may help to answer the following questions for each activity. (1) What does the activity entail? (2) What are you trying to do? (3) How will you do it? (4) Where is the activity conducted? (5) When compared will all of the nonprofit's activities, what percent of time will be spent on each activity? (6) Who may participate in the activity? (7) How are the participants selected? (8) Is the activity advertised to the public? ANY other details you can send us will be great. **IF YOU DON'T HAVE THIS YET - THAT'S OKAY. WE'LL HELP YOU WITH IT. If you have this information written elsewhere, please feel free send us a copy if that is easier.**Financial InformationHow will your organization be supported financially? Do you have a plan for fundraising? What are your anticipated funding sources?Board of DirectorsMost states require three directors who are not related by family or business. To learn more about directors, you may like to read our articles: Recruit Directors and What Do Directors Do? http://www.cullinanelaw.com/forming-a-nonprofit-public-charity-step-3-recruit-directors/Name of Director #1 First Name Last Name Name of Director #2 First Name Last Name Name of Director #3 First Name Last Name If more than three initial directors, please enter their names here.Are any of the directors related to each other through family or business? If yes, please explain the relationship.Are any of the directors paid? What is their proposed compensation?Please note that it is not common for board members to be paid for their role on the board of directors. They may, however, be compensated for certain duties or reimbursed for expenses in performing their duties. Please provide a brief (3-5 sentence) bio on each director, and why they are serving on the board. What makes them uniquely qualified to serve in this role? How were they selected?StaffThis section pertains to the employees that serve your non-profit. The highest ranking staff person is often called the Executive Director. As outlined above, however, this Executive Director may or may not have a vote on the full Board of Directors. We will discuss an appropriate structure for your nonprofit.Executive Director's Name First Name Last Name If you have an Executive Director or key staff person, please provide his/her name and salary (if it is above $50,000 we need to inform the IRS).Please provide a brief (3-5 sentence) bio on the executive director and other key staff people. What makes them uniquely qualified to serve in this role? How were they selected?OfficersThis section pertains to the officers that will serve on your non-profit. Most states require a President and Secretary, so we've included those here. Officers are generally members of the board of directors. The highest ranking staff person is often called the Executive Director. As outlined above, however, this Executive Director may or may not have a vote on the full Board of Directors. We will discuss an appropriate structure for your nonprofit.Presidents Name First Last The President will often have signing authority for the nonprofit. He or she will chair meetings. There can be a combination of officers, as well.Secretary's Name First Last Manages the records for the nonprofit and keeps minutes of official meetings.Other Officer - Name, if any other officer other than President and Secretary First Last This officer could be a Treasurer or Vice President. However, these are not required in many states. Treasurer manages the financial and tax affairs of the nonprofit. Vice President fills in for President. Other InformationWhat is the organization’s fiscal year?For most nonprofits, the fiscal year is the same as the calendar year: Jan. 1 - Dec. 31.BudgetPlease note that we will help you complete a three-year proposed budget. We will separately send you a template. Questions for UsWe look forward to talking with you about your project. While we have many items to go over when we visit, please list any questions or topics you'd like us to cover.