GET CERTIFIED!

                                                              IMPORTANT!

*PRINT CLEARLY the Referrer’s ME AND DMAIL ON TOP OF FORM BEFORE COPYING!*

* Referrer’sme___________________________________ email_________________________________*                                                              

                    501c3 certification Application

Just TYPE CLE OR PRINT RLY and  MAIL or email to addressee below:

Your Information:

Name_______________________________________________

Street_______________________________________________City______________ State____________

County____________ Zip Code_________

Email______________________________

Tel. No._____________________________

Your New Profit Corporation's Information:

Name________________________________________________

Alt. Name_____________________________________________

Street________________________________________________

City______________ State____________

County____________ Zip Code_________

Email______________________________

Tel. No._____________________________

Purpose of Non-Profit Corporation:

_________________________________________

_________________________________________

_________________________________________

         State of Incorporation: CALIFORNIA

                                                                   GET CERTIFIED!

                             501c3 certification Application               

501 C 3 Filing - Part 1 Identification of Applicant

1a Full Name of Organization ________________________________________________________

b Address _____________________ Apt_____ City_________ State________ Zip______________

2 E.I.N. _____________    3. Month _______  4. Contact Person _____________________________

5 Contact Ph. #_______________________________ 7 User Fee Submitted____________________

8 Names of officers, directors,etc.

First Name                                          Last Name                                  Title                                                  

___________________________________________________________________________________

Street Address                                    City                                           State             Zip                          

___________________________________________________________________________________

First Name                                          Last Name                                  Title                                                  

___________________________________________________________________________________

Street Address                                    City                                           State             Zip                          

                                                             

___________________________________________________________________________________

First Name                                          Last Name                                  Title                                                  

___________________________________________________________________________________

Street Address                                    City                                           State             Zip                          

___________________________________________________________________________________

9 a Website:

___________________________________________________

 b Email:

___________________________________________________

Part 2 Organizational Structure

 You must be a non-profit corporation:(NO Schools, Hospitals or Churches!)

Yes?______ No?______

Do you have your Articles of Incorporation for this non-profit?__________

State of Incorporation_______________________ Date of Inc.____________

Does your organization  adhere to 501 C 3 tax exempt purposes?_____

Do you agree that upon dissolution, remaining assets must be used for

tax exempt purposes?___________

                                               

                                                 

                                                                   GET CERTIFIED!

                             501c3 certification Application

Part 3 Your Specific Activities

1 Three character NTEE Code ___________

2 Check all that apply

Charitable______ Religious______ Educational______

Scientific_______ Literary_______ Public Safety_____

Amateur Sports_________ Cruelty to kids/pets______

Do you agree to refrain from:

Gaming, supporting political candidates, using funds to pay expenses of individuals,

engage in loans and payments to officers, attempting to influence legislation, having unrelated business income of $1000 or more, compensating officers, directors or trustees or provide grants or other assistance outside of the USA?

Yes?________ No?________

Do you or will you engage in disaster relief?

Yes?________ No?________

Part 4 Foundation Classification

Private Foundation _______ or Public Charity_________

   

Part 6 Signature

______ I declare under penalties of perjury that I am authorized to sign this application on behalf of the above organization and that I have examined this application, and to the best of my knowledge it is true correct and complete.

____________________________________          _________________________________

                      Type name of signer                                        Type title of signer

____________________________________           _________________________________

Signature of Officer, Director or Trustee                                               Date

 

                 Total (includes State & Federal Filing Fees) $799

Return completed documents along with payment to our Authorized Consultant:

                                Payable to: IDEAS INSTITUTE 

                                                   c/ou mas Martin, Jr.

                             10          1 West Mission Bl. Suite 110-147

                                               omomonaCa. 91766-1711

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