- - - - - - - - en-USExemption Application CALIFORNIA FORM3500en-USOrganization Informationen-USRepresentative Information California corporation number/California Secretary of State 037le number FEINName of organization as shown in the organization222s creating documentWeb addressStreet Address (suite, room, or PMB no.)CityStateZIP codeTelephone ( þ ) Second telephone ( þ ) Fax ( þ ) Name of representativeEmail addressStreet Address (suite, room, or PMB no.)CityStateZIP codeTelephone ( þ ) Second telephone ( þ ) Fax ( þ ) en-USGeneral Questions Part I þ en-US en-USOrganizational Structureen-USCheck the box for the type of organization and provide the listed documents. If the listed documents are not provided, the organization222s request for en-USexemption will be delayed, or denied. Copies are acceptable. 037036 þ037 California Corporation 226 incorporated through the California Secretary of State (SOS). See General Information E, Incorporated Organizations.Provide the articles of incorporation, including any amendments stamped by the California SOS, and the corporation222s bylaws or other code of regulations. 037036 þ037 Foreign Corporation 226 See General Information F, Foreign Corporations.If the corporation quali037ed through the California SOS: Provide the Statement and Designation by Foreign Corporation, stamped articles of incorporation including all amendments from the state of incorporation, the corporations bylaws or other code of regulations, and the federal exemption determination letter. If the organization is not quali037ed through the California SOS: Provide a letter of good standing from the state of incorporation, the stamped articles of incorporation and all amendments from the state of incorporation, the corporation222s bylaws or other code of regulations, and the federal exemption determination letter. 037036 þ037 Unincorporated Association 226 not incorporated through the California SOS. See General Information G, Unincorporated Associations.Provide the constitution, articles of association, bylaws or other code of regulations with speci037c language, and signed by the board of directors or other governing body. 037036 þ037 Trust 226 See General Information H, Trusts.Provide the trust instrument, any amendments and the trust222s federal exemption determination letter. 037036 þ037 Limited Liability Company (LLC) 226 See General Information I, Limited Liability Companies.If the LLC is registered in California: Provide the articles of organization (LLC-1), and any amendments stamped by the California SOS, and the operating agreement. If the LLC is a foreign LLC registered in California: Provide the Application to Register a Foreign Limited Liability Company (Form LLC-5), letter of good standing from the state of incorporation, articles of organization from the state of incorporation including any amendments, and the operating agreement. en-USBe sure to include the $25 application fee. en-USUsing black or blue ink, make the check or money order payable to the 223Franchise Tax Board.224 Do not send en-UScash. Make all checks or money orders payable in U.S. dollars and drawn against a U.S. 037nancial institution. Mail form FTB 3500 to: en-US en-USEXEMPT ORGANIZATIONS UNIT MS F120, FRANCHISE TAX BOARD, PO BOX 1286, RANCHO CORDOVA, CA 95741-1286. þ Under penalties of perjury, I declare that I have examined this application, including accompanying schedules and statements, and to the best of my knowledge and belief, it is en-US þ true, correct, and complete. DATETITLEen-USSIGNATURE OF OFFICER OR REPRESENTATIVE7221183 American LegalNet, Inc. www.FormsWorkFlow.com Side 2 þ FTB 3500 þ 2018 þ 1 þ Has the organization already received tax-exempt status under IRC Sections 501(c)(3), 501(c)(4), 501(c)(5), 501(c)(6), 501(c)(7), or 501(c)(19) at the federal level? þ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .................................................... þ 1 þ þ Yes þ þ No þ If 223Yes,224 the organization may choose to file form FTB 3500A, Submission of Exemption Request, if the tax-exempt status was not previously revoked. For more information, get form FTB 3500A. If 223No,224 continue. þ 2 þ Enter the California Revenue and Taxation Code (R&TC) section that best fits the organization222s purpose/activity. See the Exempt Classification Chart on page 6. þ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .................................................. þ 2 þ R&TC Section 23701 þ 3 þ Enter the date the organization formed þ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......................................................... þ 3 þ þ / þ / þ þ 4 þ Was the organization formed in another state? þ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ................................................... þ 4 þ þ Yes þ þ No þ If 223Yes,224 answer question 4a and question 4b. þ a þ List the state where the organization was formed. þ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................. þ 4a þ þ þ b þ Is the organization qualified through the California SOS? þ. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....................................... þ 4b þ þ Yes þ þ No þ If 223Yes,224 enter the date quali037ed þ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ........................................................... þ þ / þ / þ þ 5 þ What is the organization222s annual accounting period ending? (must end on the last day of the calendar or fiscal year) þ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................ þ 5 þ þ / þ þ 6 þ What is the primary purpose of the organization? þ 7 þ Is the organization currently conducting, or plan to conduct activities? þ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ................................ þ 7 þ þ Yes þ þ No If 223Yes,224 enter the date the activities began, or will begin þ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................. þ þ / þ / þ þ If 223No,224 explain why the organization is not planning any activities. þ mm þ / þ dd þ / þ yyyy þ mm þ / þ dd þ / þ yyyy þ mm þ / þ dd þ þ mm þ / þ dd þ / þ yyyy en-USPart II þ en-USNarrative of Activities7222183 American LegalNet, Inc. www.FormsWorkFlow.com FTB 3500 þ 2018 þ Side 3 en-USPart II þ en-USNarrative of Activities (continued) þ 8 þ Describe the organization222s past, present, and planned activities below. Do not merely refer to or repeat the language in the organizational document. List each activity separately, in the order of importance based on the relative time and other resources devoted to the activity. Indicate the percentage of time for each activity. Each description should include a: þ a Detailed description of the activity, including its purpose and how it furthers the organization222s exempt purpose. þ b Detailed description of when the activity was or will be initiated. þ c Detailed description of where and by whom the activity will be conducted. 7223183 American LegalNet, Inc. www.FormsWorkFlow.com Side 4 þ FTB 3500 þ 2018 en-USPart III þ en-USFinancial Data FromFromFromFromTotalToToToToGifts, grants, and contributions receivedFundraisingMembership income, dues, and assessmentsNonmembership income Gross amounts derived from activities not related to exempt purposesGross receipts from admissionsGross receipts from commissionsGross receipts from advertisingGross receipts from sale of merchandiseGross receipts from services providedGross investment incomeGross receipts from furnishing of facilitiesGross royalty incomeGross rental incomeGain or loss from sale of capital assetsOther income (attach sheet itemizing each type)TOTAL RECEIPTS þ . . . . . . . . . . . . . . . . .