A new interactive version of Form 1023 is available at StayExempt.irs.gov. It includes prerequisite questions, auto-calculated fields, help buttons and links to relevant information. Department of the Treasury Internal Revenue Service Notice 1382 (Rev. October 2013) Changes for Form 1023 � Mailing address � Parts IX, X, and XI Reminder: Do Not Include Social Security Numbers on Publicly Disclosed Forms Because the IRS is required to disclose approved exemption applications and information returns, exempt organizations should not include Social Security numbers on these forms. Documents subject to disclosure include supporting documents led with the form, and correspondence with the IRS about the ling. Changes for Form 1023, Application for Recognition of Exemption Under Section 501(c)(3) of the Internal Revenue Code Change of Mailing Address The mailing address shown on Form 1023 Checklist, page 28, the rst address under the last checkbox; and in the Instructions for Form 1023, page 4 under Where To File, has been changed to: Internal Revenue Service P.O. Box 12192 Covington, KY 41012-0192 To le using a private delivery service, mail to: 201 West Rivercenter Blvd. Attn: Extracting Stop 312 Covington, KY 41011 Changes for Parts IX and X Changes to Parts IX and X are necessary to comply with new regulations that eliminated the advance ruling process. Until Form 1023 is revised to re ect this change, please follow the directions on this notice when completing Part IX and Part X of Form 1023. For more information about the elimination of the advance ruling process, visit us at IRS.gov. In the top right "Search" box, type "Elimination of the Advance Ruling Process" (exactly as written) and select "Search." Part IX. Financial Data The instructions at the top of Part IX on page 9 of Form 1023 are now as follows. For purposes of this schedule, years in existence refer to completed tax years. 1. If in existence less than 5 years, complete the statement for each year in existence and provide projections of your likely revenues and expenses based on a reasonable and good faith estimate of your future nances for a total of: a. Three years of nancial information if you have not completed one tax year, or b. Four years of nancial information if you have completed one tax year. (Continued) IRS.gov Notice 1382 (Rev. 10-2013) Cat. No. 52336F 2. If in existence 5 or more years, complete the schedule for the most recent 5 tax years. You will need to provide a separate statement that includes information about the most recent 5 tax years because the data table in Part IX has not been updated to provide for a 5th year. Part X. Public Charity Status Do not complete line 6a on page 11 of Form 1023, and do not sign the form under the heading "Consent Fixing Period of Limitations Upon Assessment of Tax Under Section 4940 of the Internal Revenue Code." Only complete line 6b and line 7 on page 11 of Form 1023, if in existence 5 or more tax years. Part XI. Increase in User Fees User fee increases are effective for all applications postmarked after January 3, 2010. 1. $400 for organizations whose gross receipts do not exceed $10,000 or less annually over a 4-year period. 2. $850 for organizations whose gross receipts exceed $10,000 annually over a 4-year period. For the current user fee amounts, go to IRS.gov and in the "Search" box at the top right of the page, enter "Exempt Organizations User Fees." You can also call 1-877-829-5500. Application for reinstatement and retroactive reinstatement. An organization must apply to have its tax-exempt status reinstated if it was automatically revoked for failure to le a return or notice for three consecutive years. The organization must: (1) Complete and le Form 1023 if applying under section 501(c)(3) or Form 1024 if applying under a different Code section; (2) Pay the appropriate user fee and enclose it with the application; (3) Write "Automatically Revoked" at the top of the application and mailing envelope; and (4) Submit a written statement supporting its request if applying for retroactive reinstatement. If the application is approved, the date of reinstatement generally will be the postmark date of the application, unless the organization quali es for retroactive reinstatement. Alternate submissions and standards apply for retroactive reinstatement back to the date of automatic revocation. See Notice 2011-44, 2011-25 I.R.B. 883, at http://www.irs.gov/irb/2011-25_IRB/ar10.html, for details. Changes for the Instructions for Form 1023 � � Change to Part III. Required Provisions in Your Organizing Documents Clarification to Appendix A. Sample Conflict of Interest Policy (Continued) IRS.gov Notice 1382 (Rev. 10-2013) Changes to Instructions for Form 1023, Application for Recognition of Exemption Under Section 501(c)(3) of the Internal Revenue Code (Rev. June 2006) Part III. Required Provisions in Your Organizing Document Applicable to organizations in the state of New York. Changes are necessary to comply with Rev. Proc. 82-2, 1982-1 C.B. 367, to incorporate the state of New York as a jurisdiction that complies with the cy pres doctrine to keep a charitable testamentary trust from failing the requirement for a dissolution clause under Regulations section 1.501(c)(3)-1(b)(4), when the language of the trust instrument demonstrates a general intent to bene t charity. Therefore, the instructions on page 8, line 2c, after the third paragraph now include the state of New York in the state listing as an authorized state. Since the state of New York allows testamentary charitable trusts formed in that state and the language in the trust instruments provides for a general intent to bene t charity, you do not need a speci c provision in your trust agreement or declaration of trust providing for the distribution of assets upon dissolution. Appendix A. Sample Conflict of Interest Policy Appendix A, Sample Conflict of Interest Policy, is only intended to provide an example of a con ict of interest policy for organizations. The sample con ict of interest policy does not prescribe any speci c requirements. Therefore, organizations should use a con ict of interest policy that best ts their organization. IRS.gov Notice 1382 (Rev. 10-2013) Form (Rev. December 2013) Department of the Treasury Internal Revenue Service 1023 Application for Recognition of Exemption Under Section 501(c)(3) of the Internal Revenue Code (00) OMB No. 1545-0056 Note: If exempt status is approved, this