Form 1024 (Rev. September 1998) Department of the Treasury Internal Revenue Service Application for Recognition of Exemption Under Section 501(a) OMB No. 1545-0057 If exempt status is approved, this application will be open for public inspection. Read the instructions for each Part carefully. A User Fee must be attached to this application. If the required information and appropriate documents are not submitted along with Form 8718 (with payment of the appropriate user fee), the application may be returned to the organization. Complete the Procedural Checklist on page 6 of the instructions. Part I. Identification of Applicant (Must be completed by all applicants; also complete appropriate schedule.) Submit only the schedule that applies to your organization. Do not submit blank schedules. Check the appropriate box below to indicate the section under which the organization is applying: a b c d e f g h i j k l Section 501(c)(2)--Title holding corporations (Schedule A, page 7) Section 501(c)(4)--Civic leagues, social welfare organizations (including certain war veterans' organizations), or local associations of employees (Schedule B, page 8) Section 501(c)(5)--Labor, agricultural, or horticultural organizations (Schedule C, page 9) Section 501(c)(6)--Business leagues, chambers of commerce, etc. (Schedule C, page 9) Section 501(c)(7)--Social clubs (Schedule D, page 11) Section 501(c)(8)--Fraternal beneficiary societies, etc., providing life, sick, accident, or other benefits to members (Schedule E, page 13) Section 501(c)(9)--Voluntary employees' beneficiary associations (Parts I through IV and Schedule F, page 14) Section 501(c)(10)--Domestic fraternal societies, orders, etc., not providing life, sick, accident, or other benefits (Schedule E, page 13) Section 501(c)(12)--Benevolent life insurance associations, mutual ditch or irrigation companies, mutual or cooperative telephone companies, or like organizations (Schedule G, page 15) Section 501(c)(13)--Cemeteries, crematoria, and like corporations (Schedule H, page 16) Section 501(c)(15)--Mutual insurance companies or associations, other than life or marine (Schedule I, page 17) Section 501(c)(17)--Trusts providing for the payment of supplemental unemployment compensation benefits (Parts I through IV and Schedule J, page 18) m Section 501(c)(19)--A post, organization, auxiliary unit, etc., of past or present members of the Armed Forces of the United States (Schedule K, page 19) n Section 501(c)(25)--Title holding corporations or trusts (Schedule A, page 7) 1a Full name of organization (as shown in organizing document) 2 Employer identification number (EIN) (if none, see Specific Instructions on page 2) 1b c/o Name (if applicable) 3 Name and telephone number of person to be contacted if additional information is needed 1c 1d Address (number and street) City, town or post office, state, and ZIP + 4 Instructions for Part I, page 2. 4 Room/Suite If you have a foreign address, see Specific ( 1e Web site address 6 7 Month the annual accounting period ends 5 ) Date incorporated or formed Did the organization previously apply for recognition of exemption under this Code section or under any other section of the Code? If "Yes," attach an explanation. Has the organization filed Federal income tax returns or exempt organization information returns? If "Yes," state the form numbers, years filed, and Internal Revenue office where filed. Yes Yes No No 8 a b c Check the box for the type of organization. ATTACH A CONFORMED COPY OF THE CORRESPONDING ORGANIZING DOCUMENTS TO THE APPLICATION BEFORE MAILING. Corporation-- Attach a copy of the Articles of Incorporation (including amendments and restatements) showing approval by the appropriate state official; also attach a copy of the bylaws. Trust-- Association-- Attach a copy of the Trust Indenture or Agreement, including all appropriate signatures and dates. Attach a copy of the Articles of Association, Constitution, or other creating document, with a declaration (see instructions) or other evidence that the organization was formed by adoption of the document by more than one person. Also include a copy of the bylaws. If this is a corporation or an unincorporated association that has not yet adopted bylaws, check here I declare under the penalties of perjury that I am authorized to sign this application on behalf of the above organization, and that I have examined this application, including the accompanying schedules and attachments, and to the best of my knowledge it is true, correct, and complete. PLEASE SIGN HERE (Signature) (Type or print name and title or authority of signer) (Date) For Paperwork Reduction Act Notice, see page 5 of the instructions. Cat. No. 12343K American LegalNet, Inc. www.FormsWorkFlow.com Form 1024 (Rev. 9-98) Page 2 Part II. Activities and Operational Information (Must be completed by all applicants) 1 Provide a detailed narrative description of all the activities of the organization--past, present, and planned. 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, as a minimum, the following: (a) a detailed description of the activity including its purpose and how each activity furthers your exempt purpose; (b) when the activity was or will be initiated; and (c) where and by whom the activity will be conducted. 2 List the organization's present and future sources of financial support, beginning with the largest source first. American LegalNet, Inc. www.FormsWorkFlow.com Form 1024 (Rev. 9-98) Page 3 Part II. Activities and Operational Information (continued) 3 a Give the following information about the organization's governing body: Names, addresses, and titles of officers, directors, trustees, etc. b Annual compensation 4 If the organization is the outgrowth or continuation of any form of predecessor, state the name of each predecessor, the period during which it was in existence, and the reasons for its termination. Submit copies of all papers by which any transfer of assets was effected. 5 If the applicant organization is now, or plans to be, connected in any way with any other organization, describe the other organization and explain the relationship (e.g., financial support on a continuing basis; shared facilities or employees; sam