NON PROFIT- General Information Form
IRS FEE-1023-Church- $600 & IRS FEE-1023EZ- $275 (pay online)
Name of Organization/Church Institution
Your Name/President
Address (no PO Box)
City, State, Zip
Phone Number
Phone
County
Email address
example@example.com
Do you have an EIN# ? If so, please provide
Social Security Number for SS 4 Form
3-5 board members including yourself (not related or don't have same last name)
1. President Name
2.
3.
4.
5.
Mission Statement: (1 sentence)
Purpose Statement: (1 sentence)
FOR CHURCHES ONLY:
# Of Active Members
# of Average Attendance
Days and Times of Service
Please share your Church Statement of Faith
Church Website Address
Attach a copy of your latest Church Bulletin
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ADDITIONAL INFORMATION
By signing below, I hereby acknowledge that I have completed this form to the best of my ability.
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