501c3 Application Starter

501c3 Application Starter

This form is to be used to assist us in completing your 1023EZ application. We understand that you may not be able to answer all the questions at this time. If you have to skip or enter N/A for questions that you are unable to answer we will reach out to you and assit.
Responsible Party`s Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Organization`s Name (or CHOICE 1 Name if not yet incorporated)*
CHOICE 2 Name if not yet incorporated*
Address or Organization (If Different from Responsible Party Address)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Please provide your Social Security Number for the Responsible Party
Yes. Please call me to obtain itNo. I have provided my social using this form
Please provide the names and andresses of AT LEAST 3 board members. It is recommended that the Executive Director Not serve as a board member.
Name (Board Member) 1 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name ( Board Member ) 2 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name (Board Member) 3 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
You may add additional board member (s) name (s) and addresses here. Also use the space to describe titles (if any) of these and other (above named) board members
Describe your planned activities in a narrative.*
Section B
YesNoDoes Not Apply
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
Your signature confirms that you understand the terms of this agreement and are the authorized representative of this organization.*

Clear
Should be Empty:

501c3 Application Starter

Please provide the names and andresses of AT LEAST 3 board members. It is recommended that the Executive Director Not serve as a board member.

Section B