Application for Church Affiliation and Group Exemption Coverage

Application for Church Affiliation and Group Exemption Coverage

Please complete all applicable sections of this application. This form is for churches requesting affiliation with the Associated Brotherhood of Christians and inclusion under the ABofC nonprofit group exemption. Incomplete applications may delay review and processing. If you have any question please reach out to the General Secretary Joseph Hale (615)495-3569 or email jhale245@comcast.net
Church Information
Church Name
Church Physical Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Church Mailing Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Church Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Church Email Address
example@example.com
Church Website
Pastor and Principal Officer Information
Pastor's Name
Pastor's Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Pastor's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Pastor's Email Address
example@example.com
Pastor's Social Security Number
Note: Because the Pastor is considered the Principal Officer of the Church, the IRS requires the Pastor's SSN for filing purposes. It will not be used for anything else
Organizational and Tax Information
Date church was started or acquired

MonthDayYear
Date
Closing month of church’s accounting year
Has the church ever applied for and previously received an Employer Identification Number?
EIN Number
Approximate date when EIN was obtained

MonthDayYear
Date
City & State where EIN application was filed
Required Supporting Documents & Items
Confirmation: Copy of church minutes approving affiliation attached

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Confirmation: Copy of church deed attached (Not the original )

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Confirmation: Complete list of church board with contact details attached

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Affiliation Acknowledgment & Compliance
Federal Law requires the Association's Secretary to maintain an accurate roster of Affiliated Churches; therefore, your Church will be registered under the name on this application.

Each Affiliated Church will be issued their own Employer Identification Number, filed with the Association's Group Exemption Number.

Submission of this application does not guarantee approval of affiliation. Affiliation with the Associated Brotherhood of Christians and inclusion under the ABofC nonprofit group exemption are subject to review, approval, and continued compliance with applicable Association requirements and governing regulations.

In order to comply with our Association By-Laws and Federal Regulations, please report the following future changes:
- Change of Church Affiliation
- Change of Church name or address
- Change of Pastor
Certification and Signature
Pastor's Printed Name
Title
Pastor's Signature
Signature Date

MonthDayYear
Date
Payment Options

Dues are due by December 31st Annually
Mail checks to ABofC @ P.O. Box 166 Greenbrier, TN 37073 or Pay online below.
Pay Online
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Annual Church Dues

$300.00

Total

$0.00
Payment Methods

Fastlane Checkout

Choose from one of the PayPal options to make your payment.

Contact Info

Payment Info
Should be Empty:

Application for Church Affiliation and Group Exemption Coverage

Church Information

Pastor and Principal Officer Information

Organizational and Tax Information

Required Supporting Documents & Items

Affiliation Acknowledgment & Compliance

Certification and Signature

Payment Options

Pay Online

Payment Methods