Nonprofit Formation and 501(c)(3) Intake Form

Nonprofit Formation & 501(c)(3) Intake Form

Please complete this form to request nonprofit formation and federal tax-exemption services. Hynacee Tax & Business Services will review your information and schedule a phone or Zoom consultation. Following the consultation, you will receive a QuickBooks invoice showing the agreed-upon services, professional fees, and applicable government filing fees. Preparation and filing will begin after payment and all required information are received.
Primary Contact’s Full Legal Name

First NameLast Name
Primary Contact’s Proposed Role or Title
Primary Contact’s Email Address
example@example.com
Primary Contact’s Best Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Primary Contact’s Mailing Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
How would you like to complete your nonprofit consultation?
Nonprofit Organization Information
First Choice for Nonprofit Organization Name
Second Choice for Nonprofit Organization Name
Third Choice for Nonprofit Organization Name
Which nonprofit formation service are you requesting?
Select the nonprofit formation package you are requesting. If you are unsure which application is appropriate, select “I am unsure” and we will review your eligibility during the phone or Zoom consultation.
Select Your State and Form 1023-EZ Package Price
Price includes professional preparation, EIN application, standard state nonprofit incorporation fee and the $275 IRS Form 1023-EZ user fee.
Select Your State and Full Form 1023 Package Price
Price includes professional preparation, EIN application, standard state nonprofit incorporation fee and the $600 IRS Form 1023 user fee.
Nonprofit Organization Location
Enter the primary physical or mailing address where the nonprofit’s records will be maintained.

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
County Where the Nonprofit Organization Will Be Located
Purpose, Mission and Planned Activities
Describe the Nonprofit’s Purpose and Planned Activities

Explain why the organization is being created, the programs or services it will provide, who will benefit, the geographic area it will serve and how its activities will accomplish its charitable purpose.
Mission Statement, If Available
Enter the organization’s current or proposed mission statement. If you need assistance developing one, leave this field blank and discuss it during the consultation.
Optional Program Documents
Upload Program Materials, If Available

ou may upload any available documents, including:Detailed program descriptionsInformation about individuals or communities servedService-area informationProgram-delivery plansProgram timelines and expected start datesBrochures, budgets or presentations
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Texas Registered Agent Renewal Acknowledgment
I understand that my initial fee will be prorated through December 31 and that the service renews for $186 each January, subject to payment of the annual invoice.
Registered Agent’s Legal Name or Business Name
The Registered Agent must consent to the appointment and maintain a physical street address where the agent is available during regular business hours. A P.O. Box cannot be used. The Registered Agent must be located in the same state where the nonprofit organization is formed.
Registered Agent’s Physical Street Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Registered Agent’s Email Address
example@example.com
Registered Agent’s Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Board of Directors and Officers
How many initial directors will the nonprofit have?
A nonprofit does not have owners. For good governance and IRS purposes, three or more directors preferably individuals who are not related to one another is generally recommended. State requirements vary.
Director 1 Position
Director 1 Full Name

First NameLast Name
Director 1 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Director 1 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Director 2 Full Name

First NameLast Name
Director 2 Position
Type a question
Director 2 Mailing Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Director 3 Full Name

First NameLast Name
Director 3 Position
Director 3 Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Director 4 Full Name

First NameLast Name
Director 4 Position
Director 4 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Director 5 Full Name

First NameLast Name
Director 5 Position
Director 5 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Tax, Employment and Identification Information
Has the Nonprofit Organization Already Received an EIN?
Will the Nonprofit Organization Have Employees?
Upload Government-Issued Identification for the Incorporator and Initial Directors/Officers

Upload a clear copy of a valid government-issued photo ID for each person listed. Do not upload Social Security cards, bank information or passwords. Accepted formats: PDF, JPG and PNG.
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Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Nonprofit Formation & 501(c)(3) Intake Form

Nonprofit Organization Information

Nonprofit Organization Location

Purpose, Mission and Planned Activities

Describe the Nonprofit’s Purpose and Planned Activities

Mission Statement, If Available

Optional Program Documents

Board of Directors and Officers

Tax, Employment and Identification Information