501C3 Intake Form

501C3 Intake Form
Today's Date & Time

Month Day Year Hour Minutes AM/PM Option
Is this for a 501C3 Reinstatement? *

No Yes
Full Name *

First Name Last Name
TItle
Phone Number *

Area Code Phone Number
E-mail *
ORGANIZATION INFORMATION
Organization Name *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
What COUNTY? (not country) *
Primary Type of Organization *

Religious (church, mosque, synagogue, temple, etc) Religious (ministry, not a church, etc) Charitable Educational Amateur Sports Literary Child Cruelty Prevention Animal Cruelty Prevention Public Safety Testing
Website address (if any)
CORPORATE DOCUMENT INFORMATION
Is organization incorporated? *

Yes. Will provide a copy of FILED Articles No. Ordering this service below
If yes, upload FILED Articles here
Does organization have an EIN? *

Yes, number is below No. Ordering this service below
The EIN is
If no EIN, what is your Social Security #? (Required by U.S. Patriot Act to get a new EIN from IRS)
Does organization have bylaws? *

Yes. Will provide a copy No. Ordering this services below
If yes, upload here
If ordering Bylaws below, what is your Mission Statement? (1 or 2 sentences)
OFFICER INFORMATION

The President can't be Secretary or Treasurer, but Secretary and Treasurer can be same person. If unknown at this time, please write TBD (to be determined)
Name & Address of President *
Name & Address of Secretary *
Name & Address of Treasurer *
DIRECTOR INFORMATION

Board should be an odd number in case of tie vote (minimum 3, no maximum) with the majority unrelated by blood or marriage. All 3 officers above can also be the Board members below. Board members do not have to be U. S. citizens or reside in the same state as the organization, but should be at least 18 years old due to their fiduciary service. If unknown at this time, please write TBD (to be determined)
Name & Address of Chairman (if different from President or write SAME) *
Name & Address of Director #2 (if different from Secretary or write SAME) *
Name & Address of Director #3 (if different from Treasurer or write SAME) *
Names & Addresses of additional Directors (if any)
ACTIVITY & OPERATION INFORMATION

If possible, use a "who", "what", "when", "where", "why" and "how" format.
Describe what your organization does (or intends to do) *
We're so glad you found us!
How did you hear of Jen Williams? *

I'm an Existing Client Referral by a Client Referral by a Lawyer/Accountant/Consultant Postcard/Business card Internet Search YouTube/Facebook/Twitter/LinkedIn/Tumblr
What is your Cash App name (if any)? *
TERMS OF SERVICE & PRIVACY POLICY

Both policies are at jenwilliamsintl.com
By checking this box and electronically signing below, I have read the Terms of Service and Privacy Policy, and agree to same. *

I AGREE
Electronic Signature *

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Thank you!

We will contact you with a quote and answer any questions you have.
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501C3 Intake Form

ORGANIZATION INFORMATION

CORPORATE DOCUMENT INFORMATION

OFFICER INFORMATION

DIRECTOR INFORMATION

ACTIVITY & OPERATION INFORMATION

We're so glad you found us!

TERMS OF SERVICE & PRIVACY POLICY

Thank you!