Form 1028 PDF Details

In order to file a petition for international recognition of your divorce, you will need to complete and submit form 1028. The purpose of this form is to provide the United States with information about your divorce so that it can be recognized by foreign authorities. By completing and submitting this form, you are asking the United States to investigate your divorce and determine whether or not it is valid under international law. There are a number of factors that the government will consider when making its determination, including the residency requirements for both you and your ex-spouse, as well as the grounds for divorce. You should be aware that there is no guarantee that the US will recognize your divorce, regardless of how valid it may be in your home country.

If you wish to know a handful of specific details concerning the file you're going to work with, here's the specifics you may want to read prior to filling in the form 1028.

QuestionAnswer
Form NameForm 1028
Form Length4 pages
Fillable?Yes
Fillable fields221
Avg. time to fill out22 min 38 sec
Other namesnonmember, form 1028 instructions, depletable, what is form 1028

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Form 1 0 2 8

(Rev. October 1999)

Department of the Treasury Internal Revenue Service

Application for Recognition of Exemption

Under Section 521 of the Internal Revenue Code

For the use of farmers’, fruit growers’, or like associations applying for recognition of

exemption as cooperatives.

See separate Instructions.

OMB No. 1545-0058

If your organization does not have an organizing document, do not file this application. Every organization must furnish all the information specified on the form and in the instructions. An attachment may be used if more space is needed for any item. If the required information and appropriate documents are not submitted along with Form 8718 (with payment of the appropriate user fee), the application may be returned to you.

Part I Identification

1a Full name of organization (See instructions.)

bEmployer identification number (See instructions.)

2a Number, street, and room or suite no. (or P.O. box number if mail is not delivered to street address)

b City or town, county, state, and ZIP code

3Name and telephone number (including area code) of person to be contacted during business hours

( )

4Date incorporated or formed

5Month the annual accounting period ends

6a Has the organization filed Federal income tax returns?

b If “Yes,” state the form numbers, years filed, and Internal Revenue office where filed

Yes

No

Part II Type of Entity and Organizational Documents (See instructions.)

Check the applicable entity box below and attach a conformed copy of the organizing and operational documents listed.

Corporation—Articles of Incorporation, bylaws Other—Constitution or Articles of Association, bylaws

Part III Activities and Operational Information

1Number of shares of each class of capital stock currently outstanding, if any, the value of the consideration for which issued,

 

and the rate of dividend paid:

 

Shares

Amount

Rate of Dividend

a

Preferred stock (voting)

1a

 

 

 

 

b

Preferred stock (nonvoting)

1b

 

 

 

 

c

Common stock (voting)

1c

 

 

 

 

d

Common stock (nonvoting)

1d

 

 

 

 

2

Number of shares of capital stock (other than nonvoting preferred) owned by:

 

 

 

a

Producers

 

 

 

2a

 

b

Nonproducers

 

 

 

2b

 

c

Current and active producers

 

 

 

2c

 

d

Total number of shares—Add lines 2a and 2b

 

 

 

2d

 

e

Percentage owned by current and active producers—Divide line 2c by line 2d

 

2e

%

3What provision is made for retiring the voting stock held by a nonproducer?

4Describe who is accorded voting rights in the cooperative and how many votes one person may have. If a person may be entitled to more than one vote, explain in detail how voting rights are acquired.

5 Legal rate of interest in the state where the association is located

Please

Sign

Here

Under penalties of perjury, I declare that I am authorized to sign this application on behalf of the above organization; and I have examined this application, including the accompanying statements, and to the best of my knowledge and belief it is true, correct, and complete. (See General Instruction “C.”)

(Signature)(Title or authority of signer)(Date)

For Paperwork Reduction Act Notice, see page 2 of the separate instructions.

Cat. No. 17138N

Form 1028 (Rev. 10-99)

Form 1028 (Rev. 10-99)

Page 2

 

 

Part III

Activities and Operational Information ( Continued)

 

 

 

 

6If the association issues any nonvoting preferred stock, explain whether the owners, upon dissolution or liquidation, may participate in the profits of the association beyond fixed dividends.

7a Does state law require the accumulation and maintenance of reserves?

b If “Yes,” state the names and purposes of the reserves and enter the amount of each:

Yes

No

Amount

8a Does the association maintain or plan to maintain any reserve or reserves other than those required by state law?

b If “Yes,” state the names and purposes of the reserves and enter the amount of each:

Yes

No

Amount

9

Does the association deal or plan to deal with both members and nonmembers?

Yes

No

10a

Does the association pay or plan to pay patronage dividends?

Yes

No

b

If “Yes,” are they paid or will they be paid to all patrons, both member and nonmember, on the same basis?

Yes

No

11a

Is the allocation of patronage dividends based on an obligation in existence before the cooperative

 

 

 

received the amounts allocated?

Yes

No

bIf “Yes,” is the obligation in:

Organizing document (specify)

Bylaws

12Explain all of the activities in which the association is or will be engaged.

13Explain how distribution is or will be made of the proceeds of products marketed for members and nonmembers. Also, if the organization operates on a basis of allocated units (i.e., functional, departmental, etc.), explain how losses are or will be treated.

14 Explain how the association charges for supplies and equipment bought for members and nonmembers.

Form 1028 (Rev. 10-99)

Form 1028 (Rev. 10-99)

Page 3

 

 

Part III

Activities and Operational Information ( Continued)

 

 

 

 

15 Explain the requirements for membership in the association.

16Federated cooperatives only:

aAre all the association’s member cooperatives exempt under section 521?

bIf “No,” do the nonexempt member cooperatives have the same annual accounting period as the association’s?

Yes

Yes

No

No

cIf “No,” to 16b, check the method below that the association used, or will use, to provide a common or comparable unit of time for analyzing and evaluating its operations and those of its members.

Note: Methods listed below do not apply to the filing of retur ns or the manner in which operating results are reported by a federated cooperative and its members.

1.

2.

3.

Method 1—The association uses the operations of members for those months that correspond to the months that make up its tax year.

Method 2—The association uses the tax years of members that end within its tax year. Method other than 1 or 2 above (explain)

17

Value of agricultural products marketed or handled

Current tax

 

3 prior tax years

 

 

 

 

 

for: (See instructions.)

year

 

 

 

 

 

 

 

 

(a) From

(b)

(c)

(d)

*a

Members—

to

 

 

 

1.Actually produced by members

2.Not actually produced by members but marketed by them through the association

bNonmembers—

1.Actually produced by nonmembers

2.Not actually produced by nonmembers but marketed by them through the association

cNonproducers (purchased from nonproducers for marketing by the association)

18Value of supplies and equipment purchased for or sold to: (See instructions.)

*a Members who were producers

bNonmembers who were producers

cMembers and nonmembers who were not producers

19Amount of business done with the United States Government or any of its agencies

20

Does the association plan to do business with the United States Government or any of its agencies in the future?

Yes

No

21a

Were all of the net earnings (after payment of dividends, if any, on capital stock) for the years shown on

 

 

 

lines 17–19 distributed as patronage dividends? (See instructions for lines 17–19.)

Yes

No

b

If “No,” were undistributed net earnings apportioned on the records to all patrons on a patronage basis?

Yes

No

22a

Has the organization operated in a manner consistent with the information given since the date formed?

Yes

No

bIf “No,” state the changes that have occurred and dates of the changes.

*If it is necessary to own one or more shares of stock in order to become a member, include on lines 17a and 18a only the amount of business transacted with persons actually owning the required number of shares.

Form 1028 (Rev. 10-99)

Form 1028 (Rev. 10-99)

Page 4

Part IV

Financial Data (See instructions.)

 

Complete the Statement of Receipts and Expenditures and Balance Sheets for the current year and for each of the three immediately preceding years that the organization was in existence.

Statement of Receipts and Expenditures, for period ending

 

 

 

 

 

 

 

,

 

.

 

(If you prepare a statement of receipts and expenditures that is more descriptive and detailed than the statement below, you

 

may submit that statement instead of this one.)

 

 

 

 

 

 

 

 

 

 

 

 

1

Gross dues and assessments from members

 

 

 

 

 

 

 

1

 

 

 

 

2

Gross dues and assessments from affiliated organizations

 

 

 

 

 

 

 

2

 

 

 

 

3a

Gross amount derived from activities related to organization’s exempt

 

3a

 

 

 

 

 

 

 

 

 

purpose (attach schedule)

 

 

 

 

 

 

 

 

 

 

 

 

<![endif]>Receipts

 

b Less cost of goods sold

 

 

 

 

 

 

3b

(

 

)

3c

 

 

 

4a

Gross amount from other business activities (attach schedule)

 

 

4a

 

 

 

 

 

 

 

b

Less cost of goods sold

 

 

 

 

 

 

4b

(

 

)

4c

 

 

 

5a

Gross amount received from sale of assets, excluding inventory items

 

 

 

 

 

 

 

 

 

 

 

(attach schedule)

 

 

 

 

 

 

5a

 

 

 

 

 

 

 

 

b Less cost or other basis and sales expense of assets sold (attach schedule)

 

5b

(

 

)

5c

 

 

 

 

6

Interest, dividends, rents and royalties

 

 

 

 

 

 

 

6

 

 

 

 

7

Other receipts (attach schedule)

 

 

 

 

 

 

 

 

 

 

7

 

 

 

 

8

Total receipts—Add lines 1 through 7 in far right column

 

 

 

 

 

 

 

8

 

 

 

 

9

Compensation of officers, directors, and trustees (attach schedule)

 

 

 

 

 

 

9

 

 

 

 

10

Other salaries and wages

 

 

 

 

 

 

 

 

 

 

10

 

 

<![endif]>Expenditures

 

11

Interest

 

 

 

 

 

 

 

 

 

 

11

 

 

 

12

Rent

 

 

 

 

 

 

 

 

 

 

12

 

 

 

13

Depreciation and depletion

 

 

 

 

 

 

 

 

 

 

13

 

 

 

14

Dues and assessments to affiliated organizations

 

 

 

 

 

 

 

14

 

 

 

15

Other expenditures (see instructions—attach schedule)

 

 

 

 

 

 

 

15

 

 

 

16

Patronage dividends (see instructions—attach schedule)

 

 

 

 

 

 

 

16

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

17

Total expenditures—Add lines 9 through 16

 

 

 

 

 

 

 

17

 

 

 

 

18

Excess of receipts over expenditures (line 8 less line 17)

 

 

 

 

 

 

 

18

 

 

Balance Sheets

 

 

 

 

 

Enter

 

 

Beginning date

 

Ending date

 

 

 

 

 

dates

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

19

Cash

 

 

 

 

 

 

 

19

 

 

 

 

 

 

 

20

Trade notes and accounts receivable (less allowance for bad debts)

 

 

 

20

 

 

 

 

 

 

 

21

Inventories

 

 

 

 

 

 

 

21

 

 

 

 

 

<![endif]>Assets

 

22

Investments (attach schedule)

 

 

 

 

 

 

 

22

 

 

 

 

 

 

23

Other current assets (attach schedule)

 

 

 

 

23

 

 

 

 

 

 

24

Depreciable and depletable assets (less accumulated depreciation/depletion)

24

 

 

 

 

 

 

 

 

 

 

 

 

 

 

25

Land (net of any amortization)

 

 

 

 

 

 

 

25

 

 

 

 

 

 

 

26

Other assets (attach schedule)

 

 

 

 

 

 

 

26

 

 

 

 

 

 

 

27

Total assets

 

 

 

 

 

 

 

27

 

 

 

 

 

 

 

28

Accounts payable

 

 

 

 

 

 

 

28

 

 

 

 

 

 

 

29

Mortgages, notes, bonds payable in less than one year

 

 

 

 

29

 

 

 

 

 

 

 

30

Other current liabilities (attach schedule)

 

 

 

 

30

 

 

 

 

 

 

 

31

Mortgages, notes, bonds payable in one year or more

 

 

 

 

31

 

 

 

 

 

 

 

32

Other liabilities (attach schedule)

 

 

 

 

 

 

 

32

 

 

 

 

 

<![endif]>Capital

 

33

Patronage dividends allocated in noncash form, other than capital stock and

 

 

 

 

 

 

 

 

interest-bearing obligations

 

 

 

 

 

 

 

33

 

 

 

 

 

 

34

Per-unit retains allocated in noncash form

 

 

 

 

34

 

 

 

 

 

<![endif]>and

 

35

Capital stock (enter numbers at

 

 

 

Number of shares

 

 

 

 

 

 

 

 

Number of

 

 

 

 

 

 

 

 

 

 

 

 

 

end of year):

 

 

Issued for

 

Issued as

 

 

 

 

 

 

 

 

shareholders

 

 

 

 

 

 

 

<![endif]>Liabilities

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

money

patronage benefits

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

a Voting preferred stock

 

35a

 

 

 

 

 

 

 

 

 

 

 

 

 

b Nonvoting preferred stock

 

35b

 

 

 

 

 

 

 

 

 

 

 

 

 

c Voting common stock

 

35c

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

d Nonvoting common stock

 

35d

 

 

 

 

 

 

 

 

 

 

 

 

 

 

36

Paid-in or capital surplus

 

 

 

 

 

 

 

36

 

 

 

 

 

 

 

37

Retained earnings (attach schedule)

 

 

 

 

 

 

 

37

 

 

 

 

 

 

 

38

Less cost of treasury stock

 

 

 

 

 

 

 

38

(

 

)

(

)

 

 

39

Total liabilities and capital

 

 

 

 

 

 

 

39

 

 

 

 

 

Form 1028 (Rev. 10-99)

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17138N blanks to fill in

Remember to complete the a b c d, a b c d e, Number of shares of each class of, Rate of Dividend, Shares, Amount, Preferred stock (voting) Preferred, 1a 1b 1c 1d, Number of shares of capital stock, 2a 2b 2c 2d 2e, 3 What provision is made for, 4 Describe who is accorded voting, entitled to more than one vote, and Legal rate of interest in the space with the requested data.

Filling in 17138N part 2

In the Please Sign Here, Under penalties of perjury, (Signature), (Title or authority of signer), (Date), For Paperwork Reduction Act, Cat, and Form 1028 (Rev box, point out the key details.

step 3 to finishing 17138N

Indicate the rights and obligations of the parties inside the box If the association issues any, Does state law require the, If “Yes, Yes Amount, 8a Does the association maintain, state law, If “Yes, and Yes Amount.

Completing 17138N part 4

Look at the sections 9 Does the association deal or, 10a Does the association pay or, If “Yes, 11a Is the allocation of patronage, received the amounts allocated, If “Yes, Organizing document (specify) 䊳, Explain all of the activities in, Yes, Yes Yes, Yes, No No, and Explain how distribution is or and next fill them out.

Finishing 17138N step 5

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