Form 3500A PDF Details

Navigating the intricate landscape of tax exemption within California, organizations often encounter the Form 3500A as a pivotal step in affirming their tax-exempt status. This form serves as a submission of exemption request under various sections of the Internal Revenue Code (IRC), specifically targeting organizations eligible under sections 501(c)(3), 501(c)(4), 501(c)(5), 501(c)(6), 501(c)(7), and 501(c)(19). A critical component of this process is the inclusion of a federal determination letter, which acts as a validation of the organization's tax-exempt status at the federal level. The form comprehensively gathers essential information about the organization, including its identification numbers, contact details, and the nature of its establishment within California. Furthermore, it delves into the history of the entity’s tax-exempt status, its financial receipts over recent years, and its eligibility for group exemptions, laying down a framework for assessing its qualifications. The nuances of Form 3500A extend to specifying the organization's primary purpose and activities, encompassing a wide range of intents from charitable to educational, and even recreational. This detailed submission process underscores the importance of precise documentation in maintaining tax-exempt integrity, which not only benefits the organization but also aligns with California’s regulatory standards. Through this, Form 3500A emerges as a critical tool in the seamless governance of tax-exempt entities within the state.

QuestionAnswer
Form NameForm 3500A
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesstate of california exemption form, letter exemption california, how to form exemption request, tax exempt form california

Form Preview Example

Submission of Exemption Request

CALIFORNIA FORM

Exemption Based on Internal Revenue Code (IRC) Sections 501(c)(3), 501(c)(4), 501(c)(5),

3500A

 

501(c)(6), 501(c)(7), or 501(c)(19), Federal Determination Letter

 

 

 

 

 

 

 

 

 

 

Enclose a copy of the Federal Determination Letter.

 

 

 

 

 

 

 

 

 

 

Organization Information

 

 

 

 

 

 

 

 

 

 

California corporation number/California Secretary of State file number

FEIN

 

 

 

 

 

 

Name of organization as shown in the organization’s creating document

Web address

 

 

 

 

 

 

 

Street address (suite, room, or PMB no.)

 

 

 

 

 

 

 

 

 

 

City

 

 

State

ZIP code

 

 

 

 

 

Telephone

Second telephone

 

Fax

 

 

 

 

 

 

 

Representative Information

 

 

 

 

 

 

 

 

 

 

 

Name of representative

 

 

 

Email address

 

 

 

 

 

 

Representative’s mailing address (suite, room, or PMB no.)

 

 

 

 

 

 

 

 

 

 

 

City

 

 

State

ZIP code

 

 

 

 

 

 

Telephone

Second telephone

 

Fax

 

 

 

 

 

 

 

Part I — Entity Information. See instructions.

1 Has the Franchise Tax Board (FTB) previously revoked the entity’s tax-exempt status?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Yes

No

If “Yes,” STOP. File form FTB 3500.

 

2

3

4

Is the entity a trust? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

When did the organization establish, incorporate, organize, or conduct business in California? . . . . . . . . . . . . . . . . . . . . . . . 3

Provide gross receipts for the current year and the three immediately preceding taxable years in existence. Gross receipts are defined as the total amounts the organization received from all sources during its annual account period without subtracting any costs or expenses. If the organization has been in existence for less than one year, provide the projected amount of gross receipts for the entire year. List the account period beginning to the account period ending. Example: mm/dd/yyyy

Yes No

mmdd yyyy

____ / ____ / ____

 

Current Year or Projected

Gross Receipts for the three immediately preceding taxable years:

 

 

Gross Receipts

 

 

 

 

 

 

 

 

 

 

 

From:

From:

From:

From:

 

 

 

 

 

 

 

 

To:

To:

To:

To:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Part II — Group Exemption. See instructions.

5 Is the parent organization applying for a group exemption?

5 Yes

No

If “Yes,” attach the federal group determination letter and a list of all California subordinates. Include each subordinate’s name, California corporation number, federal employer identification number (FEIN), address, and affiliation date.

6Is a subordinate unit applying for tax-exempt status using a parent’s Internal Revenue Service (IRS) group determination letter?

If “Yes,” see instructions

6 Yes

No

Mail form FTB 3500A and a copy of the federal determination letter to:

EXEMPT ORGANIZATIONS UNIT, MS F120, FRANCHISE TAX BOARD, PO BOX 1286, RANCHO CORDOVA CA 95741-1286.

Under penalties of perjury, I declare I have examined this submission for exemption based on the IRC Sections 501(c)(3), 501(c)(4), 501(c)(5), 501(c)(6), 501(c)(7), or 501(c)(19), federal determination letter, and to the best of my knowledge and belief, it is true, correct, and complete.

DATE

SIGNATURE OF OFFICER OR REPRESENTATIVE

TITLE

8091203

FTB 3500A 2020 Side 1

Part III — Purpose and Activity

1Exemption based on IRC Section 501(c)(3) Federal Determination Letter Check the organization’s primary purpose and activity:

Charitable

Hospital

Health care center

Educational

Mosque

Church

Temple

Synagogue

Testing for public safety

Qualified sports organization

Prevent cruelty to animals

Prevent cruelty to children

Literary

Scientific

Religious

School

 

 

 

 

2Exemption based on IRC Section 501(c)(4) Federal Determination Letter

Check the organization’s primary purpose and activity:

Civic league

Local association of

Social welfare

Service clubs

Veterans’ organization

 

employees

 

 

 

Legislative activities

Festival organizations

Municipal building

Police, sheriff,

Quasi governmental

 

 

corporation

volunteer firemen

 

 

 

 

association

 

3Exemption based on IRC Section 501(c)(5) Federal Determination Letter Check the organization’s primary purpose and activity:

Agriculture

Horticulture

Labor

Agriculture or horticulture county fair

Public employees union

AFL-CIO

Independent

Transportation

Teamsters

 

 

 

workers

 

 

4Exemption based on IRC Section 501(c)(6) Federal Determination Letter Check the organization’s primary purpose and activity:

Board of trade

Business league

Chamber of commerce

Real estate board

Professional association or society

5Exemption based on IRC Section 501(c)(7) Federal Determination Letter Check the organization’s primary purpose and activity:

Social and recreational

Golf club

Camps

Fraternity or sorority

Dog or horse club

Car, motorcycle,

Hunting or

Common recreational

Flying or airplane club

 

trailer club

fishing club

area

 

 

6Exemption based on IRC Section 501(c)(19) Federal Determination Letter Check the organization’s primary purpose and activity:

Veterans’ organization

FTB 3500A 2020 Side 2

8092203