The IRS Form 3500A is a relatively new form that was created in order to make it easier for tax payers to report their foreign-owned assets. The form was released in 2014, and replaced the older Form 3520. It is shorter and simpler than its predecessor, which makes it easier to complete. Tax payers who have holdings outside of the United States are required to file this form, as well as Report of Foreign Bank and Financial Accounts (FBAR). Filing Form 3500A can be confusing, so it is important to seek assistance if you are unsure about how to fill out the form correctly. The penalties for not filing can be significant, so it is important to take this requirement seriously.
| Question | Answer |
|---|---|
| Form Name | Form 3500A |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | state of california exemption form, letter exemption california, how to form exemption request, tax exempt form california |
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 |
□ 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
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
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 |
□ |
□ 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