2019 Group Exemption Application

Units applying for the NCTE Tax-Exempt Group for the first time must fill out and submit this application by the January 30 deadline. Applying units must be approved affiliate, assembly, TYCA-Regional, or TAWL Groups.

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* 1. NCTE Unit name (please spell out):

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* 2. Please fill in Employer Identification Number (EIN) for Unit. If Unit does not have an EIN, answer Question #3.

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* 3. Our organization does not have an EIN number.

After consulting IRS instructions AND instructions from NCTE, we have submitted Form SS-4 to the IRS.

We submitted Form SS-4 to the IRS before consulting this application form.

We are enclosing with this application a completed Form SS-4 filled out according to IRS instructions AND instructions from NCTE.

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* 4. Please give a detailed description of the purpose(s)of the unit. The description should come directly from your Constitution and Bylaws and use the exact words of the document(s). Attach additional pages to your application if necessary.

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* 5.
Please give a detailed description of your unit's past (last three years), present, and future activities. Include the specific benefits, services, publications, and educational activities you have or will provide. If your unit is just starting or being reorganized, explain what activities will be taken to make it operational.
NOTE: This description should be different from #4 above and you should attach additional pages to the application if necessary.

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* 6. On what date was your unit formed?

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* 7. To the best of your unit's knowledge and belief, is your unit organized and operated exclusively for charitable and educational purposes so that it qualifies as an organization described in the Internal Revenue Code as 501(c)(3) and is not a private foundation as defined in Section 509(a) of the Internal Revenue Code?

Yes

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* 8. Has your unit amended its Constitution as described in Instructions for Amending Your Unit's Constitution/By-laws, "Requrements to be exempt as an organization describe in Section 501(c)(3) of the Internal Revenue Code"? Please send a copy of your amended constitution to the Affiliate Office.

Yes

Additional Comment

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* 9. Does your unit's accounting year run from July 1–June 30?

Yes

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* 10. Has your unit ever applied for and/or obtaned an exemption from federal income tax?

Yes

Note: if you answered "yes" to this question, please provide an explanation below and attach the appropriate documentation (this would include the Letter of Determination from the IRS) in the next question.

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* 11. If you answered "yes" to question 10 above, please attach the appropriate documentation including a Letter of Determination from the IRS. (Only PDF, DOC, DOCX, PNG, JPG, JPEG, GIF files are supported.)

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.

Choose File

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* 12. Has your organization adopted the following policies? Please check all that apply. Find information on these policies on the NCTE website.

Code of Ethics

Conflict of Interest Policy

Document Retention and Destruction Policy

Whistleblower Policy

Joint Venture Policy

Compensation Policy

Please explain in the box below.

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* 13.
Report on IRS Requirements for Filing Annual Tax Forms. Please respond to the item that pertains to your group for the most recently completed fiscal year (the year that ended on June 30).
Also note that some states also require your organization to file tax forms. Please check with your state tax office on this.

Our group is new and has not filed tax forms with the IRS. We are including a Financial Report Form with our application.

We filed an e-Postcard (Form 990N) with the IRS for our most recently completed fiscal year and we are submitting the e-Postcard receipt along with a copy of the Financial Report Form to NCTE.

We filed a 990EZ form with the IRS or our most recently completed fiscal year and we are submitting a copy of that form to NCTE.

We filed a 990 form with the IRS or our most recently completed fiscal year and we are submitting a copy of that form to NCTE.

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* 14. Our organization has gross income from an unrelated trade or business of $1,000 or more. See Resources on NCTE website for "Brief Explanation of Unrelated Business Income Tax."

Yes, and we are sending a copy of our 990-T form for the most recent fiscal year to NCTE.

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* 15. Please include the contact information for your organization's IRS Contact FOR THE YEAR THIS CHECKLIST IS DUE.
Unit IRS Contact Data. NOTE: no P.O. box allowed.
Please also send a copy of the unit's roster of officers to the NCTE Affiliate Office (1111 W. Kenyon Rd., Urbana, Il 61801 or by email to affsec@ncte.org)

Name

Institution

Address 1

Address 2

City/Town

State/Province

Zip/Postal Code

Home or OfficeTelephone Number

Email Address

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* 16. By submitting this application, does your unit agree that it will continue to operate in accordance with your state purposes and will promptly notify NCTE if your state purposes change?

Yes

Additional Comment

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* 17. By submitting this application, does your unit authorize NCTE to include your unit in NCTE's group exemption letter as a tax-exempt organiation described in Internal Revenue Code 501(c)(3) for the next fiscal year?

Yes

Additional Comment

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* 18. Please sign this form. By filling in the information for this question, you attest that to the best of your knowledge, information and belief, the information set forth above and on the documents you will send to the Affiliate Office is accurate and fairly states the answers and information sought.

Name

Position in Group

Date

Home or Office Telephone

Email Address

Please note that you'll need to send the following documents by postal mail or by email to affsec@ncte.org:

Additional pages, if necessary, regarding purpose of your unit.
Additional pages, if necessary, regarding unit's activities.
A copy of your constitution amended with the "Requirements to be exempt as an organization described in Section 501(c)(3) of the Internal Revenue Code."
A Financial Report if you filed an e-Postcard (form 990N) and the e-Postcard Receipt.
A Financial Report if your organization is new.
A copy of your form 990EZ or your form 990 if your organization filed either of these.
A copy of your 990T form if your group filed this form.
A copy of the Fees Form with a $30 check made payable to NCTE to apply for membership in the group.