1023-EZ Form Helper

Step 1 of 6

PART I: Identification of Applicant

Enter your complete name exactly as it appears in your organizing document, including amendments.
Enter your complete address where all correspondence will be sent. If mail is not delivered to the street address and you have a P.O. box, enter your box number instead of the street address.
Enter the nine-digit EIN assigned to you.
Enter the month that your tax year (annual accounting period) ends, using a two-digit number format. For example, if your annual accounting period ends in December, enter “12.” Your annual accounting period is the 12-month period on which your annual financial records are based. Your first tax year could be less than 12 months. Check your bylaws or other rules of operation for consistency with the annual accounting period entered on line 3.
Enter the name and title of the person to contact if more information is needed. The person to contact may be an officer, director, trustee, or other individual who is permitted to speak with us according to your bylaws or other rules of operation. Your person to contact may also be an “authorized representative,” such as an attorney, certified public accountant (CPA), or enrolled agent (EA).
Enter the user fee amount paid.

8) List the names, titles, and mailing addresses of your officers, directors, and/or trustees. (If you have more than five, see instructions.)

 

Enter the full names, titles, and mailing addresses of your officers, directors, and/or trustees. You may use the organization's address for mailing. If you have more than five, list only five in the order below.

  1.  President or chief executive officer or chief operating officer.
  2. Treasurer or chief financial officer.
  3. Chairperson of the governing body.
  4. Any officers, directors, and trustees who are substantial contributors (not already listed above).
  5. Any other officers, directors, and trustees who are related to a substantial contributor (not already listed above).
  6. Voting members of the governing body (not already listed above).
  7. Officers (not already listed above).

If an individual serves in more than one office (for example, as both an officer and director), list this individual on only one line and list all offices held.

An officer is a person elected or appointed to manage the organization’s daily operations, such as president, vice president, secretary, treasurer, and, in some cases, board chair. The officers of an organization are determined by reference to its organizing document, bylaws, or resolutions of its governing body, or otherwise designated consistent with state law.

A director or trustee is a member of the organization’s governing body, but only if the member has voting rights.

------ Officer 1 ------

------ Officer 2 ------

------ Officer 3 ------

------ Officer 4 ------

------ Officer 5 ------