Department of the Treasury Instructions for Form 8734 Internal Revenue Service

(January 2004)

Support Schedule for Advance Ruling Period

Section references are to the Internal Revenue Code unless otherwise noted.

General Instructions When To File

File Form 8734 within 90 days after the Specific Instructions Important: end of your advance ruling period (90 The instructions that follow are keyed to • Get Schedule A (Form 990 or days after the end of Year 5). By doing items in the heading of Form 8734. 990-EZ), Organization Exempt Under so, you will continue to be treated as a Section 501(c)(3), and its separate For tax years beginning and ending. publicly supported organization until we Instructions before you complete this The line that asks about information for make a final decision. form. Twenty-four hours a day, seven beginning and ending tax years refers

days a week, you can: If we do not receive your Form 8734, to the first tax year when your advance

1. Access the IRS website by we will presume that you are a private ruling period began and the fifth tax

computer at www.irs.gov and foundation and publish that fact in our year when your advance ruling period

download these items or publications. ended. For example, if a calendar year

2. Order them by calling organization’s advance ruling period If you file Form 8734 after this 1-800-TAX-FORM (1-800-829-3676). began September 15, 1999, and ended period, we will consider the information December 31, 2003, then it would • The terms “you” and “your” refer to you provide to determine whether you provide this information. the organization. “We” and “us” refer to are a publicly supported organization. If the Internal Revenue Service (IRS). you were always a publicly supported Your exemption letter will inform organization, we will correct your you about when your advance Purpose of Form status. If you are not eligible to be ruling period began and ended.

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Use Form 8734, Support Schedule for reclassified, you will continue to be If you are not sure about when your Advance Ruling Period, at the end of listed as a private foundation. advance ruling period began and your five-year advance ruling period, to ended, call the IRS Exempt provide financial information supporting Phone Help Organizations Customer Account your qualification as a publicly Services toll free at 1-877-829-5500. If you have questions and/or need help supported organization under section completing Form 8734, call IRS Exempt Name and address. If you operate 509(a). Organizations Customer Account under a name different from your legal

When your advance ruling period Services toll free at 1-877-829-5500, name, give your legal name but identify

ends, unless you obtain a final between 8:00 a.m. and 6:30 p.m. your alternate name after the legal

determination that you are a publicly Eastern time, Monday through Friday. name by writing ‘‘aka’’ (also known as)

supported organization, you will be and the alternate name.

responsible for filing an annual return Public Inspection Include the suite, room, or other unit as a private foundation for your sixth A submitted Form 8734 is not a publicly number after the street address. If the tax year and thereafter while you are a available document. See Regulation Post Office does not deliver mail to the private foundation. section 301.6104(a)-1(i)(5). street address and you have a P.O.

box, show the box number instead of Note: Form 8734 may also be filed by the street address. a private foundation at the end of its Accounting Method 60-month termination period under Form 8734 For foreign addresses, enter must be completed on the section 507(b)(1)(B) in connection with cash method information in the following order: city, of accounting. its request for a determination that it province or state, and the name of the

qualifies as a publicly supported For example, if a grantor makes a country. Follow the foreign country’s

organization. grant to an organization payable over a practice in placing the postal code in term of years, such grant will be the address. Please do not abbreviate

includible in the support fraction of the the country name. Who Should File grantee organization only when and to

the extent amounts payable under the If you change your address after the A charitable organization described in grant are received by the grantee. form is filed, use Form 8822, Change section 501(c)(3) should file Form 8734 of Address, to notify the IRS of the new when it seeks to establish at the end of If you use the accrual method of address. its advance ruling period that it is a accounting, a worksheet such as the publicly supported organization under Employer identification number. You one in Part IV-A of the Instructions for sections 509(a)(1) and 170(b)(1)(A)(vi) should have only one Federal employer Schedule A (Form 990 or 990-EZ) may or section 509(a)(2). identification number (EIN). If you have be used to convert any revenue more than one and have not been account from an accrual basis to a cash advised which to use, notify the Internal Where To File basis. Revenue Service Center, Attention:

The completed Form 8734 should be Entity Control, Stop 6273, Ogden, UT

sent to the: Attachments 84201-0027. State what numbers you

Show your name, employer have, the name and address to which

Internal Revenue Service identification number, and “Form 8734” each number was assigned, and the

P.O. Box 192 at the top of any attachments you address of your principal office. We will

Covington, KY 41012 include with your Form 8734. advise which number to use.

Cat. No. 35120F
Telephone number. Enter a telephone Line 12b Example

number that we can call during normal

business hours to obtain information Amount on line 12a of the Support Schedule (2% limitation) ................ $12,000

about your finances and activities. If Contributors whose total gifts from Year 5 through Year 1 were in excess of

you do not have a telephone number, the 2% limitation

enter the telephone number of your (a) (b) (c) (d) (e) (f) (g) (h) official who can provide such Name Year 5 Year 4 Year 3 Year 2 Year 1 Total Excess

information. contriEmail and fax number. butions If you have an (col. (g) email address or a fax number, enter less the this information. 2%

Calendar year (or fiscal year limitation)

beginning in). This refers to your

annual accounting period. For example, XYZ Foundation $56,000 3,000 3,000 $62,000 $50,000 a calendar year accounting period is

the 12-month period that begins on

January 1st and ends on December Apple Office $12,000 3,000 $15,000 3,000

31st. If you were formed after the Supply

beginning of an accounting period, your

first year (Year 1) will be less than the Plum $7,500 15,000 7,500 $30,000 18,000 full 12-month period. Your Corporation determination letter will state the

accounting period that you adopted. John Smith $5,000 5,000 5,000 1,000 $16,000 4,000

Lines 1 through 14 of this form

are comparable to lines 15 Sue Adams $10,000 10,000 $20,000 8,000 through 28 of Schedule A (Form

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990 or 990-EZ). If you filed Schedule A

for Year 4, show the information you Apple Trade $20,000 7,000 $27,000 15,000

reported in Part IV-A of Schedule A in Assoc.

the spaces for Year 4 through Year 1 in Total (Carry the total of column (h) to line 12(b) of the Support Schedule. $98,000 the applicable lines of Form 8734. Then

enter your information for Year 5 on the

applicable lines of Form 8734. 509(a)(1)/170(b)(1)(A)(vi) public Section 509(a)(1)/170(b)(1)(A)(vi)

Please note, however, that the lists computation: support test as follows: that you prepared for your records for Line 12c Total support ............ $600,000 Total support (line 10): ............ $600,000 lines 26b, 27a, 27b, and 28 of Schedule Line 12d Less total of lines:

A for Year 4 through Year 1 must now Direct contributions: 4 . . . $300,000 be attached to Form 8734 in support of Total direct contributions from persons who 5 . . . –0– lines 12b, 13a, 13b, and 14. Be sure contributed less than 2% of total support 50,000 8 . . . –0– you change the line numbers used in

support of Schedule A to the line Total direct contributions from six donors, 12b . . . 98,000 $398,000

each of whom gave more than 2% numbers used for Form 8734, and Line 12e Total public support ........ $202,000 ($12,000) of total support ........... 170,000 include the information for Year 5. Line 12f Public support percentage (line

Indirect contributions from the general 12e divided by line 12c— $202,000/ The examples that follow are public: $600,000) ................... 33.67% comparable to the examples given in

Schedule A except that these examples United Fund ................... 40,000 Since X organization received more reflect the 5-year advance ruling period than 331

/3% of its total support for the Grant from Y City ................ 40,000 instead of a 4-year period in Schedule period from public sources, it qualifies A. Total gifts, grants & contributions ...... $300,000 as a section 509(a)(1)/170(b)(1)(A)(vi)

Line 12. Organization meeting the publicly supported organization. Total direct contributions from six section 509(a)(1) and 170(b)(1)(A)(vi) donors, each of whom gave Facts and circumstances test. If you public support test. This example more than 2% of total support . . $170,000 do not meet the 331

/3% public support shows that you meet the test but received at least 10% of your 2% limitation for six donors: (2% 331

/3%-of-support test. × $600,000 × 6) . . . . . . . . . . . 72,000 support from the general public, other

Example. X organization reported publicly supported organizations, or Less: Direct contributions in the following amounts in its Support governmental units for your first five excess of 2% of total support . . 98,000 Schedule for the 5-year period, Year 5 years, you may qualify as a publicly

through Year 1: Total public support ........ $202,000 supported section 509(a)(1) and

170(b)(1)(A)(vi) organization. If you

Line (f) Total believe you are a publicly supported

1 Gifts, grants & contributions ...... $300,000 organization according to applicable

3 Gross receipts from admissions, etc. 100,000 regulations, you must attach a detailed

statement of the facts upon which you 4 Dividends & interest ........... 300,000 base your conclusion. Your facts and 10 Line 9 minus line 3 ........... 600,000 circumstances may include (1) the

12a 2% of line 10 (2% limitation) ...... 12,000 amount of support you received from

b Total of contributions exceeding the the general public, governmental units,

2% limitation ............... 98,000 or public charities, (2) whether you

The X organization determined have a continuous and bona fide

whether or not it met the section program for solicitation of funds from

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the general public, governmental units, Line 13a Example

or public charities, and (3) all other

facts and circumstances, including the (a) (b) (c) (d) (e) (f) (g)

public nature of your governing board, Name Year 5 Year 4 Year 3 Year 2 Year 1 Total

the extent to which your facilities or

programs are publicly available, the David Smith $5,000 5,000 6,000 $16,000 extent to which your dues encourage

membership, and whether your Anne Parker $8,000 10,000 $18,000 activities are likely to appeal to persons

having a broad common interest or

purpose. For additional information Total $5,000 $5,000 $6,000 $8,000 $10,000 $34,000

about the 10% facts and circumstances

 Enter the total for each year of columns (b) through (f) on line 13a of the Support Schedule. test, see Pub. 557, Tax-Exempt Status

for Your Organization, and Regulations  Enter the total of column (g) on the line 13a entry space for line 13d of the Support Schedule.

section 1.170A-9(e)(3).

Line 12b. Contributions in excess of

the 2% limitation. An example of a income percentage was 40.0%.

list for line 12b showing the name of Therefore, it did not meet the second Signature and amount contributed by each person part of the section 509(a)(2) test—the An officer, director, or trustee who is (other than a governmental unit or not-more-than-one-third of total support authorized to sign must sign Form publicly supported organization) whose from gross investment income and net 8734. Show the title or authority of the total gifts for the advance ruling period unrelated business taxable income. signer and the date. exceeded the amount shown in line 12a Since T did not satisfy both of the is shown on page 2. one-third tests of section 509(a)(2), it Line 13. Organization meeting the Paperwork Reduction Act Notice failed the section 509(a)(2) public section 509(a)(2) public support support test for its five-year period. We ask for the information on this form

to carry out the Internal Revenue laws tests. The following example illustrates Line 13a. Contributions, membership of the United States. You are required the public support tests. fees, and gross receipts from to give us the information. We need it to Example. Organization T reported disqualified persons. The example ensure that you are complying with the following amounts in its Support above shows a list of the names and these laws. You are not required to Schedule for the 5-year period, Year 5 total amounts received in each year provide the information requested on a through Year 1: from each “disqualified person” for form that is subject to the Paperwork amounts that were included in lines 1, Line (f) Total Reduction Act unless the form displays 2, and 3 of Form 8734. a valid OMB control number. Books or 1 Gifts, grants & contributions ...... $45,000 Line 13b. Gross receipts from other records relating to a form or its 2 Membership fees ............ 50,000 than disqualified persons. The instructions must be retained as long as 3 Gross receipts from admissions, example below is a list showing the their contents may become material in merchandise, etc. ............ 25,000 name of, and amount received for each the administration of any Internal 4 Gross income from interest, year that was more than the larger of: Revenue law. The rules governing the dividends, etc. .............. 80,000 1. The amount on line 11 for the confidentiality of Form 8734 are in 9 Total of lines 1 through 8 ........ $200,000 year or section 6104.

13a Gifts from disqualified persons .... 25,000 2. $5,000 The time needed to complete and

b Excess gross receipts from file this form will vary depending on for any amount included in line 3 that nondisqualified persons ........ 20,000 was received from each person (other individual circumstances. The

T determined whether it met the estimated average time is: than “disqualified persons”) for Year 5. one-third tests of section 509(a)(2) in Attach similar lists to determine excess the following computation: Recordkeeping . . . . . . . . 29 hr., 39 min. amounts for Years 4, 3, 2, and 1 entry Section 509(a)(2) computation: Learning about the law or lines of 13b. Line the form . . . . . . . . . . . . . 1 hr., 27 min.

13c Add: Amounts from column (f), Line 13b Example Preparing the form . . . . . 2 hr., 56 min.

lines 1, 2, 3, 6, and 7 .......... $120,000 Copying, assembling, and

13d Total of line 13a ....... $25,000 Year 5 sending the form to the

Total of line 13b IRS . . . . . . . . . . . . . . . . . 16 min. ....... 20,000 45,000 (a) (b) (c) (d) (e)

13e Public support (line 13c Name Amount Amount Enter Year 5 If you have comments concerning minus line 13d total) .... $75,000 received on the Excess the accuracy of these time estimates or 13f Total support (line 9, in line 11 larger (column

column (f)) .......... $200,000 Year 5 for Year of (b) less suggestions for making this form

13g Public support percentage 5 column column simpler, we would be happy to hear (line 13e divided by line (c) or (d)) from you. You can write to the Tax 13f — $75,000/$200,000) 37.50% $5,000 Products Coordinating Committee, 13h Investment income

percentage (line 4 divided Western Area Distribution Center, Word by line 13f — $80,000/ Rancho Cordova, CA 95743-0001. Do Processing, $200,000) ........... 40.0% Inc. $25,000 $2,000 $5,000 $20,000 not send the form to this address.

T received 37.50% of its total Instead, see Where To File on page 1.

support from the public and thus met Enter the total for column (e) on line

the more-than-one-third test of public 13b for the Year 5 entry space ..... $20,000

support to total support. T’s investment

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