Application for Legal Assistance to Incorporate A California Nonprofit Organization

Attain 501 (c)(3) Tax-Exempt Status

Thank you for inquiring about Public Counsel’s Community Development Project (CDP) pro bono legal service of incorporating your nonprofit organization and applying for State and Federal Tax-Exemption. CDP provides pro bono legal assistance to qualified proposed nonprofit organizations andis required to obtain the following information from its prospective clients. This applicationhelps us determine whether the organization qualifies for our services. We cannot consider your application unless you provide ALL of the information requested. All information will remain confidential. Completing an application does not automatically qualify the organizationfor legal assistance. CDP retains complete discretion as to which applications it accepts. Please keep a copy of this application for your records.

Eligibility Criteria

If the organization’s mission and work benefit low-income individuals and communities in Los Angeles County, you may be eligible for legal assistance from the Community Development Project. We are not able to assist organizations that have not demonstrated their readiness level to operate a nonprofit. One of the ways in which we assess readiness is reviewing this application for completeness.

This application requests (1) information to determine whether you qualify for legal assistance, and (2) information that a volunteer attorney will need to help you form a nonprofit corporation and apply for tax-exemption. If you are in the beginning stages of forming your nonprofit, you may want to consider whether this is the appropriate time to apply for tax-exempt status. If you are unable to fully answer the questions in this application, please consider investing additional time and effort in developing your programming, budget and board of directors in order to meet the appropriate readiness level to submit this application.We outline the steps involved in forming a nonprofit corporation in our publication, “Guide to Forming a Charitable Tax-Exempt Nonprofit Corporation” available here; also, please see our List of Resources and Organizations Providing Technical Assistance to Nonprofits available here. This application is not as complex as it may appear once you have established the aforementioned elements of your nonprofit. Each question in this application requests information that the government requires to qualify the organization as a tax-exempt nonprofit, so taking the time to complete this application now should make your filing process easier.

Costs

CDP does not charge for any of its services. However, please note, we do not assist with any of the filing fees associated with incorporating and filing for State and Federal tax-exemption. The total fees for incorporating and applying for tax-exemption are approximately *$960.If you submit this application to CDP, you will be certifying that you have sufficient resources to pay these fees.

Application Timeline

Once you submit your completed application, it will take approximately two weeks to review and make an eligibility determination. If the organization qualifies for our assistance, we will try and match you with a volunteer attorney. The placement process may take up to an additional four weeks.

Seminar

In addition, we STRONGLYencourage you to attend the CDP workshop on Forming a California Charitable, Tax-Exempt, Nonprofit Corporation. Please note that all seminars require advance registration. Call the CDP Hotline at (213) 385-2977, extension 210 to obtain a registration form and learn the date and time of the next workshop, or click hereto complete the online registration form.

Part I & II–organization individual contact information

NOTE:If this application for legal assistance is accepted by the Community Development Project, the individual(s) listed below will be required to respond promptly to any of the volunteer attorney’s requests for information and will need to update the attorney about any organizational changes. Timely responses are critical for a smooth working relationship and successful completion of any matter. Please make sure to list individuals that have both the time and knowledge of the organization to be able to work effectively with a volunteer attorney.
Name of Organization:
Address (Street Address – No P.O. Boxes please): / Mailing Address (if different):
Phone Number: / Organization Website:
Primary Contact Person: / Title:
Address (Street Address – No P.O. Boxes please): / Mailing Address (if different):
Phone Number: / Fax Number: / E-mail Address:
Additional Contact (if any): / Title:
Address (Street Address – No P.O. Boxes please): / Mailing Address (if different):
Phone Number: / Fax Number: / E-mail Address:
Organizational Leadership
Please list all of the Directors who have agreed to serve on your Board of Directors and all of your officers below. In Part V Section F of this application, you will be asked to include more detailed information regarding the board and officers listed here.
Names of Board of Directors: / Positions/Names of Officers:
President:
Secretary:
Treasurer/CFO:

Part III– General InformationWhen including additional sheets, please make sure to label parts.

Is the organization incorporated?
Yes No
If yes, on what date did you incorporate?
NOTE: we do NOT recommend incorporating before sending in this application. However, if you have already incorporated your nonprofit organization, we cannot review your application unless you send us its articles and if it has already adopted them, its bylaws. / Have you ever applied for or obtained an Employer
Identification Number (EIN) for the organization?
Yes No
If yes, what is your EIN?
Exemption Have you previously filed for the following exemptions?Yes No
If yes, please describe in the chart below and include a copy of the application/correspondence.
Exemption / Result
Federal
State of California
Other State
Is the organization affiliated with a governmental unit?
Yes No
If yes, please explain:
Does the organization control, or is it controlled by another organization?
Yes No
If yes, please explain:
Fiscal Sponsorship Has the organization inquired into fiscal sponsorship?Yes No
Is the organization currently a project of a fiscal sponsorship?Yes No
If yes, please include a copy of the fiscal sponsorship agreement.
If no, why was fiscal sponsorship not undertaken?
NOTE:We require all prospective applicants to consider whether Fiscal Sponsorship is an appropriate alternative to forming a separate nonprofit. For more information on fiscal sponsorship, see our Fiscal Sponsorship Alert or go to .

Part IV – Legal Services

  1. Past Legal Services
Has the organization obtained legal services in the past? Yes No
If yes, did the organization pay for the past services? Yes No
If yes, please describe circumstances of past paid legal services and why the organization can no longer afford to pay for legal services:
  1. Referral Information
How did you hear about our legal services?
Agency:
Attorney: / Former Client:
Friend: / TV/Radio/Newspaper:
Other:
For Office Use Only
Matter ID: / Create Paper File? Yes No

Part V – Program Information

Please attach separate sheets, labeling each section, when answering each of the following questions. Answer each question with as much detail as possible. We will not be able to consider your application unless responses to each question are detailed and contain all the required information.

  1. Organization’s Mission & Goals
Describe the mission and overall goals of the organization.
  1. Proposed Activities
Describe completely and with detail the programs, projects and services that the organization offers, including any past, present or planned activities. Include copies of any existing materials (e.g. brochures, flyers, newsletters that describe the activities of the organization). Make sure your narrative includes detailed information that answers all of the following questions:
  • What are the activities?
  • Where will the activities be conducted?
  • Will the organization rent or own office space or any other property? If so, has the location already been identified or acquired?
  • How will the activities be conducted?
  • How does each of the organization's activities further the organization’s tax-exempt purpose?
  • What percentage of the organization’s total time is dedicated to each activity?
  • How will each activity be funded? (This section should be consistent with the organization’s proposed budget.)
  • Will recipients of the organization's services be required to pay for any of the services?
  • If yes, please explain how these fees and services may be differentiated from a for-profit business, and attach a fee schedule.
  • Does or will the organization publish, own, or have rights in music, literature, tapes, artworks, choreography, scientific discoveries, or other intellectual property?
  • If yes, describe who owns or will own any copyrights, patents, or trademarks, whether fees are or will be charged, how the fees are determined, and how any items are or will be produced, distributed, and marketed.
  • Does or will the organization attempt to influence legislation or intervene in any way in political campaigns? (This includes promoting or opposing a change in law; endorsing or opposing a candidate; or promoting or opposing a ballot initiative.)
  • If yes, please attach a separate sheet, with an explanation, including the percentage of overall time you plan to spend on such activity.

  1. Target Population
Please describe the organization’s target client population (e.g. at-risk youth, people that are seniors or homeless) and geographic areas the organization plans to serve (i.e. cities and neighborhoods).
  1. Identifying the Needs of the Community
What research have you undertaken to indicate the community will benefit from the services the organization plans to offer? Are there any other organizations and resources in the community currently providing the same or similar services? If so, how do the organization’s services differ?
  1. Possible barriers
What are the possible barriers the organization may encounter in carrying out its proposed programs? How does the organization plan to address these issues?
  1. Organizational Leadership
  1. Please list each of your officers. You must include a President and/or Chairperson, Secretary, and Chief Financial Officer and/or Treasurer. You may include any other officers the organization may have. In addition to providing their names, addresses, and phone numbers, please indicate if they will be paid for their services. Please list their compensation, duties, and responsibilities, and attach a resume for each listed officer.
  2. Please list all of the Directors who have agreed to serve on your Board of Directors. Please list their names, addresses, qualifications and resumes. Also indicate if the organization plans on compensating any of the Directors or Officers.

  1. Employees/Contractors
  1. Please list any employees or independent contractors who receive or will receive compensation from the organization. For each employee or contractor, please include their title, duties, qualifications, average hours worked and mailing addresses, and list the total amount of compensation each such person is expected to receive. You do not need to list any person more than once.
  2. Are any of your officers, directors, trustees, highest compensated employees, or independent contractors related to any other such person through family or business relationships? If so, please identify the individuals and explain the relationship. Attach a separate sheet if necessary.
  1. If you intend to classify any person as an independent contractors who will provide programmatic, administrative or management services to the organization, please explain the following:
  • Where will the person work?
  • How much control will the organization have over the details of the person’s responsibilities?
  • Will the organizationprovide the tools that the person will need to do the job he or she has been contracted to do?
  1. Do you or will you purchase or sell any goods, services, or assets from any of your officers, directors, trustees, highest compensated employees, or highest compensated independent contractors listed above? If “Yes,” describe any such transaction(s) and attach copies of any written contracts or other agreements relating to such transactions.
  2. Do you or will you have any relationship with any other organization in which any of your officers, directors, or trustees are also officers, directors, or trustees, or in which any individual officer, director, or trustee owns more than a 35% interest? If “Yes,” attach a detailed explanation and attach copies of any agreements relating to such arrangements.

PartVI– Fundraising

Please check off all of the sources from which the organization plans on obtaining financial support, and describe in detail in an attachment how it plans to carry out each of the activities and approximately what percentage of its budget the organization plans to raise with each activity. Include fundraising programs, actual and planned, and identify where each activity will take place. Answers should be consistent with the proposed budget.

Mail solicitation / Phone solicitation / Email solicitation
Accept donations on website / Personal solicitations / Foundation grant solicitations
Vehicle, boat, plane, or similar donations / Government grant solicitations / Received donations from another organization’s website
Other / Events (Dinner, auction, etc.)

PART VII– Financial Data

Whether the organization has been in existence for years or is just beginning, the application for tax-exemption requires certain financial information in the form of a budget and balance sheet. If the organization has been operating for any amount of time, you should already have a good understanding of how much money the organization has been generating and how that money has been spent. If you are starting a new organization, the process of developing a budget will require some research and planning. You may need to take time to think about how much money you realistically can raise, including the sources of funding in the community that are available and that the organization may qualify for. You will also need to know what it will cost to administer the organization’s programs.

You must complete this section to the best of your knowledge, including at least 3 years projected or actual revenue and expenses, to qualify for pro bono legal services with CDP. See Attachment 1 for more details. Please DO NOT submit a blank budget or a form with all zeros. Also, you must use the following form budget; please DO NOT submit substitute budgets and attachments because we require the specific line items listed in the following pages. Start-up organizations must provide projections for revenue and expenses.

Finally, please ensure that the information you submit in the text portion of the application is consistent with the budget in the Financial Data Section. For example, if you listed that you plan to hire employees, please indicate the corresponding compensation in the budget. CDP CANNOT assist you with developing your budget.

For additional guidance on developing your budget,please see the link to ourList of Resources and Organizations Providing Technical Assistance to Nonprofitson page one of this application.This list includes but is not limited to the Center for Nonprofit Management, Long Beach Nonprofit Partnership, and Valley Nonprofit Resources.

Instructions for Statement of Revenue and Expenses

The number of columns you must complete will depend on the number of full and partial tax years the organization has been in existence. For purposes of these instructions, years in existence refer to completed tax years. The organization’s tax year is the 12 month period that you have selected for calculating the organization’s annual financial statements.

  1. Organizations in existence for 5 or more years – If the organization has been in existence for 5 or more prior years, complete the statement for the 5 most recent years. Place financial information for the most recently completed year in column (a). Financial projections for the current year are not required.
  1. Organizations in existence for 1 to 4 years – If the organization has been in existence for more than one year, but less than five years, complete the statement for each year in existence and provide projections of the organization’s likely income and expenses for a total of 4 years of financial information (including the current year). Place projections for the current year (up to the end of the organization’s tax year) in column (a).
  1. Organizations in existence for less than 1 year – If the organization is recently formed and has been in existence for less than one year, provide projections of the organization’s likely income and expenses for the current year (up to the end of the organization’s tax year) in column (a) and the next 2 years in columns (b) and (c).

Public Counsel | Community Development Project | nonprofit incorporation &tax-exemption application | Page 1

Statement of Revenue and Expenses(Budget)

Revenue / Current Tax Year (Mo/Yr) / Actual Budget for prior tax years
or proposed budget for future years / Total
(a)From
To / (b)From
To / (c)From
To / (d)From
To / (e)From
To / (f) Provide Total for (a) through (e)
1 / Gifts, grants, and contributions received (not including unusual grants)
2 / Membership fees received
3 / Gross investment income
4 / Net income from organization's unrelated business activities
5 / Tax revenues levied for and either paid to or spent on behalf of the organization
6 / Value of services or facilities furnished by a governmental unit to the organization without charge (not including the value of services or facilities generally furnished the public without charge)
7 / Any revenue not otherwise listed above or in lines 9-12 below (attach itemized list)
8 / Total of lines 1 through 7
9 / Gross receipts from admissions, merchandise sold or services performed, or furnishing of facilities in any activity that is related to your exempt purposes (attach itemized list)
10 / Total of lines 8 and 9
11 / Net gain or loss on sale of capital assets(attach schedule and see instructions)
12 / Unusual Grants
13 / Total Revenue
Add lines 10 through 12
Expenses / 14 / Fundraising expenses
15 / Contributions, gifts, grants, and similar amounts paid out (attach itemized list)
16 / Disbursements to or for benefit of members (attach itemized list)
17 / Compensation of officers, directors, trustees (attach itemized list)
18 / Other salaries and wages (attach itemized list)
19 / Interest Expense
20 / Occupancy (rent, utilities, etc.)
21 / Depreciation and depletion
22 / Professional fees (attach itemized list)
23 / All other expenses, including programmatic (operational and administrative) expenses (attach itemized list)
24 / Total expenses
Add lines 14 through 23

**Please provide a schedule when requested by using the form provided on the following pages**