The California Form 3500 is an exemption application used by organizations seeking tax-exempt status in California. This form collects essential information about the organization, including its structure, activities, and financial data. Completing this form accurately is crucial for ensuring your organization's request for exemption is processed smoothly.
To get started on your application, click the button below.
The California Form 3500 is an essential document for organizations seeking tax-exempt status in California. This form, known as the Exemption Application, gathers crucial information about the organization, including its structure, purpose, and activities. Organizations must provide their California corporation number or Secretary of State file number, along with their Federal Employer Identification Number (FEIN). The form also requires detailed information about the organization's representative, including contact details. In Part I, applicants answer questions regarding their organizational structure, such as whether they are a foreign corporation, trust, or limited liability company (LLC). Part II focuses on the narrative of activities, where organizations describe their past, present, and planned activities in detail. Financial data is covered in Part III, requiring previous tax filings and income statements. Parts IV through VII delve into the organization's officers, fundraising activities, and any specific operations, such as gaming or leasing property. Completing the California Form 3500 accurately is crucial for organizations to secure their tax-exempt status and fulfill compliance requirements.
CALIFORNIA FORM
Exemption Application
3500
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
General Questions
Part I
Organizational Structure
If the listed documents are not provided, the organization’s request for exemption will be delayed, or denied . Copies are acceptable .
1
.Is this a foreign corporation?
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
.□. .Yes. . 1
□No
See General Information F, Foreign Corporations .
2
Is this a trust?
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
□Yes
See General Information H, Trusts .
3
Is this a limited liability company (LLC)?
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
.□. Yes. . .
□. .No
See General Information I, Limited Liability Companies .
a Is the parent organization a nonprofit organization? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . □. .Yes. . .□. No. . . . . . .
If “Yes,” enter parent’s employer identification number (EIN) ___________________
If “No,” STOP, the LLC does not qualify for California tax-exempt status .
4 Are you currently tax-exempt with the Internal Revenue Service? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . □. Yes. . . .□. No. . . . . . .
5 Are you applying for group exemption? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . □. . Yes. . . . □. 5No See General Information L, Group Exemption .
Mail form FTB 3500 to: EXEMPT ORGANIZATIONS UNIT MS F120, FRANCHISE TAX BOARD, PO BOX 1286, RANCHO CORDOVA, CA 95741-1286 .
Under penalties of perjury, I declare that I have examined this application, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete.
DATE
SIGNATURE OF OFFICER OR REPRESENTATIVE
TITLE
7221213
FTB 3500 2021 Side 1
Organization name: __________________________
Corp number/CA SOS file number:
Part II Narrative of Activities
Was the organization’s California tax-exempt status previously revoked?
. . . . . . . . . . . . . . . . . . . . .
. . . . . . .
. . □. Yes. .
.
.□. No. . . . . 1
If “No,” the organization may qualify to file form FTB 3500A, Submission of Exemption Request . For more information, get form FTB 3500A .
Enter the California Revenue and Taxation Code (R&TC) section that best fits the organization’s purpose/activity
See the Exempt Classification Chart on page 6
. . R&TC. . . . Section. . . . 23701. . . .
. . 2
Enter the date the organization formed
. . . . . ./ .
. .
. / . .
. . . . . . 3
mm /
dd
/
yyyy
4What is the organization’s annual accounting period ending?
(must end on the last day of the calendar or fiscal year) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4 . . . . . / . . . . . . . . .
mm / dd
5What is the primary purpose of the organization?
6
Is the organization currently conducting, or plan to conduct activities?
. 6. .
□. .Yes. . . □. No
If “Yes,” enter the date the activities began, or will begin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . /.
. ./
Side 2 FTB 3500 2021
7222213
Part II Narrative of Activities (continued)
7Describe the organization’s past, present, and planned activities below. Do not merely refer to or repeat the language in the organizational document . List each activity separately, in the order of importance based on the relative time and other resources devoted to the activity. Indicate the percentage of time for each activity. Each description should include a:
a Detailed description of the activity, including its purpose and how it furthers the organization’s exempt purpose . b Detailed description of when the activity was or will be initiated .
c Detailed description of where and by whom the activity will be conducted .
7223213
FTB 3500 2021 Side 3
Part III Financial Data
1a Has the organization filed the Form 199, California Exempt Organization Annual Information Return, for the current
and prior years?
1a □Yes
b Has the organization filed the FTB 199N, California e-Postcard, for the current and prior years?
. . . □1bYes
We will review information reported on previously filed Form 199 to determine exemption eligibility. If the FTB 199Ns were filed or no returns were filed, attach a detailed income and expense statement for the current year and three previous years . If you are not yet active, attach a proposed budget covering the next four years .
Part IV Officers, Directors, and Trustees
1List names, titles, and mailing addresses of all officers, directors, and trustees whether or not compensation is or will be paid . For each person listed, state their total annual compensation, or proposed compensation, for all services to the organization, whether as an officer, employee, or other position . Use actual figures, if available . Enter “none” if no compensation is or will be paid . If additional space is needed, attach a separate sheet .
Name
Title
Mailing Address
Compensation Amount (annual actual or estimated)
2Will any incorporator, founder, board member or other person(s) or entity:
a Share any facilities with the organization?
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. a.
. □. Yes. .
. .□. No
b Rent, sell, or transfer property to this organization?
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b
c Be compensated for services other than performing as a board member or employee?
c
Part V
History
. . . . .
1 Has the organization been issued any previous California ID number?
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. .□. Yes. .
. □. .No.
Was this organization’s exemption previously revoked by the Internal Revenue Service?
. □. .Yes. .
. □. No. . 2
If “Yes,” enter date revoked
mm
Part VI
Fund Raising
Does or will the organization participate in fund-raising activities? . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . .
. .□. .Yes. □. 1No. .
If “Yes,” check all the fund-raising programs the organization conducts, or will conduct .
□ Mail solicitations
□ Phone solicitations
□ Email solicitations
□ Accept donations on the organization’s website
□ Personal solicitations
□ Receive donations from another organization’s website
□ Vehicle, boat, plane, or similar donations
□ Government grant solicitations
□ Foundation grant solicitations
□ Other - Attach description
Side 4 FTB 3500 2021
7224213
Part VII Specific Activities
Does the organization conduct any gaming activities (bingo, raffles, etc .) .
. . . . . . . . . . . . . . . . . . . . . . .
. . .
. . . . . . . . .
1 □Yes □No
Does the organization lease property from others?
. . . . . . . . . . . . . . . . . .
. . .□. Yes. . . .
□. . No. 2
If “Yes,” attach copy of lease agreement .
Does the organization lease property to others?
. . □. Yes. . .
.□. No
4
Does or will the organization publish, sell, or distribute any literature? . . .
. . . . . . . . . . . . . . . . . . . . . .
4 □Yes
5
Does or will the organization own, or have rights in music, literature, tapes, artworks, choreography, scientific discoveries,
or other intellectual property?
6Does or will the organization accept contributions of real property, conservation easements, closely held securities, intellectual
property such as patents, trademarks, and copyrights, works of music or art licenses, royalties, automobiles, boats, planes, or
other vehicles, or collectibles of any type? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . □. Yes. . . .□. No. . . . . . .
7Does or will the organization operate outside of the United States? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .□. Yes. . . □. .No. . . . . . .
7225213
FTB 3500 2021 Side 5
Schedule 1
Section A R&TC Section 23701a – Labor, agricultural, or horticultural organization
1 Are any services to be performed for members? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. . .□. Yes. . . . □. . No If “Yes,” explain .
Is the organization formed as a cooperative?
If “Yes,” provide a copy of the federal exemption letter showing exemption under IRC Section 501(c)(5)
2 □Yes □No
Section B R&TC Section 23701b – Fraternal societies, orders, or associations, etc. (Lodge system with benefits)
Operating under the lodge system means carrying on activities under a form of organization that comprises local branches called lodges, chapters, or the like, that are largely self-governing and chartered by a parent organization .
1 Is the organization a college fraternity or sorority or a chapter of a college fraternity or sorority? . . . . . . . . . . . . . . . . . . . . . . . 1 □Yes □No
If “Yes,” college fraternities and sororities generally qualify as organizations described in R&TC Section 23701g .
For more information, get FTB Pub 1077, Guidelines for Social and Recreational Organizations . If R&TC Section 23701g appears to apply, do not complete Section B . Go to Section G on Schedule 3, Social and recreational organization .
2Does the organization operate, or plan to operate under the lodge system or for the exclusive benefit of the members of
the lodge system?
. . . . . 2
Is the organization a subordinate of a national or state level organization?
. . . . 3.
. □. No
If “Yes,” attach a certificate signed by the secretary of the parent organization certifying that the subordinate is a duly
constituted body operating under the jurisdiction of the parent body.
Is the organization a parent or grand lodge?
. . . . . 4
5Describe the types of benefits (life, sick, accident, or other benefits) paid, or to be paid, to members .
Section L R&TC Section 23701l – Fraternal beneficiary societies, orders, or associations, etc. (Lodge system with no benefits)
Operating under the lodge system means carrying on activities under a form of organization that comprises local branches (called lodges, chapters, or the like) that are largely self-governing and chartered by a parent organization .
1 Is the organization a college fraternity or sorority, or a chapter of a college fraternity or sorority? . . . . . . . . . . . . . . . 1. . □. .Yes. . . □No
For more information, get FTB Pub 1077, Guidelines for Social and Recreational Organizations . If R&TC Section 23701g appears to apply, do not complete Section L . Go to Section G on Schedule 3, Social and recreational organization .
2Does the organization operate or plan to operate under the lodge system or for the exclusive benefit of the members of
a lodge system?
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. .
.□. .Yes. . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . 3.
. □. .Yes. . . □. No
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Side 6 FTB 3500 2021
7226213
Schedule 2
Section D R&TC Section 23701d – Religious, charitable, scientific, literary, or educational organization
1Check the box(es) below that best describes the organization .
□ Charitable
□ Educational
□ Credit Counseling
□ Synagogue
□ School
□ Testing for public safety
□ Church
□ Literary
□ Hospital, Medical Center
□ Temple
□ Scientific
□ Qualified sports organization
□ Mosque
□ Religious
□ Prevent cruelty to children or animals
2Has the organization received or expect to receive 10% or more of its assets from any organization or group of affiliated organizations (affiliated through stockholding, common ownership, or otherwise), any individuals, or members of a family
group (brother or sister whether whole or half blood, spouse/RDP, ancestor or lineal descendant)?
Does the organization attempt to influence legislation?
3. . .
□. Yes. . . .
□. . No
4Does the organization support or oppose candidates in political campaigns in any way? . . . . . . . . . . . . . . . . . . . . 4. . □. Yes. . . .□. No.
5Does the organization hold, or plan to hold, 10% or more of any class of stock or 10% or more of the total combined
voting power of stock in any corporation?
. 5. .
.□. .Yes.
a
Does the organization operate as a church, mosque, synagogue, or temple?
.6a. .
.□. .Yes
If “Yes,” complete Schedule 2A, Churches .
Is the organization’s main function to provide hospital or medical care?
6b
If “Yes,” complete Schedule 2B, Hospitals .
Is the organization a credit counseling organization?
6c
If “Yes,” complete Schedule 2C, Credit Counseling Organizations .
7227213
FTB 3500 2021 Side 7
Schedule 2A – Churches
Complete Schedule 2A only if the organization answered “Yes” to Specific Section D, Question 6a .
1Check the box that best describes the organization .
□Church □Mosque □Synagogue
□Temple
Has a place of worship been established?
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . □. Yes. . . .□. No
If “Yes,” at what address? Who is the legal owner of the property? Other property use?
If “No,” explain where religious services are held .
3 Does the organization have a regular congregation or conduct religious services on a regular basis?. . . . . . . . . . . . . . . . . . . . 3 □Yes □No If “Yes,” how many usually attend the regular worship services? How often are religious services held?
If “No,” explain .
4Explain the background and training of the religious leaders .
5Will income be received from incorporators, ministers, officers, directors, or their families? . . . . . . . . . . . . . . . . . . . . □. Yes. . . .□. No5 If “Yes,” explain, including dollar amounts received .
Will any founder, member, or officer take a vow of poverty? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .□. Yes. . . □. .No
If “Yes,” explain .
7Will any founder, member, or officer transfer personal assets to this organization, like a home, automobile, furnishings,
business, or recreational assets, etc ., that will be made available for the personal use of the donors? . . . . . . . . . . . . . . . □. .Yes. . 7□No If “Yes,” explain .
Side 8 FTB 3500 2021
Schedule 2A Churches continued
7228213
Schedule 2A – Churches (continued)
8Will any founder, member, or officer assign or donate income to the organization that will be used to pay their own personal salary, living allowance, or that will result in any other personal benefit (such as food, medical expenses, clothing,
insurance, etc .)?
8 □Yes □No
9
Does the organization have a written creed, statement of faith, or summary of beliefs?
9 □Yes □No
10
Do the religious leaders conduct baptisms, weddings, funerals, etc .?
10. . . .□Yes □No
11
Does the organization ordain, commission, or license ministers or religious leaders?
11 □Yes □No
If “Yes,” describe .
7229213
FTB 3500 2021 Side 9
Schedule 2B – Hospitals
Complete Schedule 2B only if the organization answered “Yes” to Specific Section D, Question 6b . Attach a statement to explain any answers .
Are all the doctors in the community eligible for staff privileges?
If “No,” give the reasons why and explain how the medical staff is selected .
2a Does or will the organization provide medical services to all individuals in the community who can pay for themselves
or have private health insurance? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a. . . □. Yes. . . □. .No. . . . . . .
bDoes or will the organization provide medical services to all individuals in the community who participate in
Medicare? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . □. Yes. . . .□. No. . . . . . .
3a Does or will the organization require persons covered by Medicare or Medicaid to pay a deposit before receiving
services?
3a
b Does the same deposit requirement, if any, apply to all other patients?
3b
Does or will the organization maintain a full-time emergency room?
4a
If “No,” explain why the organization does not maintain a full-time emergency room . Also, describe any emergency
services provided .
Does the organization have a policy on providing emergency services to persons without apparent means to pay? . . . .
4b. .
If “Yes,” provide a copy of the policy.
cDoes the organization have any arrangements with police, fire, and voluntary ambulance services for the delivery
or admission of emergency cases?
.□. Yes. . 4c □No
If “Yes,” describe the arrangements, including whether they are written or oral agreements . If written, submit copies of
all such agreements .
Does the organization provide for a portion of the organization’s services and facilities to be used for charity patients? . . .
5a
If “Yes,” answer question 5b through question 5e .
Explain the organization’s policy regarding charity cases, including how the organization distinguishes between charity
care and bad debts . Submit a copy of the written policy.
Provide data on the organization’s past experience in admitting charity patients, including the amounts expended for
treating charity care patients and types of services provided to charity care patients .
d
Describe any arrangements with federal, state, or local governments or government agencies for paying for the cost
of treating charity care patients . Submit copies of any written agreements .
e
Does the organization provide services on a sliding fee schedule depending on financial ability to pay?
5e
If “Yes,” submit the sliding fee schedule .
Does or will the organization carry on a formal program of medical training or medical research?
6a
If “Yes,” describe such programs, including the type of programs offered, the scope of such programs, and affiliations
with other hospitals or medical care providers with which the organization carries on the medical training or research
programs .
Does or will the organization carry on a formal program of community education?
.□. Yes6b
with other hospitals or medical care providers with which the organization offers community education programs .
Schedule 2B Hospitals continued
Side 10 FTB 3500 2021
Filling out the California 3500 form is an important step in applying for tax-exempt status. Once you complete the form, you will need to submit it to the Franchise Tax Board. Ensure that all information is accurate and complete to avoid delays or denial of your application.
What is the California 3500 form?
The California 3500 form is an application used by organizations seeking tax-exempt status in California. It is essential for nonprofits and other qualifying entities to submit this form to the Franchise Tax Board to receive exemption from state income tax.
Who needs to file the California 3500 form?
Organizations such as nonprofits, trusts, and certain limited liability companies (LLCs) that wish to obtain tax-exempt status in California must file this form. If your organization is not a nonprofit or does not meet the criteria outlined in the form, it may not qualify for exemption.
What information is required to complete the form?
The form requires various details, including the organization’s name, address, and contact information. It also asks for information about the organizational structure, financial data, activities, and the identities of officers and directors. Providing accurate and complete information is crucial to avoid delays or denials.
What happens if my organization’s tax-exempt status is revoked?
If your organization’s tax-exempt status has been revoked, you must indicate this on the form. Depending on the circumstances, you may need to provide additional documentation or explanations regarding the revocation and any steps taken to rectify the situation.
Can I apply for a group exemption using the California 3500 form?
Yes, if your organization is part of a group that qualifies for tax-exempt status, you can apply for a group exemption. Ensure you check the appropriate box on the form and provide any required information related to the group structure.
What are the consequences of not providing the required documents?
If you fail to provide the necessary documents or information, your application for tax exemption may be delayed or denied. It is important to submit all requested materials, including copies of relevant documents, to support your application.
Is there a deadline for submitting the California 3500 form?
While there is no specific deadline mentioned for the California 3500 form, it is advisable to submit it as soon as your organization is ready. Delays in submission can impact your organization’s ability to operate as a tax-exempt entity and may lead to financial consequences.
Where should I send the completed California 3500 form?
The completed form should be mailed to the Exempt Organizations Unit at the Franchise Tax Board. The address is: MS F120, Franchise Tax Board, PO Box 1286, Rancho Cordova, CA 95741-1286. Ensure you send it to the correct address to avoid any processing issues.
Completing the California Form 3500 can be a daunting task, and many applicants make common mistakes that can delay or jeopardize their exemption status. Understanding these pitfalls can help ensure a smoother application process.
One frequent mistake is not providing all required documentation. The form clearly states that if the listed documents are not submitted, the request for exemption may be delayed or denied. Many applicants assume that submitting the form alone is sufficient. However, attaching copies of relevant documents is crucial for a successful application.
Another error involves misidentifying the organizational structure. Applicants sometimes fail to accurately answer questions about whether the entity is a foreign corporation, trust, or limited liability company. Misclassification can lead to significant issues, as different types of organizations have different requirements under California law.
Many applicants overlook the importance of the narrative section. This part of the form requires a detailed description of the organization’s activities. Simply stating the organization’s purpose without elaboration does not meet the requirements. Each activity should be clearly outlined, including its purpose, when it began, and who is involved.
Additionally, some individuals neglect to provide accurate financial data. This section is critical, as it helps demonstrate the organization’s financial health and compliance with tax regulations. Failing to include this information or providing incomplete financial statements can raise red flags during the review process.
Another common mistake is not including all officers, directors, and trustees on the form. It’s important to list everyone involved, regardless of whether they are compensated. Omitting individuals can lead to questions about the organization’s governance and transparency.
Many applicants also misinterpret the question regarding previous tax-exempt status. If the organization’s status was revoked, it’s essential to disclose this information. Failing to do so could be seen as an attempt to mislead the reviewing body, which can result in denial of the application.
Some individuals forget to sign and date the form. This might seem like a minor detail, but an unsigned application can be returned, leading to unnecessary delays. Always ensure that the form is properly signed before submission.
Lastly, applicants sometimes fail to double-check for accuracy. Simple typographical errors, such as incorrect addresses or numbers, can create complications. Taking the time to review the form before submission can prevent these avoidable mistakes.
By being aware of these common pitfalls, applicants can navigate the California Form 3500 process more effectively, reducing the risk of delays and increasing the likelihood of a successful exemption application.
The California Form 3500 is an important document for organizations seeking tax-exempt status. When submitting this form, you may also need to prepare additional documents to support your application. Here are five commonly used forms and documents that often accompany the California 3500 form.
Having these documents ready can streamline the exemption application process. Make sure to review each form's requirements carefully to ensure a smooth submission. Good luck with your application!
When filling out the California 3500 form, here are six important guidelines to follow:
Here are six things to avoid when completing the California 3500 form:
Misconceptions about the California 3500 form can lead to confusion and delays in the exemption application process. Here are four common misconceptions:
The California 3500 form is used to apply for tax-exempt status for organizations in California.
Organizations must provide accurate information, including their legal name, address, and federal employer identification number (FEIN).
Completing the form requires detailing the organizational structure, such as whether the entity is a corporation, trust, or LLC.
Organizations should include copies of necessary documents to avoid delays or denial of their exemption request.
Part II of the form requires a narrative describing past, present, and planned activities, emphasizing their purpose and how they support the organization's exempt status.
Financial information, including previous filings of Form 199 or FTB 199N, is essential for determining exemption eligibility.
Organizations must mail the completed form to the designated address for processing.