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California Free Printable California Form 3500 A, Submission of Exemption Request for 2021 California Submission of Exemption Request and Instructions

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Submission of Exemption Request and Instructions
California Form 3500 A, Submission of Exemption Request

Submission of Exemption Request CALIFORNIA FORM 3500A Exemption Based on Internal Revenue Code (IRC) Sections 501(c)(3), 501(c)(4), 501(c)(5), 501(c)(6), 501(c)(7), or 501(c)(19), Federal Determination Letter Enclose a copy of the Federal Determination Letter. 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 Telephone Second telephone ZIP code Fax Representative Information Name of representative Email address Representative’s mailing address (suite, room, or PMB no.) City State Telephone Second telephone ZIP code Fax Part I — Entity Information. See instructions. 1 □ Yes Has the Franchise Tax Board (FTB) previously revoked the entity’s tax-exempt status?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 □ No If “Yes,” STOP. File form FTB 3500. □ Yes □ No mm dd yyyy ____ / ____ / ____ 2 Is the entity a trust? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 3 When did the organization establish, incorporate, organize, or conduct business in California? . . . . . . . . . . . . . . . . . . . . . . . 3 4 Provide gross receipts for the current year and the three immediately preceding taxable years in existence. Gross receipts are defined as the total amounts the organization received from all sources during its annual account period without subtracting any costs or expenses. If the organization has been in existence for less than one year, provide the projected amount of gross receipts for the entire year. List the account period beginning to the account period ending. Example: mm/dd/yyyy Current Year or Projected Gross Receipts From: To: Gross Receipts for the three immediately preceding taxable years: From: To: From: To: From: To: Part II — Group Exemption. See instructions. 5 □ Yes □ No Is a subordinate unit applying for tax-exempt status using a parent’s Internal Revenue Service (IRS) group determination letter? If “Yes,” see instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 □ Yes □ No Is the parent organization applying for a group exemption? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 If “Yes,” attach the federal group determination letter and a list of all California subordinates. Include each subordinate’s name, California corporation number, federal employer identification number (FEIN), address, and affiliation date. 6 Mail form FTB 3500A and a copy of the federal determination letter to: EXEMPT ORGANIZATIONS UNIT, MS F120, FRANCHISE TAX BOARD, PO BOX 1286, RANCHO CORDOVA CA 95741-1286. Under penalties of perjury, I declare I have examined this submission for exemption based on the IRC Sections 501(c)(3), 501(c)(4), 501(c)(5), 501(c)(6), 501(c)(7), or 501(c)(19), federal determination letter, and to the best of my knowledge and belief, it is true, correct, and complete. DATE TITLE SIGNATURE OF OFFICER OR REPRESENTATIVE 8091203 FTB 3500A 2020 Side 1 Part III — Purpose and Activity 1 Exemption based on IRC Section 501(c)(3) Federal Determination Letter Check the organization’s primary purpose and activity: □ Charitable □ Mosque □ Testing for public safety □ Literary 2 □ Hospital □ Church □ Qualified sports organization □ Scientific □ Health care center □ Temple □ Prevent cruelty to animals □ Religious □ Educational □ Synagogue □ Prevent cruelty to children □ School Exemption based on IRC Section 501(c)(4) Federal Determination Letter Check the organization’s primary purpose and activity: □ Civic league □ Local association of □ Social welfare □ Service clubs □ Veterans’ organization □ Municipal building □ Police, sheriff, □ Quasi governmental employees □ Legislative activities □ Festival organizations corporation 3 volunteer firemen association Exemption based on IRC Section 501(c)(5) Federal Determination Letter Check the organization’s primary purpose and activity: □ Agriculture □ AFL-CIO □ Horticulture □ Independent □ Labor □ Transportation □ Agriculture or horticulture county fair □ Teamsters □ Public employees union workers 4 Exemption based on IRC Section 501(c)(6) Federal Determination Letter Check the organization’s primary purpose and activity: □ Board of trade 5 □ Business league □ Real estate board Exemption based on IRC Section 501(c)(7) Federal Determination Letter Check the organization’s primary purpose and activity: □ Social and recreational □ Golf club □ Camps □ Car, motorcycle, □ Hunting or trailer club 6 □ Chamber of commerce fishing club □ Common recreational area Exemption based on IRC Section 501(c)(19) Federal Determination Letter Check the organization’s primary purpose and activity: □ Veterans’ organization FTB 3500A 2020 Side 2 8092203 □ Professional association or society □ Fraternity or sorority □ Flying or airplane club □ Dog or horse club
Extracted from PDF file 2020-california-form-3500-a.pdf, last modified November 2020

More about the California Form 3500-A Corporate Income Tax TY 2020

When submitting this form, please include a copy of the Federal Determination Letter. This form requires general information of the organization and representative along with the reason for exemption.

We last updated the Submission of Exemption Request and Instructions in March 2021, so this is the latest version of Form 3500-A, fully updated for tax year 2020. You can download or print current or past-year PDFs of Form 3500-A directly from TaxFormFinder. You can print other California tax forms here.

Other California Corporate Income Tax Forms:

TaxFormFinder has an additional 174 California income tax forms that you may need, plus all federal income tax forms.

Form Code Form Name
Form 100-ES Corporation Estimated Tax
3805-Z Booklet Enterprise Zone Business Booklet
Form 541 California Fiduciary Income Tax Return
Form 541-B Form Charitable Remainder and Pooled Income Trusts
Form 3522 Limited Liability Company Tax Voucher

Download all CA tax forms View all 175 California Income Tax Forms


Form Sources:

California usually releases forms for the current tax year between January and April. We last updated California Form 3500-A from the Franchise Tax Board in March 2021.

Show Sources >

About the Corporate Income Tax

The IRS and most states require corporations to file an income tax return, with the exact filing requirements depending on the type of company.

Sole proprietorships or disregarded entities like LLCs are filed on Schedule C (or the state equivalent) of the owner's personal income tax return, flow-through entities like S Corporations or Partnerships are generally required to file an informational return equivilent to the IRS Form 1120S or Form 1065, and full corporations must file the equivalent of federal Form 1120 (and, unlike flow-through corporations, are often subject to a corporate tax liability).

Additional forms are available for a wide variety of specific entities and transactions including fiduciaries, nonprofits, and companies involved in other specific types of business.

Historical Past-Year Versions of California Form 3500-A

We have a total of ten past-year versions of Form 3500-A in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:


2020 Form 3500-A

California Form 3500 A, Submission of Exemption Request

2019 Form 3500-A

California Form 3500 A. Submission of Exemption Request

2018 Form 3500-A

2018 Form 3500A - Submission of Exemption Request

2017 Form 3500-A

2017 Form 3500-A - Submission of Exemption Request

2016 Form 3500-A

2016 3500A Submission of Exemption Request

Submission of Exemption Request and Instructions 2015 Form 3500-A

2015 Form 3500A -- Submission of Exemption Request

Submission of Exemption Request and Instructions 2014 Form 3500-A

2014 Form 3500A -- Submission of Exemption Request

Submission of Exemption Request and Instructions 2013 Form 3500-A

2013 Form 3500A -- Submission of Exemption Request

2012 Form 3500-A

2012 Form 3500A

2011 California Form 3500A 2011 Form 3500-A

2011 Form 3500A -- Submission of Exemption Request


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