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Federal Free Printable Form 3491 (Rev. October 2023) for 2024 Federal Consumer Cooperative Exemption Application

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Consumer Cooperative Exemption Application
Form 3491 (Rev. October 2023)

Form 3491 Consumer Cooperative Exemption Application OMB No. 1545-1941 (For Exemption From Filing Forms 1099-PATR) (Rev. October 2023) Department of the Treasury Internal Revenue Service File in duplicate. Go to www.irs.gov/Form3491 for the latest information. This application is for certain consumer cooperatives that are engaged primarily in retail sales of goods or services that are generally for personal, living, or family use. 1a Name of organization 2 b Employer identification number Number, street, and room or suite no. (If a P.O. box, see instructions.) City, state, and ZIP code 4 Month and day on which the annual accounting period ends 3 Principal activity of the organization 5 Has the organization filed a federal income tax return(s)? . . . . . . . . . . . . . . . . . If “Yes,” enter the form number(s) of the return(s) filed and the Internal Revenue Service location where filed. No IRS Location Form Number 6 Yes Gross Receipts Period (1) Part of total receipts from retail sales of goods or services that is generally for personal, living, or family use (2) Other receipts (3) Total receipts (add (1) and (2)) a First preceding year $ $ $ b Second preceding year $ $ $ c Third preceding year $ $ $ d Total $ $ * Note: If line a, column (4), is at least 85%, do not complete lines b, c, and d. (4)* Percentage (Divide (1) by (3) and multiply by 100) % $ % Under penalties of perjury, I declare that I have examined this application, including any accompanying statements, and, to the best of my knowledge and belief, it is true, correct, and complete. Signature of officer Title Date Notice to Applicant—To be completed by the Internal Revenue Service We have approved your application. We have not approved your application because Director For Privacy Act and Paperwork Reduction Act Notice, see page 2. Date Cat. No. 19756J Form 3491 (Rev.10-2023) Page 2 Form 3491 (Rev. 10-2023) Instructions Section references are to the Internal Revenue Code unless otherwise noted. What’s New New filing address. The address for filing Form 3491 has changed. See Where To File below. Purpose of Form A cooperative may use Form 3491 to apply for exemption from filing Form 1099-PATR, Taxable Distributions Received From Cooperatives. Form 1099-PATR is used to report patronage distributions of $10 or more to a recipient during the calendar year. Who Must File Any cooperative that is requesting exemption, under section 6044(c), from filing Form 1099-PATR must file Form 3491 and receive a determination from the IRS. To qualify for the exemption, 85% of the cooperative’s gross receipts for the preceding tax year, or 85% of its total gross receipts for the preceding 3 tax years, must have been from retail sales of goods or services that are generally for personal, living, or family use (qualifying retail sales). See Regulations section 1.6044-4. Period of Exemption The period of exemption begins with the date the first payment is made during the calendar year in which exemption is approved. It ends on the date the first payment is made after the end of the cooperative’s first tax year in which less than 70% of the gross receipts is from qualifying retail sales. Examples for Calendar Year Cooperatives Example 1. In September 2021, Oak Cooperative’s application for exemption from filing Forms 1099-PATR is approved. In October 2021, Oak made the first patronage payments for the year. For the tax year ending December 31, 2023, less than 70% of Oak’s gross receipts are from qualifying retail sales. In November 2024, Oak made the first patronage payments for the year. Oak’s exemption period begins October 2021 and ends November 2024. Oak does not have to file Forms 1099-PATR for 2021, 2022, and 2023, but must file for 2024. Example 2. The facts are the same as in Example 1, except that Oak made the first payment for 2021 in February, before the exemption is approved. The result is the same. Oak does not have to file Forms 1099-PATR for 2021, 2022, and 2023, but must file for 2024. Example 3. In September 2021, Maple Cooperative’s application for exemption from filing Forms 1099-PATR is approved. In October 2021, Maple made the first patronage payments for the year. For the year ending December 31, 2021, less than 70% of Maple’s gross receipts are from qualifying retail sales. In March 2022, Maple made the first patronage payments for the year. Maple’s exemption period begins October 2021 and ends March 2022. Maple does not have to file Forms 1099-PATR for 2021 only. Examples for Fiscal Year Cooperatives (July 1–June 30) Example 1. In September 2021, Cedar Cooperative’s application for exemption from filing Forms 1099-PATR is approved. In October 2021, Cedar made the first patronage payments for the year. For the tax year ending June 30, 2024, less than 70% of Cedar’s gross receipts are from qualifying retail sales. In November 2024, Cedar made the first patronage payments for the new fiscal year. Cedar’s exemption period begins October 2021 and ends November 2024. Cedar does not have to file Forms 1099-PATR for 2021, 2022, and 2023, but must file for 2024. Example 2. The facts are the same as in Example 1, except that Cedar made the first payment for 2021 in February, before the exemption is approved. The result is the same. Cedar does not have to file Forms 1099-PATR for 2021, 2022, and 2023, but must file for 2024. Example 3. In September 2021, Elm Cooperative’s application for exemption from filing Forms 1099-PATR is approved. In October 2021, Elm made the first patronage payments for the year. For the tax year ending June 30, 2022, less than 70% of Elm’s gross receipts are from qualifying retail sales. In August 2022, Elm made the first patronage payments for the new fiscal year. Elm’s exemption period begins October 2021 and ends August 2022. Elm does not have to file Forms 1099-PATR for 2021 only. How To Prepare the Form Complete all items on the form. An officer authorized to sign for the cooperative must sign and date the form. P.O. box. If the Post Office does not deliver mail to the street address and the cooperative has a P.O. box, show the box number instead of the street address. Where To File Send two copies of the form to: Department of the Treasury Internal Revenue Service Mail Stop 4-G08.151 Philadelphia, PA 19255-0633 The IRS will return this application to you showing whether the application has or has not been approved. Paperwork Reduction Act Notice We ask for the information on this form to carry out the Internal Revenue laws of the United States. If you want your organization to be considered exempt from filing Form 1099-PATR, you are required to give us this information. We need it to determine whether the organization meets the requirements of section 6044(c) for exemption status. You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number. Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law. Generally, tax returns and return information are confidential, as required by section 6103. The time needed to complete and file this form will vary depending on individual circumstances. The estimated average time for preparing the form is 44 minutes. If you have comments concerning the accuracy of these time estimates or suggestions for making this form simpler, we would be happy to hear from you. You can send us comments through www.irs.gov/FormComments. Or write to the Internal Revenue Service, Tax Forms and Publications Division, 1111 Constitution Ave. NW, IR-6526, Washington, DC 20224. Do not send your application to this address. Instead, see Where To File, earlier.
Extracted from PDF file 2023-federal-form-3491.pdf, last modified November 2023

More about the Federal Form 3491 Other TY 2023

We last updated the Consumer Cooperative Exemption Application in February 2024, so this is the latest version of Form 3491, fully updated for tax year 2023. You can download or print current or past-year PDFs of Form 3491 directly from TaxFormFinder. You can print other Federal tax forms here.

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Form Sources:

The Internal Revenue Service usually releases income tax forms for the current tax year between October and January, although changes to some forms can come even later. We last updated Federal Form 3491 from the Internal Revenue Service in February 2024.

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Historical Past-Year Versions of Federal Form 3491

We have a total of twelve past-year versions of Form 3491 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:


2023 Form 3491

Form 3491 (Rev. October 2023)

2022 Form 3491

Form 3491 (Rev. October 2014)

2021 Form 3491

Form 3491 (Rev. October 2014)

2020 Form 3491

Form 3491 (Rev. October 2014)

2019 Form 3491

Form 3491 (Rev. October 2014)

2018 Form 3491

Form 3491 (Rev. October 2014)

2017 Form 3491

Form 3491 (Rev. October 2014)

2016 Form 3491

Form 3491 (Rev. October 2014)

Consumer Cooperative Exemption Application 2015 Form 3491

Form 3491 (Rev. October 2014)

Consumer Cooperative Exemption Application 2014 Form 3491

Form 3491 (Rev. October 2014)

Consumer Cooperative Exemption Application 2012 Form 3491

Form 3491 (Rev. December 2010)

Consumer Cooperative Exemption Application 2011 Form 3491

Form 3491 (Rev. December 2010)


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