Nonprofit Formation Questionnaire
Please complete the form below. Once you submit your questionnaire, a Biz Specialist will contact you to set up your assessment call! If you have any questions about the questionnaire, please contact us at 323-744-8571 or email info@coffeyandbiz.com
Full Name
First Name
Middle Name/Initial
Last Name
What will be the official physical address for the nonprofit? (Must be a physical address. No P.O. Boxes)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Will there be a different mailing address for the organization? (This can be a P.O. Box)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What County, in your state, will the nonprofit be located in?
Phone Number
-
Area Code
Phone Number
E-mail
Social Security Number
This information is utilized to obtain your EIN (Employer Identification Number) with the IRS. If you do not want to provide this information at this time, we will schedule a call at the time of obtaining your EIN so that we can input the information directly into the IRS's database.
Desired Business Name
What is the purpose of your organization or church?
What activities will the organization or church participate in and/or host?
What is the vision and mission statement?
If you don't have one at this time, please type N/A
What is the end of your fiscal year?
December 31st is what most people choose.
Registered Agent
A registered agent is someone whom you designate to receive official papers for your business. These would include documents related to lawsuits, and also important communications from the state such as renewal notices for business registrations. Often, laws or official instructions relating to registered agents refer to their receiving “service of process,” which is a way of saying that registered agents are designated to receive papers relating to lawsuits. This person must live in your state. It can be yourself or any other third-party that you designate.
Who is your Registered Agent? (It can be an individual person or a 3rd-party company)
If an individual, please provide their first and last name
What is the Registered Agent's mailing address? (If you do not have this information, we will gather it at a later time.)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What type of 501c3 tax exemption status would you like to apply for?
Public Organization
Private Foundation
Not Sure As of Yet / Will Need Assistance With Decision
Please list the names, addresses and phone numbers of your three Board of Directors (President, Secretary, and Treasurer) and any additional Board Members that you may have.
Two or more offices may be held by the same individual, except for president and secretary. It is best to have three separate people for each office. *PLEASE NOTE: If all addresses are the same for each person, please only provide the address once under the President's information.
President Name
First Name
Last Name
President Phone Number
-
Area Code
Phone Number
President Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Vice President/Chair Name (If Applicable)
First Name
Last Name
Vice President/Chair Phone Number (If Applicable)
-
Area Code
Phone Number
Vice President/Chair Mailing Address (If Applicable)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Secretary Name
First Name
Last Name
Secretary Phone Number
-
Area Code
Phone Number
Secretary Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Treasurer Name
First Name
Last Name
Treasurer Phone Number
-
Area Code
Phone Number
Treasurer Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Board Member #1 Name (Optional)
First Name
Last Name
Board Member #1 Phone Number
-
Area Code
Phone Number
Board Member #1 Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Board Member #2 Name (Optional)
First Name
Last Name
Board Member #2 Phone Number
-
Area Code
Phone Number
Board Member #2 Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Board Member #3 Name (Optional)
First Name
Last Name
Board Member #3 Phone Number
-
Area Code
Phone Number
Board Member #3 Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How often will your board of directors meet?
Some organizations meet bi-weekly, monthly, quarterly, or annually
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