501(c)3 LMC Congregation Application

This form provides authorization to LMC to include the congregation listed below in the application for Group Exemption.

Please fill out all sections of the form in order to submit the application.
Congregation Name*
Church Mailing Address*
Church Physical Address (if different)
Church Phone Number:*
Church email:*
Enter Email Confirm Email
Federal EIN Number:*
The Employer Identification Number, also known as the Federal Employer Identification Number or the Federal Tax Identification Number, is a unique nine-digit number assigned by the IRS to business entities operating in the United States for the purposes of identification.
Church formation date:*
(mm/dd/yyyy)
Type of governing document (e.g., bylaws, charter):*
Application continue next page...

In addition, this congregation affirms as follows:
1. It is a church and therefore not normally required to apply for recognition of its status as tax-exempt under Internal Revenue Code 508(a)*
- True
1. It is a church and therefore not normally required to apply for recognition of its status as tax-exempt under Internal Revenue Code 508(a)*
- True
2. It is affiliated with LMC*
- True
3. It is subject to the general supervision or control of LMC*
- True
4. It qualifies for exemption under Internal Revenue Code 501(c)3*
- True
6. It has not already submitted a separate IRS application to request tax-exempt status*
- True
7. The Parent Organization (LMC) does not file a tax return on behalf of the Subordinate Organization (the congregation)*
- True

Application Continued...
The purposed and activities of the named congregation are consistent with those described in the LMC governing document. The sources of contributions to the named congregation are primarily in the form of individual contributions from the organization's members. Other contributions are in the form of grants. Expenditures are primarily for the purpose of operation, maintenance, payroll, and outreach.
The purposed and activities of the named congregation are consistent with those described in the LMC governing document.*
- Yes
- No
The sources of contributions to the named congregation are primarily in the form of individual contributions from the organization's members. Other contributions are in the form of grants.*
- Yes
- No
Expenditures are primarily for the purpose of operation, maintenance, payroll, and outreach.*
- Yes
- No

Verification of application...
LMC is hereby authorized to include the named congregation in its application for group exemption from federal income tax.*
- Yes
- No
Name of person filing application:*
First Last
Email of the person filing the application*
Position of the person filing application*
By typing your name below, you are signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application.*

Please fill out all sections of the form in order to submit the application.