Form 1023 (Rev. June 2006) Department of the Treasury Internal Revenue Service Application for Recognition of Exemption Under Section 501(c)(3) of the Internal Revenue Code OMB No. 1545-0056
Note: If exempt status is approved, this application will be open for public inspection.

Use the instructions to complete this application and for a definition of all bold items. For additional help, call IRS Exempt Organizations Customer Account Services toll-free at 1-877-829-5500. Visit our website at www.irs.gov for forms and publications. If the required information and documents are not submitted with payment of the appropriate user fee, the application may be returned to you.

Attach additional sheets to this application if you need more space to answer fully. Put your name and EIN on each sheet and identify each answer by Part and line number. Complete Parts I - XI of Form 1023 and submit only those Schedules (A through H) that apply to you.

Identification of Applicant

Full name of organization (exactly as it appears in your organizing document)1 The Bull Riding Hall of Fame, Inc. 2 c/o Name (if applicable)
Mailing address (Number and street) (see instructions)3 1701 SPRINGLAKE DR Room/Suite 4 Employer Identification Number (EIN) 45-5083536
City or town, state or country, and ZIP + 4 DRIPPING SPRINGS, TX 78620 5 Month the annual accounting period ends (01 – 12) 12
Primary contact (officer, director, trustee, or authorized representative)6 a Name: CALEB ELLINGER b Phone: 512-484-1478
c Fax: (optional) 512-519-8843

Are you represented by an authorized representative, such as an attorney or accountant? If “Yes,” provide the authorized representative’s name, and the name and address of the authorized representative’s firm. Include a completed Form 2848, Power of Attorney and Declaration of Representative, with your application if you would like us to communicate with your representative.

Yes

No

Was a person who is not one of your officers, directors, trustees, employees, or an authorized

Yes

representative listed in line 7, paid, or promised payment, to help plan, manage, or advise you about the structure or activities of your organization, or about your financial or tax matters? If “Yes,provide the person’s name, the name and address of the person’s firm, the amounts paid or promised to be paid, and describe that person’s role.

No

9a Organization’s website: http://www.the-bull-riding-hall-of-fame.com/ b Organization’s email: (optional)

10 Certain organizations are not required to file an information return (Form 990 or Form 990-EZ). If you Yes are granted tax-exemption, are you claiming to be excused from filing Form 990 or Form 990-EZ? If “Yes,” explain. See the instructions for a description of organizations not required to file Form 990 or Form 990-EZ.

No

11 Date incorporated if a corporation, or formed, if other than a corporation. (MM/DD/YYYY) 04 / 04 / 2012

12 Were you formed under the laws of a foreign country?

Yes

If “Yes,” state the country.

No

For Paperwork Reduction Act Notice, see page 24 of the instructions. Cat. No. 17133K Form 1023 (Rev. 6-2006)
Organizational Structure

You must be a corporation (including a limited liability company), an unincorporated association, or a trust to be tax exempt. (See instructions.) DO NOT file this form unless you can check “Yes” on lines 1, 2, 3, or 4.

Yes

No

Are you a corporation? If “Yes,” attach a copy of your articles of incorporation showing certification of filing with the appropriate state agency. Include copies of any amendments to your articles and be sure they also show state filing certification.

Are you a limited liability company (LLC)? If “Yes,” attach a copy of your articles of organization showing

Yes

certification of filing with the appropriate state agency. Also, if you adopted an operating agreement, attach a copy. Include copies of any amendments to your articles and be sure they show state filing certification. Refer to the instructions for circumstances when an LLC should not file its own exemption application.

No

Are you an unincorporated association? If “Yes,” attach a copy of your articles of association,

Yes

constitution, or other similar organizing document that is dated and includes at least two signatures. Include signed and dated copies of any amendments.

No

4a Are you a trust? If “Yes,” attach a signed and dated copy of your trust agreement. Include signed and dated copies of any amendments. Yes No
b Have you been funded? If “No,” explain how you are formed without anything of value placed in trust. Yes No
5 Have you adopted bylaws? If “Yes,” attach a current copy showing date of adoption. If “No,” explain Yes No
how your officers, directors, or trustees are selected.
Required Provisions in Your Organizing Document

The following questions are designed to ensure that when you file this application, your organizing document contains the required provisions to meet the organizational test under section 501(c)(3). Unless you can check the boxes in both lines 1 and 2, your organizing document does not meet the organizational test. DO NOT file this application until you have amended your organizing document. Submit your original and amended organizing documents (showing state filing certification if you are a corporation or an LLC) with your application.

Section 501(c)(3) requires that your organizing document state your exempt purpose(s), such as charitable, religious, educational, and/or scientific purposes. Check the box to confirm that your organizing document meets this requirement. Describe specifically where your organizing document meets this requirement, such as a reference to a particular article or section in your organizing document. Refer to the instructions for exempt purpose language. Location of Purpose Clause (Page, Article, and Paragraph): PAGE 2 ARTICLE 2 SECTION 1

2a Section 501(c)(3) requires that upon dissolution of your organization, your remaining assets must be used exclusively for exempt purposes, such as charitable, religious, educational, and/or scientific purposes. Check the box on line 2a to confirm that your organizing document meets this requirement by express provision for the distribution of assets upon dissolution. If you rely on state law for your dissolution provision, do not check the box on line 2a and go to line 2c.

2b If you checked the box on line 2a, specify the location of your dissolution clause (Page, Article, and Paragraph).

page 13 article 8 section 3

Do not complete line 2c if you checked box 2a.

2c See the instructions for information about the operation of state law in your particular state. Check this box if you rely on operation of state law for your dissolution provision and indicate the state:

Narrative Description of Your Activities

Using an attachment, describe your past, present, and planned activities in a narrative. If you believe that you have already provided some of this information in response to other parts of this application, you may summarize that information here and refer to the specific parts of the application for supporting details. You may also attach representative copies of newsletters, brochures, or similar documents for supporting details to this narrative. Remember that if this application is approved, it will be open for public inspection. Therefore, your narrative description of activities should be thorough and accurate. Refer to the instructions for information that must be included in your description.

Compensation and Other Financial Arrangements With Your Officers, Directors, Trustees, Employees, and Independent Contractors

1a List the names, titles, and mailing addresses of all of your officers, directors, and trustees. 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. Refer to the instructions for information on what to include as compensation.

Name Title Mailing address Compensation amount (annual actual or estimated)
BILL PUTNAM PRESIDENT 1701 SPRINGLAKE DR DRIPPING SPRINGS, TX 78620 NONE
TAMMI PUTNAM TREASURER 1701 SPRINGLAKE DR DRIPPING SPRINGS, TX 78620 NONE
AMY PUTNAM SECRETARY 1511 STONE RIM LOOP BUDA, TX 78610 NONE

b List the names, titles, and mailing addresses of each of your five highest compensated employees who receive or will receive compensation of more than $50,000 per year. Use the actual figure, if available. Refer to the instructions for information on what to include as compensation. Do not include officers, directors, or trustees listed in line 1a.

Name Title Mailing address Compensation amount (annual actual or estimated)
NONE

c List the names, names of businesses, and mailing addresses of your five highest compensated independent contractors that receive or will receive compensation of more than $50,000 per year. Use the actual figure, if available. Refer to the instructions for information on what to include as compensation.

Name Title Mailing address Compensation amount (annual actual or estimated)
NONE

The following “Yes” or “No” questions relate to past, present, or planned relationships, transactions, or agreements with your officers, directors, trustees, highest compensated employees, and highest compensated independent contractors listed in lines 1a, 1b, and 1c.

2a Are any of your officers, directors, or trustees related to each other through family or business relationships? If “Yes,” identify the individuals and explain the relationship.

b Do you have a business relationship with any of your officers, directors, or trustees other than through their position as an officer, director, or trustee? If “Yes,” identify the individuals and describe the business relationship with each of your officers, directors, or trustees.

c Are any of your officers, directors, or trustees related to your highest compensated employees or highest compensated independent contractors listed on lines 1b or 1c through family or business relationships? If “Yes,” identify the individuals and explain the relationship.

Yes No
Yes No
Yes No

3a For each of your officers, directors, trustees, highest compensated employees, and highest compensated independent contractors listed on lines 1a, 1b, or 1c, attach a list showing their name, qualifications, average hours worked, and duties.

b Do any of your officers, directors, trustees, highest compensated employees, and highest

Yes

compensated independent contractors listed on lines 1a, 1b, or 1c receive compensation from any other organizations, whether tax exempt or taxable, that are related to you through common control? If “Yes,” identify the individuals, explain the relationship between you and the other organization, and describe the compensation arrangement.

No

4 In establishing the compensation for your officers, directors, trustees, highest compensated employees, and highest compensated independent contractors listed on lines 1a, 1b, and 1c, the following practices are recommended, although they are not required to obtain exemption. Answer “Yes” to all the practices you use.

a Do you or will the individuals that approve compensation arrangements follow a conflict of interest policy?

Yes

No b Do you or will you approve compensation arrangements in advance of paying compensation?

Yes

No c Do you or will you document in writing the date and terms of approved compensation arrangements?

Yes No

The Bull Riding Hall of Fame, Inc. 45 5083536

d Do you or will you record in writing the decision made by each individual who decided or voted on compensation arrangements?

e Do you or will you approve compensation arrangements based on information about compensation paid by similarly situated taxable or tax-exempt organizations for similar services, current compensation surveys compiled by independent firms, or actual written offers from similarly situated organizations? Refer to the instructions for Part V, lines 1a, 1b, and 1c, for information on what to include as compensation.

f Do you or will you record in writing both the information on which you relied to base your decision and its source?

g If you answered “No” to any item on lines 4a through 4f, describe how you set compensation that is reasonable for your officers, directors, trustees, highest compensated employees, and highest compensated independent contractors listed in Part V, lines 1a, 1b, and 1c.

Yes Yes No No
Yes No
Yes No

5a Have you adopted a conflict of interest policy consistent with the sample conflict of interest policy in Appendix A to the instructions? If “Yes,” provide a copy of the policy and explain how the policy has been adopted, such as by resolution of your governing board. If “No,” answer lines 5b and 5c.

b What procedures will you follow to assure that persons who have a conflict of interest will not have influence over you for setting their own compensation?

c What procedures will you follow to assure that persons who have a conflict of interest will not have influence over you regarding business deals with themselves?

Note: A conflict of interest policy is recommended though it is not required to obtain exemption.

Hospitals, see Schedule C, Section I, line 14.

6a Do you or will you compensate any of your officers, directors, trustees, highest compensated employees, and highest compensated independent contractors listed in lines 1a, 1b, or 1c through non-fixed payments, such as discretionary bonuses or revenue-based payments? If “Yes,” describe all non-fixed compensation arrangements, including how the amounts are determined, who is eligible for such arrangements, whether you place a limitation on total compensation, and how you determine or will determine that you pay no more than reasonable compensation for services. Refer to the instructions for Part V, lines 1a, 1b, and 1c, for information on what to include as compensation.

b Do you or will you compensate any of your employees, other than your officers, directors, trustees, or your five highest compensated employees who receive or will receive compensation of more than $50,000 per year, through non-fixed payments, such as discretionary bonuses or revenue-based payments? If “Yes,” describe all non-fixed compensation arrangements, including how the amounts are or will be determined, who is or will be eligible for such arrangements, whether you place or will place a limitation on total compensation, and how you determine or will determine that you pay no more than reasonable compensation for services. Refer to the instructions for Part V, lines 1a, 1b, and 1c, for information on what to include as compensation.

Yes

No

Yes

No

7a Do you or will you purchase any goods, services, or assets from any of your officers, directors, trustees, highest compensated employees, or highest compensated independent contractors listed in lines 1a, 1b, or 1c? If “Yes,” describe any such purchase that you made or intend to make, from whom you make or will make such purchases, how the terms are or will be negotiated at arm’s length, and explain how you determine or will determine that you pay no more than fair market value. Attach copies of any written contracts or other agreements relating to such purchases. Yes No
b Do you or will you sell any goods, services, or assets to any of your officers, directors, trustees, highest compensated employees, or highest compensated independent contractors listed in lines 1a, 1b, or 1c? If “Yes,” describe any such sales that you made or intend to make, to whom you make or will make such sales, how the terms are or will be negotiated at arm’s length, and explain how you determine or will determine you are or will be paid at least fair market value. Attach copies of any written contracts or other agreements relating to such sales. Yes No
8a Do you or will you have any leases, contracts, loans, or other agreements with your officers, directors, trustees, highest compensated employees, or highest compensated independent contractors listed in lines 1a, 1b, or 1c? If “Yes,” provide the information requested in lines 8b through 8f. Yes
b c d e f Describe any written or oral arrangements that you made or intend to make. Identify with whom you have or will have such arrangements. Explain how the terms are or will be negotiated at arm’s length. Explain how you determine you pay no more than fair market value or you are paid at least fair market value. Attach copies of any signed leases, contracts, loans, or other agreements relating to such arrangements.
9a Do you or will you have any leases, contracts, loans, or other agreements with any organization in which any of your officers, directors, or trustees are also officers, directors, or trustees, or in which any individual officer, director, or trustee owns more than a 35% interest? If “Yes,” provide the information requested in lines 9b through 9f. Yes

No

No

b Describe any written or oral arrangements you made or intend to make.

c Identify with whom you have or will have such arrangements.

d Explain how the terms are or will be negotiated at arm’s length.

e Explain how you determine or will determine you pay no more than fair market value or that you are paid at least fair market value. f Attach a copy of any signed leases, contracts, loans, or other agreements relating to such arrangements.

Your Members and Other Individuals and Organizations That Receive Benefits From You

The following “Yes” or “No” questions relate to goods, services, and funds you provide to individuals and organizations as part of your activities. Your answers should pertain to past, present, and planned activities. (See instructions.)

1a In carrying out your exempt purposes, do you provide goods, services, or funds to individuals? If “Yes,” describe each program that provides goods, services, or funds to individuals.

b In carrying out your exempt purposes, do you provide goods, services, or funds to organizations? If “Yes,” describe each program that provides goods, services, or funds to organizations.

Yes Yes

No No

Do any of your programs limit the provision of goods, services, or funds to a specific individual or group of specific individuals? For example, answer “Yes,” if goods, services, or funds are provided only for a particular individual, your members, individuals who work for a particular employer, or graduates of a particular school. If “Yes,” explain the limitation and how recipients are selected for each program.

Yes

No

Do any individuals who receive goods, services, or funds through your programs have a family or

Yes

business relationship with any officer, director, trustee, or with any of your highest compensated employees or highest compensated independent contractors listed in Part V, lines 1a, 1b, and 1c? If “Yes,” explain how these related individuals are eligible for goods, services, or funds.

No

Your History

The following “Yes” or “No” questions relate to your history. (See instructions.)

1 Are you a successor to another organization? Answer “Yes,” if you have taken or will take over the activities of another organization; you took over 25% or more of the fair market value of the net assets of another organization; or you were established upon the conversion of an organization from for-profit to non-profit status. If “Yes,” complete Schedule G. Yes
2 Are you submitting this application more than 27 months after the end of the month in which you were legally formed? If “Yes,” complete Schedule E. Yes

No

No

Your Specific Activities

The following “Yes” or “No” questions relate to specific activities that you may conduct. Check the appropriate box. Your answers should pertain to past, present, and planned activities. (See instructions.)

1 Do you support or oppose candidates in political campaigns in any way? If “Yes,” explain. Yes
Do you attempt to influence legislation? If “Yes,” explain how you attempt to influence legislation and complete line 2b. If “No,” go to line 3a. 2a Yes
Have you made or are you making an election to have your legislative activities measured by expenditures by filing Form 5768? If “Yes,” attach a copy of the Form 5768 that was already filed or attach a completed Form 5768 that you are filing with this application. If “No,” describe whether your attempts to influence legislation are a substantial part of your activities. Include the time and money spent on your attempts to influence legislation as compared to your total activities. b Yes

No

No No

3a Do you or will you operate bingo or gaming activities? If “Yes,” describe who conducts them, and list all revenue received or expected to be received and expenses paid or expected to be paid in operating these activities. Revenue and expenses should be provided for the time periods specified in Part IX, Financial Data. Yes No
b Do you or will you enter into contracts or other agreements with individuals or organizations to conduct bingo or gaming for you? If “Yes,” describe any written or oral arrangements that you made or intend to make, identify with whom you have or will have such arrangements, explain how the terms are or will be negotiated at arm’s length, and explain how you determine or will determine you pay no more than fair market value or you will be paid at least fair market value. Attach copies or any written contracts or other agreements relating to such arrangements. Yes No
c List the states and local jurisdictions, including Indian Reservations, in which you conduct or will conduct gaming or bingo.
Your Specific Activities (Continued)

4a Do you or will you undertake fundraising? If “Yes,” check all the fundraising programs you do or will

Yes

No

conduct. (See instructions.)

mail solicitations

phone solicitations

email solicitations

accept donations on your website

personal solicitations

receive donations from another organization’s website vehicle, boat, plane, or similar donations

government grant solicitations foundation grant solicitations

Other

Attach a description of each fundraising program.

b Do you or will you have written or oral contracts with any individuals or organizations to raise funds Yes No for you? If “Yes,” describe these activities. Include all revenue and expenses from these activities and state who conducts them. Revenue and expenses should be provided for the time periods specified in Part IX, Financial Data. Also, attach a copy of any contracts or agreements.

c Do you or will you engage in fundraising activities for other organizations? If “Yes,” describe these Yes No arrangements. Include a description of the organizations for which you raise funds and attach copies of all contracts or agreements.

d List all states and local jurisdictions in which you conduct fundraising. For each state or local jurisdiction listed, specify whether you fundraise for your own organization, you fundraise for another organization, or another organization fundraises for you.

e Do you or will you maintain separate accounts for any contributor under which the contributor has Yes No the right to advise on the use or distribution of funds? Answer “Yes” if the donor may provide advice on the types of investments, distributions from the types of investments, or the distribution from the donor’s contribution account. If “Yes,” describe this program, including the type of advice that may be provided and submit copies of any written materials provided to donors.

5 Are you affiliated with a governmental unit? If “Yes,” explain. Yes No
6a Do you or will you engage in economic development? If “Yes,” describe your program. Yes No
b Describe in full who benefits from your economic development activities and how the activities
promote exempt purposes.

7a Do or will persons other than your employees or volunteers develop your facilities? If “Yes,” describe each facility, the role of the developer, and any business or family relationship(s) between the developer and your officers, directors, or trustees.

b Do or will persons other than your employees or volunteers manage your activities or facilities? If “Yes,” describe each activity and facility, the role of the manager, and any business or family relationship(s) between the manager and your officers, directors, or trustees.

c If there is a business or family relationship between any manager or developer and your officers, directors, or trustees, identify the individuals, explain the relationship, describe how contracts are negotiated at arm’s length so that you pay no more than fair market value, and submit a copy of any contracts or other agreements.

Yes

Yes No

No

Do you or will you enter into joint ventures, including partnerships or limited liability companies

Yes

treated as partnerships, in which you share profits and losses with partners other than section 501(c)(3) organizations? If “Yes,” describe the activities of these joint ventures in which you participate.

No

9a Are you applying for exemption as a childcare organization under section 501(k)? If “Yes,” answer Yes

lines 9b through 9d. If “No,” go to line 10. b Do you provide child care so that parents or caretakers of children you care for can be gainfully

Yes employed (see instructions)? If “No,” explain how you qualify as a childcare organization described in section 501(k).

c Of the children for whom you provide child care, are 85% or more of them cared for by you to

Yes

enable their parents or caretakers to be gainfully employed (see instructions)? If “No,” explain how you qualify as a childcare organization described in section 501(k).

d Are your services available to the general public? If “No,” describe the specific group of people for

Yes

whom your activities are available. Also, see the instructions and explain how you qualify as a

childcare organization described in section 501(k).

No No

No

No

10 Do you or will you publish, own, or have rights in music, literature, tapes, artworks, choreography, scientific discoveries, or other intellectual property? If “Yes,” explain. Describe who owns or will own any copyrights, patents, or trademarks, whether fees are or will be charged, how the fees are determined, and how any items are or will be produced, distributed, and marketed.

Yes

No

Your Specific Activities (Continued)

11 Do you or will you 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? If “Yes,” describe each type of contribution, any conditions imposed by the donor on the contribution, and any agreements with the donor regarding the contribution.

Yes

No

12a Do you or will you operate in a foreign country or countries? If “Yes,” answer lines 12b through

Yes

12d. If “No,” go to line 13a. b Name the foreign countries and regions within the countries in which you operate. c Describe your operations in each country and region in which you operate. d Describe how your operations in each country and region further your exempt purposes.

No

13a Do you or will you make grants, loans, or other distributions to organization(s)? If “Yes,” answer lines

13b through 13g. If “No,” go to line 14a.
b Describe how your grants, loans, or other distributions to organizations further your exempt purposes.
c Do you have written contracts with each of these organizations? If “Yes,” attach a copy of each contract.
d Identify each recipient organization and any relationship between you and the recipient organization.
e Describe the records you keep with respect to the grants, loans, or other distributions you make.
f Describe your selection process, including whether you do any of the following:
(i) Do you require an application form? If “Yes,” attach a copy of the form.
(ii) Do you require a grant proposal? If “Yes,” describe whether the grant proposal specifies your
responsibilities and those of the grantee, obligates the grantee to use the grant funds only for the
purposes for which the grant was made, provides for periodic written reports concerning the use
of grant funds, requires a final written report and an accounting of how grant funds were used,
and acknowledges your authority to withhold and/or recover grant funds in case such funds are,
or appear to be, misused.
g Describe your procedures for oversight of distributions that assure you the resources are used to
further your exempt purposes, including whether you require periodic and final reports on the use of
resources.

Yes No
Yes No
Yes No
Yes No
14a Do you or will you make grants, loans, or other distributions to foreign organizations? If “Yes,” answer lines 14b through 14f. If “No,” go to line 15. Yes
b Provide the name of each foreign organization, the country and regions within a country in which each foreign organization operates, and describe any relationship you have with each foreign organization.
c Does any foreign organization listed in line 14b accept contributions earmarked for a specific country or specific organization? If “Yes,” list all earmarked organizations or countries. Yes
d Do your contributors know that you have ultimate authority to use contributions made to you at your discretion for purposes consistent with your exempt purposes? If “Yes,” describe how you relay this information to contributors. Yes
e Do you or will you make pre-grant inquiries about the recipient organization? If “Yes,” describe these inquiries, including whether you inquire about the recipient’s financial status, its tax-exempt status under the Internal Revenue Code, its ability to accomplish the purpose for which the resources are provided, and other relevant information. Yes
f Do you or will you use any additional procedures to ensure that your distributions to foreign organizations are used in furtherance of your exempt purposes? If “Yes,” describe these procedures, including site visits by your employees or compliance checks by impartial experts, to verify that grant funds are being used appropriately. Yes

No

No No

No

No

Form 1023 (Rev. 6-2006)

Your Specific Activities (Continued)
15 Do you have a close connection with any organizations? If “Yes,” explain. Yes No
16 Are you applying for exemption as a cooperative hospital service organization under section Yes No
501(e)? If “Yes,” explain.

No

17 Are you applying for exemption as a cooperative service organization of operating educational

Yes

organizations under section 501(f)? If “Yes,” explain.

18 Are you applying for exemption as a charitable risk pool under section 501(n)? If “Yes,” explain. Yes No
19 Do you or will you operate a school? If “Yes,” complete Schedule B. Answer “Yes,” whether you Yes No
operate a school as your main function or as a secondary activity.

20 Is your main function to provide hospital or medical care? If “Yes,” complete Schedule C.

Yes

No

21 Do you or will you provide low-income housing or housing for the elderly or handicapped? If

Yes

“Yes,” complete Schedule F.

No

22 Do you or will you provide scholarships, fellowships, educational loans, or other educational grants to individuals, including grants for travel, study, or other similar purposes? If “Yes,” complete Schedule H.

Note: Private foundations may use Schedule H to request advance approval of individual grant procedures.

Yes

No

Financial Data

For purposes of this schedule, years in existence refer to completed tax years. If in existence 4 or more years, complete the schedule for the most recent 4 tax years. If in existence more than 1 year but less than 4 years, complete the statements for each year in existence and provide projections of your likely revenues and expenses based on a reasonable and good faith estimate of your future finances for a total of 3 years of financial information. If in existence less than 1 year, provide projections of your likely revenues and expenses for the current year and the 2 following years, based on a reasonable and good faith estimate of your future finances for a total of 3 years of financial information. (See instructions.)

A. Statement of Revenues and Expenses

Part IX Financial Data (Continued)
B. Balance Sheet (for your most recently completed tax year) Year End:
Assets (Whole dollars)
1 Cash 1 1050
2 Accounts receivable, net 2
3 Inventories 3
4 Bonds and notes receivable (attach an itemized list) 4
5 Corporate stocks (attach an itemized list) 5
6 Loans receivable (attach an itemized list) 6
7 Other investments (attach an itemized list) 7
8 Depreciable and depletable assets (attach an itemized list) 8
9 Land 9
10 Other assets (attach an itemized list) 10
11 Total Assets (add lines 1 through 10) 11
Liabilities 1050
12 Accounts payable 12
13 Contributions, gifts, grants, etc. payable 13
14 Mortgages and notes payable (attach an itemized list) 14
15 Other liabilities (attach an itemized list) 15
16 Total Liabilities (add lines 12 through 15) 16 0
Fund Balances or Net Assets
17 Total fund balances or net assets 17 1050
18 Total Liabilities and Fund Balances or Net Assets (add lines 16 and 17) 18 1050

19 Have there been any substantial changes in your assets or liabilities since the end of the period

Yes

shown above? If “Yes,” explain.

No

Public Charity Status

Part X is designed to classify you as an organization that is either a private foundation or a public charity. Public charity status is a more favorable tax status than private foundation status. If you are a private foundation, Part X is designed to further determine whether you are a private operating foundation. (See instructions.)

1a Are you a private foundation? If “Yes,” go to line 1b. If “No,” go to line 5 and proceed as instructed. Yes

If you are unsure, see the instructions.

b As a private foundation, section 508(e) requires special provisions in your organizing document in addition to those that apply to all organizations described in section 501(c)(3). Check the box to confirm that your organizing document meets this requirement, whether by express provision or by reliance on operation of state law. Attach a statement that describes specifically where your organizing document meets this requirement, such as a reference to a particular article or section in your organizing document or by operation of state law. See the instructions, including Appendix B, for information about the special provisions that need to be contained in your organizing document. Go to line 2.

No

Are you a private operating foundation? To be a private operating foundation you must engage

Yes No

directly in the active conduct of charitable, religious, educational, and similar activities, as opposed to indirectly carrying out these activities by providing grants to individuals or other organizations. If “Yes,” go to line 3. If “No,” go to the signature section of Part XI.

Have you existed for one or more years? If “Yes,” attach financial information showing that you are a private

Yes

No

operating foundation; go to the signature section of Part XI. If “No,” continue to line 4.

Have you attached either (1) an affidavit or opinion of counsel, (including a written affidavit or opinion

Yes No

from a certified public accountant or accounting firm with expertise regarding this tax law matter), that sets forth facts concerning your operations and support to demonstrate that you are likely to satisfy the requirements to be classified as a private operating foundation; or (2) a statement describing your proposed operations as a private operating foundation?

5 If you answered “No” to line 1a, indicate the type of public charity status you are requesting by checking one of the choices below. You may check only one box.

The organization is not a private foundation because it is: a 509(a)(1) and 170(b)(1)(A)(i)—a church or a convention or association of churches. Complete and attach Schedule A. b 509(a)(1) and 170(b)(1)(A)(ii)—a school. Complete and attach Schedule B. c 509(a)(1) and 170(b)(1)(A)(iii)—a hospital, a cooperative hospital service organization, or a medical research

organization operated in conjunction with a hospital. Complete and attach Schedule C.

d 509(a)(3)—an organization supporting either one or more organizations described in line 5a through c, f, g, or h or a publicly supported section 501(c)(4), (5), or (6) organization. Complete and attach Schedule D.

Public Charity Status (Continued)

e 509(a)(4)—an organization organized and operated exclusively for testing for public safety.

f 509(a)(1) and 170(b)(1)(A)(iv)—an organization operated for the benefit of a college or university that is owned or operated by a governmental unit.

g 509(a)(1) and 170(b)(1)(A)(vi)—an organization that receives a substantial part of its financial support in the form of contributions from publicly supported organizations, from a governmental unit, or from the general public.

h 509(a)(2)—an organization that normally receives not more than one-third of its financial support from gross investment income and receives more than one-third of its financial support from contributions, membership fees, and gross receipts from activities related to its exempt functions (subject to certain exceptions).

A publicly supported organization, but unsure if it is described in 5g or 5h. The organization would like the IRS to decide the correct status.

If you checked box g, h, or i in question 5 above, you must request either an advance or a definitive ruling by selecting one of the boxes below. Refer to the instructions to determine which type of ruling you are eligible to receive.

a Request for Advance Ruling: By checking this box and signing the consent, pursuant to section 6501(c)(4) of the Code you request an advance ruling and agree to extend the statute of limitations on the assessment of excise tax under section 4940 of the Code. The tax will apply only if you do not establish public support status at the end of the 5-year advance ruling period. The assessment period will be extended for the 5 advance ruling years to 8 years, 4 months, and 15 days beyond the end of the first year. You have the right to refuse or limit the extension to a mutually agreed-upon period of time or issue(s). Publication 1035, Extending the Tax Assessment Period, provides a more detailed explanation of your rights and the consequences of the choices you make. You may obtain Publication 1035 free of charge from the IRS web site at www.irs.gov or by calling toll-free 1-800-829-3676. Signing this consent will not deprive you of any appeal rights to which you would otherwise be entitled. If you decide not to extend the statute of limitations, you are not eligible for an advance ruling.

Consent Fixing Period of Limitations Upon Assessment of Tax Under Section 4940 of the Internal Revenue Code

For Organization

BILL PUTNAM

(Signature of Officer, Director, Trustee, or other (Type or print name of signer) (Date) authorized official)

PRESIDENT

(Type or print title or authority of signer)

For IRS Use Only

IRS Director, Exempt Organizations (Date)

b Request for Definitive Ruling: Check this box if you have completed one tax year of at least 8 full months and you are requesting a definitive ruling. To confirm your public support status, answer line 6b(i) if you checked box g in line 5 above. Answer line 6b(ii) if you checked box h in line 5 above. If you checked box i in line 5 above, answer both lines 6b(i) and (ii).

(i)
(a) Enter 2% of line 8, column (e) on Part IX-A. Statement of Revenues and Expenses.
(b) Attach a list showing the name and amount contributed by each person, company, or organization whose gifts totaled more than the 2% amount. If the answer is “None,” check this box.
(ii)
(a) For each year amounts are included on lines 1, 2, and 9 of Part IX-A. Statement of Revenues and Expenses, attach a list showing the name of and amount received from each disqualified person. If the answer is “None,” check this box.

(b) For each year amounts are included on line 9 of Part IX-A. Statement of Revenues and Expenses, attach a list showing the name of and amount received from each payer, other than a disqualified person, whose payments were more than the larger of (1) 1% of line 10, Part IX-A. Statement of Revenues and Expenses, or (2) $5,000. If the answer is “None,” check this box.

Did you receive any unusual grants during any of the years shown on Part IX-A. Statement of

Yes

Revenues and Expenses? If “Yes,” attach a list including the name of the contributor, the date and amount of the grant, a brief description of the grant, and explain why it is unusual.

No

User Fee Information

You must include a user fee payment with this application. It will not be processed without your paid user fee. If your average annual gross receipts have exceeded or will exceed $10,000 annually over a 4-year period, you must submit payment of $750. If your gross receipts have not exceeded or will not exceed $10,000 annually over a 4-year period, the required user fee payment is $300. See instructions for Part XI, for a definition of gross receipts over a 4-year period. Your check or money order must be made payable to the United States Treasury. User fees are subject to change. Check our website at www.irs.gov and type “User Fee” in the keyword box, or call Customer Account Services at 1-877-829-5500 for current information.

Have your annual gross receipts averaged or are they expected to average not more than $10,000? If “Yes,” check the box on line 2 and enclose a user fee payment of $300 (Subject to change—see above). If “No,” check the box on line 3 and enclose a user fee payment of $750 (Subject to change—see above).

Yes

No

Check the box if you have enclosed the reduced user fee payment of $300 (Subject to change).

Check the box if you have enclosed the user fee payment of $750 (Subject to change).

I declare under the penalties of perjury that I am authorized to sign this application on behalf of the above organization and that I have examined this application, including the accompanying schedules and attachments, and to the best of my knowledge it is true, correct, and complete.

Please
Sign Here (Signature of Officer, Director, Trustee, or other authorized official) (Type or print name of signer) BILL PUTNAM PRESIDENT (Date)
(Type or print title or authority of signer)

Reminder: Send the completed Form 1023 Checklist with your filled-in-application. Form 1023 (Rev. 6-2006)

Names of individual recipients are not required to be listed in Schedule H.

Public charities and private foundations complete lines 1a through 7 of this section. See the instructions to Part X if you are not sure whether you are a public charity or a private foundation.

1a Describe the types of educational grants you provide to individuals, such as scholarships, fellowships, loans, etc. b Describe the purpose and amount of your scholarships, fellowships, and other educational grants and loans that you award.

c If you award educational loans, explain the terms of the loans (interest rate, length, forgiveness, etc.). d Specify how your program is publicized. e Provide copies of any solicitation or announcement materials.

f Provide a sample copy of the application used.

Do you maintain case histories showing recipients of your scholarships, fellowships, educational loans, or other educational grants, including names, addresses, purposes of awards, amount of each grant, manner of selection, and relationship (if any) to officers, trustees, or donors of funds to you? If “No,” refer to the instructions.

Yes

No

3 Describe the specific criteria you use to determine who is eligible for your program. (For example, eligibility selection criteria could consist of graduating high school students from a particular high school who will attend college, writers of scholarly works about American history, etc.)
4a Describe the specific criteria you use to select recipients. (For example, specific selection criteria could consist of prior academic performance, financial need, etc.)
b Describe how you determine the number of grants that will be made annually.
c Describe how you determine the amount of each of your grants.
d Describe any requirement or condition that you impose on recipients to obtain, maintain, or qualify for renewal of a grant. (For example, specific requirements or conditions could consist of attendance at a four-year college, maintaining a certain grade point average, teaching in public school after graduation from college, etc.)
5 Describe your procedures for supervising the scholarships, fellowships, educational loans, or other educational grants. Describe whether you obtain reports and grade transcripts from recipients, or you pay grants directly to a school under an arrangement whereby the school will apply the grant funds only for enrolled students who are in good standing. Also, describe your procedures for taking action if the terms of the award are violated.
6 Who is on the selection committee for the awards made under your program, including names of current committee members, criteria for committee membership, and the method of replacing committee members?
7 Are relatives of members of the selection committee, or of your officers, directors, or substantial contributors eligible for awards made under your program? If “Yes,” what measures are taken to ensure unbiased selections? Yes No
Note. If you are a private foundation, you are not permitted to provide educational grants to disqualified persons. Disqualified persons include your substantial contributors and foundation managers and certain family members of disqualified persons.

Private foundations complete lines 1a through 4f of this section. Public charities do not complete this section.

1a If we determine that you are a private foundation, do you want this application to be

Yes No

N/A

considered as a request for advance approval of grant making procedures?

b For which section(s) do you wish to be considered?

2 Do you represent that you will (1) arrange to receive and review grantee reports annually and upon completion of the purpose for which the grant was awarded, (2) investigate diversions of funds from their intended purposes, and (3) take all reasonable and appropriate steps to recover diverted funds, ensure other grant funds held by a grantee are used for their intended purposes, and withhold further payments to grantees until you obtain grantees’ assurances that future diversions will not occur and that grantees will take extraordinary precautions to prevent future diversions from occurring? Yes No
3 Do you represent that you will maintain all records relating to individual grants, including information obtained to evaluate grantees, identify whether a grantee is a disqualified person, establish the amount and purpose of each grant, and establish that you undertook the supervision and investigation of grants described in line 2? Yes No
The Bull Riding Hall of Fame, Inc. 45 5083536

Schedule H. Organizations Providing Scholarships, Fellowships, Educational Loans, or Other Educational Grants to Individuals and Private Foundations Requesting Advance Approval of Individual Grant Procedures

(Continued)

Private foundations complete lines 1a through 4f of this section. Public charities do not complete this section. (Continued)

4a Do you or will you award scholarships, fellowships, and educational loans to attend an Yes No

educational institution based on the status of an individual being an employee of a

particular employer? If “Yes,” complete lines 4b through 4f.

b Will you comply with the seven conditions and either the percentage tests or facts and

Yes No

circumstances test for scholarships, fellowships, and educational loans to attend an educational institution as set forth in Revenue Procedures 76-47, 1976-2 C.B. 670, and 80-39, 1980-2 C.B. 772, which apply to inducement, selection committee, eligibility requirements, objective basis of selection, employment, course of study, and other objectives? (See lines 4c, 4d, and 4e, regarding the percentage tests.)

c Do you or will you provide scholarships, fellowships, or educational loans to attend an Yes No N/A

educational institution to employees of a particular employer?

If “Yes,” will you award grants to 10% or fewer of the eligible applicants who were

Yes No

actually considered by the selection committee in selecting recipients of grants in that

year as provided by Revenue Procedures 76-47 and 80-39?

d Do you provide scholarships, fellowships, or educational loans to attend an educational Yes No N/A

institution to children of employees of a particular employer?

If “Yes,” will you award grants to 25% or fewer of the eligible applicants who were

Yes No

actually considered by the selection committee in selecting recipients of grants in that

year as provided by Revenue Procedures 76-47 and 80-39? If “No,” go to line 4e.

e If you provide scholarships, fellowships, or educational loans to attend an educational Yes No N/A institution to children of employees of a particular employer, will you award grants to 10% or fewer of the number of employees’ children who can be shown to be eligible for grants (whether or not they submitted an application) in that year, as provided by Revenue Procedures 76-47 and 80-39?

If “Yes,” describe how you will determine who can be shown to be eligible for grants without submitting an application, such as by obtaining written statements or other information about the expectations of employees’ children to attend an educational institution. If “No,” go to line 4f.

Note. Statistical or sampling techniques are not acceptable. See Revenue Procedure

85-51, 1985-2 C.B. 717, for additional information.

f If you provide scholarships, fellowships, or educational loans to attend an educational Yes No institution to children of employees of a particular employer without regard to either the 25% limitation described in line 4d, or the 10% limitation described in line 4e, will you award grants based on facts and circumstances that demonstrate that the grants will not be considered compensation for past, present, or future services or otherwise provide a significant benefit to the particular employer? If “Yes,” describe the facts and circumstances that you believe will demonstrate that the grants are neither compensatory nor a significant benefit to the particular employer. In your explanation, describe why you cannot satisfy either the 25% test described in line 4d or the 10% test described in line 4e.

Form 1023 (Rev. 6-2006)

Form 1023 Checklist

(Revised June 2006)

Application for Recognition of Exemption under Section 501(c)(3) of the Internal Revenue Code

Note. Retain a copy of the completed Form 1023 in your permanent records. Refer to the General Instructions regarding Public Inspection of approved applications.

Check each box to finish your application (Form 1023). Send this completed Checklist with your filled-in application. If you have not answered all the items below, your application may be returned to you as incomplete.

Assemble the application and materials in this order:

  • Form 1023 Checklist
  • Form 2848, Power of Attorney and Declaration of Representative (if filing)
  • Form 8821, Tax Information Authorization (if filing)
  • Expedite request (if requesting)
  • Application (Form 1023 and Schedules A through H, as required)
  • Articles of organization
  • Amendments to articles of organization in chronological order
  • Bylaws or other rules of operation and amendments
  • Documentation of nondiscriminatory policy for schools, as required by Schedule B
  • Form 5768, Election/Revocation of Election by an Eligible Section 501(c)(3) Organization To Make Expenditures To Influence Legislation (if filing)
  • All other attachments, including explanations, financial data, and printed materials or publications. Label each page with name and EIN.

User fee payment placed in envelope on top of checklist. DO NOT STAPLE or otherwise attach your check or money order to your application. Instead, just place it in the envelope.

Employer Identification Number (EIN)

Completed Parts I through XI of the application, including any requested information and any required Schedules A through H.

  • You must provide specific details about your past, present, and planned activities.
  • Generalizations or failure to answer questions in the Form 1023 application will prevent us from recognizing you as tax exempt.
  • Describe your purposes and proposed activities in specific easily understood terms.
  • Financial information should correspond with proposed activities.

Schedules. Submit only those schedules that apply to you and check either “Yes” or “No” below.

Schedule A Yes No Schedule E Yes No
Schedule B Yes No Schedule F Yes No
Schedule C Yes No Schedule G Yes No
Schedule D Yes No Schedule H Yes No

Pg 2, Art 2, Sec 1

  • Location of Purpose Clause from Part III, line 1 (Page, Article and Paragraph Number)
    • Location of Dissolution Clause from Part III, line 2b or 2c (Page, Article and Paragraph Number) or by operation of state law Pg 12, Art 8, Sec 3
    • Signature of an officer, director, trustee, or other official who is authorized to sign the application.
  • Signature at Part XI of Form 1023.

Your name on the application must be the same as your legal name as it appears in your articles of organization.

Send completed Form 1023, user fee payment, and all other required information, to:

Internal Revenue Service

P.O. Box 192 Covington, KY 41012-0192

If you are using express mail or a delivery service, send Form 1023, user fee payment, and attachments to:

Internal Revenue Service 201 West Rivercenter Blvd. Attn: Extracting Stop 312 Covington, KY 41011

The Bull Riding Hall of Fame, Inc 45-5083536 Page 1

Part IV Narrative Description of Your Activities

The Bull Riding Hall of Fame, Inc. was created to recognize bull riders, bull fighters, bulls, organizations, competitive events, and stock contractors that have achieved excellence in the sport of bull riding. The organization preserves the history of bull riding and educates members and the public through its website, induction events, committees, and a Bull Riding Hall of Fame museum.

The Bull Riding Hall of Fame website includes a monthly newsletter, online conference calls, and memorials related to the sport of bull riding. The Bull Riding Hall of Fame Bulletin provides members with pictures and articles on bull riding history and updates on upcoming bull riding events. The “Call of Fame” provides online conference calls on bull riding topics. The website provides a memorial section to honor fallen bull riders, members, and their friends and family. The “Wall of Fame” provides a place to preserve the previously unrecorded history of bull riding, such as memorable bull rides and stories of great bull riders.

In addition to the website, on an annual basis The Bull Riding Hall of Fame will nominate, vote on, and induct the all-time great bull riders, bull fighters, bulls, events, organizations, and legendary individuals who have play a key role in the popularity of bull riding.

The Bull Riding Hall of Fame will establish multiple committees. The nomination committee is responsible for nominating potential inductees to the Hall of Fame. The balloting and voting committee is responsible for the balloting and voting process in selecting inductees. The induction ceremonies and live events committee oversees Hall of Fame induction and live bull riding events. The building and hall facilities committee oversees the building and management of The Bull Riding Hall of Fame museum. The youth programs committee is responsible for activities to increase youth awareness, knowledge, and involvement in bull riding activities. The publications and media committee oversees the Bulletin newsletter and the Call of Fame online conference call.

The Bull Riding Hall of Fame plans to build and maintain a museum in Dripping Springs, Texas dedicated to preserving the history of bull riding through exhibits of pictures, equipment, and other memorabilia.

Part V Compensation and Other Financial Arrangements

2a. President Bill Putnam and Treasurer Tammi Putnam are husband and wife. Secretary Amy Ellinger is the daughter of Bill Putnam.

5a The Board of Directors for The Bull Riding Hall Fame, Inc. has adopted a conflict of interest policy as part of its bylaws by a resolution of the board.

Part VI Your Members and Other Individuals and Organizations That Receive Benefits From You

The Bull Riding Hall of Fame, Inc 45-5083536 Page 2

1a. The Bull Riding Hall of Fame will provide funds to youth groups such as Future Farmers of America and 4H to increase youth interest in activities related to bull riding.

Part VIII Your Specific Activities

7a. The Bull Riding Hall of Fame will hire unrelated persons to construct the Hall of Fame museum.

  1. The Bull Riding Hall of Fame will publish a monthly newsletter and an annual newsletter. It will also own a trademark, audio recordings, pictures, and artwork. No fees will be charged other than membership dues. Members will have access to these intellectual properties. Distribution of these items will be through the organization’s website, at induction ceremonies, and at the Hall of Fame museum once it is constructed.
  2. The Bull Riding Hall of Fame will receive donations of vehicles and equipment without condition or agreement with the donor.

13b. We will provide grants to organizations, such as Future Farmers of America and 4H to increase interest in activities related to bull riding, such as Animal Science. 13d. There are no current relationships with these organizations. 13e. We will keep accounting records (cancelled checks, bank statements) and a log of grants. 13g. The Board of Directors will determine by majority vote the recipients of any grants after considering that the grant furthers the educational and historical purposes of the organization. The Treasurer will disburse these funds.

Schedule H.

1a and 1b. As part of its youth program, the Bull Riding Hall of Fame will provide grants for recipients to attend bull riding camps.

1d. The Bull Riding Hall of Fame will publicize grant programs through its website newsletter.

1e and 1f. No grants have been announced currently. No solicitation materials or applications currently exist.

3. Grants are available to U.S. citizens between the ages of 12 and 16, who attend a six-day bull-riding clinic with Camp of Champions.

4a. The scholarship committee (selected by majority vote by Board of Directors) will determine and approve eligibility criteria, including age (12-16) and financial need.

The Bull Riding Hall of Fame, Inc 45-5083536 Page 3

b.
The scholarship committee will determine the total number of grants for each year. However, the organization’s current intent is to have a $5,000 pool, from which to distribute 25 grants of $250 each.
c.
The amount of each scholarship will be equal to the cost of the bull riding camp ($250). The scholarship committee will make recommendations to the Board of Directors whether to include other costs such as stall rental, pictures, or other stipends.

d. Grants will be distributed on a yearly basis. In order to receive a renewal grant after receiving a grant in a previous year, the applicant must meet the same criteria as other applicants. The scholarship committee will determine additional criteria for renewal grants.

  1. The scholarship committee will establish written rules for the application process and will provide reports to the Board of Directors, including the list of applicants, the list of selected recipients, and the grant amounts to be paid out. The Board of Directors will give final approval for the recipients by majority vote. The Treasurer will distribute grants to the Camp of Champions in the name of the selected recipients. If recipients are determined not to meet selection criteria after being selected and approved, the Treasurer will attempt to recover the distributed grants or select a previously non-selected (but eligible) applicant. Changes to these rules will be approved by the Board of Directors.
  2. There are currently no scholarship committee members. The criteria for committee members will be established by the Board of Directors. The Board of Directors will appoint scholarship committee members, who must be dues-paying members of The Bull Riding Hall of Fame.
Names of individual recipients are not required to be listed in Schedule H.

Public charities and private foundations complete lines 1a through 7 of this section. See the instructions to Part X if you are not sure whether you are a public charity or a private foundation.

1a Describe the types of educational grants you provide to individuals, such as scholarships, fellowships, loans, etc. b Describe the purpose and amount of your scholarships, fellowships, and other educational grants and loans that you award.

c If you award educational loans, explain the terms of the loans (interest rate, length, forgiveness, etc.). d Specify how your program is publicized. e Provide copies of any solicitation or announcement materials.

f Provide a sample copy of the application used.

Do you maintain case histories showing recipients of your scholarships, fellowships, educational loans, or other educational grants, including names, addresses, purposes of awards, amount of each grant, manner of selection, and relationship (if any) to officers, trustees, or donors of funds to you? If “No,” refer to the instructions.

Yes

No

Describe the specific criteria you use to determine who is eligible for your program. (For example, eligibility selection criteria could consist of graduating high school students from a particular high school who will attend college, writers of scholarly works about American history, etc.)

4a Describe the specific criteria you use to select recipients. (For example, specific selection criteria could consist of prior academic performance, financial need, etc.)

b Describe how you determine the number of grants that will be made annually. c Describe how you determine the amount of each of your grants. d Describe any requirement or condition that you impose on recipients to obtain, maintain, or qualify for renewal of a grant.

(For example, specific requirements or conditions could consist of attendance at a four-year college, maintaining a certain grade point average, teaching in public school after graduation from college, etc.)

Describe your procedures for supervising the scholarships, fellowships, educational loans, or other educational grants. Describe whether you obtain reports and grade transcripts from recipients, or you pay grants directly to a school under an arrangement whereby the school will apply the grant funds only for enrolled students who are in good standing. Also, describe your procedures for taking action if the terms of the award are violated.

Who is on the selection committee for the awards made under your program, including names of current committee members, criteria for committee membership, and the method of replacing committee members?

Are relatives of members of the selection committee, or of your officers, directors, or substantial

Yes

contributors eligible for awards made under your program? If “Yes,” what measures are taken to

ensure unbiased selections?

Note. If you are a private foundation, you are not permitted to provide educational grants to disqualified persons. Disqualified persons include your substantial contributors and foundation managers and certain family members of disqualified persons.

X

No

Private foundations complete lines 1a through 4f of this section. Public charities do not complete this section.

1a If we determine that you are a private foundation, do you want this application to be

Yes No

N/A

considered as a request for advance approval of grant making procedures?

b For which section(s) do you wish to be considered?

  • 4945(g)(1)—Scholarship or fellowship grant to an individual for study at an educational institution
  • 4945(g)(3)—Other grants, including loans, to an individual for travel, study, or other similar purposes, to enhance a particular skill of the grantee or to produce a specific product
2 Do you represent that you will (1) arrange to receive and review grantee reports annually and upon completion of the purpose for which the grant was awarded, (2) investigate diversions of funds from their intended purposes, and (3) take all reasonable and appropriate steps to recover diverted funds, ensure other grant funds held by a grantee are used for their intended purposes, and withhold further payments to grantees until you obtain grantees’ assurances that future diversions will not occur and that grantees will take extraordinary precautions to prevent future diversions from occurring? Yes No
3 Do you represent that you will maintain all records relating to individual grants, including information obtained to evaluate grantees, identify whether a grantee is a disqualified person, establish the amount and purpose of each grant, and establish that you undertook the supervision and investigation of grants described in line 2? Yes No