Form Ap-204-2 - Application For Exemption - Federal And All Others Page 2

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AP-204-2
CLEAR FORM
(Rev.1-07/4)
APPLICATION FOR EXEMPTION -
• TYPE OR PRINT
FEDERAL AND ALL OTHERS
Page 1
• Do NOT write in shaded areas.
1. Organizations applying for exemption under one of the categories listed below should check the appropriate box and complete this application.
Our publication, Guidelines to Texas Tax Exemptions (96-1045), includes a description of the additional documentation required for each category
of exemption. For the category you select, be sure to read the requirements listed in the publication. If you send in an application without
including the documentation described in the publication, we will return the application to you with a request for additional
information. We are unable to process incomplete applications.
Federal Exemption under qualifying Internal Revenue Code
Credit Unions - Federal
Section 501(c)
Credit Unions - State
Cemetery Corporations
Development Corporations
Certain Insurance Corporations for Farm Mutuals, Local Mutual Aid
Electric Cooperatives
Associations and Burial Associations
Emergency Medical Service Corporations
Certain Insurance Corporations Licensed as Title Insurance Companies
Farmers Cooperative Societies
and Title Insurance Agents
Health Facility Development Corporations
Certain Corporations subject to the Insurance Code
Hospital Laundry Cooperative Associations
Chambers of Commerce
Housing Finance Corporations
Convention and Tourist Promotional Agencies
Local Organizing Committees
Cooperative Associations
Lodges
Cooperative Credit Associations
Marketing Associations
Corporations Exempted by Another Law
Nonprofit Water Supply Corporations
Corporations with Business Interest In Solar Energy Devices
Open-End Investment Companies
Corporations Organized for Agricultural Purposes
Public Interest Organizations
Corporations Organized for Conservation Purposes
Railway Terminal Corporations
Corporations Involved with City Natural Gas Facility
Recycling Operations
Corporations Organized to Provide Cooperative Housing
Telephone Cooperatives
Corporations Organized to Provide Convalescent Homes for
Texas Natural Research Laboratory Commission Corporations
Elderly
Volunteer Fire Departments
Corporations Organized for Student Loan Funds or Student
Youth Athletic Organizations
Scholarship Purposes
2. ORGANIZATION NAME
(Legal name as provided on Articles of Incorporation, or if unincorporated, the governing document. If an out-of-state corporation, name must match the official corporate name as filed in the
home state of charter.)
3. ORGANIZATION MAILING ADDRESS
Street number, P.O. Box, or rural route and box number
City
State/province
ZIP code
County (or country, if outside the U.S.)
4. Texas taxpayer number (if applicable) ............................................................................................................................
5. Federal employer's identification number
(EIN)
(Required if applying for exemption on the basis of a federal exemption) ................
6. For TEXAS corporations, filing information issued by the Secretary of State:
Month
Day Year
File Number .............................................................
File Date .................................................
7. For NON-TEXAS corporations, filing information issued by the Texas Secretary of State:
Month
Day Year
Certificate of Authority File Number .........................
File Date .................................................
Month
Day Year
Home State
Date of
Home State Filing
of Incorporation
Incorporation
or Registration Number
8. Name, address and daytime phone number of the person submitting this application
Name
Title
Firm or Company Name
Daytime Phone (Area code and number)
Extension
Address
City
State
Zip
If address provided is not the same as the organization's mailing address, indicate to which address our response should be mailed:
To organization mailing address
To mailing address of submitter

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