Project Veritas Tax Exemption Application
Project Veritas Tax Exemption Application
Project Veritas Tax Exemption Application
Note. Retain a copy of the completed Form 1023 in your permanent records. Refer to the General Instructions
regarding Public Inspection of approved applications.
to finish your applic^ Send this filled-in
u have not answered w. your a
m
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.
3 Completed Parts I through XI of the application, including any requested information and any required
0
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.
0 Schedules. Submit only those schedules that apply to you and check either "Yes" or "No" below.
Schedule A Yes _ No 3 Schedule E Yes _ No 3
Schedule B Yes.... No 3 Schedule F Yes _ No 3
Schedule C Yes_ No 3 Schedule G Yes_ No 3
Schedule D Yes_ No 1. Schedule H Yes_ No 3
EZI An exact copy of your complete articles of organization (creating document). Absence of the proper purpose
and dissolution clauses is the number one reason for delays in the issuance of determination letters.
Location of Purpose Clause from Part Ill, line 1 (Page, Article and Paragraph Number) _ Article 7
Location of Dissolution Clause from Part Ill, line 2b or 2c (Page, Article and Paragraph Number) or by
operation of state law Article 8
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:
If you are using express mail or a delivery service, send Form 1023, user fee payment, and attachments to:
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
1 Full name of organization (exactly as it appears in your organizing document) 12 do Name (if applicable)
Project Veritas
3 Mailing address (Number and street) (see instructions) 4 Employer Identification Number (EIN)
8 Was a person who is not one of your officers, directors, trustees, employees, or an authorized LI Yes 0 No
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.
9a Organization's website:
For Paperwork Reduction Act Notice, see page 24 of the instructions, cat. No. 17133K Form 1023 (Rev. 6-2006)
Form 1023 (Rev. 6-2006) Name: Project Veritas EIN: 27 2894856 Page 2
ITiIlI 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.
1 Are you a corporation? If "Yes," attach a copy of your articles of incorporation showing certification 121 Yes LI No
of filing with the appropriate state agency. Include copies of any amendments to your articles and
be sure they also show state filing certification.
2 Are you a limited liability company (LLC)? If 'Yes," attach a copy of your articles of organization showing Li Yes IZI No
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.
3 Are you an unincorporated association? If "Yes," attach a copy of your articles of association, LI Yes 0 No
constitution, or other similar organizing document that is dated and includes at least two signatures.
Include signed and dated copies of any amendments.
4a Are you a trust? If "Yes," attach a signed and dated copy of your trust agreement. Include signed LI Yes 0 No
and dated copies of any amendments.
b Have you been funded? If "No," explain how you are formed without anything of value placed in trust. Li Yes LI No
5 Have you adopted bylaws? If "Yes," attach a current copy showing date of adoption. If "No," explain 121 Yes Li No
how your officers, directors, or trustees are selected.
uired Provisions in Your Or 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.
- 1 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): Article 7
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).
Do not complete line 2c if you checked box 2a. Article 0
2c See the instructions for information about the operation of state law in your particular state. Check this box if Li
you rely on operation of state law for your dissolution provision and indicate the state:
I1I1 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
la 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.
Compensation amount
Name Title Mailing address (annual actual or estimated)
1922 Quincy St.
Gregory Levitsky Director, President
Arlington, VA 22207
1922 Quincy St.
Maureen Wa'gner Director, Chairman
Arlington, VA 22207
1922 Quincy St.
Francisco Gonzales Director, Treasurer
Arlington, VA 22207
1922 Quincy St.
Isabel Santa Director, Sec., Executive Dir. 55,000
Arlinciton, VA 22207
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.
Compensation amount
Name Title - Mailing address (annual actual or estimated)
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 1 a, 1 b, and 1 c.
2a Are any of your officers, directors, or trustees related to each other through family or business El Yes IZ No
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 El Yes No
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.
o Are any of your officers, directors, or trustees related to your highest compensated employees or El Yes 0N
highest compensated independent contractors listed on lines lb or ic through family or business
relationships? If "Yes," identify the individuals and explain the relationship.
3a For each of your officers, directors, trustees, highest compensated employees, and highest
compensated independent contractors listed on lines 1 a, 1 b, or 10, 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 El Yes 11 No
compensated independent contractors listed on lines 1 a, 1 b, or 1 c 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.
4 In establishing the compensation for your officers, directors, trustees, highest compensated
employees, and highest compensated independent contractors listed on lines 1 a, 1 b, and 1 c, 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? 10 Yes El No
b Do you or will you approve compensation arrangements in advance of paying compensation? 2 Yes El No
c Do you or will you document in writing the date and terms of approved compensation arrangements? 2 Yes El No
Form 1023 (Rev. 6-2006) Name: Project Veritas EIN: 27 - 2894856 Page 4
ITTh'I Compensation and Other Financial Arrangements With Your Officers, Directors, Trustees,
Employees, and Independent Contractors (Continued)
d Do you or will you record in writing the decision made by each individual who decided or voted on EZI Yes Li No
compensation arrangements?
e Do you or will you approve compensation arrangements based on information about compensation paid by 0 Yes Li No
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 la, ib, and ic, 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 11 Yes Li No
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 1 a, 1 b, and 1 c.
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 Yes Li N 0
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, EZ Yes Li No
and highest compensated independelit contractors listed iiiliiies 1a,1br lc throUh 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 la, ib, and ic, 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, EZ Yes 0 No
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 1 a, 1 b,
and 1 c, for information on what to include as compensation.
7a Do you or will you purchase any goods, services, or assets from any of your officers, directors, Li Yes tZ No
trustees, highest compensated employees, or highest compensated independent contractors listed in
lines la, ib, or ic? 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.
b Do you or will you sell any goods, services, or assets to any of your officers, directors, trustees, 0 Yes II No
highest compensated employees, or highest compensated independent contractors listed in lines la,
1 b, or 1 c? 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.
8a Do you or will you have any leases, contracts, loans, or other agreements with your officers, directors, Li Yes 1I No
trustees, highest compensated employees, or highest compensated independent contractors listed in
lines la, 1b, or 1c? If "Yes," provide the information requested in lines 8b through 8f.
b Describe any written or oral arrangements that 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 you pay no more than fair market value or you are paid at least fair market value.
f 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 Li Yes IZ No
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.
Form 1023 (Rev. 6-2006)
Form 1023 (Rev. 6-2006) Name: Project Veritas EIN: 27 - 2894856 Page 5
IThI Compensation and Other Financial Arrangements With Your Officers, Directors, Trustees,
Employees, and Independent Contractors (Continued)
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.
IThY1I 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.)
la In carrying out your exempt purposes, do you provide goods, services, or funds to individuals? If El Yes ll No
"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 El Yes 121 No
"Yes," describe each program that provides goods, services, or funds to organizations.
2 Do any of your programs limit the provision of goods, services, or funds to a specific individual or LI Yes 21 No
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.
3 Do any individuals who receive goods, services, or funds through your programs have a family or El Yes 121 No
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 1 a,-1 b, and 1 c? If - - - -
"Yes," explain how these related Individuals are eligible for goods, services, or funds.
I5LI1lI 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 El Yes 121 No
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.
2 Are you submitting this application more than 27 months after the end of the month in which you El Yes 21 No
were legally formed? If "Yes," complete Schedule E.
I1Th'1llI 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.)
I Do you support or oppose candidates in political campaigns in any way? If "Yes," explain. El Yes 21 No
2a Do you attempt to influence legislation? If "Yes," explain how you attempt to influence legislation El Yes 21 No
and complete line 2b. If "No," go to line 3a.
b Have you made or are you making an election to have your legislative activities measured by El Yes No
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.
3a Do you or will you operate bingo or gaming activities? If "Yes," describe who conducts them, and El Yes 121 No
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.
b Do you or will you enter into contracts or other agreements with individuals or organizations to El Yes No
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.
c List the states and local jurisdictions, including Indian Reservations, in which you conduct or will
conduct gaming or bingo.
Form 1023 (Rev. 6-2006)
Form 1023 (Rev. 6-2006) Name: Project Veritas EN: 27 - 2894856 Page 6
I9'1lII Your Specific Activities (Continued)
4a Do you or will you undertake fundraising? If "Yes," check all the fundraising programs you do or will 1I Yes LI No
conduct. (See instructions.)
mail solicitations phone solicitations
II email solicitations 121 accept donations on your website
121 personal solicitations LI receive donations from another organization's website
LI vehicle, boat, plane, or similar donations LI government grant solicitations
121 foundation grant solicitations LI 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 21 Yes LI 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 LI Yes 121 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 LIYes 0 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 pif iiWritten mat6rialsprdvided to dbnors
5 Are you affiliated with a governmental unit? If "Yes," explain. LI Yes 121 No
6a Do you or will you engage in economic development? If "Yes," describe your program. LI 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 LI Yes 121 No
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 LI Yes 21 No
"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.
8 Do you or will you enter into joint ventures, including partnerships or limited liability companies LI Yes 123 No
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.
9a Are you applying for exemption as a childcare organization under section 501(k)? If "Yes," answer LI Yes 121 No
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 LI Yes LI No
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 LI Yes LI No
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 LI Yes LI No
whom your activities are available. Also, see the instructions and explain how you qualify as a
childcare organization described in section 501(k).
10 Do you or will you publish, own, or have rights in music, literature, tapes, artworks, choreography, 21 Yes LI No
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.
Form 1023 (Rev. 6-2006)
Form 1023 (Rev. 6-2006) Name: Project Veritas EIN: 27 - 2894856 Page 7
I1'1IlI Your Specific Activities (Continued)
11 Do you or will you accept contributions of: real property; conservation easements; closely held LI Yes I No
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.
12a Do you or will you operate in a foreign country or countries? If "Yes," answer lines 12b through LI Yes Ii No
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.
13a Do you or will you make grants, loans, or other distributions to organization(s)? If "Yes," answer lines LI Yes 0 No
13b through 13g. If "No," go to line 14a.
b Describe how your grants, loans, or other distributions to organizations further your exempt purposes.
o Do you have written contracts with each of these organizations? If "Yes," attach a copy of each contract. El Yes El No
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. LIYes El No
(ii) Do you require a grant proposal? If "Yes," describe whether the grant proposal specifies your EYes No
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,
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.
14a Do you or will you make grants, loans, or other distributions to foreign organizations? If "Yes," LI Yes 121 No
answer lines 14b through 14f. If "No," go to line 15.
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 LI Yes 0 N
or specific organization? If "Yes," list all earmarked organizations or countries.
d Do your contributors know that you have ultimate authority to use contributions made to you at your LI Yes 0N
discretion for purposes consistent with your exempt purposes? If "Yes," describe how you relay this
information to contributors.
e Do you or will you make pre-grant inquiries about the recipient organization? If "Yes," describe these LI Yes LI No
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.
f Do you or will you use any additional procedures to ensure that your distributions to foreign LI Yes LI No
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.
Form 1023 (Rev. 6-2006)
Form 1023 (Rev. 6-2006) Name: Project Veritas EIN: 27 - 2894856 Page 8
ITh'AllI Your Specific Activities (Continued)
15 Do you have a close connection with any organizations? If 'Yes," explain. El Yes Z No
16 Are you applying for exemption as a cooperative hospital service organization under section El Yes IZI No
501(e)? If "Yes," explain.
17 Are you applying for exemption as a cooperative service organization of operating educational El Yes 121 No
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. El Yes 21 No
19 Do you or will you operate a school? If "Yes," complete Schedule B. Answer "Yes," whether you El Yes 121 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. El Yes 121 No
21 Do you or will you provide low-income housing or housing for the elderly or handicapped? If El Yes 21 No
"Yes," complete Schedule F.
22 Do you or will you provide scholarships, fellowships, educational loans, or other educational grants to El Yes 121 No
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.
Form 1023 (Rev. 6-2006) Name: Project Veritas EIN: 27 - 2894856 Page 9
lTI4Financial 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.)
Form 1023 (Rev. 6-2006) Name: Project Veritas EIN: 27 - 2894856 Pane 10
Financial Data
B. Balance Sheet (for your most recently completed tax year) Year End: Current
Assets (Whole dollars)
ICash ................................ 200
2 Accounts receivable, net .........................
3 Inventories ..............................
4 Bonds and notes receivable (attach an itemized list) ................
5 Corporate stocks (attach an itemized list)
6 Loans receivable (attach an itemized list) ....................
7 Other investments (attach an itemized list) ...................
8 Depreciable and depletable assets (attach an itemized list) ..............
9 Land ................................
10 Other assets (attach an itemized list) .....................
11 Total Assets (add lines 1 through 10) .................
Liabilities 200
12 Accounts payable
13 Contributions, gifts, grants, etc. payable ....................
14 Mortgages and notes payable (attach an itemized list)
15 Other liabilities (attach an itemized list)
16 Total Liabilities (add lines 12 through 15) 0
Fund Balances or Net Assets
17 Total fund balances or net assets ...................... r 200
18 Total Liabilities and Fund Balances or Net Assets (add lines 16 and 17) 200
19 Have there been any substantial changes in your assets or liabilities since the end of the period LI Yes 21 No
shown -above? If "Yes,"explain - -
I1l 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.)
la Are you a private foundation? If "Yes," go to line lb. If "No," go to line 5 and proceed as instructed. LI Yes 21 No
If you are unsure, see the instructions.
b As a private foundation, section 508(e) requires special provisions in your organizing document in LI
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.
2 Are you a private operating foundation? To be a private operating foundation you must engage LI Yes LI 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.
3 Have you existed for one or more years? If "Yes," attach financial information showing that you are a private LI Yes LI No
operating foundation; go to the signature section of Part XI. If 'No," continue to line 4.
4 Have you attached either (1) an affidavit or opinion of counsel, (including a written affidavit or opinion LI Yes LI 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 1 a, 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. LI
b 509(a)(1) and 170(b)(1)(A)(ii)a school. Complete and attach Schedule B. LI
c 509(a)(1) and 170(b)(1)(A)(iii)a hospital, a cooperative hospital service organization, or a medical research LI
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 LI
or a publicly supported section 501(c)(4), (5), or (6) organization. Complete and attach Schedule D.
Form 1023 (Rev. 6-2006)
Form 1023 (Rev. 6-2006) Name: Project Veritas EIN: 27 -2894856 Page 11
IThE1 Public Charity Status (Continued)
e 509(a)(4)an organization organized and operated exclusively for testing for public safety. Li
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 Li
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 Li
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).
I A publicly supported organization, but unsure if it is described in 5g or 5h. The organization would like the IRS to Li
decide the correct status.
6 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 Li
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.
For Organization
(Signature of Officer, Director, Trustee, or other (Type or print name of signer) (Date)
authorized official)
b Request for Definitive Ruling: Check this box if you have completed one tax year of at least 8 full months and 0
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 Li
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. Li
(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. Li
7 Did you receive any unusual grants during any of the years shown on Part IX-A. Statement of Li Yes IZ No
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.
1 Have your annual groec receipts averaged or are they expected to average not more than 31 0.000? D Yes 2 lb
If Yes, checJc the box on Isis 2 and enclose a user fee payment of $300 (Subject to changesee above).
the box If you have enclosed the reduced user
the box if you have enclosed the user fee oavri
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5*Ci Itilxf adb1l mJ lax,iorbit eur ail
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I
Secretary
(Torplrt bile a ae-r.Ityd dgis)
Perrbv:kr Sad ff-x-- con-pleted Fcxrn13 v)1h yx 1111 r-icic31. .-,., 1 - e.zs
Form 1023 (Rev. 6-2006) Name: Project Veritas EIN: 27 - 2894856 Page 12
i1'iI71 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,
1 Have your annual gross receipts averaged or are they expected to average not more than $10,000? El Yes 0 No
If "Yes," check the box on line 2 and enclose a user fee payment of $300 (Subject to changesee above).
If 'No," check the box on line 3 and enclose a user fee payment of $750 (Subject to changesee above).
2 Check the box if you have enclosed the reduced user fee payment of $300 (Subject to change). El
3 Check the box if you have enclosed the user fee payment of $750 (Subject to change). ll
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 ------ ---- ot--er---------------
abel Santa
Here V (Signature of--
Officer, Directo r, Trustee----
, or h (Type or print name of signer) (Date)
authorized official)
Secretary
(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)
Exhibit B
Conflict of Interest Policy
Article I. Purpose.
The purpose of the conflict of interest policy is to protect this tax-exempt organization's
(Organization) interest when it is contemplating entering into a transaction or arrangement that
might benefit the private interest of an officer or director of the Organization or might result in a
possible excess benefit transaction. This policy is intended to supplement but not replace any
applicable state and federal laws governing conflict of interest applicable to nonprofit and
charitable organizations.
Article H. Definitions
1.Interested Person. Any director, principal officer, or member of a committee with
governing board delegated powers, who has a direct or indirect financial interest, as defined
below, is an interested person.
2. Financial Interest. A person has a financial interest if the person has, directly or
indirectly, through business, investment, or family: - -
- a. An ownership or investment interest in any entity with which the Organization has a
transaction or arrangement,
b. A compensation arrangement with the Organization or with any entity or individual
with which the Organization has a transaction or arrangement, or
c. A potential ownership or investment interest in, or compensation arrangement with,
any entity or individual with which the Organization is negotiating a transaction or arrangement.
Compensation includes direct and indirect remuneration as well as gifts or favors that are
not insubstantial. A financial interest is not necessarily a conflict of interest. Under Article III,
Section 2, a person who has a financial interest may have a conflict of interest only if the
appropriate governing board or committee decides that a conflict of interest exists.
Article V. Compensation
a. A voting member of the governing board who receives compensation, directly or
indirectly, from the Organization for services is precluded from voting on matters pertaining to
that member's compensation.
b. A voting member of any committee whose jurisdiction includes compensation matters
and who receives compensation, directly or indirectly, from the Organization for services is
precluded from voting on matters pertaining to that member's compensation.
c. No voting member of the governing board or any committee whose jurisdiction
includes compensation matters and who receives compensation, directly or indirectly, from the
Organization, either individually or collectively, is prohibited from providing information to any
committee regarding compensation.
Signed:
Na - -
Date:
2
Project Veritas EIN: 27- 2894856