1. Contact Information:

Name of Organization *

EIN: *

Contact Person: *

Email Address: *

Phone Number *

Address of Organization: *

City *

State *

Postal code *

Website

2. State of Incorporation:

In what state is your nonprofit incorporated? *

3. Reason for Reinstatement:

Please briefly explain why your nonprofit organization's status needs to be reinstated. *

Have you received any notice(s) from the IRS or state regulatory agencies regarding the revocation of your organization's tax-exempt status? *

4. Previous Filings:

When was the last time your organization filed IRS Form 990 or other required tax forms? *

Do you have copies of previous filings and correspondence with the IRS or state agencies related to your organization's status?

5. Changes Since Revocation:

Have there been any significant changes in your organization's structure, mission, or activities since the revocation of its tax-exempt status? *

Have you addressed any issues or deficiencies identified by the IRS or state agencies that led to the revocation? *

6. Board of Directors and Leadership:

Are the members of your organization's board of directors aware of the need for reinstatement? *

Are there any changes in board composition or leadership that have occurred since the revocation? *

Please list the current board members and their positions. *

7. Financial Records and Compliance:

Are your organization's financial records up to date and in compliance with IRS requirements? *

Have you taken steps to ensure that any outstanding taxes or penalties owed to the IRS or state agencies are addressed? *

8. Reinstatement Process:

Are you familiar with the reinstatement process for tax-exempt status with the IRS or state regulatory agencies? *

Do you have a timeline or deadline by which you need to complete the reinstatement process? *

9. Support Needed:

Are there specific areas or aspects of the reinstatement process where you need assistance or guidance from Your Nonprofit Doctor? *

Do you have any questions or concerns about the reinstatement process that you would like to discuss? *

10. Additional Information:

Is there any other specific assistance or support you're seeking from Your Nonprofit Doctor regarding nonprofit formation?

11. Preferred Consultation Method:

What is your preferred consultation method? *

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