2016-2017Marion Co. 4-H

INSTRUCTIONS FOR ESTABLISHED CLUBS AND NEW CHARTERING

Marion County Purdue Extension Service is committed to protecting its 4-H program, its members, the 4-H name andemblem in Indiana and the country. This protection comes through the commitment and requirement for all county, district, region, and state level 4-H clubs and groups to have current charters and understand the value of those charters.

Chartering 4-H clubs and affliated groups, or granting permission for groups to operate in the name of 4-H, dates back many decades. Indiana 4-H began to charter all clubs and affiliated groups following a directive from National 4-H Headquarters at USDA.

With changes at the national level, chartering is now state-based. As a result, all Indiana 4-H clubs/groups must charter to receive permission to operate and use the name/emblem of 4-H.

More specifically, this document provides an overview, as well as instructions for club/group leadership, to understand the need and requirements for chartering a 4-H club/group in Marion County Indiana.

PURPOSE OF ESTABLISHING AND CHARTERING A 4-H CLUB/GROUPChartering is a legal process which allows faculty to verify the financial status, business (with list of officers, volunteers, etc.) and legal documentation for each group operating in the name of 4-H. The chartering of a local 4-H club or group by the Indiana 4-H allows the club or group authorization to use the 4-H name and emblem, and be recognized as an Internal Revenue Service 501(c)3 not-for-profit group under the umbrella of Indiana 4-H.

WHAT IS A CHARTER?A 4-H charter is a “permit” issued annually for use of the 4-H club name and emblem. It allows a group to function with all the rights and privileges of 4-H membership. Once a club/group is officially chartered, the county office will send a letter with the club name and 4-H year to validate their charter recognition.

WHO MUST BE ESTABLISHED AND CHARTERED IN ORDER TO USE THE 4-H NAME AND EMBLEM?In Marion County Indiana, all 4-H community, project, SPARK club or groups must be chartered.

REQUIREMENTS TO ESTABLISH A NEW CLUB/GROUP OR CHARTER AN EXISTING 4-H CLUB OR GROUP Below are the requirements necessary for establishing/chartering a club or group under Marion County Indiana 4-H.

_____Charter/Established Club or Group Application Form_____Club/Group Constitution_____Employer Identification Number or EIN_____Club Officer List and Annual Plan_____Tentative Annual Club Budget (if applicable)

For established clubs with bank accounts only______Bank Account Information (Most recient bank statements)_____Annual Review of Finances (Upon County office request)

It is the policy of the Purdue University Cooperative Extension Service, that all persons have equal opportunity and access to its educational programs, services, activities, and facilities without regard to race, religion, color, sex, age, national origin or ancestry, marital status, parental status, sexual orientation, disability or status as a veteran. Purdue University is an Affirmative Action institution.

_____Authorization Letter 4-H Clubs IRS

The purpose of a 4-H club is to provide youth with educational, fun learning experiences with their peers.

4-H Clubs may be organized in several forms.

These groups include at least five members from at least three families ranging in grades 3-12. TThe club is led by one or more approved adult volunteer leaders. Youth enroll in subject matter areas of interest (projects), participate in 9-12 meetings during the year, select youth officers, carry out club responsibilities, participate in service to the community, and receive recognition for their work. Club meetings typically are held once a month in a location such as a school, community center, church, or other public meeting space. The club often uses its meetings to develop group process skills, leadership ability, and communication skills.

Community ClubSchool ClubProject Club

After School ClubSpark Club

SPARKS Clubs are open to youth grades 3-12 to “spark” new interest in the Indiana 4-H program. SPARK Clubs are special interest groups designed to capture the attention of youth with single focus, “out of the box” interests that are likely different from state-recognized 4-H projects. These clubs are led by volunteers bringing their subject mastery to the club. SPARK Clubs include six hours of instructional time that can occur in one day or over a length of time.

2016-2017 MARION CO. 4-H YOUTH DEVELOPMENT ESTABLISHED CLUBS AND NEW CLUB WORKSHEET

NOTE: This is only a worksheet for collecting data which will then be submitted to the Extension Educator ALL INFORMATION IN BOLD IS REQUIRED.

CLUB INFORMATION Charter Application Type New Club Establishing & Chartering

Chartering of Existing Club

Club Affiliation Indy Center Area

Decatur TownshipFranklin Township

Type of Club 4-H Community Club 4-H In-School Club 4-H After-School Club 4-H Project Club Administrative Club (Example: Council, Adult

Leaders, Boards – Club/Group not to be published forenrollment but needs to be chartered)

Club Name (Exactly as it appears in 4-H Online and on EIN document) Name of Primary Club Leader: Club Address Line 1: Club Address Line 2: City: State: Zip: Contact Phone Number: E-mail: Website/Social Media Site: What year was this club established?

CLUB/GROUP MEETING INFORMATION You are required to provide the physical address of the club/group meeting each month. The address should be the complete physical address, and not simply

"Fairgrounds" or "Courthouse." Incomplete/incorrect addresses will delay chartering approval.

Meeting Location (Official Name, ie 38th St. Library, Indiana): Physically Address 1: Physically Address 2: Location City: Location Zip: Regular Meeting Day (Example 2nd Tuesday of Month): Regular Meeting Time:

DEFINITIONS: Racially Ethnically Mixed Communities: An area or community in which more than one of the racial-ethnic groups make up the population of potential program participants. Racially Ethnically Integrated Group: A group composed of members of more than one of the racial-ethnic groups above.

Based on definition above, is this club in a racially mixed community? YES NO

Based on definition above, is this club integrated as to the race and ethnicity of the membership?

YES NO

Perry Township Pike Township Washington Township Wayne Township

ESTABLISHED CLUB: How many active members did this club have in the 15-16 year?

NEW CLUB: How many youth do you have committed to enroll in this club?

CLUB/GROUP OFFICERS MANAGERS

Does club have a slate of club officers? YES NO

Does club have adult volunteer(s) serving as club leader (s) who oversee the club operations?

YES NO

If YES, please provide their names

CLUB/GROUP FINANCIAL INFORMATION

Club/Group Employee Identification Number (EIN):

If club/group does not have an EIN, explain why?

Tax Filing Information Please indicate whether your last filing was under Indiana 4-H or another entity: Indiana 4-H

Other

If other, who was it filed under (school name, other foundation, organization):

Did you SUCCESSFULLY file the club/group IRS 990 form for 2015: YES NO

Each club/group under Marion County 4-H must go through an annual financial review. Provide the month/year of last review. (Ex: April 2016):

Bank Account Information Does this club/group have a bank account(s): YES

NOIf you have a bank account, you will be required to submit either an approved, or proposed budget with your chartering

List ALL Names on the Signature Card(s):

Bank Account #1 Savings or Checking: Financial Institution Name: City/State: Phone Number: Account #:

Bank Account #2 Savings or Checking: Financial Institution Name: City/State: Phone Number: Account #:

Constitution of Club of Marion County, IN

Article 1. This Constitution hereby revokes any prior Constitution or similar organizing

document adopted by the organization.

Article 2. The name of the organization shall be the Club.

The organization shall hereinafter be referred to as club.

Article 3. The club is organized exclusively for educational, scientific and charitable

purposes, specifically to provide the youth who comprise the membership with a non-

formal 4-H Youth Development educational experience through the Purdue University

Cooperative Extension Service.

Article 4. The membership shall be comprised of any young person in or below grade

12, who has indicated an interest in a 4-H Youth Development experience, has completed

an enrollment form, and who pays the 4-H program fee. The club will be organized and

led by a 4-H volunteer who has been screened, approved and appointed by the Purdue

Extension staff member of Marion County.

Article 5. No part of the net earnings of the club shall inure to the benefit of, or be

distributable to its members, officers or other private persons, except that the club shall

be authorized to make payments and distributions in furtherance of its purposes set forth

in Article 3. No substantial part of the activities of the club shall be the carrying on of

propaganda, or otherwise attempting to influence legislation, and the club shall not

participate in, or intervene in (including the publishing or distribution of statements) any

political campaign on behalf of or in opposition to any candidate for public office.

Article 6. Notwithstanding any other provision of this Constitution, the club shall not

carry on any other activities not permitted to be carried on by an organization exempt

from Federal income tax under section 501(c)(3) of the Internal Revenue Code, or the

corresponding section of any future federal tax code.

Article 7. The fiscal year of the club shall end on December 31st. An annual financial

report for the club will be presented to the Purdue Extension Office for a financial

review. The financial report shall be accompanied by a required annual report of the

club’s activities for the year. A formal, financial review of each club will be conducted

per 4-H policies and procedures every 4-5 years and at any time there is a change in the

volunteer who has signature authority on the club’s bank account or similar financial

account.

Article 8. In the event of termination or revocation of a charter for, or dissolution of, this

club, all of the principal, income, and assets shall be transferred and assigned to the

Purdue Cooperative Extension Service of Marion County to be held to support future 4-H

educational program efforts to include the formation of new 4-H clubs.

Article 9. The club shall generate its federal tax exempt status under section 501(c)(3) of

the Internal Revenue Code through a Group Exemption Number (GEN) to be issued to

Purdue University, and it shall undertake any action so required by Purdue University and

by Internal Revenue Service rules and procedures to ensure its inclusion in the GEN

issued to Purdue University. The club shall obtain an Employer Identification Number

from the Internal Revenue Service irrespective of whether a bank account is maintained

by the club. The club shall comply with requirements for, and file with the Internal

Revenue Service, annual information returns on the Form 990 Series applicable to the

club, and the club shall file all other returns required by applicable law including Federal,

State and local law. No consolidated Form 990 for subordinate organizations (i.e. clubs)

shall be prepared by Purdue University under the group exemption issued to it.

Article 10. It is the policy of Purdue Cooperative Extension that all 4-H clubs and

acknowledged 4-H groups shall have equal opportunity and access to programs and

activities.

Article 11. No amendment to this Constitution shall be effective without the written

consent of the Assistant Director and Program Leader 4-H Youth Development at Purdue

University or such person as may be delegated such authority by the said Assistant

Director and Program Leader. The club may adopt or amend By-Laws or similar

operational documents which may contain additional provisions as long as they do not

contradict the provisions of this Constitution.

Date Adopted:

Signature:

Printed name:

Title:

587573.1

Application for Employer Identification Number Form SS-4 EIN(Rev. January 2010) (For use by employers, corporations, partnerships, trusts, estates, churches,

government agencies, Indian tribal entities, certain individuals, and others.)

OMB No. 1545-0003

Department of the TreasuryInternal Revenue Service

Legal name of entity (or individual) for whom the EIN is being requested1

Executor, administrator, trustee, “care of” name3Trade name of business (if different from name on line 1)2

Mailing address (room, apt., suite no. and street, or P.O. box)4a Street address (if different) (Do not enter a P.O. box.)5a

City, state, and ZIP code (if foreign, see instructions)4b City, state, and ZIP code (if foreign, see instructions)5b

County and state where principal business is located6

Name of responsible party7a

Estate (SSN of decedent)

Type of entity (check only one box). Caution. If 8a is “Yes,” see the instructions for the correct box to check.9a

Partnership

Plan administrator (TIN)

Sole proprietor (SSN)

Farmers’ cooperative

Corporation (enter form number to be filed) ©

Personal service corporation

REMIC

Church or church-controlled organization

National Guard

Trust (TIN of grantor)

Group Exemption Number (GEN) if any ©

Other nonprofit organization (specify) ©

Other (specify) ©

9b If a corporation, name the state or foreign country(if applicable) where incorporated

Changed type of organization (specify new type) ©

Reason for applying (check only one box)10

Purchased going business

Started new business (specify type) ©

Hired employees (Check the box and see line 13.)

Created a trust (specify type) ©

Created a pension plan (specify type) ©

Banking purpose (specify purpose) ©

Other (specify) ©

1211 Closing month of accounting yearDate business started or acquired (month, day, year). See instructions.

15 First date wages or annuities were paid (month, day, year). Note. If applicant is a withholding agent, enter date income will first be paid tononresident alien (month, day, year) ©

HouseholdAgricultural

13 Highest number of employees expected in the next 12 months (enter -0- if none).

17 Indicate principal line of merchandise sold, specific construction work done, products produced, or services provided.

18 Has the applicant entity shown on line 1 ever applied for and received an EIN? Yes No

Complete this section only if you want to authorize the named individual to receive the entity’s EIN and answer questions about the completion of this form.

Designee’s telephone number (include area code)

Date ©Signature ©

For Privacy Act and Paperwork Reduction Act Notice, see separate instructions. Form SS-4 (Rev. 1-2010)

Typ

e o

r p

rint

cle

arly

.

Cat. No. 16055N

Foreign countryState

Designee’s fax number (include area code)

© See separate instructions for each line.

( )

( )

© Keep a copy for your records.

Compliance with IRS withholding regulations

SSN, ITIN, or EIN7b

Other

Applicant’s telephone number (include area code)

Applicant’s fax number (include area code)

( )

( )

Under penalties of perjury, I declare that I have examined this application, and to the best of my knowledge and belief, it is true, correct, and complete.

Name and title (type or print clearly) ©

ThirdPartyDesignee

Designee’s name

Address and ZIP code

Federal government/military Indian tribal governments/enterprises

State/local government

If you expect your employment tax liability to be $1,000or less in a full calendar year and want to file Form 944annually instead of Forms 941 quarterly, check here.(Your employment tax liability generally will be $1,000or less if you expect to pay $4,000 or less in totalwages.) If you do not check this box, you must fileForm 941 for every quarter.

Is this application for a limited liability company (LLC) (or a foreign equivalent)?

NoYes8a If 8a is “Yes,” enter the number of

LLC members ©

8b

If 8a is “Yes,” was the LLC organized in the United States?

8c

NoYes

14

Check one box that best describes the principal activity of your business.

16 Construction Real estate

Rental & leasing Manufacturing

Transportation & warehousing Finance & insurance

Health care & social assistance Accommodation & food service Other (specify)

Wholesale-agent/broker Wholesale-other Retail

If “Yes,” write previous EIN here ©

If no employees expected, skip line 14.

Club Officers and Annual Planning Form

4-H Club (Name)2016-2017

Club Officers Office Position Member’s Name

Club Annual Planning Month Club plans

August:

September:

October:

November:

December:

January:

February:

March:

April:

May:

June:

July:

Marion County

Club Name:

October 1, to September 30,

BUDGETED ACTUAL

Total Income -$ -$

BUDGETED ACTUAL

Total Expenses -$ -$

Closing Balance -$ -$

Total Opening Balance:

ESTIMATED INCOME (SOURCE, USE, PURPOSE)

PROJECTS (SUB-ACCOUNTS)

Club Leader's Signature/Date

4-H CLUB BUDGET (Marion County)

We certify that this budget was approved by the club members on (date):

President's Signature/Date

Treasurer's Signature/Date

PROJECTS (SUB-ACCOUNTS)

ESTIMATED EXPENSES (DESCRIBE)

Marion County

AUTHORIZATION OF SUBORDINATE (4-H CLUB) TO BE INCLUDED

IN INTERNAL REVENUE SERVICE GROUP EXEMPTION LETTER FOR

PURDUE UNIVERSITY

Internal Revenue Service Procedure 80-27*, 1980-1 C.B. 677 describes the process

under which the _______________________ Club of Marion County, IN may generate its

federal tax exempt status under section 501(c)(3) of the Internal Revenue Code through a

Group Exemption Letter issued by the Internal Revenue Service upon an application filed by

Purdue University as a Central Organization on behalf of 4-H Clubs and Affiliates situated in

Indiana which are subject to the general supervision and control of Purdue University. Such

4-H Clubs and Affiliates are referred to in Revenue Procedure 80-27 as a subordinate of

Purdue University.

One of the requirements for the issuance of a Group Exemption Letter by the Internal

Revenue Service contained in Section 4.03 of Revenue Procedure 80-27 is that each

subordinate of a Central Organization must authorize the Central Organization to include it in

the application for the Group Exemption Letter made by the Central Organization pursuant to

Section 4 of Revenue Procedure 80-27.

Based on my understanding that Purdue University as Central Organization will

submit to the Internal Revenue Service an application for the issuance of a Group Exemption

Letter covering 4-H Clubs and Affiliates as subordinates, the ______________________ Club

of Marion County, IN through the undersigned, hereby authorizes Purdue University to

include it in the application for the Group Exemption Letter.

Dated this _____________________ day of __________________________,

________________ (year).

______________________________ Club of __________________________ County, IN

by __________________________________ Signature of Authorized Individual

Printed name ________________________________

*587634.1