Click on the Business license, Corporation, Tax Ids or DBA / FBN Below to Select State First
|FTB 3500 Exemption Application Part Two: Receipts and Expenses Statement|
|FTB 3500 Exemption Application Part Two: Receipts and Expenses Statement |
NOTE: THIS FORM IS ABSOLUTELY NECESSARY. IF YOU HAD ANY FINANCIAL ACTIVITY, WE NEED THIS FORM COMPLETED AND A FINANCIAL BALANCE SHEET. IF YOU HAD NO CURRENT OR PAST FINANCIAL ACTIVITY, WE NEED A PROJECTED BUDGET. (JUST USE THE FORM BELOW TO GIVE US AN IDEA OF WHAT THE BUDGET WILL BE - YOU CAN USE THE MINIMUM OR MAXIMUM EXPENSE OR INCOME FIGURES - IT IS UP TO YOU AND IT IS ONLY A PROJECTED BUDGET.
Please be as Complete as Possible: this information is required. You may substitute your own receipts and expenses statement, or statements, but the details mustbe complete as indicated in this statement. Failure to provide complete financial information may result in denial of the exemption application.
•For each year exempt status is requested, provide the financial information represented in the statement below.
• If you have had financial activities for less than one year, provide a financial statement for the period of activities, and a projected budget for the entire first year.
•If this is your first year of operation, and/or you have no prior financial activity, provide a proposed budget for the entire first year of operation. The proposed budget should be based on your most reasonable expectations. . . . . . . . . . . . . . .
|FTB 3500 Exemption Application PART TWO|
|Three Preceding Years for each Year in Existence|
Example (2000 , 2001, 2002,)
|Nonmembership income (R&TC Section 23701g)|
|Other business income|
|Gross investment income|
|Gross royalty income|
|Gross rental income|
|Gross receipts from admissions|
|Gross receipts from commissions|
|Gross receipts from sale of merchandise .|
|Gross receipts from services provided|
|Gross receipts from furnishing of facilities|
|Gain or loss from sale of capital assets|
|Other income (attach sheet itemizing each type)|
|Contributions, gifts, grants, and similar amounts paid|
|Disbursements to or for member benefit|
|Compensation of officers|
|Compensation of directors|
|Compensation of trustees|
|Other salaries and wages|
|Other (including all operational and administrative|
|expenses – attach sheet) .|
Excess of receipts over expenses
In order to avoid losing your info, If you have problems submitting your form, ( for example you get a message: "oops! must be a tripod website" ) after you receive the oops message, just click the "back" button and complete the missing information - if you still receive an oops message, you may want to just print the completed form and mail it to:xkr essex, inc 2911 e. vista st. #C long beach, ca 90803
After you submit this form, You will be Re -
directed to a Confirmation Page Then to: ANOTHER Payment
Web Site --
Note: After you submit this form, You will be Re - directed to a Confirmation Page
ANOTHER Payment Web Site -- "Merchant America"