Hawaii Application for Exemption from General Excise Taxes

Application for Exemption from General Excise Taxes
G-6. Application for Exemption from General Excise Taxes, Rev. 2012
FORM G-6
(REV. 2020)

STATE OF HAWAII — DEPARTMENT OF TAXATION

INFORMATION REQUIRED TO FILE FOR AN
EXEMPTION FROM GENERAL EXCISE TAXES

PLEASE READ THE INSTRUCTIONS (FORM G-6A) BEFORE COMPLETING THIS APPLICATION
1. Federal employer identification number

2. Hawaii Tax I.D. number (if any)

GE __ __ __-__ __ __-__ __ __ __-__ __
3. Full name of organization (exactly as it appears in your organizing document)
4. Care of (if applicable)
5. Mailing address (number and street), city or town, state, and postal/ZIP code
6. Business address (number and street), city or town, state, and postal/ZIP code
7. Organization’s website

8. Date organization’s Hawaii activity began

9. Primary contact
a. Name and title

b. Telephone number

c. E-mail address

)

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10. Organization is applying for a GET exemption as an organization described under Hawaii Revised Statutes (check one):

 § 237-23(a)(3)

 § 237-23(a)(4)

 § 237-23(a)(5)

 § 237-23(a)(6)

 § 237-23(a)(7)

11. Organization has received/applied for a federal income tax exemption as an organization described under Internal Revenue Code (check one):
 §501(c)(3)
 §501(c)(4)
 §501(c)(5) Agricultural or horticultural organization
 §501(c)(6)
 §501(c)(8)
 §501(c)(12) Potable water company
 Other: ______________________ (specify)

12. The following items MUST be submitted with the completed application: (See instructions for more
information.)
	A.	Twenty dollars ($20) registration fee when filing the application for a new general excise tax account. Please make
sure you do not already have an active general excise tax account.
	B. 	An IRS determination letter granting federal tax exemption (check one):
 Attach when request.
 Was requested on (MM/DD/YY) ____________, but has not been received. Attach a statement to explain.
 Was not requested or required. Attach a statement to explain why.
	C.	Statement to request retroactive approval - If you are requesting retroactive approval, see the instructions.
	D.	Articles of Organization
	E.	Amendments to articles of organization (if any)
	F.	 Bylaws and amendments – If the organization has not adopted bylaws, enclose a statement to that effect.

SCHEDULE A

STATEMENT OF ORGANIZATION

N

Date of Inception:	

Under the Laws of:	

o

If Part of a Central (National) Organization, Indicate Name of the Central Organization:	

D

Month of Organization’s Accounting Year End:	

F

Character of Organization:	

Purpose for Which Organized (describe fully):	
	
	
	

FORM G-6

	FORM G-6
(REV. 2020)

PAGE 2

SCHEDULE A (Continued)
Actual Activities in Hawaii (describe fully):	
	
	
	
	
	
	
Types of Income in Hawaii (describe fully):	
	
	
	
	
	

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Disposition of Income in Hawaii (describe fully):	
	
	
	
	
	
	

Date of Last Amendment to Bylaws:	

SCHEDULE B

LIST OF OFFICERS, DIRECTORS OR TRUSTEES

Name in Full

Address

Daytime
Telephone No.

Office Held

Salary

Time Devoted
to Duties

N

		

		

o

		

D

		

F

		

		

		
	

FORM G-6

SCHEDULE C

FORM G-6
(REV. 2020)

PAGE 3

COMPARATIVE BALANCE SHEET FOR HAWAII ACTIVITIES

Complete the following balance sheet for the organization’s last two completed tax years. If your organization was recently
formed and has not completed a full tax year, enter the most current information available in column (B). Be sure to enter
the date(s) for the information provided. If the organization was recently formed and has not acquired any assets or incurred any liabilities, please state this on Schedule C. See the instructions (Form G-6A) for more information.

(A)
For Year Ending
____ / ____ / ____
(Year before the last
completed tax year)

ITEMS

(B)
For Year Ending
____ / ____ / ____
(Last completed
tax year)

HAWAII ASSETS
Cash
Accounts/grants/pledges receivable
Inventories

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Investments (attach an itemized list)
Furniture & Equipment
Land & Buildings

Other assets (attach an itemized list)

TOTAL ASSETS

HAWAII LIABILITIES & NET WORTH
Accounts payable

Contributions/gifts/grants payable
Deferred revenue

Mortgages & notes payable (attach an itemized list)

F

D

o

N

Other liabilities (attach an itemized list)

TOTAL LIABILITIES & NET WORTH
FORM G-6

FORM G-6
(REV. 2020)

PAGE 4

SCHEDULE D

COMPARATIVE STATEMENT OF RECEIPTS AND DISBURSEMENTS FOR HAWAII ACTIVITIES

Complete the comparative statement of receipts and disbursements for the organization’s Hawaii activities for the last two
completed tax years. If the organization recently started its activity in Hawaii or was recently formed (less than two complete years of activity in Hawaii), prepare a projected budget of anticipated income and related expenses for the organization’s Hawaii activities for 2 years.

(A)
For Year Ending
____ / ____ / ____
(Year before the last
completed tax year)

ITEMS

(B)
For Year Ending
____ / ____ / ____
(Last completed
tax year)

HAWAII RECEIPTS
Gifts/contributions received
Unusual grants

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Grants
Membership dues/fees

Fundraising/special events (attach an itemized list)
Gross receipts from admissions

Gross receipts from the sale of merchandise
Gross receipts from services performed
Gross rental income

Other revenue (attach an itemized list)

TOTAL RECEIPTS

HAWAII DISBURSEMENTS
Fundraising expenses

Contributions/gifts/grants paid out (attach an itemized list)
Salaries and wages

Occupancy (rent, utilities, etc.)
Insurance

N

Supplies

o

Professional fees

F

D

Other disbursements (attach an itemized list)

TOTAL EXPENSES
RECEIPTS OVER DISBURSEMENTS
FORM G-6