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Group Exemption Consent and Authorization Form
IRS Group Exemption Number (GEN): 0003

Purpose

This form authorizes Free State PTA, Inc. ("Free State PTA"), as the central organization, to include the undersigned local PTA/PTSA as a subordinate organization under the Free State PTA IRS Group Exemption (GEN 0003).

AUTHORIZATION

The Board of Directors of the above-named local PTA/PTSA hereby authorizes Free State PTA to include this local PTA/PTSA as a subordinate organization under the Free State PTA IRS Group Exemption (GEN 0003).

By signing this authorization, the local PTA/PTSA certifies that:

1.    The organization is a duly organized local PTA/PTSA chartered by Free State PTA and National PTA.

2.    The organization is organized and operated exclusively for charitable and educational purposes consistent with Section 501(c)(3) of the Internal Revenue Code.

3.    The organization agrees to operate in accordance with:

o  The Articles of Incorporation and Bylaws of Free State PTA;

o  The National PTA Bylaws;

o  All applicable federal, state, and local laws;

o  All policies, standards, and governance documents adopted by Free State PTA.

4.    The organization acknowledges that Free State PTA exercises general supervision and control over subordinate organizations as required by the Internal Revenue Service.

5.    The organization agrees to remain in Good Standing with Free State PTA by meeting all annual compliance requirements established by Free State PTA.

6.    The organization understands that participation under the Free State PTA Group Exemption does not relieve the local PTA/PTSA of its responsibility to:

o  Maintain its own Employer Identification Number (EIN);

o  File all required annual IRS information returns (Form 990-N, 990-EZ, or 990, as applicable);

o  Maintain all required state registrations and filings;

o  Operate in accordance with applicable nonprofit laws.

7.    The organization certifies that all information provided to Free State PTA is true and complete to the best of its knowledge.

8.    The organization acknowledges that Free State PTA may remove the local PTA/PTSA from the Group Exemption with or without cause, consistent with applicable IRS guidance and Free State PTA governing documents. If removed, the local PTA/PTSA understands it may be required to obtain its own IRS recognition of exemption in order to continue operating as a tax-exempt organization.

Today's Date: November 10, 2026

First Participant's Name
First Name*
Last Name*
Phone*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
First Participant's Information

LOCAL PTA/PTSA INFORMATION

Incorporation PTA/PTSA Name:
School:
Employer Identification Number (EIN):
President:
First Participant's Signature*
Second Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information

LOCAL PTA/PTSA INFORMATION

Incorporation PTA/PTSA Name:
School:
Employer Identification Number (EIN):
President:
Third Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information

LOCAL PTA/PTSA INFORMATION

Incorporation PTA/PTSA Name:
School:
Employer Identification Number (EIN):
President:
Fourth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information

LOCAL PTA/PTSA INFORMATION

Incorporation PTA/PTSA Name:
School:
Employer Identification Number (EIN):
President:
Fifth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information

LOCAL PTA/PTSA INFORMATION

Incorporation PTA/PTSA Name:
School:
Employer Identification Number (EIN):
President:
Sixth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information

LOCAL PTA/PTSA INFORMATION

Incorporation PTA/PTSA Name:
School:
Employer Identification Number (EIN):
President:
Seventh Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information

LOCAL PTA/PTSA INFORMATION

Incorporation PTA/PTSA Name:
School:
Employer Identification Number (EIN):
President:
Eighth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information

LOCAL PTA/PTSA INFORMATION

Incorporation PTA/PTSA Name:
School:
Employer Identification Number (EIN):
President:
Ninth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information

LOCAL PTA/PTSA INFORMATION

Incorporation PTA/PTSA Name:
School:
Employer Identification Number (EIN):
President:
Tenth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information

LOCAL PTA/PTSA INFORMATION

Incorporation PTA/PTSA Name:
School:
Employer Identification Number (EIN):
President:
Parent or Guardian's Email Address
Email*
Confirm Email*
Check to receive information, news, and discounts by e-mail.
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name
First Name*
Last Name*
Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
Parent or Guardian's Information

LOCAL PTA/PTSA INFORMATION

Incorporation PTA/PTSA Name:
School:
Employer Identification Number (EIN):
President:
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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