INTERNAL REVENUE SERVICE DEPARTMENT OF THE TREASURY P. 0. BOX 2508 CINCINNATI, OH 45201 Employer Identification Number: Date _d 45-4194537 DLN: 17053055346012 RESTORING OHIO INC Contact Person: 501 MORRISON RD STE 201 JANINE ESTES 31126 GAHANNA, OH 43230 Contact Telephone Number: (877) 829-5500 Accounting Period Ending: December 31 Form 990 Required: Yes Effective Date of Exemption: December 20, 2011 Contribution Deductibility: NO Addendum Applies: Yes Dear Applicant: We are pleased to inform you that upon review of your application for tax- exempt status we have determined that you are exempt from Federal income tax under section 501(c)(4) of the Internal Revenue Code. Because this letter could help resolve any questions regarding your exempt status, you should keep it in your permanent records. Please see enclosed Publication 4221--NC, Compliance Guide for Tax--Exempt organizations (other than 501(c)(3) Public Charities and Private Foundations). for some helpful information about your responsibilities as an exempt organization. Contributions to you are not deductible by donors under section 170(c)(2) of the Code. We have sent a copy of this letter to your representative as indicated in your power of attorney. 3 Since%?1y, Holly 0. Pas Director. Exempt Organizations Rulings and Agreements Enclosure: Publication 4221-NC Letter 948 RESTORING OHIO INC Enclosed with this letter is an educational booklet about the various tax law requirements applicable to section 501(c)(4) organizations. Additional information about these requirements is available at For example, as discussed in pages 3-5 of the enclosed Pub 4221--NC, section 501(c)(4) organizations may attempt to influence the selection, nomination, election or appointment of an indvidual to a federal, state, or local public office (political campaign activity). However, political campaign activity does not further a section 501(c)(4) exempt purpose and together with all other non- exempt activity, cannot be the organization's primary activity. We hope you will find this information helpful and encourage you to review it carefully. Letter 948 17053055346012 Application for Recognition of Exemption Under Section 501 OMB No. 1545-005? Form 1 (Rev. September 1993) ll elempt status is approved. Department oi the Treasury this application will on open internal Revenue Service '07 Publlfi Read the instructions for each Part carefully. A User Fee must be attached to this application. If the required information and appropriate documents are not submitted along with Form 8713 (with payment of the appropriate user fee). the application may be returned to the organization. Complete the Procedural Checklist on page 6 of the instructions. Part I. Identification of A plicant (Must be completed by all applicants; also complete appropriate schedule.) Submit only the sc edule that applies to your organization. Do not submit blank schedules. Check the appropriate box below to indicate the section under which the organization is applying: a Section holding corporations (Schedule A. page 7) Section leagues. social welfare organizations (including certain war or local employees [Schedule B. page 8) Section agricultural. or horticultural organizations (Schedule C. page 9) 2 2 1 Section leagues. chambers of commerce. etc. (Schedule C, page 9) 2912 2 2 3 2012 Section clubs [Schedule D. page 11) Section beneficiary societies. etc.. providing life. sick. accident. or other benefits to ri?W ule E. page 13) El Section employees' beneficiary associations (Parts I through IV and Schedule CENTER [3 Section fraternal societies. orders. etc.. not providing life. sick, accident, or other benefits [Schedule E. page 13) i Section life insurance associations. mutual ditch or irrigation companies. mutual or cooperative telephone companies. or like organizations (Schedule G. page 15) El Section crematoria. and like corporations (Schedule H. page 16) It Cl Section insurance companies or associations. other than life or marine (Schedule I. page 17) I Section providing (or the payment of supplemental unemployment compensation benefits (Parts I through IV and Schedule J. page 18) Section post. organization. auxiliary unit. etc.. of past or present members of the Armed Forces of the United States (Schedule K. page 19) Section holding corporations or trusts [Schedule A. page 7) 2 Employer identification number (EIN) (ii none, see Specific Instructions on page 2) 45 5 4184687 -I 9 Full name of organization (as shown in organizing document) Restoring Ohio. Inc. 3 Name and telephone number of person to be contacted if additional information is needed 1b clo Name (If applicable) Address (number and street) Roomlsuite 501 Morrison Road Suite 201 City. town or post office. state, and ZIP 4 If you have a loreign address. see Specific Instructions for Part I. page 2. Gahanna. Ohio 43230 Web site address 1 Mike Blankenbecler 1d 614 475-7560 Date incorporated or formed 1 21201201 1 6 Did the organization previously apply for recognition of exemption under this Code section or under any other section of the Code? Yes No If attach an explanation. 4 Month the annual accounting period ends 5 December 1e El Yes No 7 Has the organization filed Federal income tax returns or exempt organization information returns? if "Yes." state the form numbers. years filed. and Internal Revenue office where filed. 8 Check the box for the type of organization. ATTACH A CONFORMED COPY OF THE CORRESPONDING ORGANIZING DOCUMENTS TO THE APPLICATION BEFORE MAILING. a El Corporation-- Attach a copy of the Articles of Incorporation (including amendments and restatements) showing approval by the appropriate state official; also attach a copy of the bylaws. Attach a copy of the Trust lndenture or Agreement. including all appropriate signatures and dates. Attach a copy of the Articles of Association. Constitution. or other creating document. with a declaration (see instructions) or other evidence that the organization was formed by adoption of the document by more than one person. Also include a copy of the bylaws. If this is a corporation or an unincorporated association that has not yet adopted bylaws. check here . I declare under the penalties of perjury that I am authorized to sign this application on behalf of the above organization. and that I have examined this application. including the comp ying heduies and attachments. and to the best of my knowledge it is true. correct. and complete. Sign gt' Mike Bianltenbecler. Treasurer HERE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. For Papenlvorl-r Reduction Act Notice. see page 5 of the instructions. 17152012055031 Trust- PLEASE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - . . . . - - - . . . . - . (Type or print name and title or authority of signer) Cat. No. I2343K Form 1024 (Rev. 9-98) Page 2 Part II. Activities and Operational Information (Must be completed by all applicants) 1 Provide a detailed narrative description of all the activities of the organization~--past. present. and planned. Do not merely refer to or repeat the language in the organizational document. List each activity separately in the order of importance based on the relative time and other resources devoted to the activity. Indicate the percentage of time for each activity. Each should include, as a minimum. the lollowing: (al a detailed description oi the activity including its purpose and how each activity furthers your exempt purpose; lb) when the activity was or will be initiated; and [cl where and by whom the activity will be conducted. The Corporation is organized and shall be operated under Section 501(c)(4) of the internal Revenue Code ("the Code") for the common good and general weilare of the people of the State of Ohio by supporting. educating and advocating on legislative and policy goals furthering free enterprise. limited government. economic growth. and traditional values. Current legislative and policy issues on which the corporation will engage inciude energy. public employee benefits. job growth and economic development. The corporations' expenditures will be allocated to approximately the following percentagesResearch. education and policy development Polling research on issues. policies and legislation issue and grassroots advocacy List acquisition and development The corporation plans to expend funds for research and policy development. and to publish its positions on the policies. It will do so through press releases. social media. distribution to its a-mail and subscriber lists. and other outlets. it may organize educational conferences, rallies and events to highlight policy issues and its proposed solutions. It will conduct polling on issues. legislation. and policies and use those in connection with its policy development. It will support its policy positions with issue-related advocacy. lobbying and advertising in various media. To maximize the corporation's purpose of promoting free enterprise. limited government, economic growth and traditional values. it will engage in advertising lobbying andior urging the public to adopt the corportions' positions on these issues. It may in limited cases engage in intervention in political campaigns. at most up to approximately 35% of its expenditures. but not to the extent such activity could be considered its primary purpose. The discussion of the corporation's policy goals. and the endorsement by some elected officials and candidates of those positions. will dramatically increase the likelihood of those policies being enacted. 2 List the organization's present and future sources of financial support. beginning with the largest source iirst. The organization will solicit funds from businesses and individuals that share its goals. including businesses in industries that are heavily impacted by government regulation. Form 10245 (Rev. 9-98) Page 3 Part II. Activities and Operational information (continued) 3 Give the following information about the organization's governing body: Names. addresses, and titles of officers. directors. trustees. etc. Annual compensation James A. Rutledge. Chairman. 100 South Third Street Columbus. OH 43215 Mike Blanltenbecler. Treasurer. 501 Morrison Road. Suite 201. Gahanna. Ohio 43230 Don Thibaut. Director. 688 Mohawk. Columbus. Ohio 43206 Doug Preisse. Director. 41 8. High St.. 37th Floor. Columbus. Ohio 43215 Joann Davidson. Director, 37 West Broad St.. Ste 970. Columbus. Ohio 43215 @5069 if the organization is the outgrowth or continuation of any form of predecessor, state the name of each predecessor. the period during which it was in existence. and the reasons for its termination. Submit copies of all papers by which any transfer of assets was effected. NIA If the applicant organization is now, or plans to be. connected in any way with any other organization. describe the other organization and explain the relationship le.g.. financial support on a continuing basis: shared facilities or employees; same officers, directors. or trustees). NIA If the organization has capital stock issued and outstanding. state: (1) class or classes of the stock; (2) number and par value of the shares: consideration for which they were issued: and (4) if any dividends have been paid or whether your organization's creating in- strument authorizes dividend payments on any class of capital stock. The oranization is a non-stock company State the qualifications necessary for membership in the organization; the classes of membership [with the number of members in each class]: and the voting rights and privileges received. if any group or class of persons is required to join. describe the requirement and explain the relationship between those members and members who join voluntarily. Submit copies of any membership solicitation material. Attach sample copies of all types or membership certificates issued. The members of the corporation shall be the members of the Board of Directors. Participation and a shared belief in the organization's mission are the only qualifications. Explain how your organization's assets will be distributed on dissolution. None of the assets of the organization will accrue to any person and. upon any dissolution. all of the assets will be returned to contributors or distributed for one or more exempt purposes. or to the Federal Government. or to a local or State Government. for a public purpose. Form 1024 (Rev. 9-98) Page 4 Part II. Activities and Operational Information (continued) Has the organization made or does it plan to make any distribution of its property or surplus funds to shareholders or If "Yes." state the full details. including: (1) amounts or value: (2) source of funds or property distributed or to be distributed; and (3) basis of. and authority for. distribution or planned distribution. Yes No 10 Does. or will. any part of your organization's receipts represent payments for services performed or to be performed?. Yes El No If "Yes." state in detail the amount received and the character of the services performed or to be performed. 11 Has the organization made. or does it plan to make. any payments to members or shareholders for services performed if "Yes." state in detail the amount paid, the character of the services. and to whom the payments have been, or will be. made. Yes [1 No 12 Does the organization have any arrangement to provide insurance for members. their dependents, or others (including provisions for the payment of sick or death benefits, pensions, or annuities"Yes." describe and explain the arrangement's eligibility rules and attach a sample copy of each plan document and each type of policy issuedthe organization under the supervisory jurisdiction of any public regulatory body. such as a social welfare agency. If "Yes." submit copies of all administrative opinions or court decisions regarding this supervision. as well as copies of applications or requests for the opinions or decisions. El Yes No Yes No Does the organization now lease or does it plan to lease any property"Yes." explain in detail. Include the amount of rent. a description of the property. and any relationship between the applicant organization and the other party. Also. attach a copy of any rental or lease agreement. (If the organization is a party. as a lesser. to multiple leases of rental real property under similar lease agreements. please attach a single representative copy of the leases.) 15 16 Has the organization spent or does it plan to spend any money attempting to influence the selection. nomination. election. or appointment of any person to any Federal. state. or local public office or to an office in a political organization?. If "Yes." explain in detail and list the amounts spent or to be spent in each case. Yes No The organization may, in furtherance of its social welfare goals. engage in political advocacy, but not to the extent its primary purpose becomes other than its social welfare purpose. It may support its policy positions with issue-related advocacy and lobbying, and to maximize that advocacy may devote up to approximately thirty-five percent of its expenditures to advertising urging candidates andlor the public to adopt the corporations' positions on these issues (Including in some cases by express advocacy). Yes El No Does the organization publish pamphlets. brochures. nevvslettersjournals. or similar printed material? If "Yes." attach a recent copy of each. Form 1024 (Rev 9-98) Part Financial Data [Must be completed by all applicants) Complete the financial statements for the current year and for each of the 3 years immediately before it. if in existence less than 4' years, complete the statements for each year in existence. if in existence less than 1 year, also provide proposed budgets for the 2 years folio living the current year. A. Statement of Revenue and Expenses Page 5 Current Tax Year 3 Prior Tax Yeats or Proposed Budget for Next 2 Years Retren 112012 53?" 1212012 (bl id) .. (9) Total 1 Gross dues and assessments of members 0 0 0 0 2 Gross conmbuuonsl g-ms. em 2000000 2000000 1000000 5000000 Gross amounts derived from activities related to the organization's exempt purpose (attach schedule) (Include related cost of sales on line 9.) 0 0 0 0 4 Gross amounts irom unrelated business activities (attach schedule] 0 0' 0 0 5 Gain from sale oi assets. excluding inventory items 0 0 0 (attach scheduleinvestment income (see page 3 of the instructions) 0 0 0 0 1 Other revenue (attach sclxadule). 0 0' 0 0 8 Total revenue (add lines 1 through 7) . 2000000 2000000 1000000 5000000 Expenses 9 Expenses attributable to activities related to the ?|.ganizafion.5 exempt purposes_ I . 1900000 1900000 950000 4750000 10 Expenses attributable to unrelated business activities 0 0' 0 0 11 Contributions, gifts. grants. and similar amounts 0 0 0 0 paid (attach scheduleDisbilrsenients to or lot the benefit of members (attach schedule) 0 0 0' 0 13 Compensation of officers. directors. and trustees (attach schedule) 0 0 0' 0 14 Other salaries and wages. 0 0 0' 0 15 Interest 0 0 0 0 16 Occupancy . . 0 0 0 0 11 Depreciation and depletion . 0 0 0 0 18 Other expenses (attach schedule) '0 0' 0 '0 19 Total expenses (add lines 9 through 18) 1900000 1000000 950000 4750000 20 Excess of revenue over expenses (line 8 minus line 19) 100000 100000 50000 250000 B. Balance Sheet (at the end of the period shown) Current Tax Year Assets as . . 1 Cash. . . 1 2000 2 Accounts receivableinventories . . . . . . . . . . . 3 0 4 Bonds and notes receivable (attach schedule) 4 0 5 Corporate stocks (attach schedule). 5 0 6 Mortgage loans (attach schedule) 5 0 1 Other investments (attach schedule) . . 7 0 8 Depreciable and depletable assets (attach schedule) 3 0 9 LandOther assets (attach schedule) . . 10 0' 11 Total assets . . . . . . 1" 2000' Liabilities 12 Accounts payable . . . . . . 0 13 Contributions. gifts. grants. etc., payable . 13 0 14 Mortgages and notes payable (attach schedule) . 14 0 15 Other liabilities (attach schedule) 15 0 16 Total liabilitiesFund Balances or Net Assets 11 Total fund balances or net assets . . . . . . . . . . . . . . . . . . . . . . . . . 17 2000 18 Total liabilities and mud balances or net assets (add line 16 and line . . . . . . . . . . . 18 2000 it there has been any substantial change in any aspect of the organization's financial activities since the end of the period shown above. check the box and attach a detailed explanation. Form 1024 (Rev. 9-98) Part IV. Notice Requirements (Sections 501(c)(9) and 501lc)(17) Organizations Only) Page 5 1 Section 501(c)(9) and organizations: Are you tiling Form 1024 within 15 months from the end of the month in which the organization was created or formed asrequired bysection505(cJ"Yes." skip the rest of this Part. If answer question 2. 2 If you answer "No" to question 1. are you filing Form 1024 within 27 months from the end of the month in which the organizationwascreated orformed"Yes." your organization qualifies under Regulation section 301.9100-2 for an automatic 12-month extension of the 15-month filing requirement. Do not answer questions 3 and 4. If answer question 3. 3 If you answer "No" to question 2. does the organization wish to request an extension of time to apply under the"reasonab|e action and good faith" and the "no prejudice to the interest of the government" requirements of Regulations section If "Yes." give the reasons for not filing this application within the 27-month period described in question 2. See Specific Instructions. Part IV. Line 3. page 4. before completing this item. Do not answer question 4. If answer question 4. 4 If you answer "No" to question 3. your organization's qualification as a section 501 or 501ic)(17) organization can be recognized only from the date this application is filed. Therefore. does the organization want us to consider its application as a request for recognition of exemption as a section 501(c)(9) or organization from the date the application is received and not retroactively to the date the organization was created or formedForm 1024 (Rev. 9-98) Page 7 Schedule A Organizations described in section 501(c)(2) or [Title holding corporations or trusts) 1 State the complete name, address. and EIN of each organization for which title to property is held and the number and type of the applicant organization's stock held by each organization. 2 if the annual excess of revenue over expenses has not been or will not be tumed over to the organization for which title to property is held, state the purpose for which the excess is or will be retained by the title holding organization. 3 in the case of a corporation described in section 501(c)(2), state the purpose of the organization for which title to property is held (as shown in its governing instrument) and the Code sections under which it is classified as exempt from tax. It the organization has received a determination or ruling letter recognizing it as exempt from taxation. please attach a copy of the letter. 4 In the case of a corporation or trust described in section 501(c)(25). state the basis whereby each shareholder is described in section For each organization described that has received a determination or ruling letter recognizing that organization as exempt from taxation. please attach a copy of the letter. 5 with respect to the activities of the organization. a Is any rent received attributable to personal property leased with reaiproperty"Yes," what percentage of the total rent, as reported on the financial statements in Part is attributable to personal property? will the organization receive income which is incidentally derived from the holding of real property. such as income from operation of a parking lot or from vending machines"Yes." what percentage of the organization's gross income. as reported on the financial statements in Part is incidentally derived from the holding of real property? Will the organization receive income other than rent from real property or personal property leased with real property or income which is incidentally derived from the holding of real property"Yes." describe the source of the income. I: Yes No Instructions Line 1.--Provide the requested information on each organization for which the applicant organization holds title to property. Also indicate the number and types of shares of the applicant organization's stock that are held by each. Line 2.--For purposes of this question. "excess of revenue over expenses" is all of the organization's income for a particular tax year less operating expenses. Line 3.--Give the exempt purpose of each organization that is the basis for its exempt status and the internal Revenue Code section that describes the organization (as shown in its IRS determination letter). Line 4.--Indicate If the shareholder is one of the following: 1. A qualified pension, profit-sharing, or stock bonus plan that meets the requirements of the Code; 2. A government plan: 3. An organization described in section 501(c)(3); or 4. An organization described in section 501(c)(25). Form 1024 (Rev. 9-93) Page ii Schedule 3 Organizations Described in Section 501(c)(4) (Civic leagues. social welfare organizations (including posts, councils, etc., of veterans' organizations not qualifying or applying for exemption under section 501 or local associations of employees.) 1 Has the Internal Revenue Service previously issued a ruling or determination letter recognizing the applicant organization tor any predecessor organization listed in question Pan ll of the application] to be exempt under section 501(c)(3) and later revoked that recognition of exemption on the basis that the applicant organization [or its predecessor] was carrying on propaganda or otherwise attempting to inliuence legislation or on the basis that it engaged in political activity? . Yes No If "Yes." indicate the earliest tax year for which recognition of exemption under section 501(c)(3) was revoked and the IRS district office that issued the revocation. 2 Does the organization perform or plan to perform (lor members. shareholders, or others) services. such as maintaining the common areas of a condominium; buying food or other items on a cooperative basis; or providing recreational facilities or transportation services. job placement. or other similar undertakings"Yes." explain the activities in detail, including income realized and expenses incurred. Also. explain in detail the nature or the benelits to the general public from these activities. (If the answer to this question is explained in Pan ll of the application (pages 2. 3. and 4). enter the page and item number here.) 3 If the organization is claiming exemption as a homeowners' association, is access to any property or facilities it owns . . . . . . . . . . . . . . . . . . . . . . . . Yes No If "Yes." explain. 4 if the organization is claiming exemption as a local association of employees. state the name and address of each employer whose employees are eligible for membership in the association. If employees of more than one plant or office of the same employer are eligible for membership. give the address of each plant or office. Form 1024 (Rev. 9-93) Page 9 Schedule Organizations described in section 501(c)(5) (Labor, agricultural, including fishermen's organizations, or horticultural organizations) or section 501(c)(5) (business leagues, chambers of commerce. etc.) 1 Describe any services the organization performs for members or others. (If the description of the services is contained in Part II of the application, enter the page and item number here.) 2 I-'ishermen's organizations only.--What kinds of aquatic resources (not including mineral) are cultivated or harvested by those eligible for membership in the organization? 3 Labor organizations only.--l5 the organization organized under the terms of a collective bargaining agreement"Yes," attach a copy of the latest agreement. Fonn 1024 (Rev. 9-98) Schedule 1 Organizations described in section 501 (Social clubs) Has the organization entered or does it plan to enter into any contract or agreement for the management or operation of its property andlor activities. such as restaurants. pro shops, lodges. etc.? . . If "Yes," attach a copy of the contractor agreement. If one has not yet been drawn up. please explain the organization's plans. Page 11 Yes No 2 Does the organization seek or plan to seek public patronage of its facilities or activities by advertisement or otherwise? Yes No it "Yes." attach sample copies of the advertisements or other requests. If the organization plans to seek public patronage. please explain the plans. 3a Qfi 4a Are nonmembers. other than guests of members. permitted or will they be permitted to use the club facilities or participate in or attend any functions or activities conducted by the organization"Yes," describe the functions or activities in which there has been or will be nonmember participation or admittance. (Submit a copy of the house rules. if any.) State the amount of nonmember income included in Part of the pplication. lines 3 and 4, column . Enter the percent of gross receipts from nonmembers for the use of club facilities . . . . . . . . . Enter the percent of gross receipts received from investment income and nonmember use of the club's facilities Does the organization's charter. bylaws. other governing instrument. or any written policy statement of the organization contain any provision that provides for discrimination against any person on the basis of race. color. or religion'? If "Yes," state whether or not its provision will be kept. it the organization has such a provision that will be repealed. deleted. or otherwise stricken from its requirements. state if the organization formerly had such a requirement and it no longer applies. give the date it ceased to apply If the organization restricts its membership to members of a particular religion. check here and attach the explanation specifiedintheinstructionsSee rverse side for instructions I: Yes No Yes No Cl Form 1024 (Rev. 3-98) Page 12 Instructions Line "Yes," if any of the organization's property or activities will be managed by another organization or company. Lines c, and d.--Enter the figures for the current year. On an attached schedule. furnish the same information for each of the prior tax years for which you completed Part of the application. Line the organization restricts its membership to members of a particular religion. the organization must be: 1. An auxiliary of a fraternal beneficiary society that: a. Is described in section 501(c)(3) and exempt from tax under section 501(a), and b. Limits its membership to members of a particular religion: or 2. A club that. in good faith. limits its membership to the members of a particular religion in order to further the teachings or principles of that religion and not to exclude individuals of a particular race or color. If you checked 4e. your explanation must show how the organization meets one of these two requirements. Form 1024 (Rev. 9-98) Page 13 Organizations described in section 501 or 501 [Fraternal societies, orders, or associations) 1 is the organization a college fraternity or sorority. or chapter of a college fratemity or sorority? Yes No If "Yes." read the instructions for Line 1, below. before completing this schedule. 2 Does or will your organization operate under the lodge systemdoes or will it operate for the exclusive benefit of the members of an organization operating under the lodge system? . Yes No 3 Is the organization a subordinate or local lodge. etc"Yes." attach a certificate signed by the secretary of the parent organization. under the seal of the organization. certifying that the subordinate lodge is a duly constituted body operating under the jurisdiction of the parent body. 4 Is the organization a parent or grand lodge"Yes." attach a schedule for each subordinate lodge in active operation showing: is) its name and address: the number of members in it: and how often it holds periodic meetings. Instructions Line 1.--To the extent that they qualify for exemption from Federal income tax. college fraternities and sororities generally qualify as organizations described in section Therefore. if the organization is a college fraternity or sorority. refer to the discussion of section 501(c)(7) organizations in Pub. 55?. Ii section 501 appears to apply to your organization. complete Schedule instead of this schedule. Line 2.--0perating under the lodge system means carrying on activities under a form of organization that is composed of local branches. chartered by a parent organization. largely self-governing. and called lodges. chapters. or the like. Form 1024 (Rev 9-98} Page 14 Organizations described in section 501(c)(9) (Voluntary mployees' beneficiary associations) 1 Describe thebenefits available to members. lnclude copies of any plan documents that describe such benefits and the terms and conditions of eligibility for each benefit. 2 Are any employees or classes of employees entitled to benefits to which other employees or classes of employees are If "Yes." explain. 3 Give the following information for each plan as of the last day of the most recent plan year and enter that date here. If there is more than one plan. attach a separate schedule (mo) (day) (yr) a Total number of persons covered by the plan who are highly compensated individuals (See instructions below.). Number of other employees covered by the plan. Numberofemployeesnotcovered bythe plan . . . . . . . . . . . . . . . . . . L. Total number employedShould equal the total of a, b. and c--if not. explain any difference. Describe the eligibility requirements that prevent those employees not covered by the plan from participating. 4 State the number of persons. if any. other than employees and their dependents the proprietor of a business whose employees are members oi the association] who are entitled to receive benefits . . . . . . . . . Instructions Line 3a.--A "highly compensated individual" is one Received more than $80,000 (adjusted for who: inflation) in compensation from the employer for the Owned 5% or more of the employer at any time Precedlng Yeafi and during the current year or the preceding year. Was among the top 20% of employees by compensation for the preceding year. However, the employer can choose not to have apply. Form 1024 (Rev. 9-95) Page 15 rganizations described in section 501(c)(12) (Benevolent life insurance associations, mutual ditch or irrigation companies, mutual or cooperative telephone companies. or like organizations) 1 Attach a schedule in columnar form for each tax year for which the organization is claiming exempt status. On each schedule: a Show the total gross income received from members or shareholders. List. by source. the total amounts of gross income received from other sources. 2 If the organization is claiming exemption as a local benevolent insurance association. state: a The counties from which members are accepted or will be accepted. it Whether stipulated premiums are or will be charged in advance. or whether losses are or will be paid solely through assessments. 3 If the organization is claiming exemption as a "like organization." explain how it is similar to a mutual ditch or irrigation company. or a mutual or cooperative telephone company. 4 Are the rights and interests of members in the organization's annual savings determined in proportion to their business vvithit"Yes." does the organization keep the records necessary to determine at any time each member's rights and interests in such savings, including assets acquired with the savingsthe organization is a mutual or cooperative telephone company and has contracts with other systems for long-distance telephone services. attach copies of the contracts. Instructions Mutual or cooperative electric or telephone companies involve their members and the gross amount of income should show income received from qualified pole received from the sale of display advertising in a rentais separately. Mutual or cooperative tetephone directory furnished to their members. companies should also show separately the gross Do not net amounts due or paid to other sources ?f "Um against amounts due or received from those sources. telephone companies for performing services that Form 1024 (Rev. 9-98) Page 15 Organizations described in section lcerneteries. cremateria, and like corporations)_ 1 Attach the following documents: a Complete copy of sales contracts or other documents. including any "debt" certificates. involved in acquiring cemetery or Crematorium property. I: Complete copy of any contract your organization has that designates an agent to sell its cemetery lots. A copy of the appraisal (obtained from a disinterested and qualified party) of the cemetery property as of the date acquked. 2 Does your organization have. or does it plan to have. a perpetual care fund"Yes." attach a copy of the fund agreement and explain the nature of the fund (cash. securities. unsold land. etc.) 3 if your organization is claiming exemption as a perpetual care fund for an organization described in section 501lc)(13). has the cemetery organization. for which funds are held. established exemption under that section? . . . . . Yes lilo If explain. Page 17 rganizations described in section (Small insurance companies or associations) is the organization a member of a controlled group of corporations as defined in section 831(b)l2)lB)(ii)? (Disregard section 1563(b)l2)lB) in determining whether the organization is a member of a controlled group"Yes," include on lines 2 through 5 the total amount received by the organization and all other members of the controlled group. If "filo," include on lines 2 through 5 only the amounts that relate to the applicant organization. Current Year 3 Prior Tax Years From To 2 Direct written premiums 3 Reinsurance assumed . 4 Reinsurance ceded . . . . . . . . . . . 5 Net written premiums ((line 2 plus line 3) minus line 4) . 5 If you entered an amount on line 3 or line 4. attach a copy of the reinsurance agreements the organization has entered into. Instructions Line 1.--Answer "Yes," if the organization would be Line 2.-- In addition to other direct written premiums, considered a member of a controlled group of include on line 2 the full amount of any prepaid or corporations if it were not exempt from tax under advance premium in the year the prepayment is section 501(a). in applying section 1563(a). use a received. For example, if a $5.000 premium for a "more than 50%" stock ownership test to determine 3-year policy was received in the current year, include whether the applicant or any other corporation is a the full $5.000 amount in the Current Year column. member of a controlled group. Form 1024 (Rev. 9-98) Page 18 Organizations described in section 501(c)(11) (Trusts providing for the payment of supplemental unemployment compensation benefits) 1 If benefits are provided for individual proprietors. partners, or self-employed persons under the plan, explain in detail. 2 If the plan provides other benefits in addition to the supplemental unemployment compensation benefits. explain in detail and state whether the other benefits are subordinate to the unemployment benefits. 3 Give the following information as of the last day of the most recent plan year and enter that date here . . . . . . a Total number of employees covered by the plan who are shareholders. officers. self-employed persons. or highly compensated (See Schedule instructions for line 3a on page 14.) . . . . I: Number of other employees covered by the plan Number of employees not covered by the plan . . . . . . . Should equal the total of a. b, and c--if not. explain the difference. Describe the eligibility requirements that prevent those employees not covered by the plan from participating. 4 At any time after December 31. 1959. did any of the following persons engage in any of the transactions listed below with the trust: the creator of the trust or a contributor to the trust; a brother or sister (whole or half blood). a spouse. an ancestor, or a lineal descendant of such a creator or contributor; or a corporation controlled directly or indirectly by such a creator or contributor? Note: lfyau know that the organization will be. or is considering being. a party to any of the transactions {or activities) listed below. check the "Planned" box. Give a detailed explanation of any "Yes" or "Planned" answer in the space below. a Borrow any part of the trust's income or corpusPlanned Receive any compensation for personal servicesPlanned Obtain any part of the trust's servicesPlanned Purchase any securities or other properties from the trustYes Planned Sell any securities or other property to the trustPlanned Receive any of the trust's income or corpus in any other transactionPlanned 5 Attach a copy of the Supplemental Unemployment Benefit Plan and related agreements. Form 1024 (Rev. 9-98) Page 19 Schedule Organizations described in section post or organization of past or present members of the Armed Forces of the United States, auxiliary units or societies for such a post or organization, and trusts or foundations formed for the benefit of such posts or organizations. 1 To be completed by a post or organization of past or present members of the Armed Forces of the United States. a Total membership of the post or organizationNumber of members who are present or former members of the U.S. Armed Forces . . . . . . . . . . . Number of members who are cadets (include students in college or university ROTC programs or at armed services academies only), or spouses. widows. or widowers of cadets or past or present members of the U.S. Armed Forces Does the organization haveamembership category other than the ones set out above'?. . . . . . . . . . El Yes No If "Yes," please explain in full. Enter numberof members in this category If you wish to apply for a determination that contributions to your organization are deductible by donors. enter the number of members from line 1b who are war veterans, as defined below. . . . A war veteran is a person who served in the Armed Forces of the United States during the following periods of war: April 21, 1898. through July 4. 1902: April 5. 1917. through November 11. 1918; December 7, 1941. through December 31. 1945: June 1950. through January 31. 1955; and August 5. 1964. through May 7, 1915. 2 To be completed by an auxiliary unit or society of a post or organization of past or present members of the Armed Forces of the United States. a Is the organization affiliated with and organized according to the bylaws and regulations formulated by such an exempt if "Yes." iubmit a copy of such bylaws or regulations. How many members does your organization haveHow many are themselves past or present members of the Armed Forces of the United States. or are their spouses. or persons related to them within two degrees of blood relationship? (Grandparents. brothers. sisters, and grandchildren are the most distant relationships allowablethe members themselves members of a post or organization. past or present members of the Armed Forces of the United States. spouses of members of such a post or organization. or related to members of such a post or organization within two degrees of blood relationshipcompleted by a trust or foundation organized for the benefit of an exempt post or organization of past or present members of the Armed Forces of the United States. a will the corpus or income be used solely for the funding of such an exempt organization (including necessary related If please explain. If the trust or foundation is formed for charitable purposes. does the organizational document contain a proper dissolution provision as described in section of the Income Tax Regulations 1. 8718 (Rev. January 2010] Department of the Treasury lntemal Revenue Service User Fee for Exempt Organization Determination Letter Request Attach this iorrn to determination letter application. [Form 8113 is NOT a determination letter application} For OMB No. 1545-1798 1 "35 Control number _jJ' Amount paid User 'ea scrarrner 1 Name of organization Restoring Ohio, inc. Caution. Do not attach Form 8718 to an rap 3 Type of request 2 Employer identitication Number 45 plication for a pension plan determination letter. Use Form instead. 4184687 Fee initial request for a determination letter for: an exempt organization that has had annual gross receipts averaging not more than $10,000 during the preceding 4 years or A new organization that anticipates gross receipts averaging not more than $10,000 during its first 4 years I- $400 Note. if you checked box 3a, you must complete the Certification below. Certification I certify that the annual gross receipts of .. name at organization have averaged (or are expected to average) not more than $10,000 during the preceding 4 (or the first 4) years of operation. Signature Title initial request for a determination letter for: I An exempt organization that has had annual gross receipts averaging more than $10,000 during the preceding 4 years or I A new organization that anticipates gross receipts averaging more than $10,000 during its first 4 years . Ir $850 Group exemption letters . . . . . . . . . . . $3.000 Instructions lntemal Revenue Service to a form or its instructions must be The law requires payment of a user fee with each application for a determination letter. The user fees are listed on line 3 above. For more information. see Rev. Proc. 2009-8; 2009-1 229. or latest annual update. Check the box or boxes on line 3 for the type of application you are submitting. If you check box 3a. you must complete and sign the cenilication statement that appears under line 3a. Attach to Form 8718 a check or money order payable to the "United States Treasury" for the full amount of the user fee. if you do not include the full amount. your application will be returned. iettach Form B'i'1'c'l to your determination letter application. Generally. the user fee will be relunded only if the Internal Revenue Service declines to issue a determination. Where To File Send the determination letter application and Form 8718 to: PO. Box 12192 Covington. KY 41012-0192 Who Should File Organizations applying for federal income tax exemption. other than Form 1023 filers. Organizations submitting Form 1023 should refer to the instructions in that application package. Papenrvork Reduction Act Notice. We ask for the Information on this form to carry out the lntemal Revenue laws of the United States. If you want your organization to be recognized as tar:-exempt by the IRS. you are required to give us this infonnation. We need it to determine whether the organization meets the legal requirements for tax-exempt status. You are not required to provide the Information requested on er tom that is subiect to the Paperwork Reduction Act unless the form displays a valid OMB control number. Books or records relating Cat. No. 647282 retained as long as their contents may become material in the administration of any lntemal Revenue law. The rules governing the confidentiality of Form 8718 are covered in section 6104. The time needed to complete and file this fonn will vary depending on individual circumstances. The estimated average time is 5 minutes. if you have comments conceming the accuracy of this time estimate or suggestions for making this form gimpler. we would be happy to hear from you. You can write to the lntemal Revenue Service, Tax Products Coordinating Committee. 11 11 Constitution Ave. NW. IR-6526. Washington, DC 20224. Do not send this form to this address. instead. see Where To File above. Form 8718 (1-2010) Defizwa re 1 Tie first State I, JEFFREY N. BULLOCK, SECRETARY OF OF STATE OF DELAWARE, DO HEREBY CERTIFY TRE ATTACHED Is A TRUE AND CORRECT COPY OF THE CERTIFICATE OF INCORPORATION OF ORIO, INC. FILED IN THIS OFFICE ON THE TWENTIETH DAY OF DECEMBER, A.D. 2011, AT 5:28 P.M. A FILED COPY OF THIS CERTIFICATE HAS BEEN FORWARDED TO THE NEW CASTLE COUNTY RECORDER OF DEEDS. SOOSQFC W. Bullock. Secretary Of State 1% 5083856 3100 AUTHEN ION: 9271220 111317930 DATE: 01-04-.12 You may verify this certificate at corp. dolavaz-9. gov/authvur. State of Delaware Series of Status Division Delivered 05:31 PM 12/20/2011 05:23 me 12/20/2011 - 5053356 CERTIFICATE OF INCORPORATION OF RESTORING OHIO, INC. ARTICLE I The name of the corporation is Restoring Ohio, Inc. ARTICLE II The address of the Corporation's registered office in the State of Delaware is 1201 North Market Street, Post Office Box 1347, in the City of Wilmington, County of New Castle (19801). The name of the Corporation's registered agent at such address is Delaware Corporation Organizers, Inc. ARTICLE The Corporation is organized and shall be operated under Section 501(c)(4) of the internal Revenue Code of 1986, as amended (the "Code") or the corresponding section of any firture federal tax code, for the common good and general welfare, including but not limited to that of the people of' the State of Ohio, by supporting, educating and advocating on positions and issues including free enterprise, limited govemment, economic growth, and traditional values. It is formed for the purposes set forth in the Corporation's bylaws and to transact any and all lawful business within the meaning of Section 501(c)(4). ARTICLE IV In furtherance of, and not in limitation of the purposes herein set forth, the Corporation shall possess and exercise all the powers and privileges granted by the Delaware General Corporation Law or by any other law of Delaware or by this Certificate of Incorporation together with any powers incidental thereto, so far as such powers and privileges are necessary or convenient to the conduct, promotion or attainment of the purposes of the Corporation. No part of the net eamings, properties or assets of the corporation, on dissolution or otherwise, shall inure to the benefit of, or be distributable to, its directors, officers or other private persons or individuals, except that the corporation shall be authorized and empowered to pay reasonable compensation for services rendered and to make payments and distributions in furtherance of the purposes set forth herein. ARTICLE VI The Corporation shall be a membership corporation, is not organized for profit and shall not have authority to issue stock. The members of the Corporation shall be the members of the Board of Directors. ARTICLE VII The business and affairs of the Corporation shall be managed and under the direction of a governing body called the Board of Directors. The members of the Board of Directors shall be appointed in the manner set forth in the By-laws of the Corporation. ARTICLE ln furtherance and not in limitation of the powers conferred by the laws of the State of Delaware, the Board of Directors is expressly authorized to make, amend and repeal the By-laws of the Corporation. ARTICLE IX No member, Director, or officer of the Corporation shall be personally liable for the payment of the debts of the Corporation. ARTICLE To the fullest extent permitted by the General Corporation Law of the State of Delaware as the 'same exists or may hereafter be amended, a Director of the Corporation shall not be liable to the Corporation or its members for monetary damages for breach of fiduciary duty as a Director. ARTICLE XI Upon the dissolution of the Corporation, the board of directors shall, alter paying or making provision for the payment of all of the liabilities of the Corporation, dispose of all of the assets of the Corporation exclusively for the purposes of the Corporation in a manner consistent with the Delaware Nonprofit Corporation Act and Section 501(c)(4) of the Internal Revenue Code. XII The Corporation reserves the right to amend and repeal any provision contained in this Certificate of Incorporation in the manner prescribed by the laws of the State of Delaware. 5898449 ARTICLE The name and mailing address of the incorporator is as follows: Delaware Corporation Organizers, Inc. P.0. Box 1347 Wilmington, DE 19899 I, the undersigned, for the purpose of forming a corporation under the laws of the State of Delaware, do make. file and record this Certificate of Incorporation, and, accordingly, have hereto set my hand this 20th day of December, 201]. DELAWARE CORPORATION ORGANIZERS, INC. By: Alyson D. Poppiti, Vice President 5898449