APPLICATION FOR EXEMPTION
FRANCHISE AND EXCISE TAXES
COMPLETE THIS APPLICATION TO REQUEST EXEMPT STATUS FROM FRANCHISE AND EXCISE TAXES
1. REASON FOR APPLICATION
2. TAX PERIOD COVERED
3. Effective date of registration with the Secretary of State:
4. ENTITY NAME AND PHYSICAL LOCATION
5. ENTITY MAILING ADDRESS
City, State, Zip:
City, State, Zip:
6. BUSINESS TELEPHONE NUMBER:
7. Current Franchise and Excise Tax Account Number:
8. ENTITY TYPE
Other Non-corporate Entity (Specify):
Limited Liability Company
Limited Liability Partnership
9. IDENTIFY TENNESSEE CODE SECTION AND REASON FOR REQUESTING FRANCHISE AND EXCISE TAX EXEMPTION.
(Please check one) (See reverse side for Exemption Criteria)
Venture Capital Fund [67-4-2008(a)(6)] - Dealing in securities primarily in non-publicly traded companies and capital is
primarily derived from investments neither related to nor affiliated with the fund.
LLC/LP/LLP Farming/Personal Residence [67-4-2008(a)(6)] - 66.67% of income is earned from either farming or holding
personal residences, including contiguous acreage, where at least one partner or member resides, and is 95% owned by
persons who are relatives.
LLC/LP/LLP Security 3rd Party Indebtedness [67-4-2008(a)(7)] - 98% owned by corporate members of an affiliated group
and formed and operated for the exclusive purpose of acquiring indebtedness from members of the group.
LLC/LP Affordable Housing [67-4-2008(a)(8)] - Must have allocation of low-income tax credits and must have an extended
low-income housing commitment for each building.
Obligated Member Entity [67-4-2008(a)(9)] - Appropriate documentation must be filed with the Secretary of State as an
obligated member or owner of an obligated member providing limited liability protection.
REMIC or FASIT [67-4-2008(a)(10)] - Real estate mortgage investment conduit or financial asset securitization investment
trust whose purpose is asset-backed securitiza