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Form 1024(Rev.1-2018) Page 4 <br /> Part II.Activities and Operational Information(continued) <br /> 9 Has the organization made or does it plan to make any distribution of its property or surplus funds to shareholders or <br /> members? ❑Yes ❑✓ No <br /> If"Yes,"state the full details,including:(1)amounts or value;(2)source of funds or property distributed or to be distributed; <br /> and(3)basis of,and authority for,distribution or planned distribution. <br /> 10 Does,or will,any part of your organization's receipts represent payments for services performed or to be performed? . ❑Yes 0 No <br /> If"Yes,"state in detail the amount received and the character of the services performed or to be performed. <br /> 11 Has the organization made,or does it plan to make,any payments to members or shareholders for services performed or <br /> to be performed? ❑Yes ❑✓ No <br /> If"Yes,"state in detail the amount paid,the character of the services,and to whom the payments have been,or will be, <br /> made. <br /> 12 Does the organization have any arrangement to provide insurance for members, their dependents, or others (including <br /> provisions for the payment of sick or death benefits,pensions,or annuities)? ❑Yes ❑✓ No <br /> If"Yes,"describe and explain the arrangement's eligibility rules and attach a sample copy of each plan document and each <br /> type of policy issued. <br /> 13 Is the organization under the supervisory jurisdiction of any public regulatory body,such as a social welfare agency,etc.? ['Yes ❑✓ No <br /> If"Yes,"submit copies of all administrative opinions or court decisions regarding this supervision,as well as copies of <br /> applications or requests for the opinions or decisions. <br /> 14 Does the organization now lease or does it plan to lease any property? ❑Yes ❑✓ No <br /> If"Yes,"explain in detail.Include the amount of rent,a description of the property,and any relationship between the <br /> applicant organization and the other party.Also,attach a copy of any rental or lease agreement.(If the organization is a <br /> party,as a lessor,to multiple leases of rental real property under similar lease agreements,please attach a single <br /> representative copy of the leases.) <br /> 15 Has the organization spent or does it plan to spend any money attempting to influence the selection, nomination,election, <br /> or appointment of any person to any federal,state,or local public office or to an office in a political organization? . . ❑Yes ❑✓ No <br /> If"Yes,"explain in detail and list the amounts spent or to be spent in each case. <br /> 16 Does the organization publish pamphlets,brochures,newsletters,journals,or similar printed material'? ['Yes 0 No <br /> If"Yes,"attach a recent copy of each. <br /> Form 1024(Rev.1-2018) <br />