CoBank Sharing Success Application Organization Name Contact Person (First and Last Name) Contact E-mail Contact Phone Number Organization Physical Address Organization Physical Address Address Address 2 City/Town State/Province - None -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP/Postal Code Organization Mailing Address (if different) Organization Mailing Address (if different) Address Address 2 City/Town State/Province - None -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP/Postal Code 501c3_Status Has the organization received notice from the Internal Revenue Service of a tax-exempt ruling or determination under Section 501 (c)(3) of the Internal Revenue Code? Yes: If yes, please supply a copy of such ruling by attaching below, or supply to Lane-Scott Electric at PO Box 758, Dighton, KS 67839 No: If no, supply your Federal Tax Identification Number below Federal Tax Identification Number 501c3 Documentation Upload Upload requirementsOne file only.20 MB limit.Allowed types: txt, pdf, doc, docx, ppt, pptx, odp, xls, xlsx, ods. Describe Your Organization and its Purpose What geographical area does your organization impact? Explain what the grant would be used for. How would it impact your organization and Lane-Scott Electric members? When do you expect the project to be completed? Who will the project benefit? CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Submit Leave this field blank
