Form Bco 10 - Charitable Organization Registration Statement printable pdf download

Form Bco 10 - Charitable Organization Registration Statement

Approved

__________

(Rev. 09/06)

COMMONWEALTH OF PENNSYLVANIA

Reg. Fee

__________

DEPARTMENT OF STATE

P/F

__________

(717) 783-1720

BUREAU OF CHARITABLE ORGANIZATIONS

Fee Recv’d

__________

1-800-732-0999 (WITHIN PA)

207 NORTH OFFICE BUILDING

FAX (717) 783-6014

HARRISBURG, PA 17120

Charitable Organization Registration Statement – Form BCO – 10

For the Fiscal Year Which Ended : ___ /___/___

Employer Identification # ________________________ Certificate #________________

(Renewal Registrants Only)

Check if registering voluntarily. (See note under “Important Information”.)

1. Legal name of organization:

Check if name change. Previous name:_____________________________________

2. c/o ________________________________________________________________________

Street address _____________________________________________________________

City___________________________ State________________ Zip Code_______________

County ____________________________________________________________________

Phone # ____________________ 800 # ___________________ Fax # _________________

3. All other names used to solicit contributions:

4. Organizations described in Section 162.7(a) of the Act, check section which describes

organization (See footnote #2 of Instructions. Volunteer registrants do not respond. ):

162.7(a)(1)

162.7(a)(2)

162.7(a)(3)

162.7(a)(4)

Not Applicable

5. List type of organization (e.g. corporation, association, etc.), where established, and date

established. ___________________________________________________________________

(Initial registrants must submit copies of organizational documents such as charter, articles of

incorporation, constitution, or other organizational instrument, and by-laws.)

6. Is any person compensated or do you intend to compensate any person for soliciting

contributions from Pennsylvania? Yes

If “yes”, give date person started or will

start soliciting contributions from Pennsylvania residents. ____/____/____ (Do not check

“yes” if you only use or intend to only use a professional fund raising counsel.)

Items 7, and 8 need only be completed by initial registrants

7. Date organization first solicited contributions from Pennsylvania residents: __/___/____

8. If organization solicited Pennsylvania residents and received gross national contributions

totaling more than $25,000 during the fiscal year covered by this registration statement or

during its current fiscal year, give date contributions first totaled more than $25,000.

____/____/____

Form Bco 10 - Charitable Organization Registration Statement

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