Charitable Organizations Application Form (Page 2 of 4) in pdf

Charitable Organizations Application Form Page 2

Addresses of any office(s) in this state and all other addresses of the organization:

__________________________________________________________________

If no RI office, please give name and address of person with custody of financial

records: __________________________________________________________

Name or names under which organization intends to solicit contributions:

__________________________________________________________________

Names and addresses of the officers, directors, trustees, partners, senior level

executive employees, as well as those persons responsible for the day to day

operations of the organization, and for a Limited Liability Company or Limited

Liability Partnership, also give the names of the members, partners and managers:

_______________________________________________________________________________

Names and addresses of any chapters, branches, affiliates or other organizations

that during the immediately preceding fiscal year shared the contributions or other

revenue raised in this state. Contributions of another organization which are

merely transferred by or through United Way or federated fund or an incorporated

community appeal, which organization is selected by the donor need not be

included:

__________________________________________________________________

Date and place of organization:

__________________________________________________________________

Charitable Organizations Application Form Page 2