Sos Form 101a 01/13 - Registration Statement Of Charitable Organization - Oklahoma Secretary Of State Page 5

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CHARITABLE ORGANIZATION REGISTRATION
ATTACHMENT
Professional Fund Raiser Information
(Complete one (1) form for each professional fund raiser. Form may be duplicated.)
a.
Legal name of the Professional Fundraiser:
b.
Street & P.O. Box address
c.
Location of offices used by them on behalf of your organization
d.
Simple statement of services provided
e.
Describe the basis of payment or other consideration payable to each professional fundraiser and the
nature of the arrangements between the charitable organization and each professional fundraiser.
f.
Specific amount, formula or percentage of compensation, or property of any kind or value to be paid or
provided to each professional fundraiser:
j.
If payment is based on a percentage, the amount of compensation as a percentage of:
(1)
Total contributions received:
(2)
Net amount of the total contributions received: ________________________________________
(total contributions received, less expenses of solicitation other than amounts payable to any professional
fundraiser)
(SOS FORM 101A-01/13)
(SOS FORM 101A-01/13)

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