Form Ss-6007 - Application To Renew Registration Of A Charitable Organization - Department Of State, State Of Tennessee
Download a blank fillable Form Ss-6007 - Application To Renew Registration Of A Charitable Organization - Department Of State, State Of Tennessee in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form Ss-6007 - Application To Renew Registration Of A Charitable Organization - Department Of State, State Of Tennessee with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2State of Tennessee
WARN ING: F a lse or mis lead ing stat e men ts
Subject to maximum $5,000 penalty. T.C.A. §48-101-514
APPLICATION TO RENEW REGISTRATION
Department of State
OF A CHARITABLE ORGANIZATION
Division of Charitable Solicitations and Gaming
312 Eighth Avenue North
th
8
Floor, William R. Snodgrass Tower
RESET BUTTON
Nashville, TN 37243
(615) 741-2555; Fax (615) 253-5173
INSTRUCTIONS: Please type or print all items on this form which are applicable to your
OFFICE USE ONLY
organization. If you are unable to answer in the space provided, you may attach additional sheets.
Reg. No.
Date Rec'd.
Indicate that an item does not apply by placing N/A by its number. A nonrefundable registration
fee must accompany this application. The amount of the filing fee is as follows:
Registration
Organization’s
Annual
Expiration
Gross Revenue
Filing Fee
Date:
$0-$48,999.99 ……………………………………. $100.00
$49,000.00-$99,999.99 ………………………...… $150.00
Fee Pd.
$100,000.00-$249,999.99 ………………………... $200.00
$250,000.00-$499,999.99 ………………………... $250.00
Rec. No.
$500,000.00-ABOVE ……………………………. $300.00
See REVERSE side for additional instructions.
1. Name of organization:
If name has changed, please indicate:_________________________________________________
FEIN:
Fiscal Year End:
Has the fiscal year changed since your last registration? Yes
No
If yes, please indicate: ____________________
2. Do you solicit contributions under any other name(s)? Yes
No
If yes, please attach a list of names used.
IF ORGANIZATION DOES NOT MAINTAIN A PHYSICAL
3A.
Principal Office Address:
OFFICE, ENTER NAME AND ADDRESS OF PERSON HAVING
(Street)d
:
CUSTODY OF FINANCIAL RECORDS
(City)d
(State)____(Zip)
(Name)
IF PRINCIPAL ADDRESS HAS CHANGED FROM ABOVE., PLEASE INDICATE:
(Street)
(Street)
(City)
(State)
(Zip)
(City)
(State)
(Zip)
IF CONTACT PERSON AND/OR MAILING ADDRESS HAS
3B.
Mailing Address:
CHANGED, PLEASE INDICATE:
(Contact Name/Title)
(Contact Name/Title)
(Street)
(Street)
(City)
(State)
(Zip)
(City)
(State)
(Zip)
4. Do you have other offices in Tennessee? Yes
No
If yes, indicate below:
_______________________________________________________________________________________________________
5. Telephone Number:
Fax Number:
Email Address:
If information in number 5 has changed, please indicate in provided area below.
Telephone #:
Fax #:
Email:
6. Have you added any Chapters, Branches or Affiliates in Tennessee since your last registration? Yes
No
If yes; list name and
address: __________________________________________________________________________________________________
__________________________________________________________________________________________________________
Are you registering and reporting the financial activities of these organizations? Yes
No
(NOTE: a chapter, branch, or affiliate that solicits or receives contributions from any source other than the parent organization
or a governmental agency must register independently and pay its own filing fee)
7. Has your charter been revoked? Yes
No . Have you amended your charter or by-laws since your last registration? Yes
No .
If yes, attach copy of amendment(s).
8. Has your tax exempt status been revoked by the Internal Revenue Service since your last registration? Yes
No
9. Attach a list of all states where you are currently registered.
10. Have you been enjoined by any court from soliciting contributions since your last registration? Yes
No
If yes, attach copy of
court order.
11. Attach a list of the name, title, address and phone number of each officer, director, trustee and principal salaried officer.
12. Has any officer, director, manager, operator or principal been the subject of an injunction, judgment or administrative order or been
convicted of a felony? Yes
No
If yes, attach copy of court order.
13. Describe the purpose of the organization: _____________________________________________________________________
_______________________________________________________________________________________________________
14. Indicate method(s) by which solicitations will be made during this registration period: Personal contact
Mail
Telephone
Radio/TV
Volunteers
Professional Solicitor
Fund Raising Counsel
Vendor
Internet
Webpage address:______________________________________ Other:___________________________________________
A. List the name(s) and address(es) of for-profit persons hired by organization to assist in solicitation activities in Tennessee:
(Name)
(Street)
(City)
(State)
Zip)
_________
(Name)
(Street)
(City)
(State)
(Zip)
_________
B. Attach a true copy of any contract with persons named above.
15. List the name and address of individual(s) who have final responsibility for the custody of contributions:
(Name)
(Street)
(City)
(State)
(Zip)
_________
16. List the name and address of individual(s) who have responsibility for the final distribution of contributions:
(Name)
(Street)
(City)
(State)
(Zip)
________
RDA 1745
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal