Institution Of Purely Public Charity Registration Statement Form - Pennsylvania Department Of State

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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF STATE
OFFICE OF THE
BUREAU OF CHARITABLE ORGANIZATIONS
SECRETARY OF THE COMMONWEALTH
207 NORTH OFFICE BUILDING
HARRISBURG, PA 17120
717-783-1720
1-800-732-0999
Dear Sir or Madam:
Section 379 of The Institution of Purely Public Charity Act, 10 P.S. Section 379, requires
your organization to annually file a copy of its IRS 990 Return, the registration statement on the
reverse side of this letter, and a $15 fee with the Bureau of Charitable Organizations within 135
days of your organization’s most recently completed fiscal year unless exempt from registration.
You may obtain a copy of Section 379 and the registration statement by contacting the Bureau or
by printing the information from our Web site at :
The following organizations are exempt from Section 379’s registration requirements: 1)
an organization which receives contributions of less than $25,000 during its most recently
completed fiscal year provided that the organization’s program service revenue does not equal or
exceed $5,000,000; 2) religious institutions and such separate groups or corporations which form
an integral part of a religious institution and are exempt from filing an IRS 990 Return.
If after reviewing these exemptions you determine your organization is exempt from the
registration requirements, please check the appropriate box on the registration statement, indicate
the applicable exemption, complete items #1 - #3, sign where indicated, and no fee is required.
If your organization is not exempt from the registration requirements and cannot meet the
filing deadline, the Bureau can grant an extension to file your organization’s IRS 990 Return. To
receive an extension, the Bureau must receive either a request for an extension by completing the
registration statement on the reverse and completing item #10 or a copy of your IRS extension
form filed with the IRS. Extension request must be postmarked on or before the date when your
organization’s registration is due.
If you have already forwarded the registration for your organization’s most recently
completed fiscal year, please disregard this notice. If you have any questions concerning
these matters, please contact the Bureau.
Visit our Web site at:

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