Registration Statement For A Charitable Organization Form - Secretary Of State Page 2
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4State of South Carolina
Post Office Box 11350
Telephone: (803) 734-1790
Office of the Secretary of State
Columbia, SC 29211
Fax: (803) 734-1604
Division of Public Charities
charities@sos.sc.gov
Physical Address
Principal address of the organization _____________________________________________________________________
City _______________________________________________ State _____________ Zip__________________________
Charity Contact
Contact Person’s Name ________________________________________ Title ______________________________
Contact Person’s Mailing Address ____________________________________________________________________
City ____________________________________________ State ____________ Zip_________________________
Contact Person’s Phone Number (Daytime) _______________________________ Fax No. _______________________
Contact Person’s E-mail Address ____________________________________________________________________
CEO
CEO’s Name _______________________________________________
Telephone Number _______________________
CEO’s Mailing Address _______________________________________________________________________________
City __________________________________________
State _______________
Zip _________________________
CFO
CFO’s Name _______________________________________________
Telephone Number _______________________
CFO’s Mailing Address _______________________________________________________________________________
City __________________________________________
State _______________
Zip _________________________
Charity Offices in South Carolina
Addresses of any of your organization’s offices in this State:
City ______________________________________________________State ___________ Zip______________________
City ______________________________________________________ State __________ Zip______________________
Custody
If the organization does not maintain an office, please provide the name and address of the person having custody of the
organization's financial records:
___________________________________________________________________________________________________
___________________________________________________________________________________________________
Charities Registration Statement Revised May 2009
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