Contracted Fundraiser Registration Form A.r.s. 44-6554 - Arizona Secretary Of State
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1
2Betsey Bayless
Secretary of State
th
1700 West Washington 7
Floor
Phoenix, Arizona 85007
602 542-6670
Fee: $25.00
CONTRACTED FUNDRAISER
REGISTRATION FORM
A.R.S. §44-6554
A contracted fundraiser must complete and file a Contracted Fundraiser Registration
form with the Secretary of State’s office before conducting a fundraising campaign for a
Charitable Organization.
1. Name of the Contracted Fundraiser: ________________________________________
DBA: ________________________________________________________________
Contact Person: ________________________________________________________
Business Street Address: _________________________________________________
City: ________________________________ State: _______________ Zip: _______
Mailing Address (If different): ____________________________________________
City: _________________________________ State: _______________ Zip: _______
Telephone: (
) ________________________
2. If the Contracted Fundraiser is located outside of Arizona, please list a local contact
person.
Name: _______________________________________________________________
Business Street Address: ________________________________________________
City: ________________________________ State: ________________ Zip: ______
Telephone: (
) ______________________
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