Contracted Fund Raiser Campaign Financial Report Form - Arizona Secretary Of State
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1
2Betsey Bayless
Secretary of State
Fund Raiser Division
th
1700 West Washington – 7
Floor
Phoenix, Arizona 85007
(602) 542-6670
CONTRACTED FUND RAISER
CAMPAIGN FINANCIAL REPORT
A.R.S. §44-6554
A contracted fund raiser must complete and file a CAMPAIGN FINANCIAL REPORT with the Secretary
of State within 90 days either after the solicitation campaign is completed or on the anniversary of the
commencement of a campaign lasting more than one year.
1. Name of Contracted Fund Raiser:________________________________
Contact Person:_________________________Title:_________________
Address:____________________________________________________
City:_______________________State:_________Zip:_______________
Telephone:(
)__________________________
2. Name of Charitable Organization for whom solicitations were made:
_____________________________________________________________
3. Name and/or description of promotions:__________________________
_____________________________________________________________
4. Period of solicitation/promotion: Begin__________End__________
5. Gross amount of contributions pledged:___________________________
6. Gross amount of contributions collected:__________________________
7. Amount of contributions remitted to the Charitable Organization as of
this filing:__________________________________________________
8. Amount of contributions owed and yet to be remitted to the Charitable
Organization:_______________________________________________
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