Contracted Fund Raiser Campaign Financial Report Form - Arizona Secretary Of State Page 2
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29. Percentage of the total contributions remitted to the Charitable
Organization:________________________________________________
10.
Aggregate amount retained by or paid to contracted fund raiser
(including all overhead, expenses, commission, etc):_________________
I, the undersigned, swear and/or affirm under penalty of law that the
representations made in this Financial Report are true and accurate.
____________________
____________________
Name of Contracted Fund Raiser
Signature of Contracted Fund Raiser
_____________________________
Title
Subscribed and sworn before me, this_________day of __________, 19___.
____________________
____________________
Name of Notary Public
Signature of Notary Public
Revised 04/98
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