Form Ce - Notice Of Exemption For Charitable Organizations printable pdf download

Form Ce - Notice Of Exemption For Charitable Organizations

FORM CE

NOTICE OF EXEMPTION

FOR CHARITABLE ORGANIZATIONS

Mississippi Secretary of State’s Office

P O Box 136, Jackson MS 39205-0136

(601) 359-1633 or (888) 236-6167

Name and complete address of organization:

Phone number:

List name, address, and phone number of the person to whom correspondence should be directed:

Exemption claimed..... §79-11-505..... (a)____ (b)____ (c)____ (d)____

(e)____ (f)____ (g)____ (h)____

Statement of Purpose:

Attach a list of any other offices in this state.

Attach a list of all officers, trustees, and directors of the charitable organization. This list

must include full names, full addresses, and phone numbers.

List name, address, and phone number of individual who has custody of the financial records of the charitable

organization:

Please give a brief statement of why your organization qualifies under this exemption:

I certify that the information on this document and in the attachments hereto is true and correct. I further certify that I am authorized to submit this form

on behalf of the Registrant. I understand that I am under a continuing obligation to notify the Secretary of State's Office of any changes in the information

provided to that office.

___________________________________

SIGNATURE OF PRESIDENT

DATE

___________________________________

Sworn to and subscribed before me

TYPED (or printed) NAME

This the ______ day of ____________, 20___.

NOTARY SEAL

____________________________________

Notary Public