OFFICE USE ONLY
$25____________
Other _________
STATE OF MINNESOTA
OFFICE OF THE ATTORNEY GENERAL
MIKE HATCH
CHARITIES UNIT
Attorney General
Suite 1200, Bremer Tower
445 Minnesota Street
(651) 296-6172 (Voice)
St. Paul, MN 55101-2130
(651) 296-1410 (TDD)
Upon request this material can be made available in alternate formats.
CHARITABLE ORGANIZATION REGISTRATION STATEMENT
Minnesota law requires a charitable organization soliciting or intending to solicit contributions in excess
of $25,000 a year, or having paid officers or staff, or using a professional fund raiser, to file a Registration
Statement. For definitions and exemptions, see Minnesota Statutes §§ 309.50 and 309.515 (1998).
INSTRUCTIONS:
A.
Complete each section on this registration statement, including date of board
approval and two signatures.
B.
Attach a copy of the Articles of Incorporation.
C.
Attach a copy of the IRS determination letter (tax exempt status).
D.
Attach a copy of the most recent IRS form 990 or financial statement.
E.
Attach a $25.00 filing fee made payable to the State of Minnesota.
FEDERAL EIN NUMBER
:
1.
_________________________________________________________________________________
Legal Name of Organization
___________________________________________________ _____________________________
Address of Principal Office
Contact Person
City _______________ State ______ Zip _______ Telephone # __________________________
2.
Address of registered agent in the State of Minnesota or the address of the person who has custody of
the organization's books and records if not kept at the organization's office.
Name ____________________________________________________________________________
Street and Number _________________________________________________________________
City _______________ State ______ Zip _______ Telephone # __________________________
(9/00)