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Form 1952 - Supplement To Financial Report

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STATE OF WISCONSIN

Chapter 202, Wis. Stats.

Division of Banking

Subchapter II

Department of Financial Institutions

Mailing Address:

PO Box 7876

Telephone: (608) 267-1711

Madison, WI 53707-7876

Fax: (608) 267-6889

Courier Address:

201 W. Washington Ave.

Suite 500

FORM #1952 - WISCONSIN

Madison, WI 53703

SUPPLEMENT TO FINANCIAL

REPORT

Purpose: Charitable organizations that are registered, or are required to be registered, with the Department of Financial

Institutions – Division of Banking (“division”) must file an annual financial report with the division within 9 months after the

organization’s fiscal year-end unless the organization qualifies for an exemption from the annual filing requirement.

An organization must file its annual report on Form #308 or on Form #1952. This form, Form #1952, is a shorter, more

commonly used version of the annual report form and must be accompanied by the organization’s IRS 990, 990EZ, or 990-PF. If

an organization is unable to submit an IRS 990, 990EZ, or 990-PF, it should submit Form #308 to the division instead of Form

#1952.

Please note that an organization may not have to file a Form #308 or a Form #1952 if:



it received $5,000 or less in contributions during its most recently completed fiscal year, or



it operates solely in the county in which its principal office is located and received less than $50,000 in contributions

during its most recently completed fiscal year.

If the organization’s contributions fall into either of the above categories, an Affidavit in Lieu of Annual Financial Report (Form

#1943) should be submitted instead of Form #308 or Form #1952.

Print or type the information requested in the spaces provided.

1. Name of charitable organization and any trade names or DBA (doing business as) names the organization uses when soliciting.

2. WI Charitable Organization Registration Number:

3. Federal Employer Identification Number:

4. Provide the following information for the organization’s headquarters office, if any:

Street:

City:

State:

Zip:

Daytime Phone Number:

5. Provide the organization’s mailing address if different than above.

Street Address:

P.O. Box:

City:

State:

Zip:

CO WI SUPPLEMENT TO FINANCIAL REPORT

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DFI/LFS/1952 (R 3/2014)

Form 1952 - Supplement To Financial Report

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