Form Sosbs - Charitable Organization Religious Organization Registration - 2012
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1
2
3REGISTRATION #_____________
D
N
W
T
S
State of Arizona
O
OT
RITE IN
HIS
PACE
Charitable Organization
Religious Organization Registration
Mail to: Arizona Secretary of State Ken Bennett
Attention: Business Services, Charities Division
400 West Congress, 2nd Floor Room 252, Tucson, AZ 85701
(602) 542-6187 (800) 458-5842 (within Arizona)
Website:
F
O
U
O
– R
. 07/26/12
OR
FFICE
SE
NLY
EV
R
O
R
~
A.R.S. § 44-6552(F)
ELIGIOUS
RGANIZATION
EGISTRATION
About this form
How to complete this form
Use this application to register or renew a Religious
This form must be written legibly or computer generated for
Organization under A.R.S. § 44-6552(F). A copy of this law is
accuracy of your registration. This form has been designed to
available at .
be filled out and printed online at the website referenced above.
Read this application carefully, and fill in all blank spaces. If an
Filing Fee: None
item is not applicable, write “N/A” in the space.
The registration form requires notarized signatures of any TWO
Processing: by mail, one week
officers.
Failure to Renew by Deadline: The deadline to file a renewal
File by mail to the address above or the Phoenix location, or
notice is September 30 of each year. A late fee will be
Return in person at the following locations:
assessed if the renewal is received after this date.
PHOENIX - State Capitol
TUCSON - Arizona State
Late Fee: $25
Executive Tower
Complex Building
1700 W. Washington Street
400 W. Congress
Payment: If filing late make a check or money order payable
First Floor, Room 103
Second Floor, Room 252
to the Secretary of State and include it with this application.
These locations are open Monday through Friday, 8 a.m. to 5 p.m.
Credit cards are not accepted.
except state holidays.
Registration Statement ~ Financial Disclosure
Any charitable organization that is a bona fide and duly constituted religious institution and any other entity that is an integral part of a
religious institution shall file the registration statement prescribed in this section [A.R.S. § 44-6552(F)] but is not required to file any
financial disclosure information prescribed by the secretary of state pursuant to this section if all of the following apply:
1. The religious institution or entity is a tax exempt institution or entity pursuant to the internal revenue code.
2. No part of the religious institution's or entity's net income inures to the direct benefit of any individual.
3. The religious institution or entity only solicits monies from the institution's or entity's membership, congregation or previous donors
and the institution's or entity's conduct and fees charged for services are primarily supported and paid through government grants or
contracts.
Please Type or Print
Renewal
Check One:
Initial Registration
(If filed after September 30, please include a $25 check. See “Late Fee” above)
1. Name and Address Information
Name of Charitable Organization
Doing Business As (DBA)
Former Name of Charitable Organization (if changed since last filing)
Charitable Organization Business Address
Business Address (include street, box or suite number)
City
State
Zip Code
Business Phone Number (include area code)
Is this a NEW business address?
YES
NO
Charitable Organization Mailing Address
Mailing Address (include street, box or suite number)
City
State
Zip Code
Toll Free Number
Is this a NEW mailing address?
YES
NO
Internet Address
Office Form SOSBS_Charity_Religious_Org.doc
R eli gious Or gani zation R e gistr ation/R enew al Form
Page 1 of 3
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