Form Char 015 - Annual Bond (For Professional Fund Raisers)

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CHAR 015
STATE of NEW YORK
DEPARTMENT OF LAW
CHARITIES BUREAU
ANNUAL BOND
(for Professional Fund Raisers)
THE CAPITOL
ALBANY, NY 12224
(518) 486-9797
Bond Number: _____________________________
ag.sta te.ny.u s/char ities/c haritie s.html
KNO W AL L ME N BY THE SE PR ESEN TS, that we ,
,
(Name of Registrant Exa ctly As It Appears In Item #1A Of The Professional Fund Raiser Registration Statement)
of
, as Principal, and
, as Surety, are he ld
(Address Of Registrant)
(Name Of Surety)
firmly bound to the Attorney General of the State of New York and to any other person who may have a cause of action or claim against the Principal
for any malfeasance or misfeasance in the conduct of a solicitation by the Principa l as a Professio nal Fund R aiser, in the sum o f $10,00 0, to be pa id
to the Attorney G eneral of th e State of New York or to any other person who may have a cause of action or claim against the Principal for any
malfeasance or misfeasance in the conduct of a solicitation by the Principal as a Professional Fund Raiser, and that we bind ourselves, our heirs,
executors, administrators, successors and assigns, jointly and severally, by this bond.
WHEREAS, the Principal has applied to the Attorney General of the State of New York for registration as a Professional Fund Raiser
pursuant to Article 7-A of the Executive Law of the State of New York;
NOW, therefore, the terms of this obligation shall be:
That if the Attorney General of the State of New York shall register the P rincipal as a P rofessional F und Raise r and if the Prin cipal shall
faithfully and honestly act as such in accord ance with the law, and if the Principal sh all fully comply with the provisions of Article 7-A of the
Executive Law of the State of New Y ork, and if the Principal shall fully indemnify and save harm less from loss the S tate of New York and any person
who may have a cause of action or claim against the Principal for any malfeasance or misfeasance in the conduct of solicitation as such Professional
Fund Ra iser, then this oblig ation shall be v oid; otherw ise it shall remain in full fo rce and effec t.
In addition, this bond shall not beco me void u pon the first rec overy thereo n but may be sued upo n from time to time until the full amount
thereof shall have been exhausted.
This bond sh all cover any cause of action or claim arising on account of the Principal's action as a Professional Fund Raiser during the
period beginning on
and endin g on the thirty-first day o f the next succe eding Aug ust when the P rincipal's registration shall
expire; provided , however, the Principal a nd the Sure ty shall be liable, to the full extent of this bond, for any such cause of action or claim notice
of which is pre sented to the Principal o r to the Surety.
IN WITNE SS WHER EOF, we have signed and acknowledged this bond on the date indicated below.
SIGNATURE OF PRINCIPAL
SIGNATURE OF SURETY
Name o f Authorized Represe ntative of Prin cipal (Please Print):
Name o f Attorney-In-Fa ct (Please Print):
Signature o f Authorized Represe ntative of Prin cipal*
Signature o f Attorney-In-Fa ct:*
Date:
Date:
* Complete Section A or B below (whichever is appropriate)
* Complete Section C below and attach appropriate Power of
Attorney for Attorney-In-Fact
SECTIO N A - AC KNO WLE DGM ENT O F PRIN CIPAL AS UN INCO RPO RATE D ASSO CIATIO N/SOL E PRO PRIET ORSH IP
STATE OF
)
: ss.:
COUN TY OF
)
On this
day of
, 20
, before me personally came
,
residing at
, to me known and known to be the same person described in and who
executed the foregoing instrument and who acknowledged to me that (he)(she) executed the same.
Notary P ublic
(
)
SECTIO N B - AC KNO WLE DGM ENT O F PRIN CIPAL AS CO RPO RATIO N OR PART NERS HIP
STATE OF
)
: ss.:
COUN TY OF
)
On this
day of
, 20
, before me personally came
,
residing at
, to me know n and who , being duly swo rn by me, did depose and say
that (he)(she) is the
of the Princip al describe d in and that e xecuted the foregoing ins trument.
(Notary Public)
SECTION C - ACKNOWLEDG MENT OF SURETY
STATE OF
)
: ss.:
COUN TY OF
)
On this
day of
, 20
, before me personally came
,
residing at
, to me known and known to be the same person described in and who
executed the foregoing instrument in the firm name of
acknowledged to me that (he)(she) executed the same as and for the act and deed of said firm.
(Notary Public)
CHAR 015 (Rev. 10/01)

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