Form Cri-200 - Short-Form Registration/verification Statement (Page 2 of 4) in pdf

8. The organization is eligible to file a Short Form Registration because:

a) It did not receive gross contributions in excess of $25,000 in the preceding fiscal year, AND all of the organization’s

functions, including fund-raising, are conducted by volunteers, members, officers or persons who are not compensated for

soliciting contributions.

£ Yes £ No

b) It is a fraternal, patriotic, social or alumni organization, historical society or similar organization organized under the provisions

of Title 15 of the New Jersey Revised Statutes or Title 15A of the New Jersey Statutes, AND solicitation of contributions is

confined to the organization’s membership and performed by members of the organization.

£ Yes £ No

c) It solicits on behalf of a specified individual, and all contributions, without any deductions whatsoever, will be turned over to

this beneficiary.

£ Yes £ No

d) It is a local post, camp, chapter or similarly designated element or county unit, of a bona fide veterans’ organization which

issues charters to the local elements throughout New Jersey or to any veterans’ organization chartered under federal law or a

service foundation of such an organization recognized in the organization’s by-laws.

£ Yes £ No

e) It is a private foundation that raised less than $25,000 in public contributions.

£ Yes £ No

Note to question 8: If after reviewing the answers to questions 8a through 8e, none of the statements can be answered “Yes,” the

charity is not eligible to use the Short-Form CRI-200 and instead must use the Long-Form Initial Registration Statement

CRI-150-I or the Long-Form Renewal Statement CRI-300R.

9. Have there been changes in the organization’s name, address, Internal Revenue Service (I.R.S.) status, etc. since the date of your

last reporting?

£ Yes £ No

If “Yes,” please provide the details on a separate sheet of paper, and provide copies of the documentary proof of a name change

(example: amendment to incorporation) and/or a copy of the letter of determination from the I.R.S. regarding the tax-exempt-status

changes.

9a. Is the organization a chapter or local unit of a parent organization?

£ Yes £ No

If “Yes,” write in the full name, address and phone number (include the area code) of the parent organization. Please do not use

abbreviations.

_______________________________________________________________________________________________________

10. Purpose for which the organization was created (write in or attach a statement to this registration): _______________________

______________________________________________________________________________________________________

10a. Does the organization solicit or intend to solicit contributions from the general public in the State of New Jersey (including through

the sale of merchandise)? £ Yes £ No

If “Yes,” explain the purpose for which solicited funds are being raised (write in or attach a statement to this registration):

_______________________________________________________________________________________________________

10b. Does the organization solicit funds under any other name(s)? £ Yes £ No

If “Yes,” please attach to this registration a list of all other names used: _________________________________________

11. Does the organization register or solicit in other states? £ Yes £ No

If “Yes,” please indicate other states here or, if necessary, attach to this registration a list of those states. __________________

11a. Has the organization ever been enjoined in any jurisdiction from soliciting contributions or has it been found to have engaged in

unlawful practices in the solicitation of contributions or the administration of charitable assets? £ Yes £ No

If “Yes,” list the jurisdiction and attach copies all of the relevant documents. _________________________________________

11b. Has the organization’s charity registration been denied, suspended or revoked by any jurisdiction or state? £ Yes £ No

11c. Has the organization voluntarily entered into an assurance of voluntary compliance agreement or any similar order or legal

agreement with any jurisdiction, state or federal agency or officer? £ Yes £ No

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Form Cri-200 - Short-Form Registration/verification Statement Page 2

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