Form Char015 - Annual Bond (For Professional Fund Raisers) - Department Of Law printable pdf download

CHAR015

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: _____________________________

KN OW ALL MEN BY TH ESE P RE SENT S, that we ,

(Name of Registrant Exactly As It Appears In Item #1A Of The Professional Fund Raiser Registration Statement)

, as Principal, and

, as Sure ty, are held

(Address Of Registrant)

(Name Of Surety)

firmly bound to the Attorney General of the State of New Y ork and 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 Professio nal Fund R aiser, in the sum of $10 ,000 , to be p aid

to the Attorney G enera l of the 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.

WH EREAS, the Principal has applied to the Attorney General of the State o f New York for registration as a Professional Fund Raiser

pursuant to Article 7-A of the Executive Law of the State of New Y ork;

NOW , therefore, the terms of this obligation shall be:

That if the Principal shall register with the Attorney General of the State of New Y ork as a Professional Fund Raiser and if the Principal

shall faithfully and honestly act as such in accordance with the law, and if the Principal shall fully comply with the provisions of Article 7-A of the

Executive Law of the State o f New Y ork, and if the Principal shall fully indemnify and save harm less from lo ss the State 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 Raiser, then this obligation shall be void ; otherw ise it shall rem ain in full force and effect.

In addition, this bond shall not beco me vo id upon the first recov ery there on but may b e sued upon from time to time until the full amount

thereof shall have been exhausted.

This bo nd shall cover any cause of actio n or claim arising on account of the P rincipal's action as a Professional Fund Raiser for a period

beginning on

, 20

, which shall be deem ed the date o f the Principal's annual registration with the A ttorney G enera l,

and ending exactly one year from that d ate, which shall be dee med to be the exp iration d ate of the Principal's annual registration, pursuant to §17 3.1

of Article 7-A of the Executive Law of the State of New Y ork; provided, however, the Principal and the Surety shall be liable, to the full extent of

this bond, for any such cause of action or claim notice o f which is presented to the Principal or to the Surety.

IN W ITNE SS W HERE OF, we have signed and acknowledged this bond on the date indicated below.

SIGNATURE OF PRINCIPAL

SIGNATURE OF SURETY

Name o f Autho rized Rep resentative of P rincipa l (Please Print):

Name o f Attorney-In-Fact (Please Print):

Signature of A uthorized R epresentative of Principal*

Signature of A ttorney-In -Fact:*

Date:

* Com plete Section A or B below (whichever is appropriate)

* Complete Section C below and attach appropriate Power of

Attorney for Attorney-In-Fact

SEC TIO N A - AC KN OW LED GM EN T O F PR INC IPA L A S UN INC OR PO RA TED ASS OC IAT ION OR SO LE P RO PR IETO RSH IP

STATE OF

)

: ss.:

COU NT Y O F

)

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

(

)

SEC TIO N B - AC KN OW LED GM EN T O F PR INC IPA L A S CO RP OR AT ION , LIM ITED LIABIL ITY CO . OR PA RT NE RSH IP

STATE OF

)

: ss.:

COU NT Y O F

)

On this

day of

, 20

, before me personally came

residing at

, to me known and who, b eing duly sworn by me, did depose and say

that (he)(she) is the

of the P rincipa l described in and that executed the foregoing instrume nt.

(Notary Public)

SECTION C - ACKNOW LEDGM ENT OF SURETY

STATE OF

)

: ss.:

COU NT Y O F

)

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)

CHAR015 (Rev. 6/02)

Form Char015 - Annual Bond (For Professional Fund Raisers) - Department Of Law

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