Form Rf-C - Registration For Charitable Organizations (2011)

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Form

Charitable Activities Section

DOJ USE ONLY

Registration #:

RF-C

Oregon Department of Justice

1515 SW 5th Avenue, Suite 410

VOICE

(971) 673-1880

Portland, OR 97201-5451

TTY

(800) 735-2900

Registration for

E-Mail: charitable.activities@doj.state.or.us

FAX

(971) 673-1882

Charitable Organizations

Web site:

Name

Write the organization’s legal name.

____________________________________________________________________________________________________________

Contact Information

Mailing Address: ______________________________________________________________________________________________

______________________________________________________________________________________________

City, State, Zip: _______________________________________________________________________________________________

Phone:

(

)

E- Mail:

________________________________________________

Fax:

(

)

Web site:

________________________________________________

Employer Identification Number

Write the organization’s employer identification number assigned by the Internal Revenue Service. If the EIN has not been applied for, write “N/A.”

______

Date and State of Incorporation or Organization

Write the date the organization incorporated and the state in which the organization was formed.

______________________________

Date of Incorporation or Organization

State of Incorporation or Organization

Primary County of Operations

Write the name of the primary Oregon county in which the organization conducts charitable activities. If the organization conducts charitable activities

in more than one county in Oregon, list the name of the county in which the most charitable activities are conducted. If charitable activities

are conducted evenly across the state, write the county in which the headquarters of the organization is located.

_____________________________________

Accounting Period

Write the last month of the organization’s accounting period:

_____________________________________

Organization’s Purpose

Describe the charitable purpose of the organization in one or two sentences. The information is used to describe the organization in response to

public inquiries.

____________________________________________________________________________________________________________

Beneficiaries

If the organization raises funds or intends to raise funds on behalf of another organization(s), list the name and address of the organization(s).