Short Form Pc - Massachusetts Non-Profit Organizations/public Charities Division printable pdf download

Short Form Pc - Massachusetts Non-Profit Organizations/public Charities Division

Short Form PC

Office of the Attorney General

Non-Profit Organizations/Public Charities Division

One Ashburton Place

Boston, MA 02108

To be filed only by organizations that wish to solicit funds prior to completion of their first fiscal year.

Report for the Fiscal Period: Beginning _____/_____/_____ and ending _____/_____/_____

Check all items attached: Articles of Organization _____ Agreement or Association _____ Instrument of Trust _____ By-laws _____

Attorney General’s Acct. No.:

Federal ID Number:

IRS Exemption under 501(c):

Check box if No IRS Exemption [

]

Has the organization applied for or been granted IRS tax exemption status? Yes ______ No ______ If yes:

Date of Application: ____________________________________

Date of Determination

Letter:___________________________________________

If exempt under 501(c), are contributions to the organization tax deductible as charitable contributions? Yes ________ No ________

ORGANIZATION DATA

Name:

Mailing Address:

City:

State:

Zip:

Phone: (

)

Fax: (

)

E-Mail:

Web Site (URL):

All questions must be completed in their entirety whether or not similar questions are answered

in an attached federal form. See instructions and definition section for guidance.

In the section below, please enter the appropriate codes from the corresponding tables found on the instruction sheets:

Short Form Pc - Massachusetts Non-Profit Organizations/public Charities Division