Form Sc - Registration Statement For Solicitations December 1999

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Secretary of State/Corporation Division
Form
Registration Statement for Solicitations
SC
This report covers the tax year which ended
Month/Day/Year
1.
Name of organization:
1a. Name/names under which it will solicit:
2.
Principal mailing address and street address of the organization:
Street Address
City, State, Zip
Do not write in this space.
Do not write in this space.
3.
Mailing address and street address (plus city, state, zip) of any offices such organization has in Kansas:
4.
Purpose for which organization was organized:
5.
Names and mailing addresses and street addresses (plus city, state, zip) of any subsidiary or subordinate
chapters, branches or affiliates in Kansas:
6.
The place where and the date when the organization was legally established:
7. Form of organization: (Trust, Corporation, etc. ):
8. Reference to any determination of tax-exempt status by the Federal Internal Revenue Code of 1986:
9.
Names
Addresses
(Mailing and Street)
Officers
Directors
Trustees
Employees
(principal salaried - attach additional pages, if necessary)
10. Person having custody of such organizations' financial records:
Street addresss
Mailing address
11. Names of the individuals or officers of the organization who will have responsibility for the custody of
contributions:
12. Names of the individuals or officers of the organization who will have responsibility for the distribution of the
contributions:
13. Names of the individuals or officers of the organization who will have responsibility for the conduct of
solicitation activities:

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