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Minnesota Attorney General’s Office
Charities Division
STATE OF MINNESOTA
445 Minnesota Street, Suite 1200
St. Paul, MN 55101-2130
CHARITABLE ORGANIZATION
INITIAL REGISTRATION FORM
Website Address
(Pursuant to Minn. Stat. ch. 309)
SECTION A: Organization Information
Legal Name of Organization _______________________________________________________________
Federal EIN:________________________ Most Recent Fiscal Year-End: ________________________
mm/dd/yyyy
Mailing Address:
Physical Address:
____________________________________________________
_____________________________________________________
Contact Person
Contact Person
____________________________________________________
_____________________________________________________
Street Address
Street Address
____________________________________________________
_____________________________________________________
City, State, and Zip Code
City, State, and Zip Code
____________________________________________________
_____________________________________________________
Phone Number
Phone Number
____________________________________________________
_____________________________________________________
Email Address
Email Address
1. Organization’s website:___________________________________________________________________
2. List all of the organization’s alternate and former names (attach list if more space is needed).
___________________________________________________________________
Alternate
Former
___________________________________________________________________
Alternate
Former
3. List all names under which the organization solicits contributions (attach list if more space is needed).
________________________________________________________________________________________
________________________________________________________________________________________
4. Type of legal entity:
Corporation
Partnership
Sole Proprietorship
Unincorporated Association
_____________________
Limited Liability Company
Other:
5. Is the organization incorporated pursuant to Minn. Stat. ch. 317A?
Yes
No
6. Place and date of organization/incorporation:__________________________________________________
State
Date
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