Form Fr 90-05 - Professional Fund Raiser Annual Report
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KANSAS SECRETARY OF STATE
FR
Professional Fund Raiser Annual Report
Kansas Secretary of State
Ron Thornburgh
90-05
Memorial Hall, 1st Floor
All information must be completed or this document will not be accepted for filing.
120 S.W. 10th Avenue
Topeka, KS 66612-1594
(785) 296-4564
Print
Reset
Please complete the form, print, sign and
Name of professional fund raiser:
mail to the Kansas Secretary of State with
the filing fee. Selecting 'Print' will print
the form and 'Reset' will clear the entire
Street address
form.
City
State
Zip
Do not write in this space
The professional fund raiser is the following type of organization:
Proprietorship
Partnership
Other
Corporation, state of
_____________________
If partnership, list names and addresses of general partners; if corporation, list names and addresses of officers:
Name
Title
Address
City
State
Zip
Charitable organizations solicited for in the preceding 12 months:
Name of organization
Address
City
State
Zip
Financial information:
Name of charitable
Gross
Solicitation/operating
Net amount to
organization
receipts
expenses
charitable organization
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