Form Dscb:15-3331 - Annual Benefit Report Benefit Corporation
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3PENNSYLVANIA DEPARTMENT OF STATE
BUREAU OF CORPORATIONS AND CHARITABLE ORGANIZATIONS
Return document by mail to:
Name
Address
City
State
Zip Code
Return document by email to:
_________________________________
Read all instructions prior to completing. This form may be submitted online at https://
Fee: $70
In compliance with the requirements of 15 Pa.C.S. § 3331 (relating to annual benefit report), the undersigned
benefit corporation hereby states that:
1. The name of the corporation is:
____________________________________________________________________________________________________
2. Complete part (a) or (b) – not both:
(a) The address of this corporation’s current registered office in this Commonwealth is
____________________________________________________________________________________________________
Number and Street
City
State
Zip
County
(b) The name of this corporation’s commercial registered office provider and the county of venue is:
c/o:_________________________________________________________________________________________________
Name of Commercial Registered Office Provider
County
3. A narrative description of:
(i) the ways in which the benefit corporation pursued general public benefit during the year and the extent to
which general public benefit was created;
____________________________________________________________________________________________________
(ii) the ways in which the benefit corporation pursued any specific public benefit that the articles state is the
purpose of the benefit corporation to create and the extent to which that specific public benefit was created;
____________________________________________________________________________________________________
(iii) any circumstances that have hindered the creation by the benefit corporation of general or specific public
benefit; and
____________________________________________________________________________________________________
(iv) the process and rationale for selecting or changing the third-party standard used to prepare the benefit report.
____________________________________________________________________________________________________
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