Registration Statement For A Charitable Organization - South Carolina Secretary Of State Page 2
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44.
Enter the state and country in which the organization was legally established, as well as the date of establishment:
State____________________________ Country_______________________ Date ________________________
(mo/day/year)
**
5.
Form of organization. Check one: [ ]
Corporation (includes all nonprofit [i.e. 501(c)3] and for profit corporations)
[ ] Association [ ] Other _____________________
(
Please Specify)
**
All corporations must provide a name and street address for a registered agent.
_______________________________________________________
Name (This cannot be the name of the organization)
_______________________________________________________________________________________________
Street Address (PO Box cannot be accepted)
City
State
Zip Code
6.
Complete A or B, whichever applies: (6A or 6B must be a street address, not a PO Box)
A. Principal address of the organization:
_______________________________________________________________________________________________
Street Address, City, State, Zip Code
B. If the organization does not maintain an office, please provide the name and address of the person having custody
of the organization's financial records:
_________________________________________
Name
_______________________________________________________________________________________________
Street Address, City, State, Zip Code
7.
Addresses of any of your organization’s offices in South Carolina. Attach a list if necessary.
_______________________________________________________________________________________________
Name
Address, City, State, Zip Code
8.
Names and addresses of any chapters, branches or affiliates of your organization in South Carolina. Attach a list if
necessary.
_______________________________________________________________________________________________
Name
Address, City, State, Zip Code
For the current fiscal year,
9.
please provide the names and addresses of your organization’s officers, directors,
trustees, and board members. Attach a list if necessary.
_______________________________________________________________________________________________
Name
Address, City, State, Zip Code
Title
_______________________________________________________________________________________________
Name
Address, City, State, Zip Code
Title
_______________________________________________________________________________________________
Name
Address, City, State, Zip Code
Title
_______________________________________________________________________________________________
Name
Address, City, State, Zip Code
Title
Charities Registration Statement, Revised December 2016
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