Form FR90-05 "Professional Fund Raiser Annual Report" - Kansas

Form FR90-05 or the "Professional Fund Raiser Annual Report" is a form issued by the Kansas Secretary of State.

Download a PDF version of the Form FR90-05 down below or find it on the Kansas Secretary of State Forms website.

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Download Form FR90-05 "Professional Fund Raiser Annual Report" - Kansas

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kansas secretary of state
FR
Professional Fund Raiser
Annual Report
90-05
Instructions
Kansas Office of the Secretary of State:
Memorial Hall, 1st Floor
(785) 296-4564
120 S.W. 10th Avenue
kssos@sos.ks.gov
Topeka, KS 66612-1594
www.sos.ks.gov
Professional fund
Each professional fund raiser shall file an annual report with the Secretary of State on or
o
raiser annual report
before July 31 each year, reflecting the professional fund raiser’s solicitation activities that
occurred on and after July 1 of the previous year through the following June 30.
Fund raising methods
A description of the fund raising methods used by the professional fund raiser can be through
o
personal contact, mail, telephone, radio, TV, volunteers, internet, vendors, or you may specify
other methods.
Other
If the professional fund raiser is filed with the Secretary of State as a corporation, LLC, LP,
o
LLP, or other entity, you may need to file an annual report for your entity, in addition to this
fund raiser annual report. Go to www.sos.ks.gov for more information on business entity
filings.
Additional information
If additional space is needed, please provide an attachment.
o
Inst.
Please proceed to form.
K.S.A. 17-1764
Rev. 6/10/15 tc
kansas secretary of state
FR
Professional Fund Raiser
Annual Report
90-05
Instructions
Kansas Office of the Secretary of State:
Memorial Hall, 1st Floor
(785) 296-4564
120 S.W. 10th Avenue
kssos@sos.ks.gov
Topeka, KS 66612-1594
www.sos.ks.gov
Professional fund
Each professional fund raiser shall file an annual report with the Secretary of State on or
o
raiser annual report
before July 31 each year, reflecting the professional fund raiser’s solicitation activities that
occurred on and after July 1 of the previous year through the following June 30.
Fund raising methods
A description of the fund raising methods used by the professional fund raiser can be through
o
personal contact, mail, telephone, radio, TV, volunteers, internet, vendors, or you may specify
other methods.
Other
If the professional fund raiser is filed with the Secretary of State as a corporation, LLC, LP,
o
LLP, or other entity, you may need to file an annual report for your entity, in addition to this
fund raiser annual report. Go to www.sos.ks.gov for more information on business entity
filings.
Additional information
If additional space is needed, please provide an attachment.
o
Inst.
Please proceed to form.
K.S.A. 17-1764
Rev. 6/10/15 tc
Print
Reset
kansas secretary of state
FR
Professional Fund Raiser
Annual Report
90-05
Please complete the form, print, sign and mail to the
Kansas Secretary of State with the filing fee. Selecting
'Print' will print the form and 'Reset' will clear the entire
form.
Kansas Office of the Secretary of State:
Memorial Hall, 1st Floor
(785) 296-4564
120 S.W. 10th Avenue
kssos@sos.ks.gov
Topeka, KS 66612-1594
www.sos.ks.gov
THIS SPACE FOR OFFICE USE ONLY.
Name
Address
1.
Name of professional
fund raiser and
address of principal
City
State
Zip
Country
place of business
Name
Address
2.
Name and address of
each general partner
if partnership, or each
City
State
Zip
Country
officer if corporation
Attach additional pages if
necessary.
Name
Address
City
State
Zip
Country
Name
Address
City
State
Zip
Country
Name
Address
3.
Charitable
organizations
solicited for in
City
State
Zip
Country
preceding 12 months
Attach additional pages if
necessary.
Name
Address
City
State
Zip
Country
Name
Address
City
State
Zip
Country
4.
Description of fund
raising methods used
by professional fund
raiser
1 / 2
Please continue to next page.
K.S.A. 17-1764
Rev. 6/10/15 tc
5.
Provide the financial information on each charitable organization for which the professional fund raiser solicited.
Attach additional pages if necessary.
Name of charitable organization
Gross receipts
Net proceeds or
Net proceeds given
Fees or profits given
received for
revenue received
to the charitable
to the professional
each charitable
by the fund raiser
organization
fund raiser
organization
for each charitable
organization
6.
On a separate page, provide an itemized list of the professional fund raiser’s expenses for each charitable
organization.
Name
Address
7.
Name, address,
and registration
number of each
professional solicitor
City
State
Zip
Country
employed during
past 12 months, and
name(s) of charitable
Registration Number of Professional Solicitor
Charitable Organization(s)
organization(s)
solicited
Name
Address
Attach additional pages if
necessary.
City
State
Zip
Country
Registration Number of Professional Solicitor
Charitable Organization(s)
Name
Address
City
State
Zip
Country
Registration Number of Professional Solicitor
Charitable Organization(s)
Month
Day
Year
8.
This report covers
June
30
year ending
9.
I declare under penalty of perjury under the laws of the state of Kansas that the foregoing is true and correct.
Signature of Authorized Agent of the Professional Fund Raiser
Month
Day
Year
X
Name of Signer (printed or typed)
Phone Number
2 / 2
Please review to ensure completion.
K.S.A. 17-1764
Rev. 6/10/15 tc
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