Form CT-NRP-2 Nonprofit Raffle Report - California

Form CT-NRP-2 or the "Nonprofit Raffle Report" is a form issued by the California Department of Justice.

Download a PDF version of the Form CT-NRP-2 down below or find it on the California Department of Justice Forms website.

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STATE OF CALIFORNIA
DEPARTMENT OF JUSTICE
CT-NRP-2
NONPROFIT RAFFLE REPORT
PAGE 1 of 2
(Rev. 08/2017)
MAIL TO:
Office of the Attorney General
Registry of Charitable Trusts
A report must be completed for each year in
P.O. Box 903447
Sacramento, CA 94203-4470
which a raffle was conducted (September 1
through August 31).
STREET ADDRESS:
1300 I Street
Sacramento, CA 95814
Reports are due on or before October 1.
(916) 210-6400
(California Penal Code section 320.5)
WEBSITE ADDRESS:
www.ag.ca.gov/charities
PART A: General Organization Reporting Information
Provide at least one of the following:
Name of Organization:
Raffle Registration Number:
Address of Organization:
Federal Employee Identification Number (FEIN):
City or Town, State and ZIP Code:
E-mail Address:
Corporate Number:
Telephone Number:
Organization Number:
Fax Number:
State Charity Registration Number:
Part B: Raffle Information
1.
Raffle year ending August 31,
(Year)
2.
Aggregate gross receipts from the operation of raffle(s): $
3.
Aggregate direct costs incurred by the organization from the operation of raffle(s): $
Were funds from sources other than ticket sales used to pay for administration or other costs of
4.
Yes
No
conducting the raffle(s)?
If yes,
4(A) Total funds from sources other than ticket sales used for the administration or other costs of conducting the
raffle(s)?
4(B) What was the source of these funds?
Describe the charitable or beneficial purpose
5.
for which the raffle proceeds were used.
6.
Were some or all of the raffle proceeds used for the benefit of another eligible organization?
Yes
No
6(A) If the answer to 6 above is yes, provide the following information for each organization for which the proceeds were
used. Attach additional sheets of paper, if necessary.
STATE OF CALIFORNIA
DEPARTMENT OF JUSTICE
CT-NRP-2
NONPROFIT RAFFLE REPORT
PAGE 1 of 2
(Rev. 08/2017)
MAIL TO:
Office of the Attorney General
Registry of Charitable Trusts
A report must be completed for each year in
P.O. Box 903447
Sacramento, CA 94203-4470
which a raffle was conducted (September 1
through August 31).
STREET ADDRESS:
1300 I Street
Sacramento, CA 95814
Reports are due on or before October 1.
(916) 210-6400
(California Penal Code section 320.5)
WEBSITE ADDRESS:
www.ag.ca.gov/charities
PART A: General Organization Reporting Information
Provide at least one of the following:
Name of Organization:
Raffle Registration Number:
Address of Organization:
Federal Employee Identification Number (FEIN):
City or Town, State and ZIP Code:
E-mail Address:
Corporate Number:
Telephone Number:
Organization Number:
Fax Number:
State Charity Registration Number:
Part B: Raffle Information
1.
Raffle year ending August 31,
(Year)
2.
Aggregate gross receipts from the operation of raffle(s): $
3.
Aggregate direct costs incurred by the organization from the operation of raffle(s): $
Were funds from sources other than ticket sales used to pay for administration or other costs of
4.
Yes
No
conducting the raffle(s)?
If yes,
4(A) Total funds from sources other than ticket sales used for the administration or other costs of conducting the
raffle(s)?
4(B) What was the source of these funds?
Describe the charitable or beneficial purpose
5.
for which the raffle proceeds were used.
6.
Were some or all of the raffle proceeds used for the benefit of another eligible organization?
Yes
No
6(A) If the answer to 6 above is yes, provide the following information for each organization for which the proceeds were
used. Attach additional sheets of paper, if necessary.
STATE OF CALIFORNIA
DEPARTMENT OF JUSTICE
CT-NRP-2
NONPROFIT RAFFLE REPORT
PAGE 2 of 2
(Rev. 08/2017)
$
Recipient Organization
Exact Dollar Amount of Proceeds to Recipient Organization
Address of Recipient Organization
Contact Person for Recipient Organization
City, State, and ZIP Code
Telephone Number of Recipient Organization
Part C: Certification by Authorized Officer or Director of Reporting Organization
, I hereby certify that:
For the raffle(s) held during the year ending August 31,
(Year)
True False
At least 90% of the gross receipts (total dollar amount prior to deduction of expenses) received from the sale
1)
of raffle tickets was used for the beneficial or charitable purposes of the eligible organization conducting the
raffle or for the benefit of another eligible organization.
None of the funds required to be used for beneficial or charitable purposes were provided to an officer,
2)
director or member (as defined by Corporations Code section 5056) of the organization which conducted the
raffle(s).
3)
No person involved in or connected with the conduct of the raffle(s) was compensated by the organization
conducting the raffle(s) from raffle proceeds required to be used for beneficial or charitable purposes.
No gaming machine, apparatus or device, including but not limited to one which meets the definition of a slot
4)
machine as described in California Penal Code sections 330a, 330b, or 330.1, was used in conducting the
raffle(s).
No individual corporation, partnership or other legal entity has or holds a financial interest in the conduct of
5)
the raffle(s) other than the organization conducting the raffle(s) or any private, nonprofit eligible organization
which received funds from the raffle(s).
6)
No raffle was conducted, and no raffle tickets were sold, traded, or redeemed, within an operating racetrack
enclosure, satellite wagering facility, or gambling establishment.
7)
Tickets were not sold, traded, or redeemed over the Internet.
If the answer to any question in Part C, Items 1 through 7, was "False", please explain the circumstances that support
the answer. Use additional sheets of paper, if necessary, for the explanation. If the answer to more than one question
in Part C was "False", reference the question number next to each explanation.
In signing this Nonprofit Raffle Report, I hereby certify that all of the information contained herein is true and correct.
Signature of Authorized Officer or Director Who Prepared the
Date
Report
Printed Name of Authorized Officer or Director
Title of Authorized Officer or Director

Download Form CT-NRP-2 Nonprofit Raffle Report - California

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