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Get NY CHAR014 2014-2024

Form Fund Raising Counsel Registration Statement CHAR014 Open to Public Inspection New York State Department of Law Office of the Attorney General Charities Bureau The Capitol Albany NY 12224 http //www. Changes to Registration to the information provided on Form CHAR014. Mailing Instructions All registration documents and payment should be mailed to the following address VIII. Additional Charities Bureau Contact Information Telephone 518 486-9797 E-mail Charities. Fundraising ag. ny. gov -i- IX. Any person who for compensation consults with a charitable organization or who plans manages advises or assists with respect to the solicitation in this state of contributions for or on behalf of a charitable organization but who does not have access to contributions or other receipts from a solicitation or authority to pay expenses associated with a solicitation and who does not solicit. CharitiesNYS*com Article 7-A of the Executive Law excluding pg. 5 Part A - Identification of Fund Raising Counsel FRC 1. Full Legal Name of Fund Raising Counsel per the Registrant s organizing documents 2. NYS Fund Raising Counsel ID if any - - 3. Mailing Address Number and Street Room/Suite City or Town State or Country and ZIP 4 4. Primary Contact 6. Main Address or Principal NYS Address Number and Street if any or different from item 3 7. Telephone Number 8. Fax Number 9. Email Address 10. Name of Third Party Representative relating to this registration and other statutory filings 11. Primary Contact for Third Party include title Third Party Mailing Address Number and Street 12. Third Party Telephone 13. Third Party Fax 14. Third Party Email Address 15. List all other legally authorized names by which the Registrant is known Submit a copy of all authorizing documents not previously filed* Part B - Certification - Registrant s Signature Required I an authorized representative of the Registrant certify under the penalties for perjury that I have reviewed this Registration Statement including all schedules and attachments and to the best of my knowledge and belief they are true correct and complete in accordance with the laws of the State of New York applicable to this statement. FRC Registrant Signature Printed Name Title Date Part C - Fee and Mailing Statutory Fee Due Submit a check or money order made payable to NYS Department of Law. Mail completed form with the required attachments and fee to the address at the top of this page. Part D - Activities 1. Does the Registrant or any representative of the Registrant solicit as that term is defined in 171-A of the Executive Law. G Yes G No DATE RECEIVED FOR OFFICE USE ONLY FEE RECEIVED REGISTRATION FILING ID FRC ID REVIEWER ACCEPT DATE START DATE END DATE Page 1 of 5 Form CHAR014 2010 Part E - Organization Structure 1. Incorporation/formation Submit a copy of all organizing documents and amendments not previously filed* a* Type of Registrant b. Date incorporated if a corporation or formed if other than a corporation Corporation. G Limited liability company LLC.

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