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Charitable Solicitation Financial Statement FS - Kansas
| Charitable Solicitation Financial Statement Form. This is a Kansas form and can be used in Charitable Organization Business Entities Secretary Of State . |
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Contact Information Kansas Secretary of State Memorial Hall, 1st Floor 120 S.W. 10th Avenue Topeka, KS 66612-1594 (785) 296-4564 kssos@sos.ks.gov www.sos.ks.gov Charitable Solicitation Financial Statement All information must be completed or this document will not be accepted for filing. KANSAS SECRETARY OF STATE FS 53-10 Period covering ______________________ to ______________________ . Gross receipts: (Attach a listing of total receipts and income for each separate solicitation project/source) Solicitations expenses: Net profit: Administrative expenses: Operating income: Educational/informational program expenses: ( Other expenses: Net income: Charitable distributions in Kansas: ( ) ) ( ) ) ( ) ( ) Do not write in this space Charitable distributions outside of Kansas: ( (Attach a listing of non-Kansas recipients of distributions and such recipients' purposes) Other distributions: Balance this period: Beginning balance: Ending balance: ( ) I declare under penalty of perjury under the laws of the state of Kansas that the foregoing is true and correct. Executed by me on ____________ ________ , _________ . Month Day Year Authorized officer Chief fiscal officer Rev. 12/28/10 jdr K.S.A. 17-1763 American LegalNet, Inc. www.FormsWorkFlow.com
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