Kansas > Secretary Of State > Business Entities > Charitable Organization
Professional Solicitor Application PS - Kansas
| Professional Solicitor Application 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 Professional Solicitor Application All information must be completed or this document will not be accepted for filing. KANSAS SECRETARY OF STATE PS 90-06 1. Name of professional solicitor: 2. Address: Street address City State Zip Do not write in this space 3. Name of professional fund raiser: 4. Address: City Street address State Zip 5. Date of Application: Month Day Year 6. I agree to abide by the disclosure requirements of Kansas law, specifically, K.S.A. 17-1766, as set forth below. All solicitations by professional solicitors shall contain the following disclosures at the point of solicitation: (a) The name, address and telephone number of the charitable organization; (b) the registration number, obtained pursuant to K.S.A. 17-1763 for the charitable organization; (c) if the solicitation is made by a person acting as a professional solicitor, the registration number obtained pursuant to K.S.A. 17-1765; and (d) that an annual financial report required by K.S.A. 17-1763 for the preceding fiscal year is on file with the secretary of state. I declare under penalty of perjury under the laws of the state of Kansas that the foregoing is true and correct. Executed on the ________ of ___________ , _____________ . Day Month Year Signature of applicant Signature of professional fund raiser Instructions 1. Please be sure to enclose the $25 filing fee made payable to the secretary of state with the form. Please do not send cash. 2. This registration/re-registration shall be for a period of one year, or a part thereof, expiring on the 30th day of June and may be renewed upon written application for additional one-year periods. Notice: There is a $25 service fee for all returned checks. Rev. 8/11/03 jdr Rev. 12/27/10jb K.S.A. 17-1765 American LegalNet, Inc. www.FormsWorkFlow.com
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