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Charitable Organization Registration Statement BCO-10 - Pennsylvania

Charitable Organization Registration Statement Form. This is a Pennsylvania form and can be used in Bureau Of Charitable Organizations Department Of State .
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Mail to: Pennsylvania Department of State Bureau of Corporations and Charitable Organizations 207 North Office Building Harrisburg, PA 17120 Charitable Organization Registration Statement BCO-10 (rev. 8/2017) Fee: See instructions See www.dos.pa.gov/charities for more information Read all instructions prior to completing form. Certificate number: ________________________ (N/A if initial registration) Fiscal year ended: _______/________/_________ MM DD YYYY If this is a voluntary registration, check and complete the applicable box(es). For a registration to be voluntary, at least one of the following must apply: Organization is exempt from registration because ___________________________________________ Organization does not solicit contributions in Pennsylvania FEIN: ___ ___ - ___ ___ ___ ___ ___ ___ ___ 1. Legal name of organization: ________________________________________________________ Check if name change and give previous name ________________________________________ 2. All other names used to solicit contributions: ___________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ 3. 4. Contact person: ___________________________ Contact's e-mail: ________________________ Principal address of organization: _______________________________________ _______________________________________ _______________________________________ County: ________________________________ 800 number: ____________________________ Mailing address (if different than principal address): _______________________________________ _______________________________________ _______________________________________ Phone number: __________________________ Fax number: ____________________________ Email (if different than Contact's email): ______________________________________________ Website: ________________________________________________________________________ 5. Type of organization (e.g. non-profit corporation, unincorporated association, etc.): ________________________________________________________________________________ Where established: ________________________ Date established:* _______________________ *Initial registrants must submit copies of organizational documents such as charter, articles of incorporation, constitution or other organizational instrument and by-laws. American LegalNet, Inc. www.FormsWorkFlow.com Page 1 of 6 Form BCO-10 (rev. 8/2017) 6. Name and addresses of all offices, chapters, branches, auxiliaries, affiliates or other subordinate units located in Pennsylvania, which share in the contributions or other revenue raised in the Commonwealth: (Attach a separate sheet if necessary) ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ 7. Short form registration applicability ­ Specified types of charitable organizations described in §162.7(a) of the Act may file a short form registration, which permits the organization to register without filing a financial report. Check the section that describes the organization. If the organization does not meet any of the criteria below for short form registration, check "Not Applicable": §162.7(a)(1) ­ Persons or organizations which solicit contributions for the relief of a specific individual, when all of the contributions collected are turned over to the named beneficiary for his/her use without any deductions and provided that all contributions collected shall be held in trust §162.7(a)(2) ­ Organizations which only solicit within the membership of the organization by other members of the organization. The term "membership" shall not include those persons who are granted a membership solely upon making a contribution as the result of solicitation. "Member" means a person having membership in a nonprofit corporation, or other organization, in accordance with the provisions of its articles of incorporation, bylaws or other instruments creating its form and organization and having bona fide rights and privileges in the organization such as the right to vote, to elect officers and directors, to hold office or position as ordinarily conferred on members of such organizations. §162.7(a)(3) ­ Organizations which receive gross contributions of no more than $25,000 per fiscal year whose fundraising activities are carried on only by volunteers, members, officers or permanent employees and only permanent employees are compensated for those fundraising activities §162.7(a)(4) ­ Veterans organizations chartered under Federal law, organizations of volunteer firemen, ambulance associations, rescue squad associations and their auxiliaries or affiliates, which are not exempt from registration, did not receive gross contributions in excess of $100,000 and did not use a professional solicitor. Not Applicable Charitable organizations which check boxes §162.7(a)(1) ­ §162.7(a)(4) are not required to file a financial report with this registration. If "Not Applicable" is checked, the charitable organization must submit financial reports which are audited, reviewed, compiled or internally prepared. See Instructions. Items 8 and 9 are required to be completed by initial registrants only 8. Date organization first solicited contributions from Pennsylvania residents: ______/______/______ MM DD YYYY Other ________________________________________________________ 9. If organization solicited Pennsylvania residents and received gross* contributions totaling more than $25,000 in any given fiscal year, provide the date the organization first received contributions totaling more than $25,000. ______/______/______ MM DD YYYY Other _________________________________________________________ *Includes contributions received both within and outside Pennsylvania before any deductions or expenses. Page 2 of 6 Form BCO-10 (rev. 8/2017) American LegalNet, Inc. www.FormsWorkFlow.com 10. Has the organization been granted IRS tax-exempt status? Yes No A. If "Yes," under which IRS code section: ________________________________ and attach a copy of the IRS exemption letter if not previously submitted. B. Has the organization's tax-exempt status ever been denied, revoked or modifie
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