TITLE 14: COMMERCE
SUBTITLE B: CONSUMER PROTECTION
CHAPTER II: ATTORNEY GENERAL
PART 400 SOLICITATION FOR CHARITY ACT
SECTION 400.APPENDIX A CHARITABLE ORGANIZATION FORMS


Section 400.APPENDIX A   Charitable Organization Forms

 

Section 400.ILLUSTRATION D   Annual Report and Instructions

 

For Office Use Only

PMT#

 

 

ILLINOIS CHARITABLE ORGANIZATION ANNUAL REPORT

Form AG990-IL

 

 

 

Attorney General LISA MADIGAN State of Illinois

 

AMT

 

 

Charitable Trust Bureau, 100 West Randolph

 

 

 

 

3rd Floor, Chicago, Illinois  60601

CO

#

INIT

 

 

 

 

 

Check all items attached:

 

 

 

 

Report for the Fiscal Period:

Make checks

Copy of IRS Return

 

 

Beginning

        /         /

 

Payable to

Audited Financial Statements

 

 

& Ending

       /         /

 

the Illinois

Copy of Form IFC

 

 

 

MO

DAY

YR

Charity

$15 Annual Report Filing Fee

 

 

 

Bureau Fund

$100 Late Report Filing Fee

Federal ID

#

 

 

MO   Day  Year

Are contributions to the organization tax deductible?

Yes

No

Date Organization was created:

  /     /     

LEGAL

 

 

Year-end

 

NAME

 

 

amounts

 

MAIL

 

 

A)

ASSETS

A)

$

ADDRESS

 

 

B)

LIABILITIES

B)

$

CITY, STATE

 

 

C)

NET ASSETS

C)

$

ZIP CODE

 

 

 

 

I.

SUMMARY OF ALL REVENUE ITEMS DURING THE YEAR:

PERCENTAGE

AMOUNT

 

D)

PUBLIC SUPPORT, CONTRIBUTIONS & PROGRAM SERVICE REV. (GROSS AMTS.)

%

 

D)

$

 

E)

GOVERNMENT GRANTS & MEMBERSHIP DUES

%

 

E)

$

 

F)

OTHER REVENUES

%

 

F)

$

 

G)

TOTAL REVENUE, INCOME AND CONTRIBUTIONS RECEIVED (ADD D, E, & F)

100%

 

G)

$

II.

SUMMARY OF ALL EXPENDITURES DURING THE YEAR:

 

 

 

H)

OPERATING CHARITABLE PROGRAM EXPENSE

%

 

H)

$

 

I)

EDUCATION PROGRAM SERVICE EXPENSE

%

 

I)

$

 

J)

TOTAL CHARITABLE PROGRAM SERVICE EXPENSE (ADD H & I)

%

 

J)

$

 

J1)

JOINT COSTS ALLOCATED TO PROGRAM SERVICES (INCLUDED IN J):

$

 

 

 

 

K)

GRANTS TO OTHER CHARITABLE ORGANIZATIONS

%

 

K)

$

 

L)

TOTAL CHARITABLE PROGRAM SERVICE EXPENDITURE (ADD J & K)

%

 

L)

$

 

M)

MANAGEMENT AND GENERAL EXPENSE

%

 

M)

$

 

N)

FUNDRAISING EXPENSE

%

 

N)

$

 

O)

TOTAL EXPENDITURES THIS PERIOD (ADD L, M, & N)

100%

 

O)

$

III.

SUMMARY OF ALL PAID FUNDRAISER AND CONSULTANT ACTIVITIES:

 

 

 

(Attach Attorney General Report of Individual Fundraising Campaign Form IFC. One for each PFR.)

 

 

 

PROFESSIONAL FUNDRAISERS:

 

 

 

P)

TOTAL AMOUNT RAISED BY PAID PROFESSIONAL FUNDRAISERS

100%

 

P)

$

 

Q)

TOTAL FUNDRAISERS FEES AND EXPENSES

%

 

Q)

$

 

R)

NET RECEIVED BY THE CHARITY (P MINUS Q=R)

%

 

R)

$

 

PROFESSIONAL FUNDRAISING CONSULTANTS:

 

 

 

 

S)

TOTAL AMOUNT PAID TO PROFESSIONAL FUNDRAISING CONSULTANTS

S)

$

IV.

COMPENSATION TO THE 3 HIGHEST PAID PERSONS DURING THE YEAR:

 

 

T)

NAME, TITLE

 

 

T)

$

 

U)

NAME, TITLE

 

 

U)

$

 

V)

NAME, TITLE

 

 

V)

$

V.

CHARITABLE PROGRAM DESCRIPTION: CHARITABLE PROGRAM (3 HIGHEST BY $ EXPENDED) CODE CATEGORIES

List on back side of instructions CODE

 

W)

DESCRIPTION

 

 

W)

#

 

X)

DESCRIPTION

 

 

X)

#

 

Y)

DESCRIPTION

 

 

Y)

#

 

 

 

 

 

 

 

 

IF THE ANSWER TO ANY OF THE FOLLOWING IS YES, ATTACH A DETAILED EXPLANATION:

YES

NO

1.

WAS THE ORGANIZATION THE SUBJECT OF ANY COURT ACTION, FINE, PENALTY OR JUDGMENT?....................................

1.

 

 

 

 

 

 

 

2.

HAS THE ORGANIZATION OR A CURRENT DIRECTOR, TRUSTEE, OFFICER OR EMPLOYEE THEREOF EVER BEEN CONVICTED BY ANY COURT OF ANY MISDEMEANOR INVOLVING THE MISUSE OR MISAPPROPRIATION OF FUNDS OR ANY FELONY?................................................................................................................................................................................................................

2.

 

 

 

 

 

 

 

 

 

3.

DID THE ORGANIZATION MAKE A GRANT AWARD OR CONTRIBUTION TO ANY ORGANIZATION IN WHICH ANY OF ITS OFFICERS, DIRECTORS OR TRUSTEES OWNS AN INTEREST;  OR WAS IT A PARTY TO ANY TRANSACTION IN WHICH ANY OF ITS OFFICERS, DIRECTORS OR TRUSTEES HAS A MATERIAL FINANCIAL INTEREST; OR DID ANY OFFICER, DIRECTOR OR TRUSTEE RECEIVE ANYTHING OF VALUE NOT REPORTED AS COMPENSATION?......................

3.

 

 

 

 

 

 

 

 

4.

HAS THE ORGANIZATION INVESTED IN ANY CORPORATE STOCK IN WHICH ANY OFFICER, DIRECTOR OR TRUSTEE OWNS MORE THAN 10% OF THE OUTSTANDING SHARES?............................................................................................................................

4.

 

 

 

 

 

 

 

 

 

5.

IS ANY PROPERTY OF THE ORGANIZATION HELD IN THE NAME OF OR COMMINGLED WITH THE PROPERTY OF ANY OTHER PERSON OR ORGANIZATION?............................................................................................................................................................

5.

 

 

 

 

 

 

 

 

 

6.

DID THE ORGANIZATION USE THE SERVICES OF A PROFESSIONAL FUNDRAISER? (ATTACH FORM IFC)..........................

6.

 

 

 

 

 

 

 

7a.

DID THE ORGANIZATION ALLOCATE THE COST OF ANY SOLICITATION MAILING, ADVERTISEMENT OR LITERATURE COSTS BETWEEN PROGRAM SERVICE AND FUNDRAISING EXPENSES?..................................................................

7.

 

 

 

 

 

 

 

 

 

7b.

IF "YES", ENTER (i) THE AGGREGATE AMOUNT OF THESE JOINT COSTS $                             ; (ii) THE AMOUNT ALLOCATED TO PROGRAM SERVICES $                              ; (iii) THE AMOUNT ALLOCATED TO MANAGEMENT AND GENERAL $                               ; AND (iv) THE AMOUNT ALLOCATED TO FUNDRAISING $                                      .

 

 

 

 

 

 

 

 

8.

DID THE ORGANIZATION EXPEND ITS RESTRICTED FUNDS FOR PURPOSES OTHER THAN RESTRICTED PURPOSES?.........................................................................................................................................................................................................................................................

8.

 

 

 

 

 

 

 

 

 

9.

HAS THE ORGANIZATION EVER BEEN REFUSED REGISTRATION OR HAD ITS REGISTRATION OR TAX EXEMPTION SUSPENDED OR REVOKED BY ANY GOVERNMENTAL AGENCY?...........................................................................................................

9.

 

 

 

 

 

 

 

 

 

10.

WAS THERE OR DO YOU HAVE ANY KNOWLEDGE OF ANY KICKBACK, BRIBE, OR ANY THEFT, DEFALCATION, MISAPPROPRIATION, COMMINGLING OR MISUSE OF ORGANIZATIONAL FUNDS?........................................................................

10.

 

 

 

 

 

 

 

 

 

11.

LIST THE NAME, ADDRESS AND THE ACCOUNT # OF THE FINANCIAL INSTITUTIONS WHERE THE ORGANIZATION MAINTAINS ITS THREE LARGEST ACCOUNTS:

 

 

 

 

 

12.

NAME AND TELEPHONE NUMBER OF CONTACT PERSON:

 

 

 

ALL ATTACHMENTS MUST ACCOMPANY THIS REPORT − SEE INSTRUCTIONS

UNDER PENALTY OF PERJURY, I (WE) THE UNDERSIGNED DECLARE AND CERTIFY THAT I (WE) HAVE EXAMINED THIS ANNUAL REPORT AND THE ATTACHED DOCUMENTS, INCLUDING ALL THE SCHEDULES AND STATEMENTS, AND THE FACTS THEREIN STATED ARE TRUE AND COMPLETE AND FILED WITH THE ILLINOIS ATTORNEY GENERAL FOR THE PURPOSE OF HAVING THE PEOPLE OF THE STATE OF ILLINOIS RELY THEREUPON. I HEREBY FURTHER AUTHORIZE AND AGREE TO SUBMIT MYSELF AND THE REGISTRANT HEREBY TO THE JURISDICTION OF THE STATE OF ILLINOIS.

BE SURE TO INCLUDE ALL FEES DUE:

 

1)

REPORTS ARE DUE WITHIN SIX MONTHS OF YOUR FISCAL YEAR END

PRESIDENT or TRUSTEE (PRINT NAME)

SIGNATURE

DATE

2)

FOR FEES DUE, SEE INSTRUCTIONS.

TREASURER or TRUSTEE (PRINT NAME)

SIGNATURE

DATE

3)

REPORTS THAT ARE LATE OR INCOMPLETE ARE SUBJECT TO A $100 PENALTY.

PREPARER (PRINT NAME)

SIGNATURE

DATE

 

Form AG990-IL INS

ILLINOIS CHARITABLE ORGANIZATION

– FORM AG990-IL FILING INSTRUCTIONS –

LISA MADIGAN

ATTORNEY GENERAL

 

A COMPLETE ANNUAL FINANCIAL REPORT (AG990-IL with all required attachments and applicable fees) is due within six months after the organization's fiscal year end.  A REPORT WILL NOT BE CONSIDERED FILED UNLESS IT IS COMPLETE. A COMPLETE ANNUAL FINANCIAL REPORT must include the following items:

 

1.         $15 Annual Filing Fee – Make check or money order payable to "ILLINOIS CHARITY BUREAU FUND."  An annual financial report submitted without proper fees will not be considered filed.  

 

▪    Soliciting Organizations are required to pay a $15 Annual Report Filing Fee if gross contributions are greater than $15,000 or assets are greater than $25,000.

 

▪    Trust Organizations registered under the Charitable Trust Act only are required to pay a $15 Annual Report Filing Fee if gross revenues or assets are greater than $25,000.

 

2.         Form AG990-IL – Complete all sections and line items applicable to the organization.  See 6 below for Simplified Filing Option for Small Organizations.  An annual financial report submitted with an incomplete Form AG990-IL will not be considered filed.

 

A.        CO#:  Include CO# on the Form AG990-IL.  Correct any incorrect name or address information if using preprinted form and highlight any corrections.

 

B.        SIGNATURES:  The Form AG990-IL must be signed by two different officers (president or other authorized officer and the chief fiscal officer) or by two trustees.  One signature shall be accepted if there is only one trustee.  A Form AG990-IL without required signatures is incomplete.

 

C.        Part I, Line D:  Report "contributions" as defined by the Solicitation for Charity Act.  The Solicitation for Charity Act defines "contributions" to include the gross amounts of cash donations as well as gross sums paid by the public for merchandise, special events, rights or services of the organization.  A Form AG990-IL that fails to report "contributions" as defined by the Solicitation for Charity Act is incomplete.  (A complete definition of "contribution" under the Solicitation for Charity Act is shown on the back of these instructions.)

 

D.        Part II, Line J1:  Report all program costs associated with a combined fundraising appeal to the extent such was allocated to Charitable Program Service Expense and entered on line J as Charitable Program Service Expense.  The amount should equal the amount reported on the back of the AG990-IL form, question 7b(ii).  You must have and maintain the documentation to support the allocations made.

 

E.        Part III, Line S:  List all fees paid to all fundraising consultants during the year.  Attach a list of these consultants listing the name and address of the consultant and the total of all fees paid to each.

 

F.        Part V, Lines W, X, Y Program Service Codes:  Select up to three codes from those on the back of these instructions that best describe the program services for which the organization spent funds.

 

3.         IRS Return or Report − IRS form 990 (excluding Schedule B), 990EZ (excluding Schedule B), 990PF, 1041, 1120 or other, must be attached if required by the IRS.  If the organization did not file a Federal return or report, attach explanation.  An annual financial report submitted without the required Federal return or report is incomplete.

 

4.         Audited Financial Statements must be attached by a public charity if contributions exceeded $150,000 or if the public charity raised contributions in excess of $25,000 through the services of a professional fundraiser.  The Solicitation for Charity Act defines contributions to include the gross amounts of cash donations as well as gross sums paid by the public for merchandise, special events, rights or services of the organization.  (A complete definition of "contribution" under the Solicitation for Charity Act is shown on the back of these instructions.)  An annual financial report without required audited financial statements is incomplete.

 

5.         Form IFC Report of Individual Fundraising Campaign – If the organization used a paid professional fundraiser, a separate Form IF