Form IFC
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REPORT OF INDIVIDUAL
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JIM RYAN
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FUNDRAISING CAMPAIGN
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ATTORNEY GENERAL
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CHARITY:
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Name
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Campaign Beginning
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and Ending
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Mailing Address
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CO# 01-
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City, State, Zip Code
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Phone #
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Contact Person
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Title
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Phone #
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PROFESSIONAL FUND RAISER
(PFR):
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Name
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PFR #02-
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NATURE OF FUNDRAISING
ACTIVTY:
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A.
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Amount received by the
charitable organization .......................................................... A.
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$
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PAID BY:
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B.
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Expenses:
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PFR
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Charity
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1.
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Professional Fundraiser Fee................. 1.
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2.
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Solicitor Compensation....................... 2.
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3.
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Salaries.............................................. 3.
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4.
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Printing.............................................. 4.
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5.
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Postage.............................................. 5.
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6.
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Telephone.......................................... 6.
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7.
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Rent & Utilities.................................. 7.
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8.
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Supplies............................................. 8.
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9.
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Travel................................................ 9.
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10.
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10.
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11.
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11.
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12.
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12.
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13.
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TOTAL
EXPENSES (PFR + Charity)............. 13.
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B.
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$
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C.
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Total Amount Raised.................................................................................................. C.
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$
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D.
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Percentage of funds received
by charity (Line A divided by Line C)................................ D.
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%
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E.
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Bank and account number
where funds are deposited?
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F.
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Who (charity or PFR) has
signature control of the account(s) listed above?
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F.
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Attach a schedule
explaining, in detail, how expenses are allocated between fundraising
campaigns.
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We,
the undersigned, declare and certify under perjury that we have examined this
report, 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.
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PFR CAMPGAIN
MANAGER (Print Name)
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TITLE
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SIGNATURE
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DATE
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OFFICER, DIRECTOR
OF CHARITY (Print Name)
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TITLE
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SIGNATURE
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DATE
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(Source: Added at 24 Ill. Reg.
14684, effective September 21, 2000)