TITLE 14: COMMERCE
SUBTITLE B: CONSUMER PROTECTION
CHAPTER II: ATTORNEY GENERAL
PART 480 CHARITABLE TRUST ACT
SECTION 480.EXHIBIT A REGISTRATION STATEMENT AND INSTRUCTIONS



Section 480.EXHIBIT A   Registration Statement and Instructions

 

Form CO-1

CHARITABLE ORGANIZATION

JIM RYAN

 

REGISTRATION STATEMENT

ATTORNEY GENERAL

 

PLEASE TYPE OR PRINT IN INK.  This registration statement is required by the Illinois Charitable Trust Act and "An Act to Regulate Solicitation and Collection of Funds for Charitable Purposes."  Please answer all items which are applicable to your organization.  If you are unable to answer any question fully in the space provided, please attach a sheet containing the remainder of your answer. No further registration statement is required, provided that every registered organization shall notify the Attorney General within 10 days of any change in the information submitted herein.  One copy of this Registration Statement and attachments are to be filed with the Office of the Attorney General, Charitable Trust and Solicitations Bureau, 100 West Randolph Street, Chicago, Illinois 60601.

 

 

1

This is a registration under

  Illinois Charitable Trust Act

 

 

 

  An Act to Regulate Solicitation and Collection of Funds for Charitable Purposes

 

 

 

  Both Acts

 

2

Name of Organization

Telephone Number

Federal Employer ID #

 

 

 

 

 

Street and Number

City

County

State

Zip Code

 

 

 

 

3

Type of legal entity (Corporation, Trust, Unincorporated Association or other) and date, method and place organization legally

 

 

established

 

 

 

If a foreign corporation, when was it authorized to do business in Illinois?

 

 

 

If a corporation, Illinois Secretary of State's File No.

 

 

 

 

* A copy of the Articles of Incorporation or Certificate of Authority issued by the Secretary of State must be attached.

4

Name, address and telephone number of Illinois registered agent

 

 

 

5

Address of all offices in the State of Illinois

 

 

 

 

 

6

Date on which the annual accounting period of the organization ends

Month

 

Day

 

7

State the purposes of the organization and purposes for which contributions are to be used (Be specific)

 

 

 

 

 

 

 

 

8

If the name under which the organization intends to solicits funds differs from the name listed in No. 2 provide name(s) under

 

which contributions will be solicited, and the reason for the use of such other name(s)

 

 

 

9

If organization has previously been registered with the Attorney General under either Act, give name under which registered

 

(if different than that shown in No. 2), last registration number, and date registered

 

 

 

10

Has the organization been registered with any other governmental authority to solicit contributions?

  Yes

  No

 

Name of authority and date of authorization)

 

 

Is such registration current?

  Yes

  No

11

Has the organization or any of its officers, directors or trustees ever been enjoined or prohibited by any court or other

 

governmental agency from soliciting contributions, or is such action pending?

  Yes

  No

 

If "Yes", attach an explanation.


12

Do you intend to use the services of a professional fund raiser as defined by "An Act to Regulate Solicitation and Collection

 

 

of Funds for Charitable Purposes?"

  Yes

  No

 

If "Yes", answer a, b, and comply with c below.

 

 

a.  Name and address of professional fund raiser(s):

 

 

 

 

 

 

b.  Has the professional fund raiser registered and filed a bond with the Office of the Attorney General as

 

 

 

required?

  Yes

  No

 

 

c.  Attach copies of all contracts with professional fund raiser(s).

 

13

Have any of organization's officers, directors, executive personnel, or have any of the organization's employees who have

 

 

access to funds, ever been charged with or convicted of a misdemeanor involving the misapplication or misuse of money of

 

 

another, or any felony?

  Yes

  No

If "Yes", give the following information:

 

NAME AND ADDRESS OF COURT

NATURE OF OFFENSE

DATE OF CONVICTION (Mo./Yr.)

 

 

 

 

 

14

State the board, group or individual having final discretion as to the distribution and use of contributions received

 

 

 

 

15

Will you use any of the following methods of solicitation?

  Unordered Merchandise

  Distribution or Sale of Seals

 

 

  Telephone Appeals

  Coin Collection Containers

  Special Events

  Ad Books

  Direct Mail

 

 

  Other – If other, attach an explanation.

 

16

List name, mailing address and title of the chief executive or staff officer of the organization.

 

 

 

 

 

17

Attach a list of names, mailing addresses, and daytime phone numbers of all officers and directors, or trustees of the

 

 

organization.

 

 

 

18

Has the United States Internal Revenue Service determined that this organization is tax exempt?

  Yes

  No

 

 

If "Yes", attach a copy of the determination letter. Is application pending?

  Yes

  No

 

 

*All organizations with tax exempt status or an application pending must attach a copy of Federal Form 1023

 

 

"Application for Recognition of Exemption" or an exemption letter.

 

19

Has organization's tax exempt status ever been questioned, audited, denied or cancelled at any time by any governmental

 

 

agency?

  Yes

  No

If "Yes", attach the facts.

 

20

Organizations which have been in operation for over one (1) year must attach a copy of the Federal return, or AG990IL if no Federal return was filed for each year the organization was in existence, completed in detail.  Organizations which have been in operation less than one (1) year must attach a completed Financial Information Form CO-2, notarized. Please note charitable organization's are required to maintain accurate and detailed accounting records.

 

21

Approximate amount of contributions solicited or income received from persons in this State during the organization's last

 

 

annual accounting period     $

 

 

 

22

EVERY REGISTERING ORGANIZATION MUST ATTACH THE FOLLOWING APPLIABLE DOCUMENTS:

 

 

Corporation.....................................

The Article of Incorporation, or Certificate of Authority, Amendments and By-Laws

 

 

Unincorporated Association..........

Constitution and By-Laws

 

 

Testamentary Trust..........................

Will, Probate Number and Decree of Distribution

 

 

Inter Vivos Trust..............................

Instrument Creating Trust

 

 

NOTE:  The President and the Chief Financial Officer or authorized officer both are required to sign. This must be two different individuals. If entity is a trust, all trustees must sign.

 


 

 

UNDER PENALTY OF PERJURY, THE UNDERSIGNED DECLARE AND CERTIFY THAT THE INFORMATION CONTAINED IN THIS STATEMENT AND ALL ATTACHED SHEETS IS TRUE AND CORRECT TO THE BEST OF OUR KNOWLEDGE.

 

 

Signature

Title

Date

 

 

Signature

Title

Date

 

 

 

 

 

 

 

(Source:  Added at 24 Ill. Reg. 14665, effective September 21, 2000)