Illinois Administrative Code (Last Updated: March 27, 2024) |
TITLE14. COMMERCE |
PART400. SOLICITATION FOR CHARITY ACT |
Section400.APPENDIX B. Professional Fund Raiser Forms |
§400.ILLUSTRATION D. Annual Financial Report
-
Form PFR-02
PROFESSIONAL FUND RAISER ANNUAL FINANCIAL REPORT
JIM RYAN
ATTORNEY GENERAL
THIS MUST BE FILED BY
FILE AT: Office of the Attorney General, Charitable Trust and Solicitations Bureau, 100 West Randolph Street, Chicago, Illinois 60601
GENERAL INSTRUCTIONS (FURTHER INSTRUCTIONS AT END OF FORM)
PLEASE TYPE OR PRINT IN BLACK INK
A.
RESPOND TO ALL ITEMS ON THIS FORM.
B.
CHANGES OF OR ADDITIONS TO THE INFORMATION IN THIS STATEMENT MUST BE SUBMITTED IN THIS FORMAT.
C.
ANNUAL REPORT (CHECK ONE):
PREPARED ON ACCRUAL BASIS
PREPARED ON A CASH BASIS
OR PREPARED BY ANOTHER METHOD
IF PREPARED BY ANOTHER METHOD EXPLAIN:
LEGAL NAME
REGISTERED FOR FISCAL YEAR
MAIL ADDRESS
ENDED JUNE 30,
AS
CITY
PFR# 02-
STATE, ZIP CODE
FEDERAL ID NUMBER
PHONE NUMBER
( )
REPORT IS FOR PERIOD BEGINNING JANUARY 1,
AND ENDING
CHARITIES FOR WHOM FUNDS WERE RAISED
(A)
AMOUNT TO
CHARITY
(B)
SOLICITATION
EXPENSES
(C))
TOTAL AMOUNT RAISED
(D)
% = A/C
TOTAL FOR ALL CHARITABLE FUNDRAISING BY PFR:
TOTAL NUMBER OF CHARITIES BEING REPORTED
Note: Verification must be by the Corporate President, a General Partner or the Sole Proprietor
STATE OF
}
SS
AFFIDAVIT
COUNTY OF
I,
, under penalty of perjury and being sworn on oath that I am (circle one) the
corporate president, a general partner or the sole proprietor of the registered professional fundraiser.
(Name of PFR)________________________________
, have read this annual report including all attachments and personally
know the contents thereof to be true, and such is stated herein 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 be jurisdiction of the State of Illinois.
Subscribed and sworn to
before me, this
(Signature)
day of
19
.
NOTARY PUBLIC
(Source: Added at 24 Ill. Reg. 14684, effective September 21, 2000)