Exempt Organization Fund-Raising Notice
Print this form, complete it and mail to:
Charitable Organizations Division, Office of the Secretary of State, State House, Annapolis,
Maryland 21401
For assistance, call: (410) 974-5534 or e-mail your question to us.
The Exempt Organization Fund-Raising Notice is required for charitable organizations that
raise less than $25,000 in charitable contributions or solicit contributions for a named
individual and the gross amount is delivered to the individual.
1. Name of Charitable Organization or Name of Individual for whom the fund-raising
campaign is being conducted.
2. Employer I.D. Number of Charitable Organization or Social Security Number of
Individual
3. Street Address
4. City, State & Zip
5. County
6. Telephone Number FAX Number
7. E-mail address (if applicable)
8. Purpose of Charitable Organization or Charitable Fund-raising
9. Have you received 501(c)(3) status from IRS? Check one
Yes
No
Pending
If yes, please submit a copy of your organization's tax determination letter issued by
the Internal Revenue Service.
10. Methods of Fund-raising (check all that apply).
Mail
Telephone
Canisters
Door-to-Door
Other (describe below)
11. Fund-raising Start Date
12. Name and address of individual with custody of financial records
13. Names and addresses of persons with final responsibility for custody and final
distribution of contributions
14. Bank name, address, and account number, where contributions are deposited
15. Check One:
This organization is exempt from registering as a charitable organization
because it solicits contributions for a named individual and the gross amount
is delivered to the individual. Business Regulation Section 6-102(c)(1)(ii)(1),
or
This organization is exempt from registering as a charitable organization
because it has not to date received more than $25,000 in charitable
contribu