For Oregon Corporations
and Certain Trusts
Charitable Activities Section
Oregon Department of Justice
1515 SW 5th Avenue, Suite 410 VOICE (971) 673-1880
Portland, OR 97201-5451
E-Mail: email@example.com FAX
Web site: http://www.doj.state.or.us
For Accounting Periods Beginning in:
Cross Through Incorrect Items and Correct Here:
(See instructions for change of name or accounting period.)
City, State, Zip:
Did a certified public accountant audit your financial records? - If yes, attach a copy of the auditor’s report, financial statements,
accompanying notes and any schedules presented as supplementary information to the basic financial statements.
Is the organization a party to a contract involving person-to-person, advertising, vending machine or telephone fund-raising in
If yes, write the name of the fund-raising firm(s) who conducts the campaign(s):_____________________________________
Has the organization or any officer, director, or executive personnel of the organization ever been involved in a voluntary
agreement with any district attorney or attorney general or a legal action in any court regarding the organization’s solicitation,
administration, or management practices? If yes, attach copies of the agreement and a written explanation.
During this reporting period, did the organization amend its articles of incorporation, bylaws, or trust documents, OR did the
organization receive a determination letter from the Internal Revenue Service indicating a new or amended tax-exempt status?
If yes, attach a copy of the amended document or letter.
Is the organization ceasing operations and is this the final report?