Professional Fund Raiser Annual Report Form - Kansas Secretary Of State Page 2
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26. Methods of fundraising used:
Personal contact
Mail
Telephone
Radio
TV
Volunteers
Internet
Vendors
Other __________________
specify
7. List names and addresses of professional solicitors (and their ID numbers) retained or employed during the past 12 months, and
indicate for which charitable organization(s) they solicited:
Name
Address
City
State
Zip
ID #
Charitable org.
(Add additional page if necessary.)
8. Date of this report: _________
________
________
Month
Day
Year
9. Authorized signature(s) (proprietor, or all partners, or corporate officer and title):
______________________________________________________________
______________________________________________________________
______________________________________________________________
10. I declare under penalty of perjury under the laws of the state of Kansas that the foregoing is true and correct.
Executed on this ________ day of ____________________________ , _______ .
Day
Month
Year
Name (printed or typed)
Authorized signature
Title/position
Instruction
This form is to be completed and submitted at expiration of registration or at time of re-registration.
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K.S.A. 17-1764
Rev. 4/18/05 jls
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