S
C
S
S
OUTH
AROLINA
ECRETARY OF
TATE
P
C
D
UBLIC
HARITIES
IVISION
A
F
R
NNUAL
INANCIAL
EPORT
Filing Instructions
•
Organizations who file the IRS 990-N or are not required to file with the IRS should complete this form.
•
Please follow the instructions provided on pages 4 and 5 to complete this form. You may contact our office
with any questions at 803-734-1790 or email charities@sos.sc.gov.
•
We do not accept this filing by fax or email; you may upload this report using our online filing system
at
or mail this form to: South Carolina Secretary of State, Attn: Division of Public Charities,
1205 Pendleton St., Suite 525, Columbia, SC 29201.
For the fiscal year ending __________ (mm/dd/yy)
EIN: ___ - __________
Charity ID: ______________
Organization’s Name: _________________________________________________________________
______
Part I— Fundraising Events or Contracts
If your organization held any fundraising events, or used a commercial co-venturer (CCV) or professional
fundraising company (PFR) during the previous fiscal year, you must report all revenue and expenses in the
following table. Events include, but are not limited to, carnivals, dinners, galas, raffles, and bingo games. If you need
additional space, you may list additional events on a separate sheet and include the amounts in the total revenue and
expenses on this table.
(C)
(A)
(B)
(D)
(E)
(F)
Name of Event,
Gross Receipts
Cash &
Other
Total
Net
CCV or PFR
&
Noncash Prize
Expenses
Expenses
Revenue
Contributions
Expenses
1.
$ 0.00
$ 0.00
2.
$ 0.00
$ 0.00
3.
$ 0.00
$ 0.00
4.
$ 0.00
$ 0.00
5.
$ 0.00
$ 0.00
6.
$ 0.00
$ 0.00
7.
$ 0.00
$ 0.00
8.
$ 0.00
$ 0.00
9.
$ 0.00
$ 0.00
10.
$ 0.00
$ 0.00
11. Gross Revenue
12. Total Expenses
$ 0.00
$ 0.00
$ 0.00
(add 1B through 10B)
(add 1E through 10E)
Annual Financial Report, revised January 2017
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