Incorporation Information:

  1. Provide the legal name of the organization exactly as it appears in its articles of incorporation or organizational document including all prefixes: __________________________________

               If changed since prior filings, previous name (if applicable): ____________________________

               All other names soliciting as (if applicable): ___

                       Tax ID ____________________

Organization Information:

  • Please provide the street/principal place of business for the organization.  VERY IMPORTANT NOTE:  The street/principal place of business address MUST match the principal place of business address that was listed on the Articles of Incorporation filed with the Division of Corporations.  If the address listed below does not match what is on file with the Division of Corporations, the filing will be rejected.  If the address listed on the Articles of Incorporation is not current, you MUST change the address with the Division of Corporations first.  The new/updated address cannot be listed here until that change has been made with the Division of Corporations. 

Street/Principal Place of Business:  ______________________________________________

Mailing address if different than above:  _________________________________

  • Telephone: _________________ Fax #: ________                            Website: __________________     Organization Email: ___________________      

Contact person to be listed on the filing for questions:  ___________________

Please note:  The contact person isn’t necessarily the person who will sign the initial registration documents, unless the contact person is also the treasurer.  Florida requests a contact person is listed for questions regarding the filing. 

Note:  It is important that you provide the address for electronic mail (email) and website if used to provide information to or communicate with the public.

  • Provide the name, address, and telephone number and emails of your board members and of any other offices, in this State for which you are filing


Vice President:

Treasurer & Secretary


Note:  If your organization is not located in Florida AND you do not maintain an office in this State, provide the name, address, email, and telephone number of the person with custody of the financial records.

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  • Describe the purpose for which the contributions will be used and programs of the organization:

Purpose of the organization:




What is the purpose of which the contributions will be used?

______________________is a nonprofit organization incorporated in the State of Florida. The corporation will be engaged in the following activities:

General Activities:


Activity Narrative:

  1. Charity Support for Improved Outcome:______________________________________________________________________________________________________________________________________________________________________________________
  2. Who conducts the Activities: ______________________________________________________________________________________________________________________________________________________________________________________
  3. When the activity is conducted: ______________________________________________________________________________________________________________________________________________________________________________________
  4. Where the activity is conducted:


  • The activity furthers the following exempt purpose: Charitable. ______________________________________________________________________________________________________________________________________________________________________________________
  • The percentage allocated to the activity is: 100%
  • Additional information:


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