Professional Fundraiser Registration Online Form

Name of the professional fundraiser, including any d/b/a and trade names.:

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Address and telephone number of each office, chapter, branch, or affiliate. Indicate the principle place of business.:

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Form of business.:

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Identify the state in which registrant is organized or incorporated.:

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Date organized or incorporated.:

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List the full name, title, address and telephone number of each officer, director, partner or managing agent of the professional fundraiser:

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List the contact person(s) for the professional fundraiser.:

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List the person(s) responsible for the day-to-day operations of the professional fundraiser.:

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List the person(s) who directs and controls the activities of the professional fundraiser.:

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List the person(s) responsible for custody of the professional fundraiser's records.:

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List the person(s) responsible for custody of all funds raised by the professional fundraiser:

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List the person(s) responsible for the accounting of all funds raised by the professional fundraiser.:

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List all persons managing or supervising fundraising activities in or from Iowa.:

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Has the professional fundraiser or any of the person listed in response to the previous sections ever been a party to any litigation, criminal or civil?:

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Yes, the professional fundraiser or any of the persons listed in response to the previous sections has been a party to criminal or civil litigation.

No, the professional fundraiser nor any of the persons listed in response to the previous sections has been a party to criminal or civil litigation.

Name, address and telephone number of the Iowa registered agent for service of process in Iowa.:

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Is the professional fundraiser registered to solicit funds in other states?:

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Yes, the professional fundraiser is registered to solicit funds in other states.

No, the professional fundraiser is not registered to solicit funds in other states.

Has the professional fundraiser's right to solicit funds ever been denied, suspended, revoked or enjoined by any state or by any court, or are there any such proceedings pending?:

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Yes, the professional fundraiser’s right to solicit funds has been denied, suspended, revoked or enjoined.

No, the professional fundraiser’s right to solicit funds has not ever been denied, suspended, revoked or enjoined.

Has the professional fundraiser been the subject of legal, administrative, or other proceeding regarding any solicitation or registration as a solicitor or fundraiser? If so, state the date, location and nature of each such proceeding and the outcome:

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Does the professional fundraiser have custody of or access to contributions from a solicitation at any time?:

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Yes, the professional fundraiser has had or does have custody of or access to contributions from a solicitation.

No, the professional fundraiser has not had or does not currently have custody of or access to contributions from a solicitation.

Does the registrant anticipate that any of the services it will provide to charitable organizations will be provided by another entity under a subcontractor arrangement?:

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Yes, the registrant does anticipate the services it will provide to charitable organizations will be provided by another entity under a subcontractor arrangement.

No, the registrant does not anticipate the services it will provide to charitable organizations will be provided by another entity under a subcontractor arrangement.

Professional Fundraiser Registration Online Form

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