CHICAGO .Tune 8. 2011
To the President and Members of the City Council:
Your Committee on Finance having had under consideration one (1) order authorizing five (5) applications for City of Chicago Charitable Solicitation (Tag Day) permits.
A. American Legion Illiana Post
B. Jordyne Cares
C. "Our Youth" A Community Forum
D. Planned Parenthood Action Fund, Inc.
E. Planned Parenthood Federation of America, Inc.
having had the same under advisement, begs leave to report and recommend that your Honorable Body pass the ordinance(s)/order(s) transmitted herewith.
This recommendation was concurred in by_(C^iva voce vote.
of the members of the committee with_;_dissenting vote(s)).
Respectfully submitted
Ordered, that the Committee on Finance is hereby authorized and directed to issue charitable solicitation (tag day) permits to the following organizations:
A. American Legion Illiana Post May 26-29, 2011 Citywide
B. Jordyne Cares June 11,2011 Citywide
C. "Our Youth" A Community Forum
Saturdays from May 28, 2011 through August 13, 2011 Citywide
D. Planned Parenthood Action Fund, Inc. June 8, 2011 through June 30, 2011 Citywide
E. Planned Parenthood Federation of America, Inc. July 1, 2011 through August 31, 2011 Citywide
This order shall take effect and be in for^ffrom and after its passage.
\
Edward M. Burke Alderman, 14th Ward
PERMIT NO. 2011-23
COMMITTEE ON FINANCE CHARITABEL SOLICITATION TAG DAY REQUEST FORM AND ROUTE SHEET
PERMIT NUMBER: |
2011-23 |
GROUP NAME: |
American Legion Illiana Post |
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ADDRESS: 10506 South Ewing Avenue, Chicago, IL 60617 |
TELEPHONE NUMBE |
R: |
773-734-3856 |
CONTACT PERSON: |
John Clarke, Jr. |
DATE WRITTEN REQUEST WAS RECEIVED: May 25,2011 |
SOLICITATION DATE: |
May 26-29, 2011 |
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CITY COUNCIL DATE: |
June 8, 2011 |
COMPLETION OF FILE DATE: |
STATEMENT OF RECEIPTS AND DISTRIBUTION RECEIVED: |
DATE PERMIT LETTER WAS SENT TO ORGANIZATION: May 25, 2011 |
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VIOLATION (S) |
COMMITTEE LETTER SENT: |
COMPLY RECEIVED: |
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COMMENTS: |
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APPLICATION FOR CITY OF CHICAGO CHARITABLE SOLICITATION PERMIT
(Please neatly print or type. In necessary in answering any question, please attach
additional sheets.)
1. Name of organization: /\ Merits L^to^ XK'*-** ^0j^
Address: )oSou i- Icwjk^ , CUfccjo , IL U«tn
Telephone Number: T"l:> - 1 3^-38SI
2. Use the space below to list names, current positions, residence addresses and telephone numbers of the officers in the organization:
1 \r-L?_ S. E^-j Art. VJo*V^, JWAVlwy
3. List the date and approximate location(s) of solicitation:
Mvy ul, K in f _l*ov© 1«>M lot I Skk L»» IOU AvtL
1©L ,VoV, \VV , vol. I. l*H * Avt C
4. Approximately how many persons will be engaged in the solicitation?
- lo -
5. Explain the methods your organization will use to solicit funds:
6. Has your organization ever been allowed to solicit funds in prior years in the City of Chicago? If so, when?
^c~tx -rU. Mo**
7. Include the following with your application:
A. A copy of the registration statement filed with the Attorney General ofthe State of Illinois; or exemption issued by the Attorney General ofthe State of Illinois.
B. A copy of the tag, badge, emblem or other token (if any) which will be distributed as part of the solicitation, or which will be used by your organization in its solicitation.
8.
Please include any other relevant information which would assist the Committee on Finance in reviewing this application.
APPLICATIONS MUST BE RECEIVED BY THE COMMITTEE ON FINANCE NO LATE THAN 30 DAYS PRIOR TO THE COMMENCEMENT OF THE SOLICITATION.
I/WE, THE OFFICER(S) OF THE ABOVE NAMED ORGANIZATION, CERTIFY THAT THE INFORMATION FURNISHED IN THIS STATEMENT AND ALL ATTACHED SHEETS IS TRUE AND CORRECT TO THE BEST OF MY/OUR KNOWLEDGE. (NOTE: AT LEAST ONE OFFICER OF THE ORGANIZATION MUST SIGN AND VERIFY THIS APPLICATION.)
Signature
Title %.\J^L^h^ Date ~^7^M +>
Signature_
Title
Date
Signature_
Title
Date
l
HOLD HARMLESS AGREEMENT
2.
The undersigned officer on behalf of the subject organization agrees to defend, indemnify, save and hold harmless the City of Chicago for any loss, liability, damage or cost which the City may incur due to the presence of volunteers of the subject organization on City premises for the purpose of charitable solicitations.
The subject organization assumes full responsibility for risk of bodily injury, death or property damage due to the negligence of the subject organization or otherwise resulting from conduct or activity related to the participation in charitable solicitation on the public way.
The officer of the subject organization has read and voluntarily signs the hold harmless agreement and waiver of liability and indemnity agreement.
Name of organization
§5-IS - 2oU
Date
Form 990-EZ
Short Form
Return of Organization Exempt From Income Tax
Under section 501 (c), 527, or 4947(aJ(1) of ihe Internal Revenue Code (except black lung benefit trust or ^ private foundation)
r Sponsoring organizations of donor advised .'...-.is zr.a controlling organizations as defined in section 512(b)(13) must file Form 990. All other organizations with gross receipts less r.a.- $530,000 and fotal assets less than $1,250,000 at the end of the year may use this form.
► The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB Mo. 1545-1150
2009
Open to Public Inspection
A For the 2009 calendar year, or tax year beginning JUL 1, 2009
and ending JIJN 30, 2010
B Check if applicable: 1 ..." Jfe|? I-IH3.TB 1_lcter.ga I 1 Initial 1_1 return ( {Termin-L__Jated ( 1 Amended 1-'return 1 I Appljation 1_IpMrJmg |
F;ease use IRS label or print or type-See Specific Instructions. |
C Name of organization AMERICAN LEGION POST #220 |
0 Employer Identification number 36-6092880 |
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1CHICAGO .Tune 8. 2011 To the President and Members of the City Council: Your Committee on Finance having had under consideration one (1) order authorizing five (5) applications for City of Chicago Charitable Solicitation (Tag Day) permits. A. American Legion Illiana Post B. Jordyne Cares C. "Our Youth" A Community Forum D. Planned Parenthood Action Fund, Inc. E. Planned Parenthood Federation of America, Inc. having had the same under advisement, begs leave to report and recommend that your Honorable Body pass the ordinance(s)/order(s) transmitted herewith. This recommendation was concurred in by_(C^iva voce vote. of the members of the committee with_;_dissenting vote(s)). Respectfully submitted Ordered, that the Committee on Finance is hereby authorized and directed to issue charitable solicitation (tag day) permits to the following organizations: A. American Legion Illiana Post May 26-29, 2011 Citywide B. Jordyne Cares June 11,2011 Citywide C. "Our Youth" A Community Forum Saturdays from May 28, 2011 through August 13, 2011 Citywide D. Planned Parenthood Action Fund, Inc. June 8, 2011 through June 30, 2011 Citywide E. Planned Parenthood Federation of America, Inc. July 1, 2011 through August 31, 2011 Citywide This order shall take effect and be in for^ffrom and after its passage. \ Edward M. Burke Alderman, 14th Ward PERMIT NO. 2011-23 COMMITTEE ON FINANCE CHARITABEL SOLICITATION TAG DAY REQUEST FORM AND ROUTE SHEET PERMIT NUMBER:2011-23GROUP NAME:American Legion Illiana PostADDRESS: 10506 South Ewing Avenue, Chicago, IL 60617TELEPHONE NUMBER:773-734-3856CONTACT PERSON:John Clarke, Jr.DATE WRITTEN REQUEST WAS RECEIVED: May 25,2011SOLICITATION DATE:May 26-29, 2011CITY COUNCIL DATE:June 8, 2011COMPLETION OF FILE DATE:STATEMENT OF RECEIPTS AND DISTRIBUTION RECEIVED:DATE PERMIT LETTER WAS SENT TO ORGANIZATION: May 25, 2011VIOLATION (S)COMMITTEE LETTER SENT:COMPLY RECEIVED:COMMENTS: APPLICATION FOR CITY OF CHICAGO CHARITABLE SOLICITATION PERMIT (Please neatly print or type. In necessary in answering any question, please attach additional sheets.) 1. Name of organization: /\ Merits L^to^ XK'*-** ^0j^ Address: )oSou i- Icwjk^ , CUfccjo , IL U«tn Telephone Number: T"l:> - 1 3^-38SI 2. Use the space below to list names, current positions, residence addresses and telephone numbers of the officers in the organization: 1 \r-L?_ S. E^-j Art. VJo*V^, JWAVlwy 3. List the date and approximate location(s) of solicitation: Mvy ul, K in f _l*ov© 1«>M lot I Skk L»» IOU AvtL 1©L ,VoV, \VV , vol. I. l*H * Avt C 4. Approximately how many persons will be engaged in the solicitation? - lo - 5. Explain the methods your organization will use to solicit funds: 6. Has your organization ever been allowed to solicit funds in prior years in the City of Chicago? If so, when? ^c~tx -rU. Mo** 7. Include the following with your application: A. A copy of the registration statement filed with the Attorney General ofthe State of Illinois; or exemption issued by the Attorney General ofthe State of Illinois. B. A copy of the tag, badge, emblem or other token (if any) which will be distributed as part of the solicitation, or which will be used by your organization in its solicitation. 8. Please include any other relevant information which would assist the Committee on Finance in reviewing this application. APPLICATIONS MUST BE RECEIVED BY THE COMMITTEE ON FINANCE NO LATE THAN 30 DAYS PRIOR TO THE COMMENCEMENT OF THE SOLICITATION. I/WE, THE OFFICER(S) OF THE ABOVE NAMED ORGANIZATION, CERTIFY THAT THE INFORMATION FURNISHED IN THIS STATEMENT AND ALL ATTACHED SHEETS IS TRUE AND CORRECT TO THE BEST OF MY/OUR KNOWLEDGE. (NOTE: AT LEAST ONE OFFICER OF THE ORGANIZATION MUST SIGN AND VERIFY THIS APPLICATION.) Signature Title %.\J^L^h^ Date ~^7^M +> Signature_ Title Date Signature_ Title Date l HOLD HARMLESS AGREEMENT 2. The undersigned officer on behalf of the subject organization agrees to defend, indemnify, save and hold harmless the City of Chicago for any loss, liability, damage or cost which the City may incur due to the presence of volunteers of the subject organization on City premises for the purpose of charitable solicitations. The subject organization assumes full responsibility for risk of bodily injury, death or property damage due to the negligence of the subject organization or otherwise resulting from conduct or activity related to the participation in charitable solicitation on the public way. The officer of the subject organization has read and voluntarily signs the hold harmless agreement and waiver of liability and indemnity agreement. Name of organization §5-IS - 2oU Date Form 990-EZ Short Form Return of Organization Exempt From Income Tax Under section 501 (c), 527, or 4947(aJ(1) of ihe Internal Revenue Code (except black lung benefit trust or ^ private foundation) r Sponsoring organizations of donor advised .'...-.is zr.a controlling organizations as defined in section 512(b)(13) must file Form 990. All other organizations with gross receipts less r.a.- $530,000 and fotal assets less than $1,250,000 at the end of the year may use this form. ► The organization may have to use a copy of this return to satisfy state reporting requirements. OMB Mo. 1545-1150 2009 Open to Public Inspection A For the 2009 calendar year, or tax year beginning JUL 1, 2009 and ending JIJN 30, 2010 B Check if applicable: 1 ..." Jfe|? I-IH3.TB 1_lcter.ga I 1 Initial 1_1 return ( {Termin-L__Jated ( 1 Amended 1-'return 1 I Appljation 1_IpMrJmgF;ease use IRS label or print or type-See Specific Instructions.C Name of organization AMERICAN LEGION POST #2200 Employer Identification number 36-6092880 Number and street (or P.O. box, if mail is not delivered to street address) Room/suite 10506 S. EWING AVE.E Telephone number 773-734-3856 City or town, state or country, and ZIP + 4 CHICAGO, IL 60617F Group Exemption Number ► Section 501 (c)(3) organizations and 4947(a)(1) nonexempi chariisiileUasis must attach a completed Schedule A (Form 990 or SSS-EZJ. |
G Accounting method: □□ Cash |_| Accrual Other (specify) ► |
I Website: J Tax-exemp |
► N/A |
H Check ► QD if the organization is not required to attach Schedule B (Form990,990-EZ,or99o-PF). |
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I if the organization is not a section 509(a)(3) supporting organization and its gross receipts are normally not more than $25,000. A Form 990-EZ or Form 990 return is not required, but if the orgaoizaBon chooses to file a return, be sure to file a complete return.
L Add lines 5b. 6b. and 7b, to line 9 to determine gross receipts: if $500.000 or more, file Form 990 instead of Form 990-EZ
a 3 c
§ a
Part i j Revenue, Expenses, and Changes in Net Assets or Fund Balances (See the instructions for Part I.)
IB
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§
o.
X Ul
4)
in in <
Z
1 2 3 4
5a b c
6
a
b c
7a b c
8 9
5a
5b
Contributions, gifts, grants, and similar amounts received ............................
Prog ram service revenue including government fees and contracts ................
Membership dues and assessments..........................................................
Investment income..............................................................................
Gross amount from sale of assets other than inventory..................................
Less: cost or other basis and sales expenses..............................................
Gain or (loss) from sale of assets other than inventory (Subtract line 5b from line 5a) .............................................
Special events and activities (complete applicable parts of Schedule G). If any amount is from gaming, check here
Gross revenue (not including $_of contributions
reported on line 1).................................-..................................................... 6a
Less: direct expenses other than fundraising expenses.......................................
Net income or (loss) from special events and activities (Subtract line 6b from line 6a)
Gross sales of inventory, less returns and allowances.......................................
Less: cost of goods sold............................................................................
Gross profit or (loss) from sales of inventory (Subtract line 7b from line 7a) ..............................................
Other revenue (described__ SEE STATEMENT
Total revenue. Add lines 1,2,3,4,5c, 6c, 7c, and 8 ............................................■...............................
6b
7a
7ta
10 11 12 13 14 15 16 17
Grants and similar amounts paid (attach schedule) .................
Benefits paid to or for members.........................................
Salaries, other compensation, and employee benefits ...............
Professional fees and other payments to independent contractors
Occupancy, rent, utilities, and maintenance............................
Printing, publications, postage, and shipping ...........!...............
Other expenses (describe ►__
SEE STATEMENT
Total expenses. Add lines 10 through 16
18 Excess or (deficit) for the year (Subtract line 17 from line 9) ...................
19 Net assets or fund balances at beginning of year (from line 27, column (A)) (must agree with end-of-yearfigure reported on prior year's return) ........
20 Other changes in net assets or fund balances (attach explanation).............
21 Net assets or fund balances at end of year. Combine lines 18 through 20
Part II i Balance Sheets. If Total assets on line 25, column (B) are $1,250,000 or more, file Form 990 instead of Form 990-EZ.
22 23 24 25 26 27
(See the instructions for Part II.; Cash, savings, and investments Land and buildings
Other assets (describe ►_
Total assets .......
932171 02-08-10
Total liabilities (describe __
Wet assets or fund balances (line 27 of column ffl must agree with line 21)
LHA
Form 990-EZ C2Z
fat Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
1
'590405 747703 FADAMER1484 2009.05070 AMERICAN LEGION POST #220 FASAv~
jQ-EZ(2009) AMERICAN LEGION POST #220
36-6092880 Page2
mm Statement of Program Service Accomplishments (See the instructions for Part m.)
f jf is the organization's primary exempt purpose?AMERICAN LEGION POST_
.escribe what was achieved in carrying out the organization's exempt purposes, in a dear and concise manner, describe die services provided, the number of persons benefited, and other relevant information for each program title._
Expenses
(Required for section 601(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts; optional for others.)
28 AMERICAN LEGION POST
(Grants $
) If this amount includes foreign grants, check here
28a
29
(Grants $
) If this amount includes foreign grants, check here
► □
29a
30
(Grants $
) If this amount includes foreign grants, check here
30a
31 Other program services (attach schedule)....................................................................
(Grants $_) If this amount includes foreign grants, check here
► □
31 a
32 Total program service expenses (add lines 28a through 31 a) ............................................................................► I 32
Part IV List of Officers, Directors, Trustees, and Key Employees. List each one even if not compensated. (See the instructions far Part IV.)
(a) Name and address |
(b) Title and average hours per week devoted to position |
(c) Compensation (If not paid, enter -0-.) |
(d) Contributions to employee benefit plans & deferred compensation |
(a) Expense account and other allowances |
LARRY PARKER, 10506 S. EWING AVE., |
COMMANDER 3.00 |
0. |
0. |
0. |
CHICAGO, IL 60617 |
FRANCIS DEMARCO, 10506 S. EWING |
SR. VICE COMM 3.00 |
ANDER > o. |
0. |
0. |
AVE., CHICAGO, IL 60617 |
JOHN CLARKE, 10506 S. EWING AVE., |
JR. VICE COMM 5.00 |
ANDER 0. |
0. |
0. |
CHICAGO, IL 60617 |
KENNETH PETERS, 10506 S. EWING AVE., |
SERVICE OFFIC 3.00 |
ER 0. |
0. |
0. |
CHICAGO, IL 60617 |
JOSEPH SCHUETTER, 10506 S. EWING |
HISTORIAN 5.00 |
0. |
0. |
0. |
AVE., CHICAGO, IL 60617 |
JOHN VELGOS, SR., 10506 S. EWING |
FINANCE OFFIC 3.00 |
ER 0. |
0. |
0. |
AVE., CHICAGO, IL 60617 |
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Ss-lo Form 990-EZ (2009)
2
590405 747703 FADAMER1484 2009.05070 AMERICAN LEGION POST #220 FADAMER1
PERMIT NO. 2011-24
COMMITTEE ON FINANCE CHARITABEL SOLICITATION TAG DAY REQUEST FORM AND ROUTE SHEET
PERMIT NUMBER: |
2011-24 |
GROUP NAME: |
Jordyne Cares |
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ADDRESS: 1642 E. 56th, Chicago, IL 60637 |
TELEPHONE NUMBE |
R: |
773-675-1053 |
CONTACT PERSON: |
Marc Pullins |
DATE WRITTEN REQUEST WAS RECEIVED: May 25,2011 |
SOLICITATION DATE: |
June 11,2011 |
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CITY COUNCIL DATE: |
June 8, 2011 |
COMPLETION OF FILE DATE: |
STATEMENT OF RECEIPTS AND DISTRIBUTION RECEIVED: |
DATE PERMIT LETTER WAS SENT TO ORGANIZATION: June 9,2011 |
_ |
VIOLATION (S) |
COMMITTEE LETTER SENT: |
COMPLY RECEIVED: |
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COMMENTS: |
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APPLICATION FOR CITY OF CHICAGO CHARITABLE SOLICITATION PERMIT
(Please neatly print or type. In necessary in answering any question, please attach
additional sheets.)
1. Name of organization: ^To^j^Y (2.(Z/£eS
Address: /<£ </& «S^^ S//J^f
Telephone Number: ^ 7 C5 - b"7/0-5^J3
2. Use the space below to list names, current positions, residence addresses and telephone numbers of the officers in the organization:
/H«*c rs-**~- H3'i«t'i^*
VU,* f^^"?^ ^-tM-**"* -
3. List the date and approximate location(s) of solicitation:
4. Approximately how many persons will be engaged in the solicitation?
so- 7.-r
5. Explain the methods your organization will use to solicit funds:
6. Has your organization ever been allowed to solicit funds in prior years in the City of Chicago? If so, when?
7. Include the following with your application:
A. A copy of the registration statement filed with the Attorney General ofthe State of Illinois; or exemption issued by the Attorney General ofthe State of Illinois.
B. A copy of the tag, badge, emblem or other token (if any) which will be distributed as part of the solicitation, or which will be used by your organization in its solicitation.
8. Please include any other relevant information which would assist the Committee on Finance in reviewing this application.
APPLICATIONS MUST BE RECEIVED BY THE COMMITTEE ON FINANCE NO LATE THAN 30 DAYS PRIOR TO THE COMMENCEMENT OF THE SOLICITATION.
I/WE, THE OFFICER(S) OF THE ABOVE NAMED ORGANIZATION, CERTIFY THAT THE INFORMATION FURNISHED IN THIS STATEMENT AND ALL ATTACHED SHEETS IS TRUE AND CORRECT TO THE BEST OF MY/OUR KNOWLEDGE. (NOTE: AT LEAST ONE OFFICER OF THE ORGANIZATION MUST SIGN AND VERIFY THIS APPLICATION.)
Signature
Signature_Title__Date
Signature
Title
Date
HOLD HARMLESS AGREEMENT
2.
The undersigned officer on behalf of the subject organization agrees to defend, indemnify, save and hold harmless the City of Chicago for any loss, liability, damage or cost which the City may incur due to the presence of volunteers of the subject organization on City premises for the purpose of charitable solicitations.
The subject organization assumes full responsibility for risk of bodily injury, death or property damage due to the negligence of the subject organization or otherwise resulting from conduct or activity related to the participation in charitable solicitation on the public way.
The officer of the subject organization has read and voluntarily signs the hold harmless agreement and waiver of liability and indemnity agreement.
Signature of organization officer
6- //
Date
Form CO-1 Revised 1/07
CHARITABLE ORGANIZATION - REGISTRATION STATEMENT -
LISA MADIGAN ATTORNEY GENERAL
PLEASE TYPE OR PRINT IN INK. This registration statement is required by the Illinois Charitable Trust Act and the Illinois Solicitation for Charity Act Please answer all items which are applicable to your organization. If you are unable to answer any question fully in the space provided, please attach a sheet containing the remainder of your answer. No further registration statement is required, provided that every registered organization shall notify the Attorney General within 10 days of any change in the infonnation submitted herein. One copy of this Registration Statement and attachments are to be filed with the Office of the Attorney General, Charitable Trust and Solicitations Bureau, 100 West Randolph Street, 11th Floor, Chicago, Illinois 60601
1. This is a registration under:
□ Illinois Charitable Trust Act:
□ Illinois Solicitation for Charity Act; o Both Acts
DEC 0 1 2008
SERBS**
Name of Organization
Telephone Number
Federal Employer ID#
urrlbei
3.
Street and Ni
City
66
County
State
7
Zip Code
Type of legal entity (Corporation, Trust, Unincorporated Association or other) and date, method and place organization legally established. &<=><enPc*>G /,nn_9-3n-r>?__
If a foreign corporation, when was it authorized to do business in Illinois? If a corporation, Illinois Secretary of State's File No.__
* A copy of the Articles of Incorporation or Certificate of Authority issued by the Secretary of State must be attached.
Name, address and telephone number of Illinois re^
gistered agent fi/f/l/ee. tf/ff-OAfij "7^! I/i H. 'L_6s>oi>3 7 -7-73 - 7
5. Address of all offices in the State of Illinois. /r£ £r <S~/o
*/- &o6s 7
6. Date on which the annual accounting period of the organization ends. Month_~]__ Day ft
7. State the purposes of the organization and purposesfor which contributions are to be used. (Be specific) » a
-^o 4k&.-t ~t-Aey suad" &e~ G-bi£. /Kci/e,' cjql/ZcJ' t/J,'-+k. gi'j ete-Z-if,
If the name under which the organization intends to solicit funds differs from the name listed in No.2 provide name(s) under which contributions will be solicited, and the reason for the use of such other name(s)._- ^jS --_
9. If the organization has previously been registered with the Attorney General under either Act, give the name under which registered (if different than shown in No. 2), last registration number, and date registered. _/ 7/^f-_
_/j;_
10. Has the organization been registered with any other governmental authority to solicit contributions? □ Yes Q'fro
Name of authority and date of authorization.____
Is such registration current? □ Yes □ No
11. Has the organization or any of its officers, directors or trustees ever been enjoined or prohibited by any court or other governmental agency from soliciting contributions, or is such action pending? O Yes V^No
If "Yes", attach an explanation.
12. Do you intend to use the services of a professional fund raiser as defined by "An Act to Regulate Solicitation and Collection of Funds for Charitable Purposes"? □ Yes QTNIo
If "Yes", answer a, b, and comply with c below. n
a. Name and address of professional fund raiser(s):_/'f/^f_
_ / ' '
b. Has the professional fund raiser registered and filed a bond with the Office of the Attorney General as required? □ Yes o No
c. Attach copies of all contracts with professional fund raiser(s).
13. Have any of organization's officers, directors, executive personnel, or have any of the organization's employees who have access to funds, ever been charged with or convicted of a misdemeanor involving misapplication or misuse of money of another, or any felony? □ Yes i/No If "Yes", give the following information: (IRS 1981 ch 23, sec. 5109)
NAME AND ADDRESS OF COURT ^NATURE OF OFFENSE DATE OF CONVICTION(Mo./Yr.)
/
14. State the board, group or individual having final discretion as to the distribution and use of contributions received.
/Unite, ft. /^//r>C-^ .TW^//^ t., Tfs/f/tl*)_
15. Wijl you use any of the following methods of solicitation? ^Unordered Merchandise . Cf^istribution or Sale of Seals tafrelephone Appeals Q'Coin Collection Containers ^Special Events efAd Books efDirect Mail
o Other If other, attach an explanation.
16. List name, mailing address and title of tbe chief executive or staff officer ofthe organization. /MnexL Atfotuf r^H/fanS
_F cT^fc/- Ch'Qo^n_32L_6?6/?37,_afl* ?(o</
17. Attach a list of names, mailing addresses, and daytime phone numbers of all officers and directors, or trustees ofthe organization.
18. Has the United States Internal Revenue Service determined that this organization is tax exempt? □ Yes o No If "Yes", attach a copy of the determination letter. Is application pending? □ Yes □ No *AI1 organizations with tax exempt status or an application pending must attach a copy of
Federal Form 1023 "Application for Recognition of Exemption'' or an exemption letter.
19. Has organization's tax exempt status ever been questioned, audited, denied or cancelled at any time by any governmental agency? □ Yes otfo If "Yes", attach the facts.
20. Organizations which have been in operation for over one (1) year must attach a copy ofthe form AG990-IL and Federal return, or AG990IL if no Federal return was filed for each year the organization was in existence, completed in detail. Organizations which have been in operation less than one (1) year must attach a completed Financial Information Form CO-2, notarized. Please note charitable organization's are required to maintain accurate and detailed accounting records.
21. Approximate amount of contributions solicited or income received from persons in this State during the organization's last annual accounting period $_
22. EVERY REGISTERING ORGANIZATION MUST ATTACH THE FOLLOWING APPLICABLE DOCUMENTS:
Corporation..................................The Articles of Incorporation and/or Certificate of Authority, Amendments and By-Laws
Unincorporated Association...........Constitution and By-Laws
Testamentary Trust.........................Will, Probate number and Decree of Distribution
Inter Vivos Trust.............................Instrument Creating Trust
Note: The President and the Chief Financial Officer or other authorized officer both are required to sign. This must be two different individuals. If entity is a Trust, all Trustees must sign.
UNDER PENALTY OF PERJURY, THE UNDERSIGNED DECLARE AND CERTIFY THAT THE INFORMATION CONTAINED IN THIS STATEMENT AND ALL ATTACHED SHEETS IS TRUE AND CORRECT TO THE BEST OF OUR KNOWLEDGE.
Signature f///(%Aj>, ^L^^^^^j_Title £}jA.L*/fcbJ>_Date /Q- ^" <$ 2
Signature I^JlL/) C^Aj Title Date ■ $ '6^-
PERMIT NO. 2011-25
COMMITTEE ON FINANCE CHARITABEL SOLICITATION TAG DAY REQUEST FORM AND ROUTE SHEET
PERMIT NUMBER: |
2011-25 |
GROUP NAME: |
"Our Youth" A Community Forum |
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ADDRESS: 7940 S. Ashland, Chicago, IL 60636 |
TELEPHONE NUMBER: |
773-719-1771 |
CONTACT PERSON: |
Lynda Green |
DATE WRITTEN REQUEST WAS RECEIVED: May 25, 2011 |
SOLICITATION DATE: |
Saturdays from May 28, 2011 through August 13, 2011 |
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CITY COUNCIL DATE: |
June 8, 2011 |
COMPLETION OF FILE DATE: |
STATEMENT OF RECEIPTS AND DISTRIBUTION RECEIVE |
D: |
DATE PERMIT LETTER WAS SENT TO ORGANIZATION: |
June 9,2011 |
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VIOLATION (S) |
COMMITTEE LETTER SENT: |
COMPLY RECEIVED: |
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COMMENTS: |
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APPLICATION FOR CITY OF CHICAGO CHARITABLE SOLICITATION PERMIT
(Please neatly print or type. In necessary in answering any question, please attach
additional sheets.)
"Our 1cuM>"A Cwimuii/j fVu,
>/Vi
1. Name of organization:
Address: l^Hb 3. AshicwJ
Telephone Number: (j 7 3) - HI/
2. Use the space below to list names, current positions, residence addresses and
telephone numbers of the officers intbe organization:
Sect. S. *UI Uwy
3. List the date and approximate location(s) of solicitation: , / ,
6/Z.i? ■£/</ £,//■/ 7/^ 7/<?
7/?0 »/* fS^WW©^ Ave. Chic'ajfi/'&erjree*
4. Approximately how many persons will be engaged in the solicitation?
H - / a
5. Explain the methods your organization will use to solicit funds: .
SijDS be used. ^ orj^^ti^ o.^ix<-<*
6. Has your organization ever been allowed to solicit funds in prior years in the City of Chicago? If so, when? A/O a~pp/,e J
7. Include the following with your application:
A. A copy of the registration statement filed with the Attorney General of the State of Illinois; or exemption issued by the Attorney General ofthe State of Illinois.
B. A copy of the tag, badge, emblem or other token (if any) which will be distributed as part of the solicitation, or which will be used by your organization in its solicitation.
8.
Please include any other relevant information which would assist the Committee on Finance in reviewing this application.
APPLICATIONS MUST BE RECEIVED BY THE COMMITTEE ON FINANCE NO LATE THAN 30 DAYS PRIOR TO THE COMMENCEMENT OF THE SOLICITATION.
I/WE, THE OFFICER(S) OF THE ABOVE NAMED ORGANIZATION, CERTIFY THAT THE INFORMATION FURNISHED IN THIS STATEMENT AND ALL ATTACHED SHEETS IS TRUE AND CORRECT TO THE BEST OF MY/OUR KNOWLEDGE. (NOTE: AT LEAST ONE OFFICER OF THE ORGANIZATION MUST SIGN AND VERIFY THIS APPLICATION.)
Signatun^/xfl / _Title P^Atd^f Date ^m/zoH
Signature_Title_Date_
Signature_Title _Date_
HOLD HARMLESS AGREEMENT
2.
The undersigned officer on behalf of the subject organization agrees to defend, indemnify, save and hold harmless the City of Chicago for any loss, liability, damage or cost which the City may incur due to the presence of volunteers of the subject organization on City premises for the purpose of charitable solicitations.
The subject organization assumes full responsibility for risk of bodily injury, death or property damage due to the negligence of the subject organization or otherwise resulting from conduct or activity related to the participation in charitable solicitation on the public way.
The officer of the subject organization has read and voluntarily signs the hold harmless agreement and waiver of liability and indemnity agreement.
Name of organization
Date
Our
m
n
ura
The purpose of this Organization is to enhance as well as promote the inner ability of each young 3erson and not to focus on the negative challenges that they are faced with daily .#ur goal is to initiate 3 Proactive plan which will give them a list of positive choices instead of a life time of disappointment Decause of unconstructive decisions. The following services and programs that will be offered are:
■ Resume writing/Job Readiness
■ STD's/AIDS Workshops/Healthy Communication
■ Young entrepreneurs program
■ Self Esteem Awareness/Dress Code
■ Crime awareness prevention
■ Community hours needed for graduation
■ Historical trips that Educate
■ Financial workshops/budgeting/investments
<\nd much more!
January 8,2010
OFFICE OF THE ATTORNEY GENERAL
STATE OF ILLINOIS
OUR YOUTH-A COMMUNITY FORUM, NFP 9055 S. CARPENTER AVE.
Lisa Madigan
ATTORNEY GENERAL^
CfflCAGO, IL 60620
RE: Status of OUR YOUTH-A COMMUNITY FORUM, NFP under both The Charitable Trust and The Solicitation for Charity Acts.
Dear Registrant:
I am pleased to acknowledge receipt of your registration statement under both the Charitable Trust and the Solicitation for Charity Acts. The registration number assigned to your organization is CO# 01057534.
Please note that when an organization registers under the Charitable Trust and/or the Solicitation for Charity Act, it is required to file an annual financial report with our office. The annual financial report is due six months after the end of the organization's fiscal year. It is one of the duties of the organization's officers to ensure that this report is timely filed. A copy of the form AG990-IL along with instructions are attached to this letter.
I must also call your attention to Section 12 under the Solicitation for Charity Act. Please note that this registration in no way constitutes an endorsement of your organization by the State of Illinois and that any representation as such for the purpose of soliciting or collecting funds will be grounds for cancellation of your registration.
For your convenience, additional resource materials as well as blank forms and instructions are available under the "Building Better Charities" section of our website at www.IUinoisAttorneyGeneral.gov. If you have questions, you may direct them by mail to the Charitable Trusts Bureau at 100 West Randolph Street, 11th floor, Chicago, Illinois 60601; or contact us by phone at (312) 814 - 2595. We will be happy to assist you.
Very truly yours,
LISA MADIGAN Attorney General
INTERNAL REVENUE SERVICE P. O. BOX 2508 CINCINNATI, OH 45201
DEPARTMENT OF THE TREASURY
Date:
AUG 20 2010
Employer Identification Number: 80-0310378
DIJJ: 17053335327029
OUR YOUTH - A COMMUNITY FORUM NFP C/O LYNDA GREEN 9055 S CARPENTER AVE CHICAGO, IL 60620
Contact Person: MARY M SHEER
Contact Telephone Number: (877) 829-5500
ID# 31255
Accounting Period Ending: December 31
Public Charity Status: 170(b)(1)(A)(vi)
Form 990 Reguired: Yes
Effective Date of Exemption: January 16, 2009
Contribution Deductibility: Yes
Addendum Applies: No
Dear Applicant:
We are pleased to inform you that upon review of your application for tax exempt status we have determined that you are exempt from Federal income tax under section 501(c)(3) of the Internal Revenue Code. Contributions to you are deductible under section 170 of the Code. You are also qualified to receive tax deductible bequests, devises, transfers or gifts under section 2055, 2106 or 2522 of the Code. Because this letter could help resolve any questions regarding your exempt status, you should keep it in your permanent records.
Organizations exempt under section 501(c)(3) of the Code are further classified as either public charities or private foundations. We determined that you are a public charity under the Code section(s) listed in the heading of this letter.
Please see enclosed Publication 4221-PC, Compliance Guide for 501(c)(3) Public Charities," for'some helpful infonnation about your responsibilities as an exempt organization.
Letter 947 (DO/CG)
PERMIT NO. 2011-26
COMMITTEE ON FINANCE CHARITABEL SOLICITATION TAG DAY REQUEST FORM AND ROUTE SHEET
PERMIT NUMBER: |
2011-26 |
GROUP NAME: |
Planned Parenthood Action Fund, Inc. |
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ADDRESS: 59 Temple Place, Suite 402, Boston, MA 02111 |
TELEPHONE NUMBE |
R: |
269-599-4398 |
CONTACT PERSON: |
Cecile Richards |
DATE WRITTEN REQUEST WAS RECEIVED: May 25, 2011 |
SOLICITATION DATE: |
June 8-30,2011 |
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CITY COUNCIL DATE: |
June 8, 2011 |
COMPLETION OF FILE DATE: |
STATEMENT OF RECEIPTS AND DISTRIBUTION RECEIVED: |
DATE PERMIT LETTER WAS SENT TO ORGANIZATION: June 9,2011 |
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VIOLATION CS) |
COMMITTEE LETTER SENT: |
COMPLY RECEIVED: |
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COMMENTS: |
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APPLICATION FOR CITY OF CHICAGO CHARITABLE SQIZCTTATION PERMIT
(Please neatly print or type. If necessary in answering any question, please attach other sheets.)
1. Name of organization:^(^^ p^+U^ fuy)Jy /c
Address:
"R-fuple PUue Ste^-OZy Bos-roriy HA 02-HI Telophone Number: . , _
2. Use the space below to list names, current positions, residence addresses and telephone numbers of the officers in the organization:
434 vO. 33>^ ^-r; yo^n^y [000 i
3. List the date and approximate location (s) of solicitation? ,3i*vt £ Ova£ JO
fWU(r'Son>»Uy fOe^v &>o-tL SkcUij L-o<5<xn iiiu^e, "~rt-«. A'ceuat
4. Approximately how many persons will be engaged in the solicitation?
5. Explain the methods your organization will use to solicit funds:
vJii( specie -K people vOko ckaase -ft, stop -fo-tecUc -H as
6. Was your organization ever allowed to solicit funds in prior years in the City of Chicago? if so, when?
TKtb IS OUV" -^rsf" <Xpp>\<Gsjf->o <r\
7. Include the following with your application:
A. A copy of the registration statement filed with the Attorney General of the State of Illinois; or exemption issued by the Attorney General of the State of Illinois.
B. A facsimile of the tag, badge, emblem or other token (if any) which will be distributed as part of the solicitation, or which will be used by your organization in its solicitation.
8. Please include any other relevant information which would assist the Committee on Finance in reviewing this application.
APPLICATIONS MUST BE RECEIVED BY THE COMMITTEE ON FINANCE NO LATE THAN 30 DAYS PRIOR TO THE COMMENCEMENT OF THE SOLICITATION.
I/WE, THE OFFICER(S) OF THE ABOVE NAMED ORGANIZATION, CERTIFY THAT THE INFORMATION FURNISHED IN THIS STATEMENT AND ALL ATTACHED SHEETS IS TRUE AND CORRECT TO THE BEST OF MY/OUR KNOWLEDGE. (NOTE: AT LEAST ONE OFFICER OF THE ORGANIZATION MUST SIGN AND VERIFY THIS APPLICATION.)
re^Lc^-^^- - Title C#Q i Kl? Date $^7-//
Signatui
Signature_Title_Date_
Signature_Title_Date_
HOLD HARMLESS AGREEMENT
The undersigned officer on behalf of the subject organization agrees to defend, indemnify, save and hold harmless the City of Chicago for any loss, liability, damage or cost which the City may incur due to the presence of volunteers of the subject organization on City premises for the purpose of charitable solicitations.
The subject organization assumes full responsibility for risk of bodily injury, death or property damage due to the negligence of the subject organization or otherwise resulting from conduct or activity related to the participation in charitable solicitation on the public way.
The officer of the subject organization has read and voluntarily signs the hold harmless agreement and waiver of liability and indemnity agreement.
Signature of organization officer
Date
Oct-05-10 08:32am From-
Copi levitz & Canter Fax:816-472-5000
Oct 5 2010 09:22am T-888 P.02/03 F-856
October 5,2010
OFFICE OF THE ATTORNEY GENERAL
STATE Of ILLINOIS
PLANNED PARENTHOOD ACTION
FUND, INC.
434 W 33RD STREET
NEW YORK, NY 10001
Lisa Madigan
ATTOKM-.Y tjl-.NL'KAl-
RE: RB: Status of PLANNED PARENTHOOD ACTION FUND, INC. under the Illinois Charitable Laws CO# 01O214I8
Dear Registrant:
This letter is pursuant to your request that the Attorney General confirm the status of PLANNED PARENTHOOD ACTION FUND, INC. under the Charitable Organization Laws.
This organization is currently registered with the Attorney General's Charitable Trust and Solicitations Bureau as CO# 01021418. It is current in the filing of its financial reports, having filed its report for the period ended June 30, 2009. Please let us know if you require further information.
Sincerely,
Catherine Reilly.CompIiance Officer Charitable Trusts Bureau 100 West Randolph Street, 11th Floor Chicago, Illinois 60601 Telephone: (312)8)4-2595
PERMIT NO. 2011-27
COMMITTEE ON FINANCE CHARITABEL SOLICITATION TAG DAY REQUEST FORM AND ROUTE SHEET
PERMIT NUMBER: |
2011-27 |
GROUP NAME: |
Planned Parenthood Federation of America, Inc. |
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ADDRESS: 59 Temple Place, Suite 402, Boston, MA 02111 |
TELEPHONE NUMBE |
R: |
269-599-4398 |
CONTACT PERSON: |
Cecile Richards |
DATE WRITTEN REQUEST WAS RECEIVED: May 25, 2011 |
SOLICITATION DATE: |
July 1,2011 through August 31,2011 |
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CITY COUNCIL DATE: |
June 8, 2011 |
COMPLETION OF FILE DATE: |
STATEMENT OF RECEIPTS AND DISTRIBUTION RECEIVE] |
D: |
DATE PERMIT LETTER WAS SENT TO ORGANIZATION: |
June 9, 2011 |
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VIOLATION (S) |
COMMITTEE LETTER SENT: |
COMPLY RECEIVED: |
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COMMENTS: |
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APPTJCATION FOR CTTV OF CHICAGO CHARITABLE SOLTCTTRTICW PERMIT
(Please neatly print or type. If necessary in answering any question, please attach other sheets.)
1. Name of organization:-^^ ^ SR^+Uo^ £<uUrrdtrM o£ fWwcA, Inc.
Address*
"5^ "R-iuple PU.ce Ste40Zy Sos-rW, WA 02-fH Telephone Number: . . _ _ ^
2. Use the space below to list names, current positions, residence addresses and telephone numbers of the officers in the organizaticn:
434 VJ. 32^ St- Mev*) y0vfc,»oy (o^o j
3. List the date and approximate location(s) of solicitation?^yX^ | ,2.oil
Wk- vJilt he szel.'cihXa *tr&M ^flk y &v\f 1 ff^-i utwts vut'U Vvxvc Y><Lp rv.s^A+cU-iWX A ~TW Loo^ \^\"ck^r Paste-, fWU^SonViU, k)e<u^ ^o-Kv tkckAj L-o^a-n -Sau^e, ""it* M-aaki■fYo2*tt
Mild., r^£.
4. ^proximately how many persons will be engaged in tine solicitation?
VOe, will Wkvc (XpproxiMaJdy ^-2>o refuse* teuhVeS Oxt^^j eMj^oj^eA.
5. Explain the methods your ca^ganization will use to solicit funds:
Vk, vJiU s^e^lc -h pc*fo'e voUo ckoose -ft> stop to -foAic -f» as (Xbou-h ? I Ann 6^1 J^kr^nfAoocC feta^CL-hDV) of- f^^/o^ pro^rewJ
6. Was your organization ever allowed to solicit funds in prior years in the City of Chicago? rf so, when?
7. Include the following with your application:
A. A copy of the registration statement filed with the Attorney General of the State of Illinois; or exemption issued by the Attorney General of the State of Illinois.
B. A facsimile of the tag, badge, emblem or other token (if any) which will be distributed as part of the solicitation, or which will be used by your organization in its solicitation.
8. Please include any other relevant information which would assist the Oaramittee on Finance in reviewing this application.
\
APPLICATIONS MUST BE RECEIVED BY THE COMMITTEE ON FINANCE NO LATE THAN 30 DAYS PRIOR TO THE COMMENCEMENT OF THE SOLICITATION.
17WE, THE OFFICER(S) OF THE ABOVE NAMED ORGANIZATION, CERTIFY THAT THE INFORMATION FURNISHED IN THIS STATEMENT AND ALL ATTACHED SHEETS IS TRUE AND CORRECT TO THE BEST OF MY/OUR KNOWLEDGE. (NOTE: AT LEAST ONE OFFICER OF THE ORGANIZATION MUST SIGN AND VERIFY THIS APPLICATION.)
Signature
--Title CfiO * If? Date Y-M-/I
Signature_Title__Date_
Signature_Title_Date_
HOLD HARMLESS AGREEMENT
The undersigned officer on behalf of the subject organization agrees to defend, indemnify, save and hold harmless the City of Chicago for any loss, liability, damage or cost which the City may incur due to the presence of volunteers of the subject organization on City premises for the purpose of charitable solicitations.
The subject organization assumes full responsibility for risk of bodily injury, death or property damage due to the negligence of the subject organization or otherwise resulting from conduct or activity related to the participation in charitable solicitation on the public way.
The officer of the subject organization has read and voluntarily signs the hold harmless agreement and waiver of liability and indemnity agreement.
Name of organization
/
Signature of organization officer
Date
Oct-05-10 08:32am From-
Copilevitz & Canter Fax:816-472-5000
Oct 5 2010 09:22am P003/003 T-888 P.03/03 F-856
^ u a OFFICE OF THE ATTORNEY GENERAL
October 5, 2010 STATE OF ILLINOIS
PLANNED PARENTHOOD
FEDERATION OF AMERICA, INC. Lisa Madigan
434 W. 33RD STREET attorney oknfkal
NEW YORK, NY 10001
RE: RE: Status of PLANNED PARENTHOOD FEDERATION OF AMERICA, INC. under the Illinois Charitable Laws CO# 01009083
Dear Registrant:
This letter is pursuant to your request that the Attorney General confirm the status of PLANNED PARENTHOOD FEDERATION Of AMERICA, INC. under the Charitable Organization Laws.
This organization is currently registered with the Attorney General's Charitable Trust and Solicitations Bureau as CO# 01009083. It is current in the filing of its financial reports, having filed its report for the period ended June 30,2009. Please let us know if you require further information.
Sincerely,
Catherine Reilly Compliance Officer Charitable Trusts Bureau 100 West Randolph Street, 11th floor Chicago, Illinois 60601 Telephone: (312)814-2595