Fill - Free fillable ANNUAL REGISTRATION RENEWAL FEE REPORT TO ATTORNEY GENERAL (California) PDF form

STATE OF CALIFORNIA DEPARTMENT OF JUSTICE

RRF-1

(Rev. 09/2017)

PAGE 1 of 5

MAIL TO:

Registry of Charitable Trusts

P.O. Box 903447

Sacramento, CA 94203-4470

STREET ADDRESS:

1300 I Street

Sacramento, CA 95814

(916) 210-6400

WEBSITE ADDRESS:

www.oag.ca.gov/charities

ANNUAL REGISTRATION RENEWAL FEE REPORT

TO ATTORNEY GENERAL OF CALIFORNIA

Sections 12586 and 12587, California Government Code

11 Cal. Code Regs. sections 301-306, 309, 311, and 312

Failure to submit this report annually no later than four months and fifteen days after the end of the

organization's accounting period may result in the loss of tax exemption and the assessment of a

minimum tax of $800, plus interest, and/or fines or filing penalties. Revenue & Taxation Code section

23703; Government Code section 12586.1. IRS extensions will be honored.

(For Registry Use Only)

Name of Organization

List all DBAs and names the organization uses or has used

Address (Number and Street)

City or Town, State, and ZIP Code

Telephone Number

E-mail Address

Check if:

Change of address

Amended report

State Charity Registration Number

Corporation or Organization No.

Federal Employer ID No.

ANNUAL REGISTRATION RENEWAL FEE SCHEDULE (11 Cal. Code Regs. sections 301-307, 311, and 312)

Make Check Payable to Department of Justice

Gross Annual Revenue Fee

Less than $25,000 0

Between $25,000 and $100,000 $25

Gross Annual Revenue Fee

Between $100,001 and $250,000 $50

Between $250,001 and $1 million $75

Gross Annual Revenue Fee

Between $1,000,001 and $10 million $150

Between $10,000,001 and $50 million $225

Greater than $50 million $300

PART A - ACTIVITIES

For your most recent full accounting period (beginning ending ) list:

/ / / /

Gross Annual Revenue $

Noncash Contributions $ Total Assets $

Program Expenses $

Total Expenses $

PART B - STATEMENTS REGARDING ORGANIZATION DURING THE PERIOD OF THIS REPORT

Note: All questions must be answered. If you answer "yes" to any of the questions below, you must attach a separate page

providing an explanation and details for each "yes" response. Please review RRF-1 instructions for information required.

Yes No

1. During this reporting period, were there any contracts, loans, leases or other financial transactions between the organization and any

officer, director or trustee thereof, either directly or with an entity in which any such officer, director or trustee had any financial interest?

2. During this reporting period, was there any theft, embezzlement, diversion or misuse of the organization's charitable property or funds?

3. During this reporting period, were any organization funds used to pay any penalty, fine or judgment?

4. During this reporting period, were the services of a commercial fundraiser, fundraising counsel for charitable purposes, or commercial

coventurer used?

5. During this reporting period, did the organization receive any governmental funding?

6. During this reporting period, did the organization hold a raffle for charitable purposes?

7. Does the organization conduct a vehicle donation program?

8. Did the organization conduct an independent audit and prepare audited financial statements in accordance with

generally accepted accounting principles for this reporting period?

9. At the end of this reporting period, did the organization hold restricted net assets, while reporting negative unrestricted net assets?

I declare under penalty of perjury that I have examined this report, including accompanying documents, and to the best of my knowledge and

belief, the content is true, correct and complete, and I am authorized to sign.

Signature of Authorized Agent Printed Name Title Date

STATE OF CALIFORNIA DEPARTMENT OF JUSTICE

RRF-1

(Rev. 09/2017)

PAGE 2 of 5

Office of the Attorney General

Registry of Charitable Trusts

Privacy Notice

As Required by Civil Code § 1798.17

Collection and Use of Personal Information. The Attorney General's Registry of Charitable Trusts

(Registry), a part of the Public Rights Division, collects the information requested on this form as

authorized by the Supervision of Trustees and Fundraisers for Charitable Purposes Act (Gov. Code §

12580 et seq.) and regulations adopted pursuant to the Act (Cal. Code Regs., tit. 11, §§ 300-316). The

Registry uses the information in the administration and enforcement of the Act, including to register,

renew, or update your organization's registration or to prepare reports pursuant to the Act. The Attorney

General may also use the information for additional purposes, including in support of investigations and

law enforcement actions, providing public access to information as required by the Act (Gov. Code §§

12587, 12587.1, 12590), and making referrals to other law enforcement agencies. Any personal

information collected by state agencies is subject to the limitations in the Information Practices Act and

state policy. The Department of Justice's general privacy policy is available at www.oag.ca.gov/

privacy-policy.

Providing Personal Information. All the personal information requested in the form must be provided.

An incomplete submission may result in the Registry not accepting the form, and cause your

organization to be out of compliance with legal requirements to operate in California.

Access to Your Information. The completed form is a public filing that will be made available on the

Attorney General's website at www.oag.ca.gov/charities pursuant to the public access requirements of

the Act. You may review the records maintained by the Registry that contain your personal information,

as permitted by the Information Practices Act. See below for contact information.

Possible Disclosure of Personal Information. In order to process the applicable registration, renewal,

registration update, application, or report, we may need to share the information on this form with other

government agencies. We may also share the information to further an investigation, including an

investigation by other government or law enforcement agencies. In addition, the information is available

and searchable on the Attorney General's website.

The information provided may also be disclosed in the following circumstances:

· With other persons or agencies where necessary to perform their legal duties, and their use of

your information is compatible and complies with state law, such as for investigations or for

licensing, certification, or regulatory purposes;

· To another government agency consistent with state or federal law.

Contact Information. For questions about this notice or access to your records, contact the Registrar of

Charitable Trusts, 1300 I Street, Sacramento, CA 95814 at rct@doj.ca.gov

or (916) 210-6400.

RRF-1 Instructions

(Rev. 09/2017)

STATE OF CALIFORNIA DEPARTMENT OF JUSTICE

Page 3 of 5

MAIL TO:

Registry of Charitable Trusts

P.O. Box 903447

Sacramento, CA 94203-4470

(916) 210-6400

WEBSITE ADDRESS:

www.oag.ca.gov/charities

INSTRUCTION FOR FILING

ANNUAL REGISTRATION RENEWAL FEE REPORT

TO ATTORNEY GENERAL OF CALIFORNIA

Section 12586 and 12587, California Government Code

11 Cal. Code Regs. section 301-306, 309, 311 and 312

(FORM RRF-1)

The purpose of the Annual Registration Renewal Fee Report (Form RRF-1) is to assist the Attorney General's Office with early

detection of charity fiscal mismanagement and unlawful diversion of charitable assets.

WHO MUST FILE A FORM RRF-1?

Every charitable nonprofit corporation, unincorporated

association or trustee holding assets for charitable purposes

that is required to register with the Attorney General's Office is

also required to annually file Form RRF-1, even if the

corporation does not file Form 990s annually or is on extended

reporting with the Internal Revenue Service. Only those

charitable entities and trustees required by law to register with

the Attorney General are required to file Form RRF-1. Entities

exempt from the filing requirement include:

(1) a government agency,

(2) a religious corporation sole,

(3) a cemetery corporation regulated under Chapter

12 of Division 3 of the Business and Professions Code,

(4) a political committee defined in Section 82013 of the

California Government Code which is required to and

which does file with the Secretary of State any statement

pursuant to the provisions of Article 2 (commencing with

Section 84200) of Chapter 4 of Title 9,

(5) a charitable corporation organized and operated primarily

as a religious organization, educational institution or

hospital,

(6) a health care service plan that is licensed pursuant to

Section 1349 of the Health and Safety Code and reports

annually to the Department of Managed Health Care,

(7) corporate trustees which are subject to the jurisdiction of

the Commissioner of Financial Institutions of the State of

California or to the Comptroller of Currency of the United

States. However, for testamentary trusts, such trustees

should file a copy of a complete annual financial

summary which is prepared in the ordinary course of

business. See Probate Code sections 16060-16063.

WHAT TO FILE

ALL REGISTRANTS, regardless of the amount of total

revenue, must file Form RRF-1 with the Attorney General's

Registry of Charitable Trusts no later than four months and

fifteen days after the organization's accounting period ends

(May 15 for calendar year filers).

A copy of IRS Form 990, 990-PF, 990-EZ, or 1120 as filed

with IRS, together with all attachments and schedules, must

be filed with the Attorney General's Registry of Charitable

Trusts, together with Form RRF-1. Organizations whose

revenue falls below the threshold for filing IRS Form 990-EZ

shall file Form RRF-1 with the Registry, together with a

treasurer's report (CT-TR-1) sufficient to identify and account

for revenue, assets and disbursements. [See instructions for

Form CT-TR-1.]

EXTENSIONS FOR FILING

Extensions of time for filing Form RRF-1 will be allowed if an

organization has received an extension from the Internal

Revenue Service for filing the IRS Form 990, 990-PF, 990-

EZ, or 1120. An organization shall file both forms (RRF-1 and

IRS Form 990, 990-PF, 990-EZ, or 1120) with the Registry of

Charitable Trusts at the same time, together with (1) the

applicable renewal fee; and (2) a copy of all requests to IRS

for an extension and, where approval of the extension is not

automatic, a copy of each approved extension request. IT IS

NOT NECESSARY TO SEND A COPY OF THE EXTENSION

REQUEST PRIOR TO FILING THE REPORT.

ANNUAL REGISTRATION RENEWAL FEE

All registrants must include with Form RRF-1 the appropriate

registration renewal fee based on the registrant's gross annual

revenue (reported as total revenue on Form 990, 990-PF, or

990-EZ) for the preceding fiscal year, as follows:

Gross Annual Revenue Fee

Less than $25,000 0

Between $25,000 and $100,000 $25

Between $100,001 and $250,000 $50

Between $250,001 and $1 million $75

Between $1,000,001 and $10 million $150

Between $10,000,001 and $50 million $225

Greater than $50 million $300

NOTE: A REGISTRATION FEE IS NOT DUE WITH AN

AMENDED REPORT FOR ANY REPORT PERIOD IN

WHICH A FEE HAS ALREADY BEEN PAID UNLESS AN

AMENDED REPORT CHANGES THE AMOUNT OF THE

FEE DUE.

RRF-1 Instructions

(Rev. 09/2017)

STATE OF CALIFORNIA DEPARTMENT OF JUSTICE

Page 4 of 5

STATE CHARITY REGISTRATION NUMBER

The State Charity Registration Number is the Charitable Trust

(CT) number assigned to an organization by the Registry of

Charitable Trusts at the time of registration. If you do not know

the organization's State Charity Registration Number, you

may look it up using the Registry Search feature on the

Attorney General's website at www.oag.ca.gov/charities. If

you are unable to locate the State Charity Registration

Number, leave that line blank and Registry staff will insert the

number when it is received in the Registry of Charitable

Trusts.

OTHER IDENTIFICATION NUMBERS

The corporation number is a seven-digit number assigned by

the Office of the Secretary of State and is stamped on the

organization's articles of incorporation.

The organization number is a seven-digit number assigned by

the Franchise Tax Board for non-corporate entities.

The Federal Employer Identification Number is a nine-digit

number assigned by the Internal Revenue Service.

The following will assist you in responding to the questions on

Form RRF-1:

PART A

Provide the beginning and ending dates of the most recent full

accounting period (Month/Day/Year). An accounting period

may be by calendar year (ex: 01/01/2016-12/31/2016) or by

fiscal year (ex: 07/01/2016-06/30/2017).

For each amount, report only whole dollars without rounding

(e.g., $100.99 should be reported as $100).

Gross Annual Revenue - is the amount earned and received

during the current year and it includes all contributions, gifts,

grants, investment income, membership dues, program

service revenues and other revenue. For charities reporting

to the IRS it is the amount reported as total revenue on IRS

Form 990, Part 1, line 12; IRS Form 990-EZ, Part 1, line 9;

IRS Form 990-PF, Part 1, line 12.

Noncash Contributions - Are noncash donations made to a

charity. Common examples are donations of food, clothing,

equipment, pharmaceutical and medical supplies. Noncash

contributions exclude contributions made by cash, check,

electronic funds transfer, debit card, credit card, or payroll

deduction. For charities reporting to the IRS it is the amount

reported to the IRS Form 990, Part VIII, line 1g.

Total Assets - Are resources owned by the charity which have

current or future economic value that can be measured. For

charities reporting to the IRS it is the amount reported in IRS

Form 990, Part X, line 16, column (B); IRS Form 990-EZ, Part

II, line 25, column (B); and IRS Form 990-PF, Part II, line 16,

column (B).

Program Expenses - Are expenses incurred by the

organization to further its exempt purposes. For charities

reporting to the IRS it is the amount reported in IRS Form 990,

Part IX, line 25, column (B); IRS Form 990-EZ, Part III, line

32; and IRS Form 990-PF, Part 1, line 24. If you are not

required to file Form 990, 990-EZ, nor 990-PF with the IRS

because total annual revenue was under $50,000, and are

instead filing the required Form CT-TR-1, leave Program

Expense blank.

Total Expenses - Are all expenses paid or incurred by the

organization including program expenses, fundraising

expenses, employee salary & wages, accounting,

depreciation, management and administrative expenses. For

charities reporting to the IRS it is the amount reported in IRS

Form 990, Part IX, line 25, column (A); IRS Form 990-EZ, Part

1, line 17; and IRS Form 990-PF, Part 1, line 26.

PART B

PART B, QUESTION #1

If “yes,” provide the following information on the attachment:

1) Full name of the director, trustee, or officer involved and

position with the organization.

2) Nature of the transaction, e.g., loan to director, contract

with officer's business, etc.

3) Attach a copy of the board of directors' meeting minutes

authorizing the transaction.

4) Include, if applicable, the date of transaction; purpose of

transaction; amount of the loan or contract; interest

rates; repayment terms; balance due; type of collateral

provided; copy of contract, loan or other agreement;

amount paid to director, trustee, or officer for the period;

evidence of other bids received related to the

transaction.

PART B, QUESTION #2

If “yes,” provide the following information on the attachment:

1) Nature, date, amount of loss, and parties involved.

2) Description of the steps the organization took to recover

the loss. Attach a copy of any police and/or insurance

report.

3) Description of the procedures the organization

implemented to prevent a recurrence of the situation.

RRF-1 Instructions

(Rev. 09/2017)

STATE OF CALIFORNIA DEPARTMENT OF JUSTICE

Page 5 of 5

PART B, QUESTION #3

If “yes,” provide the following information on the

attachment:

1) Description of the fine, penalty, or judgment and the

circumstances that resulted in the payment, together

with the name and title of the person(s) responsible and

why the payment was made with the organization's

funds.

2) Name of the organization or government agency

that issued the fine, penalty or judgment, the

amount and date of payment.

3) Copies of all communications with any governmental

agency regarding the fine, penalty, or judgment.

4) Description of procedures the organization

implemented to prevent a reoccurrence of the fine,

penalty, or judgment.

PART B, QUESTION #4

If “yes,” provide an attachment listing the name, mailing

address, telephone number, and e-mail address of each

commercial fundraiser, fundraising counsel, or commercial

coventurer.

PART B. QUESTION #5

If “yes,” provide an attachment listing the name of each

funding source, the name of the agency, mailing address,

contact person, and telephone number. Do not submit IRS

Schedule B as a response to this question. The required

attachment must be made available for public viewing.

PART B, QUESTION #6

If “yes,” provide an attachment listing the date of each raffle.

PART B, QUESTION #7

If “yes,” provide an attachment describing whether the

vehicle donation program is operated by the charity or a

commercial fundraiser, together with the name, mailing

address, telephone number and e-mail address for each

commercial fundraiser.

PART B, QUESTION #8

If you received over $2 million in total revenue, as reported

on IRS Form 990, 990-PF or 990-EZ, audited financial

statements using generally accepted accounting principles

are required. Audit must be conducted by independent

certified public accountant in conformity with generally

accepted auditing standards. You may deduct from total

revenue grants and contracts for services with governmental

entities for which the governmental entity requires an

accounting of how grant funds were spent (to the issuing

government entity).

PART B, QUESTION #9

"Restricted assets" are assets the charity holds that may be

used only for a specific purpose. The restriction may come

from the governing documents, a condition imposed by the

donor, or the solicitation that led to the donation. Examples

of restrictions are endowment funds, building funds, gifts for

specific purposes, and fiscally-sponsored projects. For

organizations filing the IRS Form 990, refer to the Balance

Sheet. If the line reporting unrestricted net assets is a

negative number, and either or both of the lines reporting

temporarily restricted or permanently restricted net assets

are positive number(s), answer "yes."

If “yes,” provide the following information on the attachment:

1) A written statement confirming that all restricted funds

were used consistent with their restricted purpose, and

explaining why unrestricted net assets were negative

at the end of the reporting period, and

2) Proof of directors' and officers' liability insurance

coverage. Please include a cover note stating

"confidential" when submitting the proof of insurance.

SIGNATURE

A signature of an authorized agent is required. An

authorized agent may be the president or chief

executive officer, treasurer or chief financial officer of a

public benefit corporation; or a trustee if the

organization is a trust; or other authorized agent of the

organization. Signatures do not need to be original

inked signature. Copies or electronic signatures are

acceptable.

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