In the realm of nonprofit operations within Connecticut, the CPC-54 form emerges as a critical instrument for organizations seeking exemption from the registration and financial reporting mandates dictated by the Connecticut Solicitation of Charitable Funds Act. This double-sided document serves as a gateway for qualifying entities to formally declare their exemption status, thereby sidestepping the comprehensive requirements laid out for entities under the act. Essential components of the form demand detailed elucidation of the organization's registration history, legal identification, operational aliases, and the specific exemption criteria it meets among the six delineated categories. These range from religious affiliations to educational establishments, encompassing a spectrum of organizations including non-profit hospitals and governmental bodies. Moreover, the form touches upon the organization's tax-exempt status, underlining the necessity of an IRS determination to bolster the claim. Complying with the procedural aspect, the form stipulates dual endorsements, underscoring the importance of accuracy and authorization in the claim process. In essence, CPC-54 not only facilitates a streamlined exemption process but also upholds the integrity and oversight of charitable solicitations within the state, ensuring that the contributions directed towards these entities are well-accounted for and serve the intended philanthropic objectives.
| Question | Answer |
|---|---|
| Form Name | Form Cpc 54 |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | cpc form, CPC-54, CTCHARITYHELPCT, cpc 54 |
STATE OF CONNECTICUT
DEPARTMENT OF CONSUMER PROTECTION
CLAIM OF EXEMPTION FROM REGISTRATION
FORM
TELEPHONE (860)
EMAIL: CTCHARITYHELP@CT.GOV
CLAIM OF EXEMPTION FROM REGISTRATION
PLEASE READ INSTRUCTIONS ON REVERSE SIDE BEFORE COMPLETING THIS FORM
A.Is the organization now or has the organization ever been registered under the Connecticut Solicitation
of Charitable Funds Act? |
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Yes |
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No If yes, enter the registration number: ____________________ |
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B.Provide the full legal name, mailing address and federal identification number of the organization: Name:
Address:
City, State & Zip Code:
FEIN (Federal Identification Number): ____________________
C.Telephone. number: ( ) ______ - ____________ Email address (required):________________@______
D.Name(s), other than stated in part B above, under which funds will be solicited.
E. Is the organization incorporated? |
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Yes |
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No If yes, in the State of __________ in the year _______. |
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F.The organization claims an exemption from the registration and financial reporting requirements of the Con- necticut Solicitation of Charitable Funds Act as (check the applicable box and complete the line if necessary):
1.A duly organized religious corporation, religious institution or religious society.
2.A
an educational institution, the curricula of which are in whole or in part registered or approved by any State or the United States, either directly or by acceptance of accreditation by an accrediting body.
3.A
4.A governmental unit or instrumentality of: (check one and complete the line if necessary)
___ the United States; ___ the state of ______________; or ___ the town/city of ________________.
5. An organization that solicits solely for the benefit of another organization that is described in numbers 1 through 4 above. If this applies check the box above that describes the organization for which you solicit and enter its name and address here: Name:________________________________________________________________
Address:______________________________________________________________
City, State & Zip Code:__________________________________________________
6. An organization that normally receives less than $50,000 in contributions annually and does not compensate any person primarily to conduct solicitations. If this applies, ATTACH A STATEMENT describing the purposes of the organization.
G. Has the I.R.S. determined that this organization is tax exempt? |
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Yes |
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No |
If yes, under which I.R.S. code section? _______ . If no, is an application pending?
Yes
No
We hereby certify under penalty of false statement that we are authorized to sign this document on behalf of the organization and that the information provided is true and complete to the best of our knowledge.
Signed: |
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Date: |
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Printed name: |
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Title: |
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Signed: |
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***STATE LAW REQUIRES THAT TWO PERSONS SIGN THIS FORM***
INSTRUCTIONS FOR COMPLETING FORM
CLAIM OF EXEMPTION FROM REGISTRATION
BEFORE COMPLETING THIS FORM
Review the six numbered exemption categories. If any of them describes your organization, you qualify for exemption from the registration and financial reporting requirements of the Connecticut Solicitation of Chari- table Funds Act.
To claim the exemption, complete this form in accordance with the instructions below and email it to ctcharityhelp@ct.gov or mail it to:
Public Charities
Department of Consumer Protection 165 Capitol Avenue
Hartford, CT
If none of the six numbered exemption categories listed on form
INSTRUCTIONS
1.If your organization is now or was formerly registered under the Act but is now claiming exemption from registration, be sure to provide your registration number in part A so that we can remove your organization from the list of registered organizations.
2.If you claim exemption number 2 as a
3.If you claim exemption number 3 or 4 be sure to complete the additional information required for the ex- emption you claim.
4.If you claim exemption number 5, check the box above (1, 2, 3, or 4) that describes the organization for which you solicit and insert that organization's name and address in the space provided.
5.If you claim exemption 6, be sure to describe the purpose of your organization (what it was organized to accomplish) and state its major program activities (how it accomplishes its purpose). The $50,000 threshold includes
6.Two persons must sign form