(Rev. 09-06) 717-783-1720 1-800-732-0999 (WITHIN PA) FAX 717-783-6014 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF STATE BUREAU OF CHARITABLE ORGANIZATIONS 207 NORTH OFFICE BUILDING HARRISBURG, PA 17120 Approved Reg. Fee P/F Fee Recv’d ___________ ___________ ___________ ___________ EXTENSION OR NON-RENEWAL NOTICE FORM - BCO-2 (PERTAINS TO THE FILING OF REGISTRATION STATEMENT-FORM BCO-10 REQUIRED BY THE SOLICITATION OF FUNDS FOR CHARITABLE PURPOSES ACT) Employer Identification # ____________________Certificate # ________________ Official name, phone #, and principal address of charitable organization: Check if name or address below is a change (Full Official Name) (Address) (Phone #) (City) (State) (Zip Code) If an extension of time is required, please provide the information requested, complete Section A, sign and date below and return your request to the Bureau by your registration due date. Extensions not to exceed 180 days from the registration’s due date may be requested. An organization failing to file an extension request by the due date must pay a late filing fee of $25 for each month or part of a month after the date the registration was due to be filed. An extension request filed late cannot be approved unless the appropriate late filing fees are received. The Bureau will send written notification indicating whether your request was approved. An extension request may be completed and signed by any authorized individual, including the organization’s accountant, attorney, etc. An extension request may be faxed at the number listed above. Renewal registrants may request an extension for any part of the registration. A renewal registrant must have an approved registration for its prior fiscal year for an extension request to be approved. Initial registrants may only request an extension for the submittal of financial information and the registration fee. A completed Registration Statement – Form BCO-10, and a copy of any IRS tax exemption letter, the organization’s charter, articles of incorporation, constitution or other organizational documents and bylaws must be submitted with the request. If your organization is not required to renew its registration, please complete Section B below. A. An extension of time until requested for filing our Initial Reason: for fiscal year ending ______/______/______ is Renewal registration. B. If not required to file registration, please state the exemption from registration or the exclusion from the Act that is applicable (refer to page #8 for listing of exempt/excluded organizations). If the organization has been dissolved, please give date and attach supporting documentation. Be aware that an organization is required to renew its registration for each fiscal year the organization was engaged in solicitation activities in Pennsylvania. We are not required to file registration for the fiscal year that ended: ______/______/______. Reason: Company Name and Address of individual completing Form BCO-2 (if different than above): Signature Phone # of signatory Print Name of signatory Date 9 American LegalNet, Inc. www.FormsWorkFlow.com