Application for Registration of Non-Profit Organisations ( NPO )

Application for Registration of Non-Profit Organisations (“NPO”)

1. Name (or proposed name) of NPO:

2. Contact details Address:

Telephone number:

Email (if any): 3. Purpose (or intended purpose) of the NPO:

4. Objectives (or intended objectives) of the NPO:

5. Activities (or intended activities) of the NPO:

6. Structure Trust (or intended Limited company structure) of the NPO: Unlimited company (Tick relevant box) “Fidéicommis” or incorporated association Foundation Unincorporated association Other (please describe below)

Raised within Disbursed within 7. Estimate of the funds to be raised and Jersey Jersey disbursed in each £0 - £1,000 financial year of the £1,001 - £19,999 NPO within Jersey: £20,000 - £99,999 (Tick relevant boxes) £100,000 - £499,999 £500,000 - £999,999 £1,000,000+ Raised outside Disbursed outside 8. Estimate of the funds to be raised and Jersey Jersey disbursed in each £0 - £1000 financial year of the £1001 - £19,999 NPO outside Jersey: £20,000 - £99,999 (Tick relevant boxes) £100,000 - £499,999 £500,000 - £999,999 £1,000,000+ NOTES ON QUESTIONS 7 & 8

“Raised”, in respect of the funds of an NPO, includes funds given to the NPO but does not include: (a) income earned on the funds of the NPO; or (b) amounts paid to the NPO by persons to become or remain members of the NPO.

“Disbursed”, in respect of the funds of an NPO, does not include the disbursement of funds paid to the NPO by persons to become or remain members of the NPO if those funds are applied in a way that only benefits members of the NPO.

“Funds” means assets of every kind, whether tangible or intangible, movable or immovable.

9. Please use the area below to provide any additional information you think might help the Commission, e.g. whether the NPO is registered as a charity elsewhere in the British Isles, or whether funds will be disbursed to an affiliated NPO in another part of the British Isles:

Name: Position held in NPO: Signature: (only required for postal submissions)

Postal Applications: Print, sign and return the form to NPO Applications, Jersey Financial Services Commission, PO Box 267, 14-18 Castle Street, St Helier, JE4 8TP. Online Applications: http://www.jerseyfsc.org/anti-money_laundering/forms/NPO/index.asp