Memorial Donation Form

CHARITABLE SOLICITATION DISCLOSURE STATEMENTS
PEGGY BROWNING FUND
100 South Broad Street, Suite 1208, Philadelphia, PA 19110 ∙ Telephone: 267-273-7990

Contributions will be used for the support of the Peggy Browning Fund’s charitable programs and services, including fellowships, mentoring services, annual conferences, regional workshops, networking events and activities, alumni services, and related activities. Donations to the Peggy Browning Fund are tax deductible to the fullest extent allowed by law.  Financial and other information about the Peggy Browning Fund may be obtained, without cost, by writing to the Peggy Browning Fund at the address indicated above or by calling the phone number indicated above.  In addition, residents of the following states may obtain financial and/or licensing information from their states, as indicated.

CO:Colorado residents may obtain copies of registration and financial documents from the office of the Secretary of State, 303-894-2860, www.sos.state.co.us/re: Reg.No. 20143004996. FL: A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE WITHIN THE STATE, 800-HELP-FLA.  REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATION BY THE STATE. FLORIDA REGISTRATION #CH38299. GA: A full and fair description of the Peggy Browning Fund and its financial statement are available upon request at the address indicated above. IL: Contracts and reports regarding the Peggy Browning Fund are on file with the Illinois Attorney General. MD: A copy of the current financial statement of the Peggy Browning Fund is available by writing to the Peggy Browning Fund or by calling 267-273-7990. Documents and information submitted under the Maryland Charitable Solicitations Act are also available, for the cost of postage and copies, from the Maryland Secretary of State, State House, Annapolis, MD 21401, 800-825-4510. MI: Peggy Browning Fund MICS #50487. MS:  The official registration and financial information of the Peggy Browning Fund may be obtained from the Mississippi Secretary of State’s office by calling 1 (888) 236-6167. Registration by the Secretary of State does not imply endorsement by the Secretary of State. NJ: INFORMATION FILED BY THE PEGGY BROWNING FUND WITH THE NEW JERSEY ATTORNEY GENERAL CONCERNING THIS CHARITABLE SOLICITATION AND THE PERCENTAGE OF CONTRIBUTIONS RECEIVED BY THE CHARITY DURING THE LAST REPORTING PERIOD THAT WERE DEDICATED TO THE CHARITABLE PURPOSE MAY BE OBTAINED FROM THE ATTORNEY GENERAL OF THE STATE OF NEW JERSEY BY CALLING (973) 504-6215 AND IS AVAILABLE ON THE INTERNET http://www.njconsumerarffairs.gov/charity/chardir.htm. REGISTRATION WITH THE ATTORNEY GENERAL DOES NOT IMPLY ENDORSEMENT.  NY: Upon request, a person may obtain from the Peggy Browning Fund or from the Attorney General (1209 Broadway, New York, NY 10271) a copy of the last financial report filed with the Attorney General. NC: FINANCIAL INFORMATION ABOUT THIS ORGANIZATION AND A COPY OF ITS LICENSE ARE AVAILABLE FROM THE STATE SOLICITATION LICENSING BRANCH AT 1-888-830-4989 (WITHIN NORTH CAROLINA) OR (919) 807-2214  (OUTSIDE OF NORTH CAROLINA).  THE LICENSE IS NOT AN ENDORSEMENT BY THE STATE. PA: The official registration and financial information may be obtained from the PA Department of State by calling toll free, within Pennsylvania, 1-800-732-0999.  Registration does not imply endorsement. VA: A financial statement is available from the State Office of Consumer Affairs in the Department of Agriculture and Consumer Services, P.O. Box 1163, Richmond, VA 23218. WA: Financial disclosure information is available from the Secretary of State at 1-800-332-4483.  WV: West Virginia residents may obtain a summary of the registration and financial documents from the Secretary of State, State Capitol, Charleston, WV 25305. Registration does not imply endorsement. ALL STATES:  REGISTRATION DOES NOT CONSTITUTE OR IMPLY ENDORSEMENT, APPROVAL, SANCTION OR RECOMMENDATION BY ANY STATE.