Information

NON-PROFIT FORMATION & DEVELOPMENT INTAKE FORM

CLIENT INFORMATION

Client/Organization Name:

Primary Contact Name:

Phone Number:

Email Address:

Business Address:

City, State, Zip:

Proposed Nonprofit Name:

Proposed Service Area (City/County/State):

Target Population Served:

REQUESTED SERVICES, FEES & TURNAROUND TIME

Service	Fee	Estimated Turnaround Time
Advisory Board Registrant Documentation	$100.00	1 business day
Bylaws Development	$ 90.00	1 business day
Mission & Vision Statement Development	$ 25.00	1 business day
Program Development	$TBD	1 week(s)
Organizational Budget Development	$150.00	1 week(s)
Program Budget Development	$TBD	1 week(s)
Ohio Secretary of State Registration for Nonprofit Domestic Corporation (State Fee $99)	$25.00	1 day
Employer Identification Number (EIN) Filing	$25.00	1 day
Ohio Attorney General Registration	$40.00	1 day
IRS Form 1023 Completion (501(c)3 Application Fee $275)	$50.00	1 day
Board of Directors Orientation ($100)	$TBD	________ weeks
Grant Readiness Package ($150)	$TBD	________ weeks
NON-REFUNDABLE DEPOSIT:	$505.00

ORGANIZATION OVERVIEW

Mission Statement:

Vision Statement:

Core Programs/Services:

Projected Annual Budget:

Funding Sources:

Number of Board Members:

Key Community Partners:

LEGAL DISCLAIMER / HOLD HARMLESS

J&S Marketing Resources, Inc. provides business consulting and administrative support services only and does not provide legal advice. Client agrees to hold harmless and indemnify J&S Marketing Resources, Inc. from claims arising from the nonprofit’s filings, operations, compliance, or governance decisions.

I agree to the terms above.

CLIENT SIGNATURE

Client Name (Printed):

Client Signature (Type Full Name):

Date:

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