Form CO-1 CHARITABLE ORGANIZATION Revised / -REGISTRATION STATEMENT - ATTORNEY GENERAL 1.This is a registration under: Illinois Charitable Trust Act: Illinois Solicitation for Charity Act;PLEASE TYPE OR PRINT IN INK. This registration statement is required by the Illinois Charitable Trust Act and the IllinoisSolicitation for Charity Act. Please answer all items which are applicable to your organization. If you are unable to answer anyquestion fully in the space provided, please attach a sheet contaiAmerican LegalNet, Inc. www.FormsWorkFlow.com 12.Do you intend to use the services of a professional fund raiser as defined by 223An Act to Regulate Solicitation and Collection of Funds forCharitable Purposes224? Yes NoIf 223Yes224, answer a, b, and comply with c below.a.Name and address of professional fund raiser(s): b.Has the professional fund raiser registered and filed a bond with the Office of the Attorney General as required? Yes Noc.Attach copies of all contracts with professional fund raiser(s).13.Have any of organization222s officers, directors, executive personnel, or have any of the organization222s employees who have access tofunds, ever been charged with or convicted of a misdemeanor involving misapplication or misuse of money of another, or anyfelony? Yes No If 223Yes224, give the following information: (IRS 1981 ch.. 23, sec. 5109)NAME AND ADDRESS OF COURT NATURE OF OFFENSE DATE OF CONVICTION(Mo./Yr.)14.State the board, group or individual having final discretion as to the distribution and use of contributions received.15.Will you use any of the following methods of solicitation? Unordered Merchandise Distribution or Sale of Seals Telephone Appeals Coin Collection Containers Special Events Ad Books Direct Mail Other --- If other, attach an explanation.16.List name, mailing address and title of the chief executive or staff officer of the organization. 17.Attach a list of names, mailing addresses, and daytime phone numbers of all officers and directors, or trustees of the organization.18.Has the United States Internal Revenue Service determined that this organization is tax exempt? Yes NoIf 223Yes224, attach a copy of the determination letter. Is application pending? Yes No*All organizations with tax exempt status or an application pending must attach a copy ofFederal Form 1023 223Application for Recognition of Exemption224 or an exemption letter. Has organization222s tax exempt status ever been questioned, audited, denied or cancelled at any time by any governmental agency? Yes NoIf 223Yes224, attach the facts.Organizations which have been in operation for over one (1) year must attach a copy of the form AG990-IL and Federal return,or AG990IL if no Federal return was filed for each year the organization was in existence, completed in detail. Organizationswhich have been in operation less than one (1) year must attach a completed Financial Information Form CO-2. Pleasenote charitable organization222s are required to maintain accurate and detailed accounting records.Approximate amount of contributions solicited or income received from persons in this State during the organization222s last annualaccounting period $ EVERY REGISTERING ORGANIZATION MUST ATTACH THE FOLLOWING APPLICABLE DOCUMENTS: Corporation....................................The Articles of Incorporation and/or Certificate of Authority, Amendments and By-LawsUnincorporated Association...........Constitution and By-LawsTestamentary Trust.........................Will, Probate number and Decree of DistributionInter Vivos Trust.............................Instrument Creating TrustNote:The President and the Chief Financial Officer or other authorized officer are both required to sign. This must be two differentindividuals. If entity is a Trust, all Trustees must sign. UNDER PENALTY OF PERJURY, THE UNDERSIGNED DECLARE AND CERTIFY THAT THE INFORMATION CONTAINED IN THIS STATEMENT AND ALL ATTACHED SHEETS IS TRUE AND CORRECT TO THE BEST OF OUR KNOWLEDGE.SignatureTitleDate SignatureTitleDate American LegalNet, Inc. www.FormsWorkFlow.com