Charitable Law Section Office 614.466.3181 Fax 614.466.9788 150 East Gay Street, 23rd Floor Columbus, Ohio 43215-3130 www.OhioAttorneyGeneral.gov Verification of Registration with the State of Ohio Attorney General's Office (To be completed by the Charity. Please be sure to submit information as filed with the Attorney General's Office, i.e., proper name, etc. Send this form, along with a self-addressed stamped envelope, to the address listed below. NOTE: This form must be visible when the package is opened to expedite your request. Failure to make this form visible will delay a response from our office. ) To: Attorney General, Charitable Law Section 150 East Gay Street, 23rd Floor Columbus, OH 43215-3130 (614) 466-3181 From: __________________________________________________________ Name of Charity __________________________________________________________ Address of Charity __________________________________________________________ City, State, Zip __________________________________________________________ E-mail address __________________________________________________________ Web address __________________________________________________________ Employer Identification Number (To be completed by the Attorney General's Office. Please allow fourteen days from the date that the Attorney General receives this form for a response.) Is this charity registered with the Attorney General? ___ Yes ___ No Has this charity filed with the Attorney General the required financial reports, or the Verification of Filing with the Internal Revenue Service form, for each of the past three years? ___ Yes ___ No Has this charity paid all fees required for each of the past three years? ___ Yes ___ No Comments: _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Signature of Attorney General Representative ____________________________ Date (revised 2/11) American LegalNet, Inc. www.FormsWorkFlow.com