OFFICE OF THE SECRETARY OF STATE VETERANS ORGANIZATION SOLICITATION REGISTRATION STATEMENT _____New 1. _____Renewal (Please print or type. Attach additional sheets if necessary.) Name of Organization: ___________________________________________________________ Type of Organization: (Corporation, unincorporated entity, partnership, etc.) _______________________________________________________________________________ Mailing Address:________________________________________________________________ Telephone Number: (_________)______________________ 2. List the name, street address, and telephone number of each solicitor that will solicit on behalf of your organization. _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ 3. List the name, street address, and telephone number of each veterans organization or fund on behalf of which all or part of the contributions will be used, or, if there is no organization or fund, a statement describing the manner in which the contributions will be used. _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ 4. State whether this organization or fund solicits in person, by telephone and/or mail. ______________________________________________________________________________ 5. Does this organization have a charitable tax exemption under state law? _________________________ Under federal law? _______________________________ What is the basis for exemption? __________________________________________________ _______________________________________________________________________________ Form #3501 American LegalNet, Inc. www.FormsWorkFlow.com 6. List the names of veterans who are on the board of directors or the governing body of this organization or fund for which contributions are solicited, if any. _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ 7. How many of your members are veterans as determined on December 31 of last year? ______________________________________________________________________ 8. What percentage of the members of your organization are veterans as determined on December 31 of last year? ______________________________________________________________________ 9. List the name of each local, chapter, lodge, association or group of veterans that is a member of the organization filing registration for which contributions are solicited, if any. _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ 10. Have you filed an Internal Revenue Service Form 990? Yes______ No______ If yes, attach a copy of the one most recently filed. The name, address, and telephone number of the company that issued the surety bond for this organization is: ______________________________________________________________________________ ______________________________________________________________________________ 11. 12. Is this organization chartered by the United States Congress? _________________________ If so, give charter number._______________________________________________________ 13. Number of counties in which you solicit. ______________________________ American LegalNet, Inc. www.FormsWorkFlow.com 14. Has this organization ever forfeited a bond under this Act? _________________________ If so, how many? _____________________________________________________________ What was (were) the date(s) of forfeiture? ________________________________________ _____________________________________________________________________________ Executed this ______________ day of _______________________________, ___________. __________________________________________ (Signature) __________________________________________ (Typed or Printed Name & Title) INFORMATION AND INSTRUCTIONS Return the registration/renewal form and surety bond with the filing fee of $150.00 to: SECRETARY OF STATE Registrations Unit P. O. Box 13550 Austin, TX 78711-3550 For delivery: ********* James Earl Rudder Office Building, 1019 Brazos, 5th Floor Austin, Texas 78701 PLEASE NOTE: IF THE VETERANS ORGANIZATION RECEIVED MORE THAN $500 IN SOLICITED FUNDS DURING THE PRECEDING CALENDAR YEAR, IT MUST FILE A VETERANS ORGANIZATION ANNUAL REPORT WITH THE SECRETARY OF STATE. REPORT FORMS CAN BE OBTAINED FROM THE ABOVE ADDRESS. American LegalNet, Inc. www.FormsWorkFlow.com