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Char 500 Form 2011
NYS:
G
G
G
G
G
G
c. N am e of organization
d. Fed. em ployer ID no. (E IN ) (##-#######)
Address change
e. N Y S tate registration no. (##-##-##)
Name change
Initial filing
N um ber and street (or P.O . box if m ail not delivered to street address)
Final filing
R oom /suite
f.
T elephone num ber
Amended filing
NY registration pending
C ity or town, state or country and zip + 4
g. E m ail
2. Certification - Two Signatures Required
We certify under penalties of perjury that we...
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