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Get CT CPC-54 2010

OF EXEMPTION FROM REGISTRATION PLEASE READ INSTRUCTIONS ON REVERSE SIDE BEFORE COMPLETING THIS FORM A. Is the organization now or has the organization ever been registered under the Connecticut Solicitation of Charitable Funds Act? Yes No If yes, enter the registration number: ____________________ B. Provide the full legal name, mailing address and federal identification number of the organization: Name: Address: City, State & Zip Code: FEIN (Federal Identification Number): _______________.

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