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Get FL OIR-A3-1209 2006-2024

Donor Annuity Issuer's Contact Person: Donor Annuity Issuer's FEIN: STATE OF: COUNTY OF: , (both printed please), of the above named issuer, being duly sworn, each deposes and says that they are the above described officers of the said issuer, and that on , which is the fiscal year-end, the issuer has met all of the requirements of Section 627.481, FS., and Chapter 69O-202, Florida Administrative Code. (Typed Name) (Typed Name) (Signature) (Signature) (Title) (Title) Subscribed an.

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