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VETERANS ORGANIZATION SOLICITOR'S QUARTERLY REPORT
A solicitor that raises more than $5000 for a veterans organization during a calendar quarter, must
file the following report with the secretary of state at the end of that calendar quarter. A filing fee of
$50.00 must accompany this report.
(Please print or type. Use additional sheets if necessary.)
_____________Quarter
*** Please indicate which quarter you are reporting.
1st: January - March 2nd: April - June
3rd: July - September 4th: October - December
1. Solicitor's name:
Address: ___________________________________________________________________________
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Telephone number: (_________) ____________________________
2. The name and address of the veteran's organization is as follows:
4. The amount paid to the veterans organization was ______________________________________
3. The gross amount raised for the veterans organization was _______________________________
Form #3506