Form Ss-6002 Summary Of Financial Activities Of A Charitable Organization Page 2
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1
2SIGNATURE
I certify that the information furnished in this summary and all supplemental forms, documents and
continuation sheets is true and correct to the best of my knowledge and belief.
Signature of Authorized Officer
Signature of Authorized Officer
Print Name
Print Name
Title
Title
Date
Date
SS-6002 (Rev. 11/2011)
RDA 1745
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