Form Nhct-1 - Register Of Charitable Trusts Application For Registration - Office Of The New Hampshire Attorney General Charitable Trust Unit Page 3

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This form must be signed by the President and the Treasurer.
CERTIFICATION
We declare under penalties for falsification in official matters (RSA 641) that we are
authorized to sign this application on behalf of the above organization, we have examined the
application including the attachments and to the best of our knowledge, it is true, correct and
complete.
__________________________________ ______________________________________
Signature of President
Date
__________________________________ ______________________________________
(Print or Type) Name of Officer
Title
__________________________________ ______________________________________
Signature of Treasurer
Date
__________________________________ ______________________________________
(Print or Type) Name of Officer
Title
56414.doc (rev. 8/2009)

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