Form Cri-500s - Solicitor Of An Independent Paid Fund Raiser - Initial Registration And Renewal Registration Page 3

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CERTIFICATION
(This form must be signed by both the Registering Solicitor and
an Officer of the Independent Paid Fund Raiser.)
We understand that this registration will be accepted only if the requirements of the CRI Act are met. We agree to cooperate
fully with any request by the Attorney General or the Division of Consumer Affairs concerning any information given on this
registration in order to ascertain that the statements are true. We also understand it is a violation of New Jersey’s CRI Act to
solicit on behalf of an unregistered charity.
I, the Solicitor, will not misrepresent who I am or the purpose of the call when soliciting on behalf of registered charitable
organizations.
We certify that the above statements are true and we are aware that if any of the above statements are willfully false, we are
subject to punishment.
Registering Solicitor:
____________________________________________________________________________________________________________
Solicitor’s Signature
Print Solicitor’s Name
Print Title/Position
Date
Independent Paid Fund Raiser:
______________________________________________
Print Name of Independent Paid Fund Raiser
____________________________________________________________________________________________________________
Officer’s Signature
Print Name of Officer
Print Title/Position
Date
Solicitor: Before submitting this document,
please familiarize yourself with the general information and
registration requirements provided on the following page.
Page 3 of 4

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