Statement Of Consolidation Form - Colorado Secretary Of State Page 5
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7Business Information Survey (Optional)
For office use only
Submit with your form if you want to add, change, or remove survey information
Survey information can be added, changed, or removed when you file a form with our
office. The information on this survey is associated with the entity’s record- it does not
become a part of the document that you file with us.
This survey is voluntary. Any information that you enter will be available to the public. The
information is being gathered as required by law- see House Bill 13-1167 for information.
Entity information
ID number
Entity name
Choose one:
1. Remove all survey information from this entity’s record.
2. Add or update the survey information on this entity’s record as follows:
a) Gender
Male
Female
Choose not to answer / Remove this information
b) Veteran?
Yes
No
Choose not to answer / Remove this information
c) Person with a disability?
Yes
No
Choose not to answer / Remove this information
d) Race
African American
Latino
Anglo
Native American
Asian
Other
Choose not to answer / Remove this information
SurveyInfo
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Rev. 12/11/2013
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Parent category: Legal