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Solicitor Registration Statement 2012 SR-RS - North Carolina
| Solicitor Registration Statement 2012 Form. This is a North Carolina form and can be used in Lobbyist Registration Secretary Of State . |
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Form SR-RS, Page 1 of 2, (Rev. 12/11 Elaine F. Marshall, Secretary of State Solicitor Registration Statement 2012 NO REGISTRATION FEE REQUIRED Solicitor Information Complete Name of Solicitor: __________________________________________________________________ Complete Name of Firm or Organization of Solicitor (If Applicable): __________________________________ _________________________________________________________________________________________ Complete Name and Title of Authorized Representative of Solicitor: __________________________________ Mailing Address of Authorized Representative of Solicitor: _________________________________________ _________________________________________________________________________________________ Physical Address of Authorized Representative of Solicitor: ________________________________________ _________________________________________________________________________________________ Weekday Telephone for Authorized Representative of Solicitor: _____________________________________ Fax No.: ____________________________ E-Mail Address: ______________________________________ ________________________________________________________________ _______________________ Signature of Representative Authorized to Sign for Solicitor Date ________________________________________________________________ _______________________ Name & Title of Representative Authorized to Sign for Solicitor Date The Division will send notices regarding filing due dates electronically at no charge. If you desire to receive notices from our office in another format, please indicate that by checking the box and you will be invoiced according to G.S. § 132-1(b). CERTIFICATION I hereby certify that all information disclosed in this "Solicitor Registration Statement 2012" is true, complete and correct in accordance with G.S. §120C-215. By signing this certification, I understand I have an affirmative duty to understand and to comply with the Lobbying Law and the rules, including filing reports, as the law requires. __________________________________________________________________________________________ SIGNATURE OF PERSON AUTHORIZED TO SIGN FOR SOLICITOR DATE American LegalNet, Inc. www.FormsWorkFlow.com Form SR-RS, Page 2 of 2, (Rev. 12/11 Instructions 1. Do Not Use This Form If You Are Registering For Economic Information Protection. 2. Registration triggers reporting obligations. Quarterly reports must be filed regardless of whether you have any reportable expenditures. 3. "Solicitation of others" is the act of asking the public to communicate directly with designated individuals in order to influence or attempt to influence legislative or executive action in order to further the purposes of those who are doing the soliciting. G.S. 120C-100(a)(13). 4. Types of communication that triggers solicitation is an ad in print media, a television ad (including cable and satellite), e-mail or a Web site posting, a mailed letter or flyer, phone calls, and finally, communicating with the public at a conference, meeting, or similar event. 5. Registration and reporting by solicitors are triggered when the total expense for solicitation of others exceeds $3,000.00 during any 90-day period. These expenses include the cost of producing and transmitting the communication. If the communication is made at a conference, meeting, or similar event, then the solicitor must include the costs of planning, hosting, sponsoring, and attending the event. 6. A solicitor cannot be a registered lobbyist or principal. 7. If you do not provide an email address on this form and do not mark the box to receive notices in another format (page 1 of this document), we are under no obligation to inform you of report due dates, form changes, or any other information we provide via electronic methods. 8. FILING SUBMISSION LOCATIONS AND METHODS Each required filing shall be submitted to the Department by one of the following methods: (a) By United States mail at the following address: Lobbying Compliance Division Dept. of the Secretary of State P. O. Box 29622 Raleigh, N.C. 27626-0622 (b) By hand-delivery or by a designated delivery service authorized pursuant to G.S. §1A-1, Rule 4 at the following street address: Lobbying Compliance Division Dept. of the Secretary of State 2 S. Salisbury Street Raleigh, N.C. 27601-2903 (c) Electronically by electronic mail via the Internet site at the following address: lobbyistfiling@sosnc.com. Any document(s) attached to the filing other than the form or report shall be compatible with or convertible to the most recently issued version of Microsoft Word®; By facsimile (919-807-2205) for filings not requiring a fee, provided the original signed document is postmarked or delivered to the Department within seven days following the Department's receipt of the faxed transmission. A filing for which the original is not postmarked or delivered to the Department within seven days following the Department's receipt of the faxed transmission is void. A document received by hand-delivery or fax after 5:00 p.m. is considered to be received on the following day. American LegalNet, Inc. www.FormsWorkFlow.com (d)
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