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PENNSYLVANIA DEPARTMENT OF STATE BUREAU OF CORPORATIONS AND CHARITABLE ORGANIZATIONS Return document by mail to: Statement with Respect to Shares Domestic Business Corporation Name DSC:151522 Address

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Start by carefully reading the instructions provided on the form. Make sure you understand the purpose of the 1522b and what information needs to be provided.

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Begin with accurately filling out your personal details such as your name, address, and contact information.

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Indicate the relevant statement or statements for which you are providing information. This could be a legal statement, an official account, or any other statement required by the form.

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