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CFO, statement of Organization Recipient Committee StatementType date StampIElntiaONot yet qualifiedQoate all, o “o as committee1. Committee information 'L! Amendment 02, 27(if applicable)See Part

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To fill out OR5RO 410 - City, follow these steps: 1. Begin by entering your personal information, such as your name, address, and contact details. 2. Provide details about the city for which you are submitting the form, such as the name of the city and its location. 3. Include any relevant information about the purpose of your submission and the specific requirements for the city. 4. Review the form for accuracy and completeness before submitting it. 5. Finally, sign and date the form to attest to the truthfulness of the information provided.

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