Massachusetts Voluntary Associations and Trusts Annual Report Form

The Massachusetts Voluntary Associations and Trusts Annual Report Form contains the year’s registered associations in the State of Massachusetts that were registered before the 1st of June.

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report of voluntary associations and trusts	s	c	l	(General  aws,  hapter 182,  ection 12)	
1. Exact name of trust:	 	
2. Street address of principal office in Massachusetts:
3. Street address elsewhere, if doing business outside Massachusetts:
4. Number of issued and outstanding transferable certificates of participation or shares:
5. The names and addresses of all the trustees are as follows:	
ddress
ame	  a	n	 	
The Commonwealth of Massachusetts	
f	William  rancis Galvin	
Secretary of the Commonwealth	
One Ashburton Place, Boston, Massachusetts 02108-1512	
 	f	____  	
Fee: $75.00iled for the year 20	
I  have  examined  this  Report  of Voluntary Associations  and Trusts  and 
found  it  to  conform  with  the  requirements  of  Massachusetts  Gen	-	
eral  Laws,  Chapter  182,  Section  12  and  the  filing  fee  in  the  amount  of 
$__________
 	,  having  been  paid,  said  report  is  deemed  to  have  been	
filed with me this	________ 	day of	____________________
 	, 20	______ 	. 	
f	William  rancis Galvin
Secretary of the Commonwealth
  __________________________________________________________________	
, declare under penalties of perjury that I/we have examined this report and that to the best of my/our information and belief, 
the statements contained herein are true and correct and hereto sign my/our name(s) this
*I/We the trustee(s) of the above named trust,	
 	 	_______	day of	______________________________	, 20	_______	.	
 	
 	 	 ___________________________________________	, Trustee	____________________________________________	, Trustee
**	
*Delecte the inapplicable wards.**The trustee, or if more than one trustee, then at least two trustees, shall sign under the pen\
alties of perjury.	
182rptva 6/13/01

Every association or trust shall annually on or before June first, file with the Secretary of the Commonwealth a report signed un	-	
der the penalties of perjury by its trustees, stating (a) the name of the association or trust; (b) the location (with street address) 
of its principal office in this Commonwealth and elsewhere if the trust or association does business outside the Commonwealth; 
(c) the number of its issued and outstanding transferable certificates of participation or shares; and (d) the names and addresses 
of its trustees. –General Laws, Chapter 182, Section 12	
instructions for completion of this form	Note: Please type or print clearly as this document will be microfilmed. Incomplete or incorrect reports will be returned to sender for comple	-	tion and/or correction. Please send original document only; keep a photocopy for your fi\
les.
A. Item 1. Insert the exact name of the trust. Do not use any d/b/a names, trade names, or abbreviations.
B.  Item 2. Insert the full address of the trust’s principal office in Massachusetts, using number and street, city or town, state and zip code.
C.  Item 3. If the trust is doing business outside of Massachusetts, please insert it’s additional address.
D.  Item 4. Insert the number of issued and outstanding transferable certificates of participation or shares.
E.   Item 5. Insert the names and residential addresses of all the trustees.
F.  Complete the statement at the end of the form, insert date and sign where indicated. If more than one trustee exists, than at least two trustees must sign this 	report.	
G. Issue a check in the amount of $75.00 payable to the Commonwealth of Massachusetts. Attach check to the document and mail both to: 	 	William Francis Galvin, Secretary of the Commonwealth, Attention: Trust MT-1, One Ashburton Place, Room 1717, Boston, MA 02108-1512