501(c)(3) Pledge Form - GOTV Georgia

Attachment: 2138/COSF_YEN_Ask_-_Prospects_-_4.pdf

Convention of States Foundation (COS Foundation) is registered as a section

501©(3) non-profit organization

. Contributions to Convention of States Foundation

are tax-deductible to the full extent permitted by law. Convention of States Foundation respects the wishes of its donors to keep their identities confidential.

COSF YEN

5850 San Felipe Street, Suite 575



⚫



Houston, TX 77057



⚫



ConventionofStates.org



⚫



512-487-5525

CALIFORNIA

–

Citizens for Self-

Governance DBA Convention of States Foundation’s audited financial statement is available upon request to

Citizens for Self-Governance.

100 percent of your gift may be deducted under Federal and State income tax laws.  FLORIDA

–

A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION

MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL FREE 1-800-435-7352 (800-HELP-FLA) WITHIN THE STATE.  REGISTRATION DOES
NOT IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATION BY THE STATE.  Florida registration number CH38736.   GEORGIA

–

Upon request Citizens for Self-

Governance  DBA  Convention  of  States  Foundation  will  provide  a  full  and  fair  description  of  this  and  its  other  programs,  and  a  financial  statement  or  summary.
MARYLAND

–

A copy of Citizens for Self-

Governance DBA Convention of States Foundation’s current financial statement is available upon

request to Citizens for Self-

Governance, 5850 San Felipe, Suite 575, Austin, TX 78701. For the cost of copies and postage, documents and information submitted under the Maryland Solicitations
Act are available from the Maryland Secretary of State, State House, Annapolis, MD 2140, (410) 974-5534. MINNESOTA

–

100 percent of your gift may be deducted as

a charitable contribution under Federal and State income tax laws. MISSISSIPPI

–

The official registration and financial information of Citizens for Self-Governance DBA

Convention of States Foundation may be obtained from the Mississippi Secretary of State’s office by calling 1

-888-236-6167.  Registration by the Secretary of State does

not imply endorsement.  NEVADA

–

Citizens for Self-Governance DBA Convention of States Foundation provides communication, education, and training on matters

related to self-governance. Contributions may be tax deductible under section 170© of the Internal Revenue Code. SelfGovern.com.  NEW JERSEY

–

INFORMATION

FILED WITH THE ATTORNEY GENERAL CONCERNING THIS SOLICITATION AND THE PERCENTAGE OF CONTRIBUTIONS RECEIVED BY CITIZENS FOR SELF-GOVERNANCE DBA

CONVENTION OF STATES FOUNDATION DURING THE LAST REPORTING PERIOD THAT WERE DEDICATED TO THE ORGANIZATION’S EXEMPT PURPOSES MA

Y BE OBTAINED

FROM  THE  ATTORNEY  GENERAL  OF  THE  STATE  OF  NEW  JERSEY  BY  CALLING  (973)  504-6215  AND  IS  AVAILABLE  ON  THE  INTERNET  AT
http:%%//%%www.njconsumeraffairs.gov/ocp/charities.htm. REGISTRATION WITH THE ATTORNEY GENERAL DOES NOT IMPLY ENDORSEMENT. NEW YORK

–

Upon request, a

copy  of  Citizens  for  Self-

Governance  DBA  Convention  of  States  Foundation’s  last  annual  report  filed  with  the  Attorney  General  is  available  from  Citizen

s  for  Self-

Governance or

from the New York State Attorney General’s Charitable Bureau, Attn: FOIL Officer, 120 Broadway, New York, NY 10271.  NORTH CA

ROLINA

–

Financial

information about this organization and a copy of its license are available from the State Solicitation Licensing Branch at (888) 830-4989 (within North Carolina) or (919)
807-2214 (outside of North Carolina).  The license is not an endorsement by the State.  PENNSYLVANIA

–

The official registration and financial information of Citizens

for Self-Governance DBA Convention of States Foundation may be obtained from the Pennsylvania Department of States by calling toll-free, within Pennsylvania, 1-800-
732-0999.  Registration does not imply endorsement.  VIRGINIA

–

A financial statement is available from the State Division of Consumer Affairs in the Department of

Agriculture and Consumer Services upon request.  WASHINGTON

–

The notice of solicitation required by the Charitable Solicitation Act is on file with the Secretary of

State’s office. Additional financial disclosur

e information can be obtained from the Office of the Secretary of State (800) 332-4483, https://www.sos.wa.gov/.  WEST

VIRGINIA

–

Residents may obtain a summary of the registration and financial documents from the Secretary of State, State Capitol, Charleston, WV 25305.  Registration

does not imply endorsement.

Please  accept  my  501©(3)  tax-deductible  contribution  to  continue  the  good  work  of  COS
Foundation in the amount of: $___________

To make your contribution by credit card, please fill in the information below:

Name on Card:

Card #:

Exp.:

/

Sec Code:

Signature:

TO DONATE BY CREDIT CARD

TO DONATE BY CHECK

Payable to:

COS Foundation

Mail to:

COS Foundation
5850 San Felipe St. Ste 575
Houston, Texas 77057

TO DONATE BY WIRE

Account #: 593398691

Routing #: 021000021

Contact Patty Meckler at: 512-487-5525

pmeckler@conventionofstates.org

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Created:	2020-12-21 23:50 GMT
Updated:	2021-12-22 00:00 GMT
Published:	2020-12-21 07:00 GMT
Converted:	2025-11-11 12:21 GMT
Change Author:	Kyle Key
Credit Author: