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STATE OF CONNECTICUT DEPARTMENT OF CONSUMER PROTECTION CLAIM OF EXEMPTION FROM REGISTRATION FORM CPC-54 REV OCT 10 DOUBLE -SIDED FORM TELEPHONE 860 713-6170 EMAIL CTCHARITYHELP CT. Signed Date / Printed name Title STATE LAW REQUIRES THAT TWO PERSONS SIGN THIS FORM INSTRUCTIONS FOR COMPLETING FORM CPC-54 BEFORE COMPLETING THIS FORM Review the six numbered exemption categories. Gov or mail it to Public Charities Department of Consumer Protection 16.

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