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PS 3526-R

Statement of Ownership, Management, and Circulation (Requester Publications Only) (8/2012)

Download and Print the PS 3526-R

Request may not be processed if the form is incomplete or illegible.

1. Publication Title

2. Publication Number

3. Filing Date

4. Issue Frequency

5. Number of Issues Published Annually

7. Complete Mailing Address of Known Office of Publication (Not printer) (Street, city, county, state, and ZIP+4®)

6. Annual Subscription Price (if any)

8. Complete Mailing Address of Headquarters or General Business Office of Publisher (Not printer)

9. Full Names and Complete Mailing Addresses of Publisher, Editor, and Managing Editor (Do not leave blank) Publisher (Name and complete mailing address) Editor (Name and complete mailing address) Managing Editor (Name and complete mailing address)

10. Owner (Do not leave blank. If the publication is owned by a corporation, give the name and address of the corporation immediately followed by the names and addresses of all stockholders owning or holding 1 percent or more of the total amount of stock. If not owned by a corporation, give the names and addresses of the individual owners. If owned by a partnership or other unincorporated firm, give its name and address as well as those of each individual owner. If the publication is published by a nonprofit organization, give its name and address.)

11. Known Bondholders, Mortgagees, and Other Security Holders Owning or Holding 1 Percent or More of Total Amount of Bonds, Mortgages, or
Other Securities. If none, check box PS Form 3526-R, August 2012 (Page 1 of 3 (Instructions Page 3)) PSN: 7530-09-000-8855 - None

Contact Person Telephone (Include area code) - Full Name - Complete Mailing Address
Complete Mailing Address - Full Name

12. Tax Status (For completion by nonprofit organizations authorized to mail at nonprofit rates) (Check one) Has Not Changed During Preceding 12 Months
Has Changed During Preceding 12 Months (Publisher must submit explanation of change with this statement) The purpose,

And much more...