Paid solicitor registration statement; closing out

(a) Every paid solicitor that is required to register or renew its registration with the department, pursuant to section 21a-190f(a) of the Connecticut General Statutes, shall provide the following information on a registration statement furnished by the department: (1) Whether the paid solicitor has ever been registered under the provisions of Chapter 419d of the Connecticut General Statutes and, if the paid solicitor has been registered, its registration number; (2) the paid solicitor's full legal name and mailing address; (3) the paid solicitor's telephone and facsimile numbers; (4) the names, residence addresses and titles of all officers and directors and all persons or entities with a twenty-five per cent or more ownership interest in the paid solicitor; (5) whether any of the persons listed in response to subdivision (4) of subsection (a) of this section have ever been convicted by a court of any state or of the United States of any felony, or of any misdemeanor involving dishonesty or arising from the conduct of a solicitation for a charitable organization or purpose and, if any of the foregoing has occurred, a detailed explanation of the circumstances; (6) whether the paid solicitor is a corporation, partnership, limited liability company, individual or other entity; (7) the year of the paid solicitor's organization and the state under the laws of which the paid solicitor was organized; (8) whether the paid solicitor is registered in other states to solicit funds and, if the paid solicitor is registered in other states, a list of those states; and (9) whether the paid solicitor's registration has ever been revoked, denied, suspended or enjoined by any state agency or by any court, or whether any proceedings are pending and, if any of the foregoing has occurred, a detailed explanation of the circumstances. (b) The registration statement shall be signed under penalty of false statement by an authorized officer of the paid solicitor. (c) A paid solicitor shall be considered as registered upon the receipt by the department of a fully completed original registration statement and the fee prescribed by section 21a-190f(a) of the Connecticut General Statutes.