Texas Society, Sons of the American Revolution

Sons of the American Revolution

Texas Society

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TXSSAR Compliance Officer Report

Please fill out and submit the following form if you have any Concerns about TXSSAR's compliance with the Sarbanes Oxley requirements. Submission of the form will automatically send the information entered to the TXSSAR Compliance Officer unless you indicate that your Concern is about the Compliance Officer, in which case the form will be sent to the Audit Committee Chairman. If you wish to remain anonymous, the Optional fields may be omitted. If included, they will make it possible for the Compliance officer to contact you for additional information or clarification if needed to process your Concern and will allow him to acknowledge receipt of the Concern. It will not be possible to acknowledge receipt of anonymously submitted Concerns.

Date:
Nature of Concern (select appropriate response)
Name of Person Lodging Concern (Optional)
Contact email (Optional)
Contact phone (Optional)
Chapter Affected
Description of Concern/ Non-Compliance
Is this Concern about the Compliance Officer?	No (Report will be sent to Compliance Officer) Yes (Report will be sent to Audit Committee Chairman)
Note: By clicking the Submit button to send this form, the user acknowledges that he has read and understands the TXSSAR Whistleblower Policy, including the paragraph under the "Acting in Good Faith" heading.	(click when you are ready to send your information)