Local Surety Association Officers Survey

After reviewing the current listing of your Local Surety Association (LSA) on the SIO Web site, please take a few minutes to complete this survey form, which will be used to update the LSA Officer Directory for 2010. This enables SIO to communicate, coordinate, and work with the network of LSAs nationwide to help promote the use of contract surety bonds. An updated officer listing also guarantees that all of your officers and Public Information Task Force/PR Committee members will receive the LSA Communiqué newsletter. The Directory of LSA Officers is available on the SIO Web site, www.sio.org, on the tab “Access Surety Professionals.”

• Please list names and titles exactly as they are to appear in the LSA Officers Directory.
• Please include exact mailing address, including suite or floor numbers.
• To use this form, simply “Tab” to each area, and enter all applicable information.
• Please have information submitted by January 4, 2010.
• If you would like a hard copy version of this form faxed to you, or if you would prefer to submit your officer roster directly to SIO, please send a message to sio@sio.org.

NAME OF LOCAL SURETY ASSOCIATION (Enter the full name of your Local Surety Association as it should appear in the Directory)
LSA WEB ADDRESS (If your LSA has a Web site, please enter it here so it can be linked on the SIO Web site)
ELECTION DATE (Please enter the date your elections are held to help us better maintain the directory.)
OFFICERS
PRESIDENT Name: Title: (e.g. bond manager, underwriter) Company: Street Address: (street address preferred to PO Box) City, State & Zip: Phone: Fax: E-mail:		VICE-PRESIDENT Name: Title: (e.g. bond manager, underwriter) Company: Street Address: (street address preferred to PO Box) City, State & Zip: Phone: Fax: E-mail:
TREASURER Name: Title: (e.g. bond manager, underwriter ) Company: Street Address: (street address preferred to PO Box) City, State & Zip: Phone: Fax: E-mail:		SECRETARY Name: Title: (e.g. bond manager, underwriter) Company: Street Address: (street address preferred to PO Box) City, State & Zip: Phone: Fax: E-mail:
PUBLIC RELATIONS COMMITTEE/PR TASK FORCE
CHAIR Name: Title: (e.g. bond manager, underwriter ) Company: Street Address: (street address preferred to PO Box) City, State & Zip: Phone: Fax: E-mail:		MEMBER Name: Title: (e.g. bond manager, underwriter ) Company: Street Address: (street address preferred to PO Box) City, State & Zip: Phone: Fax: E-mail:
MEMBER Name: Title: (e.g. bond manager, underwriter ) Company: Street Address: (street address preferred to PO Box) City, State & Zip: Phone: Fax: E-mail:		MEMBER Name: Title: (e.g. bond manager, underwriter ) Company: Street Address: (street address preferred to PO Box) City, State & Zip: Phone: Fax: E-mail:
MEMBER Name: Title: (e.g. bond manager, underwriter ) Company: Street Address: (street address preferred to PO Box) City, State & Zip: Phone: Fax: E-mail:		MEMBER Name: Title: (e.g. bond manager, underwriter ) Company: Street Address: (street address preferred to PO Box) City, State & Zip: Phone: Fax: E-mail:
SUBMITTED BY:
Name: Phone: E-mail: