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HB3755 • 2026

Oklahoma Juvenile Code; directing certain provision of medication and reimbursement; creating the Juvenile Detention Prescription Medication Fund; effective date.

Oklahoma Juvenile Code; directing certain provision of medication and reimbursement; creating the Juvenile Detention Prescription Medication Fund; effective date.

Children
Enacted

This bill passed the Legislature and reached final enactment based on the latest official action.

Sponsor
Sterling
Last action
2026-05-11
Official status
Approved by Governor 05/11/2026
Effective date
Not listed

Plain English Breakdown

Using official source text because the generated explanation was unavailable or could not be confirmed against the official bill text.

Oklahoma Juvenile Code; directing certain provision of medication and reimbursement; creating the Juvenile Detention Prescription Medication Fund; effective date.

Oklahoma Juvenile Code; directing certain provision of medication and reimbursement; creating the Juvenile Detention Prescription Medication Fund; effective date.

What This Bill Does

  • Oklahoma Juvenile Code; directing certain provision of medication and reimbursement; creating the Juvenile Detention Prescription Medication Fund; effective date.
  • Bill Summaries/Fiscal Impact for HB 3755 (House): Proposed Committee Substitute (full committee) 1 (2/16/2026) Bill Summaries/Fiscal Impact for HB 3755 (House): Amendment to Proposed Committee Substitute (full committee) 1 (2/25/2026) Bill Summaries/Fiscal Impact for HB 3755 (House): Proposed Policy Committee Recommendation (2/25/2026) Bill Summaries/Fiscal Impact for HB 3755 (House): Committee Substitute (3/10/2026) Bill Summaries/Fiscal Impact for HB 3755 (House): Floor Amendment 1 (3/10/2026) Bill Summaries/Fiscal Impact for HB 3755 (House): Senate Amendment to House Bill (4/29/2026) Bill Summaries/Fiscal Impact for HB 3755 (Senate): Committee Substitute (4/21/2026)

Limits and Unknowns

  • This entry is temporarily using official source text because the generated explanation could not be confirmed against the official bill text during the last sync.

Amendments

These notes stay tied to the official amendment files and metadata from the legislature.

Plain English: HB3755 FA1-A1 KaneJo-CJC 3/11/2026 3:43:54 pm AMEND TITLE TO CONFORM TO AMENDMENTS Amendment submitted by: John Kane Adopted: _____________________________ ______________________________________ Reading Clerk FLOOR AMENDMENT HOUSE OF REPRESENTATIVES State of Oklahoma SPEAKER: CHAIR: I move to amend amendment number 1 to HB3755 Of the printed Bill Page Section Lines Of the Engrossed Bill By striking the Title.

  • HB3755 FA1-A1 KaneJo-CJC 3/11/2026 3:43:54 pm AMEND TITLE TO CONFORM TO AMENDMENTS Amendment submitted by: John Kane Adopted: _____________________________ ______________________________________ Reading Clerk FLOOR AMENDMENT HOUSE OF REPRESENTATIVES State of Oklahoma SPEAKER: CHAIR: I move to amend amendment number 1 to HB3755 Of the printed Bill Page Section Lines Of the Engrossed Bill By striking the Title.

Plain English: HB3755 FA1 KerbsDe-CMA 3/5/2026 8:12:43 am AMEND TITLE TO CONFORM TO AMENDMENTS Amendment submitted by: Dell Kerbs Adopted: _____________________________ ______________________________________ Reading Clerk FLOOR AMENDMENT HOUSE OF REPRESENTATIVES State of Oklahoma SPEAKER: CHAIR: I move to amend HB3755 Of the printed Bill Page Section Lines Of the Engrossed Bill By deleting the content of the entire measure, and by inserting in lieu thereof the following language: Req.

  • HB3755 FA1 KerbsDe-CMA 3/5/2026 8:12:43 am AMEND TITLE TO CONFORM TO AMENDMENTS Amendment submitted by: Dell Kerbs Adopted: _____________________________ ______________________________________ Reading Clerk FLOOR AMENDMENT HOUSE OF REPRESENTATIVES State of Oklahoma SPEAKER: CHAIR: I move to amend HB3755 Of the printed Bill Page Section Lines Of the Engrossed Bill By deleting the content of the entire measure, and by inserting in lieu thereof the following language: Req.
  • No.
  • 16822 Page 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 STATE OF OKLAHOMA 2nd Session of the 60th Legislature (2026) FLOOR SUBSTITUTE FOR HOUSE BILL NO.
  • 3755 By: Sterling of the House and Stanley of the Senate FLOOR SUBSTITUTE An Act relating to children; amending 10A O.S.

Plain English: HB3755 FULLPCS1-AMD1 Danny Sterling-CMA 2/16/2026 8:40:18 am AMEND TITLE TO CONFORM TO AMENDMENTS Amendment submitted by: Danny Sterling Adopted: _____________________________ ______________________________________ Reading Clerk COMMITTEE AMENDMENT HOUSE OF REPRESENTATIVES State of Oklahoma SPEAKER: CHAIR: I move to amend amendment HB3755 FULLPCS1 Of the printed Bill Page 8 Section 1 Lines 21 Of the Engrossed Bill By deleting language starting with the word "placing" through the word "detention" and by inserting in lieu thereof the following language: "a juvenile is placed into a detention facility and is under the Office of Juvenile Affair's supervision or custody".

  • HB3755 FULLPCS1-AMD1 Danny Sterling-CMA 2/16/2026 8:40:18 am AMEND TITLE TO CONFORM TO AMENDMENTS Amendment submitted by: Danny Sterling Adopted: _____________________________ ______________________________________ Reading Clerk COMMITTEE AMENDMENT HOUSE OF REPRESENTATIVES State of Oklahoma SPEAKER: CHAIR: I move to amend amendment HB3755 FULLPCS1 Of the printed Bill Page 8 Section 1 Lines 21 Of the Engrossed Bill By deleting language starting with the word "placing" through the word "detention" and by inserting in lieu thereof the following language: "a juvenile is placed into a detention facility and is under the Office of Juvenile Affair's supervision or custody".
Filed

Plain English: Req.

  • Req.
  • No.
  • 3941 Page 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 STATE OF OKLAHOMA 2nd Session of the 60th Legislature (2026) COMMITTEE SUBSTITUTE FOR ENGROSSED HOUSE BILL NO.
  • 3755 By: Sterling of the House and Stanley of the Senate COMMITTEE SUBSTITUTE [ Oklahoma Juvenile Code – juvenile detention facilities - medication prescribed for juveniles - reimbursement - Juvenile Detention Prescription Medication Fund - codification - effective date ] BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA: SECTION 1.

Plain English: Filed

  • The official amendment file could not be read automatically during the last sync, so only the official amendment metadata is shown right now.

Plain English: Req.

  • Req.
  • No.
  • 16516 Page 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 STATE OF OKLAHOMA 2nd Session of the 60th Legislature (2026) POLICY COMMITTEE RECOMMENDATION FOR HOUSE BILL NO.
  • 3755 By: Sterling POLICY COMMITTEE RECOMMENDATION An Act relating to children; amending 10A O.S.

Plain English: HB3755 FULLPCS1 Danny Sterling-CMA 2/5/2026 4:29:23 pm AMEND TITLE TO CONFORM TO AMENDMENTS Amendment submitted by: Danny Sterling Adopted: _____________________________ ______________________________________ Reading Clerk COMMITTEE AMENDMENT HOUSE OF REPRESENTATIVES State of Oklahoma SPEAKER: CHAIR: I move to amend HB3755 Of the printed Bill Page Section Lines Of the Engrossed Bill By deleting the content of the entire measure, and by inserting in lieu thereof the following language: Req.

  • HB3755 FULLPCS1 Danny Sterling-CMA 2/5/2026 4:29:23 pm AMEND TITLE TO CONFORM TO AMENDMENTS Amendment submitted by: Danny Sterling Adopted: _____________________________ ______________________________________ Reading Clerk COMMITTEE AMENDMENT HOUSE OF REPRESENTATIVES State of Oklahoma SPEAKER: CHAIR: I move to amend HB3755 Of the printed Bill Page Section Lines Of the Engrossed Bill By deleting the content of the entire measure, and by inserting in lieu thereof the following language: Req.
  • No.
  • 15940 Page 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 STATE OF OKLAHOMA 2nd Session of the 60th Legislature (2026) PROPOSED COMMITTEE SUBSTITUTE FOR HOUSE BILL NO.
  • 3755 By: Sterling PROPOSED COMMITTEE SUBSTITUTE An Act relating to children; amending 10A O.S.

Bill History

  1. 2026-05-11 House

    Approved by Governor 05/11/2026

  2. 2026-05-05 House

    Enrolled, signed, to Senate

  3. 2026-05-05 Senate

    Enrolled measure signed, returned to House

  4. 2026-05-05 House

    Sent to Governor

  5. 2026-05-04 House

    SA's read, adopted

  6. 2026-05-04 House

    Fourth Reading, Measure passed: Ayes: 90 Nays: 0

  7. 2026-05-04 House

    Referred for enrollment

  8. 2026-04-27 Senate

    Engrossed to House

  9. 2026-04-27 House

    SA's received

  10. 2026-04-23 Senate

    General Order, Amended

  11. 2026-04-23 Senate

    Title restored

  12. 2026-04-23 Senate

    Measure passed: Ayes: 43 Nays: 0

  13. 2026-04-23 Senate

    Referred for engrossment

  14. 2026-04-22 Senate

    Placed on General Order

  15. 2026-04-20 Senate

    Reported Do Pass, amended by committee substitute Health and Human Services committee; CR filed

  16. 2026-04-01 Senate

    Second Reading referred to Health and Human Services

  17. 2026-03-12 House

    Engrossed, signed, to Senate

  18. 2026-03-12 Senate

    First Reading

  19. 2026-03-11 House

    General Order

  20. 2026-03-11 House

    Amended by floor substitute

  21. 2026-03-11 House

    Title stricken

  22. 2026-03-11 House

    Third Reading, Measure passed: Ayes: 92 Nays: 0

  23. 2026-03-11 House

    Referred for engrossment

  24. 2026-02-26 House

    CR; Do Pass, amended by committee substitute Judiciary and Public Safety Oversight Committee

  25. 2026-02-18 House

    Policy recommendation to the Judiciary and Public Safety Oversight committee; Do Pass, amended by committee substitute Criminal Judiciary

  26. 2026-02-18 House

    Authored by Senator Stanley (principal Senate author)

  27. 2026-02-10 House

    Withdrawn from Rules Committee

  28. 2026-02-10 House

    Referred to Judiciary and Public Safety Oversight

  29. 2026-02-10 House

    Referred to Criminal Judiciary

  30. 2026-02-03 House

    Second Reading referred to Rules

  31. 2026-02-02 House

    First Reading

  32. 2026-02-02 House

    Authored by Representative Sterling

Official Summary Text

Oklahoma Juvenile Code; directing certain provision of medication and reimbursement; creating the Juvenile Detention Prescription Medication Fund; effective date.
Bill Summaries/Fiscal Impact for HB 3755 (House): Proposed Committee Substitute (full committee) 1 (2/16/2026)
Bill Summaries/Fiscal Impact for HB 3755 (House): Amendment to Proposed Committee Substitute (full committee) 1 (2/25/2026)
Bill Summaries/Fiscal Impact for HB 3755 (House): Proposed Policy Committee Recommendation (2/25/2026)
Bill Summaries/Fiscal Impact for HB 3755 (House): Committee Substitute (3/10/2026)
Bill Summaries/Fiscal Impact for HB 3755 (House): Floor Amendment 1 (3/10/2026)
Bill Summaries/Fiscal Impact for HB 3755 (House): Senate Amendment to House Bill (4/29/2026)
Bill Summaries/Fiscal Impact for HB 3755 (Senate): Committee Substitute (4/21/2026)

Current Bill Text

Read the full stored bill text
An Act
ENROLLED HOUSE
BILL NO. 3755 By: Sterling of the House

and

Stanley of the Senate

An Act relating to the Oklahoma Juvenile Code;
amending 10A O.S. 2021, Section 2-3-103, as amended
by Section 1, Chapter 242, O.S.L. 2022 (10A O.S.
Supp. 2025, Section 2-3-103), which relates to
juvenile detention facilities; directing the Office
of Juvenile Affairs to provide certain medications to
juvenile detention facilities under specified
conditions; requiring the Office to make certain
reasonable efforts; directing specified reimbursement
subject to certain conditions; creating the Juvenile
Detention Prescription Medication Fund; specifying
type of fund and source of monies; stating purpose of
fund; providing for expenditure of monies; providing
for codification; and providing an effective date.

SUBJECT: Oklahoma Juvenile Code

BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:

SECTION 1. AMENDATORY 10A O.S. 2021, Section 2-3-103, as
amended by Section 1, Chapter 242, O.S.L. 2022 (10A O.S. Supp. 2025,
Section 2-3-103), is amended to read as follows:

Section 2-3-103. A. Provision shall be made for the temporary
detention of children in a juvenile detention facility or the court
may arrange for the care and custody of such children temporarily in
private homes, subject to the supervision of the court, or the court
may provide shelter or may enter into a contract with any
institution or agency to receive, for temporary care and custody,
children within the jurisdiction of the court. The Office of
Juvenile Affairs shall not be ordered to provide detention unless
ENR. H. B. NO. 3755 Page 2
said the Office has designated and is operating detention services
or facilities.

B. County sheriffs of the arresting agency, their designee, any
peace officer, private contractors under contract with the Office of
Juvenile Affairs for transportation services, or juvenile court
officers shall provide for the transportation of juveniles to and
from secure detention for purposes of admission, interfacility
transfer, discharge, medical or dental attention, court appearance,
or placement designated by the Office. No private contract for
transportation services shall be entered into by the Office unless
the private contractor demonstrates to the satisfaction of the
Office that such contractor is able to obtain insurance or provide
self-insurance to indemnify the Office against possible lawsuits and
meets the requirements of subparagraphs a, b and d of paragraph 4 of
subsection C of this section. The Office of Juvenile Affairs shall
not be ordered to provide transportation for a juvenile who is
detained in or is destined for secure detention. The Office of
Juvenile Affairs shall provide reimbursement to the entity
transporting juveniles for necessary and actual expenses for
transporting juveniles who are detained in or destined for a secure
detention center as follows:

1. A fee for the cost of personal services at the rate of
Seventeen Dollars ($17.00) per hour;

2. Mileage reimbursement for each mile actually traveled at the
rate established in the State Travel Reimbursement Act;

3. Meals for transporting personnel, not to exceed Ten Dollars
($10.00) per meal; and

4. Meals for juveniles being transported, not to exceed Ten
Dollars ($10.00) per meal.

The Office of Juvenile Affairs shall process and mail
reimbursement claims within sixty (60) days of receipt. Payments
for services provided by a county sheriff’s office shall be paid to
the county and deposited in the service fee account of the sheriff.

C. 1. All juvenile detention facilities shall be certified by
the Office of Juvenile Affairs. To be certified, a juvenile
detention facility shall be required to meet standards for
certification promulgated by the Board of Juvenile Affairs.

ENR. H. B. NO. 3755 Page 3
2. The board of county commissioners of every county shall
provide for the temporary detention of a child who is or who may be
subject to secure detention and may construct a building or rent
space for such purpose. The boards of county commissioners shall
provide for temporary detention services and facilities in
accordance with the provisions of the State Plan for the
Establishment of Juvenile Detention Services adopted pursuant to
subsection D of this section and in accordance with subsections A
and C of Section 2-7-608 of this title. The boards of county
commissioners are hereby authorized to create multicounty trust
authorities for the purpose of operating juvenile detention
facilities.

3. In order to operate the juvenile detention facilities
designated in the State Plan for the Establishment of Juvenile
Detention Services and in subsections A and C of Section 2-7-608 of
this title, the boards of county commissioners in the designated
host counties shall:

a. operate the juvenile detention facility through a
statutorily constituted juvenile bureau subject to the
supervision of the district court, or

b. operate the juvenile detention facility by employing a
manager who may employ personnel and incur other
expenses as may be necessary for its operation and
maintenance, or

c. contract with a public agency, private agency,
federally recognized tribe, or single or multi-county
trust authority for the operation of the juvenile
detention facility. In the event any board of county
commissioners contracts with a public or private
agency or a federally recognized tribe, pursuant to
the provisions of this section, the Office is
authorized to directly contract with and pay such
public or private agency or federally recognized tribe
for provision of detention services. Any contract
with a federally recognized tribe shall become
effective upon approval by the board of county
commissioners.

4. Management contracts for privately operated detention
facilities shall be negotiated with the firm found most qualified by
the board of county commissioners. However, no private management
ENR. H. B. NO. 3755 Page 4
contract shall be entered into by the board unless the private
contractor demonstrates to the satisfaction of the board:

a. that the contractor has the qualifications,
experience, and personnel necessary to implement the
terms of the contract,

b. that the financial condition of the contractor is such
that the term of the contract can be fulfilled,

c. that the ability of the contractor to obtain insurance
or provide self-insurance to indemnify the county
against possible lawsuits and to compensate the county
for any property damage or expenses incurred due to
the private operation of the juvenile detention
facility, and

d. that the contractor has the ability to comply with
applicable court orders and rules of the Office of
Juvenile Affairs.

5. All counties to be served by a secure juvenile detention
facility may, upon the opening of such facility, contract with the
operators for the use of the facility for the temporary detention of
children who are subject to secure detention; provided, however, a
jail, adult lockup, or other adult detention facility may be used
for the secure detention of a child as provided for in Section 2-3-
101 of this title.

6. Expenses incurred in carrying out the provisions of this
section shall be paid from the general fund of the county or from
other public funds lawfully appropriated for such purposes or from
private funds that are available for such purposes. A county may
also issue bonds for the construction of detention facilities.

7. The operation of a juvenile detention facility by a county
shall constitute a quasi-judicial function and is also hereby
declared to be a function of the State of Oklahoma for purposes of
the Eleventh Amendment to the United States Constitution. In
addition, no contract authorized by the provisions of this section
for the providing of transportation services or for the operation of
a juvenile detention facility shall be awarded until the contractor
demonstrates to the satisfaction of the county that the contractor
has obtained liability insurance with the limits specified by The
Governmental Tort Claims Act against lawsuits arising from the
ENR. H. B. NO. 3755 Page 5
operation of the juvenile detention facility by the contractor, or,
if the contract is for the providing of transportation services, the
contractor has obtained liability insurance with the limits
specified by The Governmental Tort Claims Act against lawsuits
arising from the transportation of juveniles as authorized by
subsection A B of this section.

D. The Board of Juvenile Affairs, from monies appropriated for
that purpose, shall develop, adopt, and implement a plan for secure
juvenile detention services and alternatives to secure detention, to
be known as the State Plan for the Establishment of Juvenile
Detention Services, which shall provide for the establishment of
juvenile detention facilities and services with due regard for
appropriate geographical distribution and existing juvenile
detention programs operated by statutorily constituted juvenile
bureaus. Said The plan may be amended or modified by the Board as
necessary and appropriate. Until said such plan is adopted by the
Board, the plan adopted by the Commission for Human Services shall
remain in effect.

1. The Board of Juvenile Affairs shall establish procedures for
the letting of contracts or grants, including grants to existing
juvenile detention programs operated by statutorily constituted
juvenile bureaus, and the conditions and requirements for the
receipt of said such grants or contracts for juvenile detention
services and facilities as provided in this section and Section 2-7-
401 of this title. A copy of such procedures shall be made
available to any member of the general public upon request. All
such grants or contracts shall require the participation of local
resources in the funding of juvenile detention facilities. A
contract for services shall be based upon a formula approved by the
Board which shall set the contract amount in accordance with the
services offered and the degree of compliance with standards for
certification.

2. The Board of Juvenile Affairs shall establish standards for
the certification of detention services and juvenile detention
facilities. Such standards may include, but not be limited to:

a. screening for detention;,

b. education and recreation opportunities for juveniles
in secure detention;, and

ENR. H. B. NO. 3755 Page 6
c. accreditation by the American Correctional
Association.

As a condition of continuing eligibility for grants or contracts,
secure juvenile detention services and facilities shall be certified
by the Board within two (2) years of the date of the initial grant
or contract.

E. 1. When a juvenile in the custody of the Office of Juvenile
Affairs is ordered to be detained in a juvenile detention facility,
the Office shall provide all medications prescribed for such
juvenile that are in the possession of the Office to the operator of
the juvenile detention facility no later than forty-eight (48) hours
following the juvenile’s reception at the facility, at no charge to
the facility or operator.

2. The Office of Juvenile Affairs shall make reasonable efforts
to coordinate the acquisition of prescribed medication through the
juvenile’s parent or guardian. The Office shall not be required to
transport medication between parents or guardians and juvenile
detention facilities.

3. Subject to the availability of funds, the Office of Juvenile
Affairs shall provide reimbursement to juvenile detention facilities
to offset the cost of necessary prescription medications for
juveniles in detention. Reimbursements under this paragraph shall
be limited to medications provided to juveniles detained pursuant to
an order of a district court of this state.

F. The State Department of Health, with the assistance of the
Office of Juvenile Affairs, shall establish standards for the
certification of jails, adult lockups, and adult detention
facilities used to detain juveniles. Such standards shall include
but not be limited to: separation

1. Separation of juveniles from adults; supervision

2. Supervision of juveniles; and health

3. Health and safety measures for juveniles.

The State Department of Health is authorized to inspect any jail,
adult lockup, or adult detention facility for the purpose of
determining compliance with such standards. No jail, adult lockup,
or other adult detention facility shall be used to detain juveniles
ENR. H. B. NO. 3755 Page 7
unless such jail, adult lockup, or other adult detention facility
complies with the standards established by the State Department of
Health and is designated as a place for the detention of juveniles
by the judge having juvenile docket responsibility in the county
from a list of eligible facilities supplied by the State Department
of Health.

The development and approval of the standards provided for in
this paragraph subsection shall comply with the provisions of the
Administrative Procedures Act.

F. G. The State Board Commissioner of Health shall promulgate
rules providing for the routine recording and reporting of the use
of any adult jail, lockup or other adult facility for the detention
of any person under the age of eighteen (18).

1. For the purpose of ensuring the uniformity and compatibility
of information related to the detention of persons under age
eighteen (18), said such rules shall be reviewed and approved by the
Oklahoma Commission on Children and Youth prior to their adoption by
the Board; and.

2. Records of detention shall be reviewed during each routine
inspection of adult jails, lockups or other adult detention
facilities inspected by the State Department of Health and a
statistical report of said such detentions shall be submitted to the
Office of Juvenile Affairs at least every six (6) months in a form
approved by the Board of Juvenile Affairs.

SECTION 2. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 2-3-103A of Title 10A, unless
there is created a duplication in numbering, reads as follows:

There is hereby created in the State Treasury a revolving fund
for the Office of Juvenile Affairs to be designated the “Juvenile
Detention Prescription Medication Fund”. The fund shall be a
continuing fund, not subject to fiscal year limitations, and shall
consist of all monies received by the Office from legislative
appropriations provided for the purpose of reimbursing juvenile
detention facilities to offset the cost of necessary prescription
medications for juveniles in detention as provided by subsection E
of Section 2-3-103 of Title 10A of the Oklahoma Statutes. All
monies accruing to the credit of the fund are hereby appropriated
and may be budgeted and expended by the Office for the purpose
provided for in this section. Expenditures from the fund shall be
ENR. H. B. NO. 3755 Page 8
made upon warrants issued by the State Treasurer against claims
filed as prescribed by law with the Director of the Office of
Management and Enterprise Services for approval and payment.

SECTION 3. This act shall become effective November 1, 2026.

ENR. H. B. NO. 3755 Page 9
Passed the House of Representatives the 4th day of May, 2026.

Presiding Officer of the House
of Representatives

Passed the Senate the 23rd day of April, 2026.

Presiding Officer of the Senate

OFFICE OF THE GOVERNOR
Received by the Office of the Governor this ____________________
day of ___________________, 20_______, at _______ o'clock _______ M.
By: _________________________________
Approved by the Governor of the State of Oklahoma this _________
day of ___________________, 20_______, at _______ o'clock _______ M.

_________________________________
Governor of the State of Oklahoma

OFFICE OF THE SECRETARY OF STATE
Received by the Office of the Secretary of State this __________
day of ___________________, 20_______, at _______ o'clock _______ M.
By: _________________________________