Certification And Copies Request - State Of Michigan
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1CSCL/CD-274 (08/15)
Michigan Department of Licensing and Regulatory Affairs
FOR BUREAU USE ONLY
Corporations, Securities & Commercial Licensing Bureau
Invoice Number
F
HC
Completed By
Corporations Division
Business Services Section - (517) 241-6470
Fax: (517) 241-0538
CERTIFICATION AND COPIES REQUEST
(Authorized by P.A. 284 of 1972, P.A. 162 of 1982, P.A. 213 of 1982, P.A. 23 of 1993, as amended)
Instructions: Orders being returned by fax may not exceed 18 pages.
Return by:
Mail
(
)
Fax #
Only orders 18 pages or less will be returned by fax.
Requestor: (Must be completed to Process)
Bill to: (if different)
Name
Name
Attention
Attention
Address
Address
Address
Address
City
State
ZIP Code
City
State
ZIP Code
Telephone Number
Telephone Number
(
)
(
)
Identification Number
Entity Name
A.
B.
C.
D.
E.
DOCUMENTS:
CERTIFIED - minimum fee is $16.00; seven pages or more $1.00 additional per page.
U UNCERTIFIED - minimum fee is $6.00; seven pages or more $1.00 additional per page.
Original Documents ONLY - NO Amendments
Original Documents and ALL Amendments
Annual Report(s)/Statement(s) Specify year(s)
Other:
filed
filed
CERTIFICATE(S):
Good Standing (Corporation and LLC) - $10.00
Status (LLC) - $10.00
Not Cancelled (Limited Partnership) - $10.00
Certificate of Fact - Listing ALL documents filed - $50.00
Other Certificate of Fact - $20.00 - stating
LARA is an equal opportunity employer/program. Auxiliary aids, services and other reasonable accommodations are available upon request to individuals with
disabilities.
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