Form 08-474 - Certificate Of Authority Foreign Cooperative Corporation/form 08-561 - Contact Information Sheet - 2013 Page 2
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7ITEM 5: Registered Agent
The registered agent of this foreign cooperative corporation must be an individual who is a resident of Alaska,
or a corporation (excluding LLC, LP and LLP) registered and in good standing with this office. The registered
agent is statutorily responsible for receiving and forwarding processes, notices, or demands on to the last
known address of the entity. A corporation may not act as its own registered agent. A physical address and
a mailing address in the State of Alaska must be given.
ITEM 6: Principal Office Address
Address of the corporation in the state or country of domicile.
ITEM 7: Alien Affiliate
Defined in AS 10.06990 as a person that directly or indirectly through one or more intermediaries controls, or is
controlled by, or is under common control with, a corporation subject to this chapter:
An individual who is not a citizen or national of the United States, or who is not lawfully admitted to the
United States for permanent residence, or paroled into the United States under the Immigration and
Nationality Act (8 U.S.C. 1101 – 1525, as amended):
1. A person, other than an individual, that was not created or organized under the laws of the United
States or of a state, or whose principal place of business is not located in any state; or
2. A person, other than an individual, that was created or organized under the laws of the United States of
a state, or whose principal place of business is located in a state, and that is controlled by a person
described in (1) or (2) of this paragraph[.]
ITEM 8: Authorized Shares
All cooperative corporations must provide the number of authorized shares, if any. If there is more than one
class or series of authorized shares, please provide this information.
ITEM 9: Issued Shares
Provide the number, class, and series of issued shares, if any. If shares have been issued, you must complete
Item 10: Shareholders.
ITEM 10: Shareholders
List the names and mailing addresses of persons owning 5% or more of any class of shares, and the
percentage owned by each person. If there are authorized shares, you must complete Item 9: Issued Shares.
ITEM 11: Officers and Directors
List the names and mailing addresses of the officers and directors of the corporation. You may attach an
additional 81/2” x 11” page, if necessary. Please note: do not include confidential information such as Social
Security Numbers, driver’s license numbers or date of birth, as this record is public information.
ITEM 12: Signatures
The printed name and signatures of the president or vice president of the corporation, and its secretary or
assistant secretary are required. If the same person holds two of these positions, two different people must
sign the application, unless that person holds all positions.
Mail the Application for Certificate of Authority and the $250.00 filing fee in U.S. dollars to:
State of Alaska, Corporations Section, PO Box 110806, Juneau, AK 99811-0806
STANDARD PROCESSING TIME for complete and correct applications submitted to this office is
approximately 10-15 business days. All applications are reviewed in the date order they are received. To file
your application online for immediate processing, visit our website at:
ADDITIONAL RESOURCES:
08-474 (Rev. 04/03/2013)
Certificate of Authority Instructions
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