Request For Certificates Or Copies - Connecticut Secretary Of State
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1
2SECRETARY OF THE STATE OF CONNECTICUT
MAILING ADDRESS: COMMERCIAL RECORDING DIVISION, CONNECTICUT SECRETARY OF THE STATE, P.O. BOX 150470, HARTFORD, CT 06115-0470
DELIVERY ADDRESS: COMMERCIAL RECORDING DIVISION, CONNECTICUT SECRETARY OF THE STATE, 30 TRINITY STREET, HARTFORD, CT 06106
860-509-6002
PHONE:
WEBSITE:
REQUEST FOR CERTIFICATES OR COPIES
USE INK. COMPLETE ALL SECTIONS. PRINT OR TYPE. ATTACH 81/2 X 11 SHEETS IF NECESSARY.
FINANCIAL UNIT USE ONLY
FILING PARTY
:
(CONFIRMATION WILL BE SENT TO THIS ADDRESS)
AMT. REC’D $
NAME:
CA CR
TRANS. ID:
ADDRESS:
BATCH DATE:
CITY:
STATE:
ZIP:
CUSTOMER ID #:
(if any)
TELEPHONE:
1. BUSINESS ENTITY NAME
(PRINT COMPLETE NAME OF BUSINESS AS IT APPEARS ON THE RECORDS OF THE SECRETARY OF
THE STATE OFFICE)
OR
2. BUSINESS ID #:
NOTE:
ONLY ONE BUSINESS NAME OR BUSINESS ID # PER FORM
CERTIFICATES OF LEGAL EXISTENCE
BE CERTAIN YOU CHECK THE CORRECT BOX. The CONCORD computer system
automatically issues these certificates based on information you provide.
PLEASE INDICATE QUANTITY ORDERED
1. CORPORATIONS:
$50.00
EXPRESS CERTIFICATE OF LEGAL EXISTENCE
$80.00
SHORT FORM CERTIFICATE (REFLECTS ALL NAME CHANGES)
$120.00
LONG FORM CERTIFICATE (DOMESTIC ONLY)
{Cannot be expedited}
2. LIMITED LIABILITY COMPANIES:
$50.00
EXPRESS CERTIFICATE
$50.00
SHORT FORM CERTIFICATE (REFLECTS ALL NAME CHANGES)
$100.00
LONG FORM CERTIFICATE (DOMESTIC ONLY)
{Cannot be expedited}
3. LIMITED PARTNERSHIPS:
$50.00
CERTIFICATE OF LEGAL EXISTENCE
4. LIMITED LIABILITY PARTNERSHIPS:
$40.00
EXPRESS CERTIFICATE
$80.00
SHORT FORM CERTIFICATE
$120.00
LONG FORM CERTIFICATE (DOMESTIC ONLY)
{Cannot be expedited}
FORM CXC-1-1.0
PAGE 1 OF 2
Rev. 7/2010
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