Form S&dc-Insurer - Nsurer - Statement And Designation By Foreign Corporation - 2005 Page 2

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♦ Los Angeles
(213) 897-3062
The Ronald Reagan Building
th
12
Floor South Tower, Room 12513
300 South Spring Street
Los Angeles, CA 90013-1233
♦ San Diego
(619) 525-4113
1350 Front Street, Suite 2060
San Diego, CA 92101-3609
♦ San Francisco
(415) 557-8000
455 Golden Gate Avenue, Suite 14500
San Francisco, CA 94102-7007
NOTE:
Cash is accepted only in the Sacramento office.
Duplicate original documents must be submitted when filing in any of the regional offices.
The regional offices do not process mailed in documents.
A $15.00 special handling fee is applicable for processing documents delivered in person at the public
counter in the Sacramento office or in any of the regional offices located in Fresno, Los Angeles, San Diego
and San Francisco. The $15.00 special handling fee must be remitted by separate check of each submittal
and will be retained whether the documents are filed or rejected. The special handling fee does not apply to
documents submitted by mail.
Preclearance or expedited filing of eligible corporate documents can be requested in a specified time frame,
for an additional fee (in lieu of the $15.00 special handling fee), as described in the
Preclearance/Expedited
Filing Service
Information. The preclearance/expedited filing service is not available in the regional offices.
Secretary of State Information
(Please see reverse)
S&DC-INSURER (REV 03/2005)

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