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STATE OF MONTANA

Prepare, sign, submit with original signature and filing fee.

This is the minimum information required.

(This space for use by the Secretary of State only)

CERTIFICATE of AUTHORITY

for FOREIGN NONPROFIT CORPORATION

LINDA McCULLOCH

MAIL:

Secretary of State

P.O. Box 202801

Helena, MT 59620‐2801

PHONE:

(406) 444‐3665

FAX:

(406) 444‐3976

WEB SITE:

sos.mt.gov

Filing Fee: $20.00

24 Hour Priority Filing Add $20.00

1 Hour Expedite Filing Add $100.00

1. The name of the Nonprofit Corporation is: _______________________________________________________________

__________________________________________________________________________________________________

2. It is incorporated under the laws of the state of: __________________________________________________________

(Must include an original, currently dated Certificate of Existence from state or territory of jurisdiction)

3. The date of its incorporation is: ___________________ and the period of duration is: ___________________________

(Mo/day/year)

4. The address of the principal office is:

Street Address: __________________________________________________________________________

Mailing Address: _________________________________________________________________________

City: _______________________________________ State: _________________ Zip Code:

5. The name and address of the registered office/agent in Montana:

Name: __________________________________________________________________________________

Street Address: ___________________________________________________________________________

Mailing Address: __________________________________________________________________________

City: ______________________________________________, MT

Zip Code: ___________________

______________________________________________________________

Signature of Registered Agent (Required):

The name, office held and address of current directors and officers (At least 3 directors & 1 officer are required. Attach

list of necessary):

____________________________________________________________________________________________________

7. The Nonprofit Corporation WILL WILL NOT have members.

8. This Nonprofit Corporation is a (check one):

Public Benefit Corporation Mutual Benefit Corporation Religious Corporation

9. A description of the business the Nonprofit Corporation intends to transact:

____________________________________________________________________________________________________

HEREBY SWEAR AND AFFIRM, under penalty of law, that the facts contained in this Application are true.

____________________________________________________________________ ___________________________

Signature of Officer or Chairperson of the Board of Directors

Date

64‐Foreign_Nonprofit_Corporation_Certificate_of_Authority.doc

Revised: 1/5/2009

Certificate Of Authority For Foreign Nonprofit Corporation Form - State Of Montana - Secretary Of State

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