Foreign Nonprofit Annual Report Form - Secretary Of State
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1RETURN TO
FILE DATE ________________
FOREIGN NONPROFIT
SECRETARY OF STATE
RECEIPT NO. ______________
STATE CAPITOL
ANNUAL REPORT
Clear Form
500 E. CAPITOL AVE.
PLEASE TYPE OR USE BLACK INK
PIERRE, S.D. 57501
(605)773-4845
FILING FEE: $10 MAKE CHECK PAYABLE TO SECRETARY OF STATE
Print
ADDITIONAL PENALTY FEE OF $50 APPLIES TO ALL LATE FILINGS
1. Corporate Name and Mailing Address; including Zip + 4:
Federal Taxpayer ID #__________________
FILING DATE: Due during the month the
Certificate of Authority was issued, and
delinquent the last day of the following
month.
2. It is incorporated under the laws of the state of _________________________________________________________________________________
3. The complete address of its principal office in state under the laws of which it is incorporated is __________________________________________
_________________________________________________________________________________________________________________________
4. The name of its registered agent in South Dakota is ______________________________________________and the address of its registered office in
South Dakota is __________________________________________________________________________________________.
5. The character of the business in which it is actually conducting in South Dakota is:____________________________________________________
_________________________________________________________________________________________________________________________.
6. The names and addresses of its directors and officers:
NAME
OFFICE
STREET ADDRESS
CITY
STATE
ZIP
__________________________________________ Director _____________________________________________________________________
__________________________________________ Director _____________________________________________________________________
__________________________________________ President ____________________________________________________________________
__________________________________________ Vice President_________________________________________________________________
__________________________________________ Secretary _____________________________________________________________________
__________________________________________ Treasurer _____________________________________________________________________
The report must be signed by the chairman of the board of directors, its president , or any other officer.
______________________.
_____________________________________________
Dated
(Signature)
_____________________________________________
(Title)
nonprofitforeignannualreport July 2005
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