Business Entities Records - Order Form - 2017
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1Secretary of State
Business Programs Division
Business Entities - Records, P.O. Box 944260, Sacramento, CA 94244-2600
Business Entities Records - Order Form
ORDERS CANNOT BE CHANGED OR CANCELLED ONCE SUBMITTED
1. Requestor’s Information
Individuals name:
________________________________________________________
In person drop off only, please indicate
Firm name (if any):
_______________________________________________________
type of return method requested:
Return address:
_________________________________________________________
Mail
Pick-Up
City:
State:
Zip:
_____________________________
__________
_______________
10-digit telephone number: (
)
-
`
2. Order Details
Entity name:
________________________________________________________________________________________________________
Secretary of State Entity/File Number (recommended):
___________________________________________
Entity type (Check 1 box):
Corporation
Limited Liability Company
Limited Partnership
General Partnership
Limited Liability Partnership
Other
(see instructions
for options):
________________________
3. Copy Requests – Plain (uncertified) copies are $1.00 for the first page, $0.50 for each additional page. Certified copies are an
additional $5.00.
See instructions
for additional detail.
• Formation/Registration document only
# of plain copies
# of certified copies
___________
___________
•
Articles & Amendments documents only
# of plain copies
# of certified copies
___________
___________
•
All Amendment documents only
# of plain copies
# of certified copies
___________
___________
•
Last complete Statement of Information
# of plain copies
# of certified copies
___________
___________
•
Last no change Statement of Information
# of plain copies
# of certified copies
___________
___________
•
All Statements of Information
# of plain copies
# of certified copies
___________
___________
•
ALL documents and Statements
# of plain copies
# of certified copies
___________
___________
•
Copy of:
# of plain copies
# of certified copies
____________________________________
___________
___________
4. Certificate/Status Requests
• Certificate of Status
- $5.00 each
# of certificates
(lists entity status: i.e., good standing, active, suspended, etc.)
_________
•
Certificate of Filing of All Documents (
) - $5.00 per document listed
# of certificates
lists all documents of record
_________
•
Certificate of No Record
- $5.00 each
# of certificates
(certifies no record of entity found)
_________
•
Status Report
- $4.00 each
# of reports
(computer print-out of entity record. Cannot be certified)
________
5. FAX – For an additional fee, we will FAX the requested copies/certificates to you prior to delivery of hard-copies.
Domestic FAX (in U.S.) – $5.00 fee
Foreign FAX (outside U.S.) – $10.00 fee
FAX # ________________________
THIS SECTION FOR SECRETARY OF STATE USE ONLY
Affix Cert & Seal
$
_________________________
_________
Making first page
$
________________________
_________
Making additional pages
$
__________________
_________
Statement of Information
$
_________________
_________
Certificate of
$
____________________________
_________
Status Report
$
___________________________
_________
FAX
$
____________________________________
_________
Special Handling Fee
$
____________________
_________
Other
$
__________________________________
_________
TOTAL AMOUNT DUE
$
___________________
_________
TOTAL AMOUNT REC’D
$
_________________
_________
REFUND AMOUNT
$
______________________
_________
BALANCE DUE
$
_________________________
_________
BE Records Requests – Order Form (Rev. 04/2017)
California Secretary of State
(916) 657-5448
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