Application For Certificate Of Authority - Pennsylvania Bureau Of Corporations And Charitable Organizations

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PENNSYLVANIA DEPARTMENT OF STATE
CORPORATION BUREAU
Application for Certificate of Authority
(15 Pa.C.S.)
Entity Number
Foreign Business Corporation (§ 4124)
Foreign Nonprofit Corporation (§ 6124)
Document will be returned to the
Name
name and address you enter to
the left.
Address
⇐
City
State
Zip Code
Fee: $180
Filed in the Department of State on ________________________
Secretary of the Commonwealth
In compliance with the requirements of the applicable provisions of 15 Pa.C.S. (relating to corporations and unincorporated
associations), the undersigned, hereby states that:
The name of the corporation is:
1.
. Complete only when the corporation must adopt a corporate designator for use in Pennsylvania.
2
The name which the corporation adopts for use in this Commonwealth is:
. If the name set forth in paragraph 1 or 2 is not available for use in this Commonwealth, complete the following:
3
The fictitious name which the corporation adopts for use in transacting business in this Commonwealth is:
The corporation shall do business in Pennsylvania only under such fictitious name pursuant to the attached resolution of the
board of directors under the applicable provisions of 15 Pa.C.S. (relating to corporations and unincorporated associations) and
the attached form DSCB:54-311 (Application for Registration of Fictitious Name).
The name of the jurisdiction under the laws of which the corporation is incorporated is:
4.
5. The address of its principal office under the laws of the jurisdiction in which it is incorporated is:
Number and street
City
State
Zip

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