Certificate Of Authority Foreign Nonprofit Corporation - Washington Secretary Of State Page 2
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SECTION 5
ADDRESS OF THE PRINCIPAL PLACE OF BUSINESS:
Street Address___________________________City___
_
___State/Country
Zip__________
PO Box_________________________________City___ _
___State/Country
Zip__________
SECTION 6
NAME AND ADDRESS OF THE WASHINGTON STATE REGISTERED AGENT:
Name: ____________________________________________________________________________
Physical Location Address (required):
______________________________________________________________
City _____________________________________________ WA Zip Code ____________
Mailing or Postal Address (optional):
_______________________________________________________________
City _____________________________________________ WA Zip Code _____________
CONSENT TO SERVE AS REGISTERED AGENT:
I consent to serve as Registered Agent in the State of Washington for the above named corporation. I
understand it will be my responsibility to accept Service of Process on behalf of the corporation; to forward mail
to the corporation; and to immediately notify the Office of the Secretary of State if I resign or change the
Registered Office Address.
X___________________________________________________________________________
Signature of Registered Agent
Printed Name
Date
SECTION 7
PURPOSE FOR WHICH THE NONPROFIT IS ORGANIZED:
(if necessary, attach additional information)
Important note: If your nonprofit organization is currently fundraising, or plans to fundraise
from the public, it may also be required to register with the Charities Program of the Secretary
of State. Registration with the Charities Program is separate from, and in addition to, filings
required under corporate law. Please visit the Charities Program website at
to review the registration requirements and forms for
Charitable Organizations.
(Continued on Page 3)
Revised 9/14
Foreign NonProfit Corporation - Certificate
Washington Secretary of State
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