Page 3 of 3
SECTION
8
NAME AND ADDRESS OF ALL CURRENT OFFICERS AND DIRECTORS:
(If necessary, attach additional names and addresses)
PRESIDENT: ____________________________________________________________________________
Address: ____________________________________________________________________________
City__________________________________ State ______ Zip Code _______ __
VICE PRESIDENT: ________________________________________________________________________
Address: ___________________________________________________________________________
City__________________________________ State ______ Zip Code __________
SECRETARY: ____________________________________________________________________________
Address: ___________________________________________________________________________
City__________________________________ State ______ Zip Code __________
TREASURER: ___________________________________________________________________________
Address: ___________________________________________________________________________
City__________________________________ State ______ Zip Code __________
DIRECTOR: _____________________________________________________________________________
Address: ___________________________________________________________________________
City__________________________________ State ______ Zip Code __________
(If necessary, attach additional names, titles and addresses)
SECTION 9
SIGNATURE OF OFFICER:
This document is hereby executed under penalties of perjury, and is, to the best of my knowledge, true and correct.
X __________________________________________________________________________
Signature of Officer
Printed Name/Title
Date
Phone Number
Notice: The Washington Secretary of State will be appointed the agent of the foreign nonprofit corporation for service of process under the
circumstances set forth in RCW 24.03.350
Revised 9/14
Foreign NonProfit Corporation - Certificate
Washington Secretary of State