Form Dfi/corp128 - Articles Of Domestication - Nonstock Corporation Page 2
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47. Executed on
(Date)
(Signature)
Title:
President
Secretary
or other officer title
(Printed name)
This document was drafted by
(Name the individual who drafted the document)
____________________________________________________________________________________
INSTRUCTIONS (Ref. sec. 181.1533(1)(b), Wis. Stats. for document content)
Submit one original and one exact copy to Department of Financial Institutions, P O Box 7846, Madison
WI, 53707-7846, together with the filing fee of $35.00, payable to the department. Filing fee is non-
refundable. (If sent by Express or Priority U.S. mail, address to 201 W. Washington Ave., Suite 300,
Madison WI, 53703). NOTICE: This form may be used to accomplish a filing required or permitted by
statute to be made with the department. Information requested may be used for secondary purposes. If
you have any questions, please contact the Division of Corporate & Consumer Services at 608-261-7577.
Hearing-impaired may call 608-266-8818 for TDY. This document can be made available in alternate
formats upon request to qualifying individuals with disabilities.
The articles must be accompanied by a CERTIFICATE OF STATUS (variously called “certificate of
existence” or “certificate of good standing”) issued by the Secretary of State of the state of incorporation
of the foreign corporation, or the state office with whom articles of incorporation are filed. The certificate
shall be dated not earlier than 60 days before its delivery and must set forth the foreign corporation’s
date of incorporation.
128
DFI/CORP
(R11/12)
2 of 4
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