Non-Stock Application For Certificate Of Authority Form
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1
2Secretary of State
State Capitol
Clear Form
500 E. Capitol Ave.
Pierre SD 57501
Phone 605-773-4845
Print
Fax 605-773-4550
Non-Stock Application for Certificate of Authority
(A Foreign Corporation)
Pursuant to the provisions of SDCL 47-27-1, the undersigned corporation hereby applies for a Non-Stock Certificate of Authority to
transact business in the State of South Dakota and for that purpose submits the following:
(1) The name of the corporation is _______________________________________________________________________________
(exact corporate name)
___________________________________________________________________________________________________________
(2) The state under the laws of which it is incorporated is ____________________________________________________________
and the address of its principal office in the state or country under the laws of which it is incorporated is ______________________
__________________________________________________________________________________________________________
(Mailing address if different from above) _________________________________________________________________________
(3) The date of incorporation is __________________________________________ and the period of duration is _______________.
(4) The street address, or a statement that there is no street address, of its proposed registered office in the State of South Dakota is
___________________________________________________________________________________________________________
and the name of the proposed registered agent in the State of South Dakota at that address is _______________________________.
(5) The purposes of the corporation in engaging in business in this state ________________________________________________
___________________________________________________________________________________________________________
__________________________________________________________________________________________________________
(6) The names and respective addresses of its directors and officers:
NAME
OFFICE
STREET ADDRESS
CITY
STATE
ZIP
_______________________________________ Director ___________________________________________________________
_______________________________________ Director ___________________________________________________________
_______________________________________ Director ___________________________________________________________
_______________________________________ President __________________________________________________________
_______________________________________ Vice President ______________________________________________________
_______________________________________ Secretary __________________________________________________________
_______________________________________ Treasurer __________________________________________________________
_______________________________________ Assistant Secretary ___________________________________________________
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