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Form C&s 560 - Application For Certificate Of Authority To Transact Business Or Conduct Affairs In Michigan

C&S 560 (Rev. 3/00)

MICHIGAN DEPARTMENT OF CONSUMER & INDUSTRY SERVICES

CORPORATION AND LAND DEVELOPMENT BUREAU

Date Received

(FOR BUREAU USE ONLY)

This document is effective on the date filed, unless a

subsequent effective date within 90 days after received

date is stated in the document.

Name

Address

City

State

Zip Code

EFFECTIVE DATE:

Document will be returned to the name and address you enter above.

If left blank document will be mailed to the registered office.

APPLICATION FOR CERTIFICATE OF AUTHORITY

TO TRANSACT BUSINESS OR CONDUCT AFFAIRS IN MICHIGAN

For use by Foreign Corporations

(Please read information and instructions on the last page)

Pursuant to the provisions of Act 284, Public Acts of 1972 (profit corporations), or Act 162, Public Acts of 1982

(nonprofit corporations), the undersigned corporation executes the following Application:

1. The name of the corporation is:

2. (Complete this item only if the corporate name in item 1 is not available for use in Michigan.)

The assumed name of the corporation to be used in all its dealings with the Bureau and in the transaction of its

business or the conducting of its affairs in Michigan is:

3. It is incorporated under the laws of __________________________________________________________. The

date of its incorporation is________________________________________________, and the term of its existence

if other than perpetual is___________________________________________________________.

4. a. The address of the main business or headquarters office of the corporation is:

(Street Address)

(City)

(State)

(ZIP Code)

b. The mailing address if different than above is:

(Street Address)

(City)

(State)

(ZIP Code)

Form C&s 560 - Application For Certificate Of Authority To Transact Business Or Conduct Affairs In Michigan