Form Fpr - Application For Certificate Of Authority, Form F-Stmnt - Statement Of Acceptance Of Appointment - Nm Secretary Of State - 2013 Page 2

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325 Don Gaspar, Suite 300 ∙ Santa Fe, NM 87501
(800) 477-3632 ∙
6. The purpose that the corporation proposes to pursue in the transaction of business in New Mexico is
(at least one specific purpose must be stated; attach additional page if needed):
_____________________________________________________________________________________
7. The names and respective addresses of the officers and directors of the corporation are (indicate the
applicable title of each officer and each director; attach additional page if needed):
Name and Title
Address
_____________________________________________________________________________________
_____________________________________________________________________________________
8. The aggregate number of shares which the corporation has the authority to issue, itemized by class
and series, if any, within each class is (attach additional page if needed):
_____________________________________________________________________________________
9. The aggregate number shares that have been issued, itemized by class and series, if any, within each
class is (attach additional page if needed):
_____________________________________________________________________________________
10. Provide an estimate expressed in dollars (or “zero” or “none”, if applicable) of the following:
(a) the gross amount of business which will be transacted by the corporation during its current fiscal
year, at or from places of business located in New Mexico is:
_____________________________________________________________________________________
(b) the gross amount of business which will be transacted by it during such year, wherever transacted,
is:
_____________________________________________________________________________________
(c) the value of all property to be owned by it and located in New Mexico during such year is:
_____________________________________________________________________________________
(d) the value of all property to be owned by it during such year, wherever located, is:
_____________________________________________________________________________________

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