Form Fnp - Application For Certificate Of Authority, Form F-Stmnt - Statement Of Acceptance Of Appointment - 2013 Page 2

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325 Don Gaspar, Suite 300 ∙ Santa Fe, NM 87501
(800) 477-3632 ∙
Name and Title
Address
Dated: __________________
Name of Corporation_______________________
Two officers must sign: By___________________________________________
Signature of Authorized Officer
By___________________________________________
Signature of Authorized Officer
THIS APPLICATION MUST BE ACCOMPANIED BY A CERTIFICATE OF GOOD
STANDING / EXISTENCE, ISSUED BY THE APPROPRIATE OFFICIAL CUSTODIAN
OF CORPORATE RECORDS FOR THE STATE OR COUNTRY UNDER THE LAWS
OF WHICH THE APPLYING CORPORATION IS INCORPORATED. THIS
CERTIFICATE MUST BE ORIGINAL OR ELECTRONICALLY ISSUED, AND MUST
BE CURRENT WITHIN THIRTY DAYS, OR HAS NOT EXPIRED, UPON
SUBMISSION TO THE SECRETARY OF STATE.
Form FNP
(revised 06/13)

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