Certificate Form Of Registration Of Corporation Partnership - Professional Photocopier

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CERTIFICATE OF REGISTRATION OF CORPORATION/PARTNERSHIP AS A
PROFESSIONAL PHOTOCOPIER
(Business and Professions Code §22450-22463)
COUNTY OF: PLACER
Filing Fees to Clerk
Registration
$ 175.00
*If also a Process Server
$ 100.00
Filing Bond
$
7.00
Additional ID Card
$ 10.00
Filing Fees to Recorder
st
Bond recording 1
page
$ 15.00*
Each additional page
$
3.00*
st
*Non-conforming charge 1
pg.
$ 18.00
*Non-conforming each addl. pg, $
6.00
The undersigned declares that __________________________________________________________ is a:
(Name of corporation/partnership)
Corporation
Partnership
Has any corporate officer or general partner been convicted of a felony? YES
NO
Will said corporation or partnership perform its duties as a Professional Photocopier in compliance with the
provision of law governing the transmittal of confidential documentary information in this state.
At least one person involved in the management of a Professional Photocopier shall be required to hold a
commission from the California Secretary of State as a notary public.
Name of Notary Public:
Commission Number:
Commissioned County:
Expiration Date:
The name(s), age(s), address(es), telephone number(s) of each corporate officers or general partner are:
Name and Title
Age
Complete Address
Telephone No.
Each of the undersigned declares under penalty of perjury the foregoing to be true except for the personal
information contained herein; and as to that personal information, each declares under penalty of perjury it
to be true only to the extent that it applies to him/her.
Signature & Title _____________________________________________________________________________
Executed at ______________________________________________________on _________________________
Signature & Title _____________________________________________________________________________
Executed at ______________________________________________________on _________________________
Signature & Title _____________________________________________________________________________
Executed at ______________________________________________________on _________________________
For Office Use Only:
Registration Number: _________________ (If a renewal, a new # must be assigned if there is a
lapse of three years or more in the period of registration).
Expiration Date: __________________
1/2016

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