Form Cf-1 - Certificate Of Authority - 2013 (Page 2 of 3) in pdf

Form Cf-1 - Certificate Of Authority - 2013 Page 2

APPLICATION FOR CERTIFICATE OF AUTHORITY

Page 2

4. Agent of Process:

_____________________________________

Name:

Properly designated person to whom

notice of legal process may be sent, if any:

_________________________________________

Address:

_________________________________________

City/State/Zip:

5. Proposed purpose(s) for transaction of business in West Virginia is:

___________________________________________________________________________________

6. Is the business a Scrap Metal Dealer?

Yes

[If “Yes,” you must complete the Scrap Metal Dealer Registration Form

(Form

SMD-1)

and proceed to question 7.].

No [

Proceed to question 7.]

7. E-mail address where future correspondence can be received: ________________________________

8. Website address of the business, if any: _________________________________________________

9. Corporate Status Information:

a. Corporation is organized as (check one):

For Profit

Non-Profit

b. Officers and Directors: (add additional pages if necessary; please list all officers)

Officer Title

Officer Name

Street Address/City/State/Zip

______________________ _____________________________ ______________________________

Form CF-1

Issued by the Office of the Secretary of State

Revised 8/13

Form Cf-1 - Certificate Of Authority - 2013 Page 2