Montana Corporation Annual Report Form (Page 2 of 2) in pdf

Montana Corporation Annual Report Form Page 2

Names and Addresses (street name and number) of Directors: Nonprofit corporations are required to have a

minimum of three (3) directors. (Attach list, if necessary).

Shares (profit corporations only). List the current total number of shares authorized and total number of shares

issued. Itemize both by class and series, if any. (Attach schedule, if necessary)

Shares Authorized

Shares Issued

Class

Series

Par Value

COMMON

Domestic Profit Corporations Only. If issued shares exceed authorized shares or a change is made in class,

par value or the number of authorized shares; an amendment must be filed according to MCA Title 35.

Professional Service Corporations only. I certify that all the shareholders, not less than one-half the directors

and

all the officers other than the secretary and treasurer of the corporation are qualified persons with respect to the

corporation.

Nonprofit Corporations only (Please mark either box). The corporation shall

have members or

shall not

have members. (This information must agree with our records).

By my signature below, I, an official of the above corporation, do state that I signed this report on behalf of

the corporation and that the statements herein contained are true, under penalty of false swearing.

Signature of officer

Title

Printed name of

Date

or chair of board

signing official

An annual report must be filed for each year of reinstatement.

The individual signing must be listed on the annual report or attachment and identified as either an officer or

chair of the board of directors in order for this office to accept the signature.

All information provided, including names and addresses of officers and directors, will be made available on the

Secretary of State’s web site or upon request.

Sign and include correct filing fee:

Please send fee and completed report to:

$15.00, if filed on or before April 15th

Brad Johnson (406) 444-3665

$30.00, if filed after April 15th

Secretary Of State

P.O. Box 202802

Helena MT 59620-2802

Make checks payable to Secretary Of State, Helena MT 59620-2802

A-Montana_Annual_Report.doc

Revised: 6/20/2007

Montana Corporation Annual Report Form Page 2

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