Application To Renew A Registration Of Corporate Name Form

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APPLICATION
TO RENEW A REGISTRATION
OF
CORPORATE
NAME
FOREIGN CORPORATION
Office of the Secretary of the State
30 Trinity Street / P.O. Box 150470 / Hartford, CT 06115-0470 / Rev. 12/1999
Space For Office Use Only
The undersigned hereby applies to renew the registration
of the following corporate name:
1. CORPORATE
NAME:
2 . STATE OR COUNTRY
OF INCORPORATION:
.
DATE OF INCORPORATION:
I
I
(mo./day/yr.)
4. THE NATURE
OF BUSINESS IN WHICH
THE CORPORATION
IS ENGAGED:
(Please reference
an 8 l/2 X 11 attachment if additional space is needed)
5. ADDRESS OF THE CORPORATION:
6. EXECUTION:
Dated this
day of
,20
.
Print or type name of signatory
Capacity of signatory
Signature
INSTRUCTIONS:
Complete and return this registration form to the Office of the Secretary of the
State at the above referenced address. The application must be accompanied by
an original Certificate of Existence issued by the
official keeper of corporate records in the state or country of the corporation’s
formation.
The Certificate may not be more that 90 days old at the time of filing.
A renewed registration
of corporate name expires at the end of the calendar year
during which an application is filed
Please type or print all information
other than the signature.

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