Form 631 - 2002 - Non-Profit Corporation Annual Report - State Of Rhode Island And Providence Plantations

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Matthew A. Brown, Secretary of State
Click here for instruction page
Corporations Division
STATE OF RHODE ISLAND
100 North Main Street, Providence, RI 02903-1335
AND PROVIDENCE PLANTATIONS
401.222.3040
Office of the Secretary of State
NON-PROFIT CORPORATION ANNUAL REPORT FOR THE YEAR
Filing Period: June 1 - June 30
Filing Fee: $20.00
(FORM MUST BE TYPED OR PRINTED IN BLACK)
1. Corporate ID No.
2. Name of Corporation
3. State of Incorporation
City
Zip
4. Corporate address in Rhode Island -Street Address
State
5. Foreign corporation: Enter principal office address
City
Zip
6. Brief Description of the character of the affairs which are actually conducted in Rhode Island
7. NAMES AND ADDRESSES OF THE OFFICERS
(“X” BOX FOR ATTACHMENT)
FILL IN SPACES BEFORE USING ATTACHMENTS
President Name
Vice President Name
Street Address
Street Address
State
Zip
City
State
Zip
City
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Secretary Name
Treasurer Name
Street Address
Street Address
City
State
Zip
City
State
Zip
8. NAMES AND ADDRESSES OF THE DIRECTORS
(“X” BOX FOR ATTACHMENT)
FILL IN SPACES BEFORE USING ATTACHMENTS
THE NUMBER OF DIRECTORS OF A DOMESTIC (RHODE ISLAND) CORPORATION SHALL NOT BE LESS THAN THREE (3).R.I.G.L 7-6-23
Director Name
Director Name
Street Address
Street Address
City
State
Zip
City
State
Zip
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Director Name
Director Name
Street Address
Street Address
State
City
Zip
City
Zip
State
9. REGISTERED AGENT IN RHODE ISLAND
-DO NOT ALTER- Changes require filing of Form 641 -R.I.G.L 7-6-13 / 7-6-78
Agent Name
Address
City
Zip
Address
This report must be signed in ink by either the President, Vice President, Secretary, Assistant Secretary, Treasurer, Receiver or Trustee
Under penalty of perjury, I declare and affirm that I have examined
this report, including any accompanying schedules and statements,
and that all statements contained herein are true and correct.
File Date
Signature of Officer
Date
Check No.
Print or Type Name of Officer
By:
FOR SECRETARY OF STATE USE ONLY
Title of Officer
Form 631 Rev. 6/02

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