Form 37035 - Application For Certificate Of Authority Of A Foreign Nonprofit Corporation To Transact Business In The State Of Indiana - Secretary Of State
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APPLICATION FOR CERTIFICATE OF AUTHORITY
CONNIE LAWSON
OF A FOREIGN NONPROFIT CORPORATION TO
SECRETARY OF STATE
TRANSACT BUSINESS IN THE STATE OF INDIANA
BUSINESS SERVICES DIVISION
302 W. Washington Street, E018
State Form 37035 (R9 / 5-14) / Corporate Form No. 364-4
Indianapolis, IN 46204
T elephone: (317) 232-6576
Approved by State Board of Accounts, 2014
INSTRUCTIONS:
1. Use 8 1/2" x 11" white paper for attachments.
2. Present original and one copy to address in the upper right corner of this form.
Indiana Code 23-17-26-1
3. Please TYPE or PRINT in INK.
4. Please visit our office at
FILING FEE IS $30.00
5. Make check or money order payable to Secretary of State.
NOTES:
1. Applicant must submit a certificate of existence issued the proper authority within the last sixty (60) days.
2. If using a fictitious name, a copy of the resolution must accompany this filing. See Indiana Code 23-17-26-6(a)(2).
APPLICATION FOR CERTIFICATE OF AUTHORITY
OF
A FOREIGN CORPORATION TO TRANSACT BUSINESS IN THE STATE OF INDIANA.
The undersigned officer desiring to effectuate the admittance of the above Corporation transact business in the State of Indiana,
Certifies the following facts:
ARTICLE I - NAME
Fictitious Name (Only used if name in the application is not available in Indiana.) (See Note 2 above.)
ARTICLE II - PRINCIPAL OFFICE
Address of Principal Office (number and street)
City
State
ZIP code
ARTICLE III - REGISTERED OFFICE AND REGISTERED AGENT
Name of Registered Agent (Cannot be corporation itself.)
Address of Registered Agent (number and street) (PO Box not accepted)
City
State
ZIP code
IN
Required:
By checking the box, the Signator(s) represents that the registered agent named in the application has consented to the appointment
of registered agent.
ARTICLE IV- DATE OF INCORPORATION AND DURATION OF EXISTENCE
The date of incorporation in domicilliary state (month, day, year)
State
The Corporation is perpetual until dissolution.
OR
The latest date upon which the Corporation is to dissolve (month, day, year):
ARTICLE V - TYPE OF CORPORATION (CHECK ONLY ONE)
If the Corporation had been incorporated in Indiana, it would be a:
public benefit corporation, which is organized for a public or charitable purpose;
religious corporation, which is organized primarily or exclusively for religious purposes; or
mutual benefit corporation (all others).
(Continued on the reverse side.)
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