C
K
OMMONWEALTH OF
ENTUCKY
T
G
, S
S
REY
RAYSON
ECRETARY OF
TATE
_________________________________________________________________________________________________________________________
Division of Corporations
Certificate of Authority
FNT
Business Filings
(Foreign Business Trust)
PO Box 718
Frankfort, KY 40602
(502) 564-3490
__________________________________________________________________________________________
Pursuant to the provisions of KRS Chapter 386, the undersigned hereby applies for a certificate of authority on behalf of the
business trust named below and, for that purpose, submits the following statements:
1. The name of the business trust is____________________________________________________________________.
2. The state or country whose law it is organized in is______________________________________________________.
3. The date of organization is ________________________________________________________________________.
4. If the trust has a specific date of dissolution, the date upon which it is to dissolve._____________________________.
5. The name of the registered agent is _________________________________________________________________.
6. The street address of the registered office in Kentucky is:
_________________________________________________________________________________________________________________________
Street Address Only (No Post Office Box Numbers)
City
State
Zip Code
7. The mailing address of the principal office is:
_________________________________________________________________________________________________
Street Address or Post Office Box Number
City
State
Zip Code
8. The name and business address of its current trustees are:
_________________________________________________________________________________________________
Name
Street Address or Post Office Box Number
City
State
Zip Code
_________________________________________________________________________________________________
Name
Street Address or Post Office Box Number
City
State
Zip Code
_________________________________________________________________________________________________
Name
Street Address or Post Office Box Number
City
State
Zip Code
9. As of the date of filing, the foreign business trust validly exists as a business trust under the laws of the jurisdiction of its
organization.
_________________________________________________________________________________________________
Signature of Trustee
Printed Name
Date
consent to serve as the registered agent on behalf of the business trust.
I, _____________________________________,
Print Name of Registered Agent
_________________________________________________________________________________________________________________________
Signature of Registered Agent
Printed Name
Date
(09/09)