Form N-15 - Articles Of Incorporation Nonprofit Corporation Community Third Party Or Medicaid Pooled Trust Page 2
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2ARTICLES OF INCORPORATION NONPROFIT CORPORATION
COMMUNITY THIRD PARTY OR MEDICAID POOLED TRUST
Page Two
14. These articles will be effective upon filing, unless a later time and/or date is specified: _________________
This is the_____day of_____________ ,20____.
_________________________________________________ _
Business Entity Name
________________________________________________
Signature of Incorporator
_________________________________________________
Type or print Incorporator’s name and title, if any
NOTES:
1. Filing fee is $60. This document must be filed with the Secretary of State.
Revised July 2010
Form N-15
CORPORATIONS DIVISION
P. O. BOX 29622
RALEIGH, NC 27626-0622
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