The street address and county of the principal office of the corporation is:
Number and Street_________________________________________________________________
City, State, Zip Code___________________________________________County______________
The mailing address, if different from the street address, of the principal office of the corporation is:
________________________________________________________________________________
b.
The corporation does not have a principal office.
9.
Any other provisions, which the corporation elects to include, are attached.
10.
The specific purpose for which the corporation is being formed:________________________________
____________________________________________________________________________________
11.
The name and address of each incorporator is as follows: (Attach additional sheets if necessary.)
12.
With respect to each professional service to be practiced through the corporation, the name of at least
one of the corporation’s incorporators who is a licensee of the licensing board which regulates such
profession in this State is:
13.
A certification by the appropriate licensing board that the shareholder interests of the corporation are in
compliance with the requirements of N.C.G.S. Sections 55B-4(2) and 55B-6 is attached.
14.
These articles will be effective upon filing, unless a date and/or time is specified: __________________
This the _____ day of ________________, 20______.
_______________________________________
_______________________________________
Signature
_______________________________________
Type or Print Name and Title
NOTES:
1.
Filing fee is $125. This document must be filed with the Secretary of State.
2.
Only a “professional corporation” may use this form. To determine whether a particular corporation is such a “professional corporation,” it is
necessary to examine the requirements of N.C.G.S. § 55B-2(5). If the corporation does not meet those requirements, it must use the standard
form for incorporation of a business corporation.
Revised January 2002
Form PC-05A
CORPORATIONS DIVISION
P. O. BOX 29622
RALEIGH, NC 27626-0622