Form Una-1 - Statement Of Agent Of Process For Unincorporated Non-Profit Association - 2007
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1Betty Ireland
Penney Barker, Team Leader
Secretary of State
Corporations Division
State Capitol Building
Tel: (304) 558-8000
1900 Kanawha Blvd. East
Fax: (304)558-8381
Charleston, WV 25305-0770
Hrs: 8:30 am - 5:00 pm
Statement of Agent of Process for
FILE ONEAPPLICATION
Unincorporated Non-ProfitAssociation
FEE: $15
Ctrl # __ __ __ __ __
1 .
The name of the Unincorporated Non-Profit Associa-
tion shall be:
2.
The principal office address of the
Street:
association will be:
City/State/Zip:
located in the County of:
County:
Street/Box:
The mailing address of the association,
if different, will be:
City/State/Zip:
3.
The name and address of the person to
Name:
whom notice of process may be sent,
in this state is:
Street:
City/State/Zip:
4.
Acknowledgement and Signatures:
Signature of the appointed agent
This statement must be signed and ac-
knowledged by a person authorized to
manage the affairs of an unincorported non-
profit association. The statement must also
Signature of applicant
(authorized to act on behalf of company)
be signed by the person appointed agent,
who thereby accepts the appointment.
Name of Contact person and phone number
of person to reach in case of problem with filing (optional)
Business and email address, if any
CHARITABLE REGISTRATION: If your company receives contributions, donations or grants, registration as a
charitable organization maybe required. Contact our office for more information or visit
FORM UNA-1
Issued by the WV Secretary of State, State Capitol, Charleston, WV 25305
Revised 8/07
CHARITABLE REGISTRATION: If your company receives contributions, donations or grants, registration as a charitable organization
may be required. Contact our office for more information or visit
RESET
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