Application For Authority To Conduct Affairs For A Foreign Corporation Form - Utah Department Of Commerce
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1This form must be type
State of Utah
For Office Use Only
File Number ________________________
written or computer
DEPARTMENT OF COMMERCE
Non-Refundable Processing Fee:
generated. For your
Division of Corporations & Commercial Code
[ ]
Profit
$52.00
convenience, this form has
been designed to be filled out
[ ]
Nonprofit
$22.00
and printed online.
Print Form
Application for Authority to Conduct Affairs for a Foreign Corporation
Clear Form
_________________________________________________
Exact Corporate Name
1. A corporation of the state of ____________________________, incorporated ______ day of ________________________, _____.
2. The corporations period of duration is ___________________________________ (usually perpetual).
3. The address of the corporation's principal office is:
_________________________________________________________________________________________________________________________
Street Address
City
State
Zip
4. The Registered Agent in Utah is: ______________________________________________________________________________________________
The street address of the registered office in Utah is:
Utah
______________________________________________________________________________________________________
_____________
Street Address
City
Zip
I, ________________________________________, agree to serve as a registered agent for the above-mentioned foreign corporation.
Signature of Registered Agent (Required) _________________________________________________________________________
The Registered Agent must sign here after the form is printed
5. The business purposes to be pursued in Utah are: ____________________________________________________________________
6. The corporation commenced or intends to commence business in Utah on: _________________________________________________
7. The names and addresses of the corporation's officers and directors are:
Name
Address
City
State
Zip
_____________________________________________________________________________________
President
__________________________________________________________________________________
Vice-President
_____________________________________________________________________________________
Secretary
_____________________________________________________________________________________
Treasurer
______________________________________________________________________________________
Director
______________________________________________________________________________________
Director
______________________________________________________________________________________
Director
8. A certification of Good Standing/Existence from the State of Incorporation dated no earlier than ninety (90) days prior to filing with
this office is attached to this application.
9. If the name is not available in Utah the corporation shall use: ________________________________________________________
{Please refer to (U.C.A. 16-10a-1506)}
Under penalties of perjury, I declare that this application for Certificate of Authority has been examined by me and is, to the best of my
knowledge and belief, true, correct and complete.
A corporate officer/director must sign here after the form
is printed
By: ____________________________________________________ ___________________________________________________
Authorized Signer Signature
Title
Date
FREE! You may visit our Web Site for this document and to access other information.
Mail In: PO Box 146705
Salt Lake City, UT 84114-6705
Walk In:160 East 300 South, Main Floor
Information Center: (801) 530-4849
Toll Free: (877) 526-3994 (within Utah)
Fax: (801) 530-6438
Web Site:
Under GRAMA {63-2-201}, all registration information maintained by the Division is classified as public record. For confidentiality purposes,
the business entity physical address may be provided rather than the residential or private address of any individual affiliated with the entity.
Revised 09/02
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