Forn Corp. 55a - Application For Certificate Of Authority Of A Foreign Nonprofit Corporation
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1
2State of Missouri
This form is designed to be filled out online for your
convenience. Enter the data and press print when
Robin Carnahan, Secretary of State
ready. Use the reset button to reset the entire form.
Corporations Division
P.O. Box 778 / 600 W. Main Street, Rm 322
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Jefferson City, MO 65102
Application for Certificate of Authority
of a Foreign Nonprofit Corporation
(Submit with filing fee of $25.00)
(1)
The corporation's name is ___________________________________________________________________________________
and it is organized and existing under the laws of ________________________________________________________________
(2)
If the corporation’s name is unavailable, the name it will use in Missouri is ____________________________________________
(3)
The date of its incorporation was _____________________, and the period of its duration is _____________________________
month/day/year
(4)
The address of its principal place of business is _________________________________________________________________
Address
City/State/Zip
(5)
The name and physical address of its registered agent and office in the State of Missouri is
________________________________________________________________________________________________________
Name
Address
City/State/Zip
(6)
The names of its officers and directors and their business or home addresses are as follows (attach additional sheets as necessary):
Name
Address
City/State/Zip
President ________________________________________________________________________________________________
Vice President ____________________________________________________________________________________________
Secretary ________________________________________________________________________________________________
Treasurer ________________________________________________________________________________________________
Director _________________________________________________________________________________________________
Director _________________________________________________________________________________________________
(7)
The specific purpose(s) of its business in Missouri: _______________________________________________________________
_________________________________________________________________________________________________________
(8)
Does the corporation have members? Yes _____________
No ______________
(9)
If incorporated in Missouri would the corporation be a public benefit _______________ or mutual benefit ________________
Corporation?
Name and address to return filed document:
Name: __________________________________________
Address: _________________________________________
City, State, and Zip Code: __________________________
Corp. 55A (01/05)
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