9. Names and usual business addresses of its current officers and directors:
Office
Name
Address
President
Vice President
Secretary
Treasurer
Director
Director
Director
10. The aggregate number of shares or other ownership units which it has the authority to issue, itemized by classes,
par value of shares, shares without par value and series, if any, within a class:
Number of Shares
Class
Series
Par Value per Share
11. The aggregate number of issued shares or other ownership units itemized by classes, par value of shares, shares
without par value and series, if any, within a class:
Number of Shares
Class
Series
Par Value per Share
12. The corporation accepts the constitution of the state of Wyoming in compliance with the requirement of Article
10, Section 5 of the Wyoming Constitution.
Date:
Signature: ___________________________________________
(mm/dd/yyyy)
Print Name:
Title:
Contact Person:
Daytime Phone Number:
Checklist
Filing Fee: $100.00 Make check or money order payable to Wyoming Secretary of State.
The application shall be executed by the Chairman of the Board, President or another of its officers.
The Articles of Domestication must be accompanied by a written consent to appointment executed by the
registered agent.
For consistency the Secretary of State’s Office will only keep one version of the agent’s name on file.
A certified copy of its original articles of incorporation and all amendments currently certified within the last
six (6) months by the proper officer of the state or nation of formation.
A certificate of good standing not more than thirty (30) days old.
Please submit one originally signed document and one exact photocopy of the filing.
Please review form prior to submitting to the Secretary of State to ensure all areas have been
completed to avoid a delay in the processing of your documents.
FP-ArticlesDomestication - Revised 12/2008