Foreign Statutory Trust Application For Certificate Of Authority - Wyoming Secretary Of State Page 2

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8. Names and business addresses of the current trustees:
9. The statutory trust company accepts the constitution of the state of Wyoming in compliance with the requirement
of Article 10, Section 5 of the Wyoming Constitution.
10. For name availability purposes list the type of business the statutory trust company will be conducting:
Trustee Signature: ____________________________________
Date:
Print Name:
Contact Person:
Daytime Phone Number:
Email:
Checklist
Filing Fee: $100.00 Make check or money order payable to Wyoming Secretary of State.
The completed application must be accompanied by an original certificate of existence/good standing,
dated not more than sixty (60) days prior to filing in Wyoming, duly authenticated by the Secretary of State
or other official having custody of corporate records in the state or country of formation.
The Application 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.
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.
Other Requirements:
An annual report will be due on or before January 1 each year. If not paid within thirty (30) days from the due date,
the entity will be subject to dissolution/revocation.
FST-CertificateAuthority - Revised 11/2012

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