Application For Certificate Of Authority - Wyoming Secretary Of State, Consent To Appointment By Registered Agent - Wyoming Secretary Of State
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1
2
3APPLICATION FOR CERTIFICATE OF AUTHORITY
Wyoming Secretary of State
Phone (307) 777-7311/7312
The Capitol Building, Room 110
Fax (307) 777-5339
200 W. 24th Street
E-mail: corporations@state.wy.us
Cheyenne, WY 82002-0020
Pursuant to W.S. 17-19-1503 of the Wyoming Nonprofit Corporation Act, the undersigned corporation
hereby applies for a Certificate of Authority to transact business in the state of Wyoming, and for that purpose
submits the following statement:
1.
The name of the corporation as incorporated is: __________________________________________
______________________________________________________________________________
2.
It is incorporated under the laws of: ___________________________________________________
3.
The date of its incorporation is: ______________________________________________________
and the period of its duration is: _____________________________________________________
(e.g.: perpetual, 50 years, 100 years, etc.)
4.
The street address of its principal office: ________________________________________________
______________________________________________________________________________
______________________________________________________________________________
5.
The mailing address where correspondence and annual report forms can be sent:
______________________________________________________________________________
______________________________________________________________________________
6.
The physical address of its registered office in Wyoming and the name of its registered agent at
that address is: ____________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
(The agent must be an individual resident of Wyoming, a domestic corporation or not-for-profit domestic corporation
or a foreign corporation or not-for-profit foreign corporation authorized to transact business in this state.)
7.
The names and usual business addresses of its current directors and officers:
(You may attach a list in lieu of completing this section)
Office
Name
Address
President ______________________________________________________________________
Vice-President __________________________________________________________________
Secretary ______________________________________________________________________
Treasurer ______________________________________________________________________
Director _______________________________________________________________________
Director _______________________________________________________________________
Director _______________________________________________________________________
(IF ADDITIONAL DIRECTORS, PLEASE ATTACH A LIST.)
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