Application For Certificate Of Authority - Wyoming Secretary Of State, Consent To Appointment By Registered Agent - Wyoming Secretary Of State Page 2

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8.
Does this corporation have members? _______ (Yes or No)
9.
If this corporation had been incorporated under the laws of this state, would it be (a) a public benefit
corporation _____ (b) a mutual benefit corporation _____ or (c) a religiouscorporation?_____
(Check appropriate line.)
10.
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: _________________________
Signed: _________________________________________
Title: ___________________________________________
(May be executed by Chairman of Board, President or another
of its officers)
Contact Name:
____________________________
Daytime Phone Number: ______________________________
For name availability purposes list the type of business the corporation will be conducting:
___________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________
************************************************************************************
Filing Fee: $25.00
Instructions:
1.
The completed application must be accompanied by an original certificate of existence/
good standing, or a document of similar import, dated not more than sixty (60) days prior to
filing in Wyoming.
2.
The application for certificate of authority shall be accompanied by a written consent to
appointment executed by the registered agent.
3.
The document shall be accompanied by one (1) exact or photo copy.
4.
Evidence of filing will be a file stamped copy and receipt. An official certificate may be obtained for
a $3.00 fee.
npca - Revised 9/2003

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