Certificate Of Authority Form For Foreign (Non-Vermont) Corporations - Vermont Secretary Of State
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1Certificate of Authority Form
Foreign (non-vermont) corporations
This form should be filled out in full, printed, and returned, with the fee, to the Secretary of State's Office, 81 River
802-828-2386
Street, Drawer 09, Montpelier, VT 05609.
CORPORATE NAME
Corp purpose:
g
f
e
d
c
g
f
e
d
c
Profit
Non-profit
CREATED UNDER THE LAWS :
DATE OF INCORPORATION:
DURATION (if not perpetual):
DECEMBER
Note: December will be designated unless stated differently.
The Fiscal month:
NAME OF REGISTERED AGENT:
Registered office address:
City
VERMONT
Zip Code
Principal Office Address:
City
State
Zip Code
OFFICERS / DIRECTORS NAMES AND ADDRESSES:
:
Pres.
Add
V.P.
Add:
Sec.
Add:
Trea.
Add:
Dir.
Add:
NAME OF DECEASED: (click here for info)
The person submitting this form should enter his or her name and title and sign:
Printed Name
Title
Signature
__________________________
________Date:
NOTE:
A certificate of good standing, dated no later than 30 days of filing, must be attached to this application.
In
the event that there is a problem with your application an email address or phone number will help us to serve you
faster:
$100.00 filing fee
(form rev. 7/01)
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