Application For Registration Name (Foreign Business Corporation) - Secretary Of State Office

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APPLICATION FOR

Secretary of State Office

500 E Capitol Ave

REGISTRATION OF NAME

Pierre, SD 57501

Clear Form

(605)773-4845

FOREIGN BUSINESS CORPORATION

Please Type or Print Clearly in Ink

HELP

Original

Photocopy

Please submit one

and one

FILING FEE $25

SECRETARY OF STATE

payable to

Telephone # ____________________

FAX #

_______________________

Pursuant to the provisions of South Dakota law, the undersigned Corporation hereby applies for the

registration of its name to and including December 31, 20 _____, and submits the following statement:

1. The name of the company is ______________________________________________________________________

______________________________________________________________________________________________

2. It is incorporated under the laws of __________________________________________________________________

3. The date of its incorporation ________________________________

4. A brief description of the nature of business

5. This application

include a

or a document of similar import, duly

must

CERTIFICATE OF EXISTENCE

authenticated by the

or other official having custody of the corporate records in the state or

Secretary of State

country under whose law it is incorporated.

6. This application does not qualify the corporation to conduct business in South Dakota.

The registration is effective until the close of the calendar year in which the application for registration is filed.

A renewal application may be filed between the first day of October and the thirty-first day of December in each year, and

shall extend the registration for the following calendar year.

Application must be signed by an authorized officer of the corporation.

Dated ____________________________

______________________________________________

(Signature of an authorized officer)

______________________________________________

(Printed Name)

______________________________________________

(Title)

registration application April 2012

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