Form C021.001 - Articles Of Domestication - Nonprofit Corporation Page 3

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10. ADOPTION OF ARTICLES OF DOMESTICATION –
see Instructions
C021i:
By the signature appearing below, the corporation certifies under penalty of perjury that these
Articles of Domestication have been adopted in accordance with A.R.S. § 10-3221 and certifies
under penalty of perjury the following:
_________________________.
Board of Directors action constituting the adoption took place on this date:
_____________________________.
Member action constituting the adoption took place on this date:
11. FURNISHING DOCUMENTS – By the signature appearing below, the corporation agrees that it
will provide the official in charge of corporate filings in the state or country of original
incorporation with a copy of these Articles of Domestication filed in the State of Arizona.
12. LAWS OF ARIZONA – By the signature appearing below, the corporation agrees that, upon
transfer of domicile, it accepts and will be subject to the laws of the State of Arizona.
SIGNATURE:
By checking the box marked "I accept" below, I acknowledge under penalty of
perjury that this document together with any attachments is submitted in
compliance with Arizona law.
I ACCEPT
Signature
Printed Name
Date
REQUIRED – check only one:
I am the Chairman of the Board
I am a duly-authorized Officer of
I am a duly authorized
of Directors of the corporation
the corporation filing this document.
bankruptcy trustee, receiver,
filing this document.
or other court-appointed
fiduciary for the corporation filing
this document.
Filing Fee: $100.00 (regular processing)
Mail:
Arizona Corporation Commission - Corporate Filings Section
Expedited processing – add $35.00 to filing fee.
1300 W. Washington St., Phoenix, Arizona 85007
All fees are nonrefundable - see Instructions.
Fax:
602-542-4100
Please be advised that A.C.C. forms reflect only the minimum provisions required by statute. You should seek private legal counsel for those matters that may pertain
to the individual needs of your business.
All documents filed with the Arizona Corporation Commission are public record and are open for public inspection.
If you have questions after reading the Instructions, please call 602-542-3026 or (within Arizona only) 800-345-5819.
C021.001
Arizona Corporation Commission – Corporations Division
Rev: 2010
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