Secretary of State Office
APPLICATION FOR
500 E Capitol Ave
Pierre, SD 57501
CERTIFICATE OF AUTHORITY
(605)773-4845
Clear Form
FOREIGN COOPERATIVE
Please Type or Print Clearly in Ink
HELP
Original
Photocopy
Please submit one
and one
FILING FEE: $750
SECRETARY OF STATE
payable to
Telephone # ____________________
FAX #
_______________________
Application must be accompanied by a one page original certificate of existence issued by the Secretary of State
or other official having custody of the corporate records in the state or country under whose law it is
incorporated.
1. The name of the cooperative is _____________________________________________________________________
______________________________________________________________________________________________
Note: This must be the exact cooperative name.
2. State where incorporated __________________________________
3. Date of its incorporation is __________________________________
4. The period of its duration ___________________________________
5. The address of its principal office in the state where incorporated
______________________________________________________________________________________________
Street Address
City
State
ZIP+4
______________________________________________________________________________________________
Mailing Address (Optional)
City
State
ZIP+4
6. The South Dakota Registered Agent name ____________________________________________________________
______________________________________________________________________________________________
Street Address or Rural Route Box Number in This State and
City
State
ZIP+4
______________________________________________________________________________________________
Mailing Address in This State, if Different from Street Address
City
State
ZIP+4
When listing a Commercial Registered Agent, please state their CRA #.
This number can be obtained from the Commercial Registered Agent.
_______________________________