Form Cf-1 - Application For Certificate Of Authority - 2017 Page 2
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APPLICATION FOR CERTIFICATE OF AUTHORITY
4. Agent for Service of Process:
Name:
Properly designated person to whom
notice of legal process may be sent, if
No. & Street:
any.
City:
State:
Zip Code:
5. E-mail address where business correspondence may be received:
6. Website address of the business, if any (ex: ):
7. Do you own or operate more than one
Yes
No
Decline to answer
* Answer a. and b. below.
business in West Virginia?
If "Yes"... a. How many businesses?
b. Located in how many West Virginia counties?
8. a. Proposed purpose(s) for transaction of business in West Virginia is(are):
b. Will the incorporation elect to be organized for purposes as a “Benefit Corporation” per West Virginia Code §31F? ONLY
applicable to "FOR PROFIT" corporations; "NON-PROFIT" corporations CANNOT elect this status.
Yes
[If "Yes," the corporation must be formed FOR PROFIT and the purpose(s) indicated in Section 10a. above must
include a "general public benefit" as set forth in
§31F-3-301(a)
of the West Virginia Code. Per §31F-1-102(c),
“general public benefit” means “a material positive impact on society and the environment taken as a whole, as
measured by a third-party standard, from the business and operations of a benefit corporation."].
No
[Proceed to Section 9.]
9. Is the business a Scrap Metal Dealer?
[If "Yes," you must complete the Scrap Metal Dealer Registration Form (Form SMD-1) and proceed to Section 10.]
Yes
No
[Proceed to Section 10.]
10. Corporate Status Information:
a. Corporation is organized as (check one):
For Profit
Non-Profit
b. Officers and Directors: (add additional pages if necessary; please list all officers)
Officer Title
Officer Name
No. & Street Address
City
State
Zip Code
Form CF-1
Issued by the Office of the Secretary of State
Rev. 01/17
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