Form S&dc-Insurer - Statement And Designation By Foreign Corporation - 2012
Download a blank fillable Form S&dc-Insurer - Statement And Designation By Foreign Corporation - 2012 in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form S&dc-Insurer - Statement And Designation By Foreign Corporation - 2012 with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1Insurer
Statement and Designation
by Foreign Corporation
________________________________________________________________________________________________________________________
[Name of Corporation]
, a corporation organized and existing under the
____________________________________________________________________
laws of
, makes the following statements and designation:
__________________________________________________________
[
State or Place of Incorporation]
1.
The address of its principal executive office is
________________________________________________________________
.
__________________________________________________________________________________________________________________
2.
The address of its principal office in the State of California is
________________________________________________
[If none, leave Item 2 blank.]
.
__________________________________________________________________________________________________________________
3.
This corporation will be subject to the California Insurance Code as an insurer.
Designation of Agent for Service of Process in the State of California
[Complete either Item 4 or Item 5.]
4.
[Use this paragraph if the process agent is a natural person.]
, a natural person residing in the State of
____________________________________________________________________
California, whose complete street address in California is
___________________________________________________
, is designated as agent upon whom process directed to
___________________________________________________
this corporation may be served within the State of California, in the manner provided by law.
5.
[Use this paragraph if the process agent is another corporation.]
__________________________________________________________________________________________________________________
a corporation organized and existing under the laws of
,
__________________________________________________
is designated as agent upon whom process directed to this corporation may be served within the State
of California, in the manner provided by law.
6.
It irrevocably consents to service of process directed to it upon the agent designated above, and to
service of process on the Secretary of State of the State of California if the agent so designated or the
agent's successor is no longer authorized to act or cannot be found at the address given.
_________________________________________________________
________________________________________________________
[Signature of Corporate Officer]
[Typed Name and Title of Officer Signing]
If an individual is designated as the agent for service of process, include the agent’s business or residential street address in California (a P.O.
Box address is not acceptable). If another corporation is designated as the agent for service of process, do not include the address of the
designated corporation. Note: Corporate agents must have complied with California Corporations Code section 1505 prior to designation, and a
corporation cannot act as its own agent.
Secretary of State Form
S&DC-INSURER (Rev. 02/2012)
Print Form
Clear Form
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal