Form Sfn 13100 - Certificate Of Authority Application Foreign Corporation printable pdf download

CERTIFICATE OF AUTHORITY APPLICATION

For Office Use Only

FOREIGN CORPORATION

ID Number:

SECRETARY OF STATE

WO Number:

SFN 13100 (01-2016)

Filed:

By:

1A. The application MUST be accompanied by ALL of the following:

1B. The following MAY be required:

• Filing fee of $145 if a Foreign Business or Professional Corporation

• Certificate of Professional License from the North

• Filing fee of $50 if a Foreign Nonprofit Corporation

Dakota licensing board for the profession

• Signed Consent to Use Business Name and fee of $10

• Current CERTIFICATE OF GOOD STANDING or CERTIFICATE OR

• Trade Name Registration and fee of $25

EXISTENCE verifying corporate existence certified by the incorporating

officer of the state or country of incorporation

SEE INSTRUCTIONS FOR FEES, FILING, AND MAILING INFORMATION

TYPE OR PRINT LEGIBLY

For reference, see North Dakota Century Code, Section 10-19.1-135 or 10-33-125.

2. Type of corporation applying for certificate of authority (check one)

Foreign Business

Foreign Professional

Foreign Nonprofit

3A. Name of corporation EXACTLY as it appears on Certificate of Good Standing or Certificate of Existence from

3B. Federal ID Number

state or country of origin

3C. If applicable, provide the trade name and complete the Trade Name Registration form if:

a. The corporate name in number 3A is not in the form as required of corporations in North Dakota.

b. The Secretary of State has notified the corporation that its corporate name is the same or deceptively similar to a name already registered, and the

corporation is unable to obtain consent to use of name from the previous filer or a certified copy of a final decree of a court of competent jurisdiction

establishing prior right of this corporation to use of the name in North Dakota.

c. The corporation does not wish to use or protect its corporate name in North Dakota and chooses to use a name other than its corporate name.

4. Complete mailing address of principal executive office (Street/RR, PO Box, City, State, ZIP+4) Street address MUST be provided; may not be only a post

office box.

5A. State or country where incorporated

5B. EXACT date incorporated (M/D/Y)

5C. Duration of corporation (check one)

Perpetual

Other - Specify date:

5D. Telephone Number

5E. Toll-Free Telephone Number

6A. Name of commercial registered agent in North Dakota

6B. Name of noncommercial registered agent in North Dakota

6C. Address of noncommercial registered agent in North Dakota (Street/RR, PO Box, City, State, ZIP+4) Street address MUST be provided; may not be only

a post office box.

7. Nature of business or activities the corporation conducts or intends to conduct in North Dakota

OFFICERS AND DIRECTORS OF THE CORPORATION

Officer also

COMPLETE MAILING ADDRESS

serves as

director

NAME

Street/RR

PO Box

City

State

ZIP+4

PRESIDENT

VICE PRESIDENT

SECRETARY

TREASURER

DIRECTOR

9. "I, the undersigned, am a person authorized by the corporation to sign this application, know the contents, and believe the statements to be true. I further

authorize the Secretary of State to correct numbers 3A, 5A, 5B, 6A, 6B and 6C if not correctly reflected. I understand that if I make a false statement in this

document, I may be subject to criminal penalties."

Signature

Date

10. Name of person to contact about this document Email Address

Daytime Telephone Number