Form Rdom-1 - Statement Of Redomestication (California Insurer Only) Page 2
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52.
Enter the 7-digit Entity (File) Number
•
The 7-digit Entity (File) Number is provided by the Secretary
issued to the corporation by the California
of State above the file stamp at the top of the corporation’s
Secretary of State at the time of
registration document filed with the California Secretary of
registration.
State.
•
Secretary of State Records can be accessed online through
our Business Search at
BusinessSearch.sos.ca.gov.
While
using the Business Search, be sure to identify your
corporation correctly including the jurisdiction that matches
your corporation. Active corporations, inactive corporations
and corporations from foreign jurisdictions registered with our
office may have the same or similar name.
3.
This statement is required and may not
be altered.
4.
This statement is required and may not
be altered.
•
5.
This statement is required and may not
The Secretary of State cannot file this Statement of
be altered.
Redomestication unless an amended certificate of authority
approving the redomestication, issued by the California
Insurance Commissioner, is attached to the Statement of
Redomestication.
6.
Enter the name of the redomesticated
entity that will be used in the foreign
jurisdiction.
•
This is the state to which the insurer is redomesticating (the
7.
Enter the new state of domicile for the
specified state must match the jurisdiction on the included
redomesticated entity.
amended certificate of authority issued by the California
Insurance Commissioner).
•
An Agent for Service of Process is responsible for accepting
8.
Enter the name and address for the
legal documents (e.g. service of process, lawsuits, other
insurer’s agent for service of process in
types of legal notices, etc.) on behalf of the insurer.
the foreign jurisdiction.
•
Do not enter the name and address of the insurer’s California
agent for service of process.
• If you need more space for signatures:
Sign and type or print the name of the
Signature
person authorized to sign for the insurer.
Place the additional signatures on only one side of a
-
standard letter-sized piece of paper (8 1/2" x 11")
Do not use a computer-generated
clearly marked as an attachment to Form RDOM-1 and
signature.
attach the extra page(s) to the completed Form RDOM-
1.
All attachments are part of this document.
-
2018 California Secretary of State
RDOM-1 - Instructions (EST 01/2018)
bizfile.sos.ca.gov
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