Statutory Trust Certificate Of Trust, Consent To Appointment By Registered Agent Form - Wyoming Secretary Of State Page 2

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Ed Murray
Wyoming Secretary of State
2020 Carey Avenue, Suite 700
Cheyenne, WY 82002-0020
For Office Use Only
Ph. 307.777.7311
Fax 307.777.5339
Email:
Business@wyo.gov
Statutory Trust
Certificate of Trust
1. Name of the statutory trust:
2. Name and address of at least one (1) of the trustees authorized to manage the statutory trust:
Name:
Address:
3. Name and physical address of its registered agent:
(The registered agent may be an individual resident in Wyoming or a domestic or foreign business entity authorized to transact business in
Wyoming. The registered agent must have a physical address in Wyoming. If the registered office includes a suite number, it must be
included in the registered office address. A Drop Box is not acceptable. A PO Box is acceptable if listed in addition to a physical address.)
Name:
Address:
(If mail is received at a Post Office Box, please list above in addition to the physical address.)
4. Mailing address of the statutory trust:
5. Principal office address:
ST-CertificateTrust - Revised October 2015

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