COMMONWEALTH OF MASSACHUSETTS
William Francis Galvin
Secretary of the Commonwealth
One Ashburton Place, Boston, Massachusetts 02108-1512
Articles of Foreign Non-profi t
Domestication and Conversion
(General Laws Chapter 156D, Section 9.41; 950 CMR 113.28)
I hereby certify that upon examination of these articles of domestication, duly submit-
ted to me, it appears that the provisions of the General Laws relative thereto have been
complied with, and I hereby approve said articles; and the fi ling fee in the amount of
$______ having been paid, said articles are deemed to have been fi led with me this
_____________ day of _____________
day of _____________
day of
, 20______ , at _______a.m./p.m.
time
Eff ective date: _________________________________________________
(must be within 90 days of date submitted)
WILLIAM FRANCIS GALVIN
Secretary of the Commonwealth
Filing fee: Minimum $250
Examiner
TO BE FILLED IN BY CORPORATION
Name Approval
Contact Information:
C
___________________________________________________________
M
___________________________________________________________
___________________________________________________________
Telephone: ___________________________________________________
Email: ______________________________________________________
Upon fi ling, a copy of this fi ling will be available at
If the document is rejected, a copy of the rejection sheet and rejected document will
be available in the rejected queue.