Foreign Nonprofit Corporation Application For Certificate Of Authority - Wyoming Secretary Of State Page 3

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8. Names and usual business addresses of its current officers and directors:
Office
Name
Address
President
Vice President
Secretary
Treasurer
Director
Director
Director
9. Does this corporation have members?
Yes
No
10. If this corporation had been incorporated under the laws of this state, would it be
:
(Check one appropriate choice.)
a. Public benefit corporation
b. Mutual benefit corporation
c. Religious corporation
11. The corporation accepts the constitution of the state of Wyoming in compliance with the requirement of
Article 10, Section 5 of the Wyoming Constitution.
Signature: ___________________________________________
Date:
(May be executed by Chairman of Board, President or another of its officers.)
(mm/dd/yyyy)
Print Name:
Contact Person:
Title:
Daytime Phone Number:
Email:
(Email provided will receive annual report reminders and filing evidence)
*May list multiple email addresses
REQUIRED ATTACHMENT TO INCLUDE WITH THE FILING
The completed application must be accompanied by an original certificate of existence/good standing,
dated not more than sixty (60) days prior to filing in Wyoming, authenticated by the Secretary of State or
official having custody of corporate records in the state or country of formation.
FNP-CertificateAuthority – Revised October 2015

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