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STATE OF SOUTH CAROLINA
SECRETARY OF STATE
ADOPTION OF A FICTITIOUS NAME
Nonprofit Corporation - Foreign
Filing Fee - $10.00
TYPE OR PRINT CLEARLY IN BLACK INK
Pursuant to S.C. Code of Laws §33-31-1506, the undersigned nonprofit corporation submits the following:
1. Applicant’s name (individual submitting form) _________________________________________________
2. The legal name of the nonprofit corporation is __________________________________________________
3. Enter the date that the Board of Directors adopted the resolution to use the fictitious name _______________
4. Enter the fictitious name that the Board of Directors adopted to use for conducting business in the state of
South Carolina ___________________________________________________________________________
5. By signing and submitting this form you are affirming that the Board of Directors of the nonprofit
corporation duly adopted the resolution to use a fictitious name in South Carolina for conducting all business
at a duly called meeting of the Board. A quorum was present for the meeting and the resolution was set forth
in the minutes of the meeting. Additionally, you are the keeper of the corporate seal and of the minutes and
records of the nonprofit corporation and the said resolution has not been rescinded or modified.
Date ______________________
____________________________________________
Signature
____________________________________________
Print Name
____________________________________________
Title
Filing Checklist
■ Fictitious Name Form (filed in duplicate)
■ $10.00 made payable to the South Carolina Secretary of State
■ Make sure the proper person has signed the document
Documents filed with the Secretary of State should be executed by:
(1) the Presiding Officer of its Board of Directors of a domestic or foreign corporation, its president or another
of its officers
(2) if directors have not been selected or the corporation has not been formed, by an incorporator; or
(3) if the corporation is in the hands of a receiver, trustee or other court appointed fiduciary, by that fiduciary.
■ Self-Addressed, Stamped Return Envelope
■ Return all documents to:
South Carolina Secretary of State’s Office
Attn: Corporate Filings
1205 Pendleton Street, Suite 525
Columbia, SC 29201
NP – Foreign – Fictitious Name Form
Form Revised by South Carolina
Secretary of State, May 2011