STATE OF SOUTH CAROLINA
SECRETARY OF STATE
APPLICATION BY A FOREIGN CORPORATION
FOR A CERTIFICATE OF AUTHORITY
TO TRANSACT BUSINESS
IN THE STATE OF SOUTH CAROLINA
TYPE OR PRINT CLEARLY WITH BLACK INK
Pursuant to Section 33-15-103 of the 1976 South Carolina Code of Laws, as amended, the undersigned
corporation hereby applies for authority to transact business in the State of South Carolina, and for that
purpose, hereby submits the following statement:
1. The name of the corporation is (see Sections 33-4-101 and 33-15-106 and Section 33-19-500(b)(1) if the
corporation is a professional corporation) __________________________________________________.
(Must match corporation name on certificate of existence from domestic state)
2. It is incorporated as (check applicable item) [ ] a general business corporation, [ ] a professional
corporation, under the laws of the state of ______________________________________________.
3. The date of its incorporation is _________________ and the period of its duration is __________________.
4. The address of the principal office of the corporation is ________________________________ in the
city of ________________________ and the state of ___________________________________.
5. The address of the proposed registered office the state of South Carolina is
___________________________________ in the city of _____________________________ in
South Carolina ____________________________.
6. The name of the proposed registered agent in South Carolina at such address is
I hereby consent to the appointment as registered agent of the corporation.
Signature of the Registered Agent
Form Revised by South Carolina
Secretary of State, March 2012