Application By A Foreign Corporation For A Certificate Of Authority To Transact Business In The State Of South Carolina Page 2

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________________________________
Name of Corporation
7. The name and usual business address of the corporation's directors (if the corporation has no directors,
then the name and address of the persons who are exercising the statutory authority of the directors on
behalf of the corporation) and principal officers:
a.)
Name of Directors
Business Address
____________________________________
______________________________________
____________________________________
______________________________________
____________________________________
______________________________________
____________________________________
______________________________________
b.)
Name and Office of Principal Officers
Business Address
____________________________________
______________________________________
____________________________________
______________________________________
____________________________________
______________________________________
____________________________________
______________________________________
8. The aggregate number of shares which the corporation has authority to issue, itemized by classes
and series, if any, within a class: (if no shares are issued please enter “none”)
Class of Shares (and Series, if any)
Authorized Number of Each Class (and Series)
____________________________________
______________________________________
____________________________________
______________________________________
____________________________________
______________________________________
9. Unless a delayed date is specified, this application shall be effective when accepted for filing by the
Secretary of State (See Section 33-1-230):______________________________________________
Date ________________________
________________________________
Name of Corporation
________________________________
Signature of Officer
________________________________
Type or Print Name
________________________________
Position of Officer
Form Revised by South Carolina
Secretary of State, March 2012

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