Filing Fee: $50.00
STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS
Office of the Secretary of State
Division of Business Services
148 W. River Street
Providence, Rhode Island 02904-2615
NON-PROFIT CORPORATION
__________________
APPLICATION FOR CERTIFICATE OF AUTHORITY
Pursuant to the provisions of Section 7-6-74 of the General Laws of Rhode Island, 1956, as amended, the undersigned foreign non-
profit corporation hereby applies for a Certificate of Authority to conduct affairs in the State of Rhode Island, and for that purpose
submits the following statement:
1.
The name of the corporation is _______________________________________________________________________________
2.
It is incorporated under the laws of ___________________________________________________________________________
3.
The date of its incorporation is _______________________________________________________________________________
4.
The address of its principal office is ___________________________________________________________________________
5.
The address of its proposed registered office in Rhode Island is _____________________________________________________
(Street Address, not P.O. Box)
_____________________________________, RI ___________ and the name of its proposed registered agent in Rhode Island at
(City/Town)
(Zip Code)
that address is ____________________________________________________________________________________________
(Name of Agent)
6.
The specific purpose or purposes which it proposes to pursue in conducting its affairs in Rhode Island are:
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
Form No. 250
Revised: 06/11