Form No. 250 - Non-Profit Corporation - Application For Certificate Of Authority Page 2
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27.
The names and respective addresses of its directors and officers are:
Name
Address
Director
____________________________________
________________________________________________
Director
____________________________________
________________________________________________
Director
____________________________________
________________________________________________
President
____________________________________
________________________________________________
Vice President
____________________________________
________________________________________________
Treasurer
____________________________________
________________________________________________
Secretary
____________________________________
________________________________________________
8.
This application is accompanied by certified copies of its articles of incorporation and all amendments thereto, duly authenticated
by the secretary of state or other authorized officer of the jurisdiction of its incorporation.
Under penalty of perjury, I declare and affirm that we have examined
this Application for Certificate of Authority, including any accompanying
attachments, and that all statements contained herein are true and
correct.
Date: __________________________
_________________________________________________________
Print Exact Name of Corporation Making Application
_________________________________________________________
Signature of
President or
Vice President (check one)
_________________________________________________________
Signature of
Secretary or
Assistant Secretary (check one)
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Parent category: Legal