Free $350.00 - Alaska

State of Alaska Department of Commerce, Community, and Economic Development Corporations, Business, and Professional Licensing Corporations Section PO Box 110808 Juneau AK 99811-0808

CERTIFICATE OF AUTHORITY
Business, Non Profit, or Cooperative Corporation
Pursuant to the provisions of the Alaska Statutes, the undersigned corporation applies for a Certificate of Authority and, for that purpose, submits the following statement: 1. The legal name of the corporation:

The entity listed above is a: Business Corporation Non Profit Corporation or Cooperative Corporation

The entity is active and in good standing in the state of domicile. 2. The assumed name elected to use in Alaska if the legal name in not available:

3. State of domicile, date of incorporation and the period of duration in the state or country of domicile:
The period of duration is the length of time a corporation expects to exist. It may be a specific number of years or perpetual.

State of Domicile:

Date of Incorporation:

Duration:

4. The purpose of the corporation and the 6-digit NAICS industry grouping code that most clearly describe the initial activities of the corporation: Purpose: NAICS Code: 5. Address of the principal office of the corporation wherever located: Mailing Address: Physical Address if Mailing Address is a Post Office Box: City: E-mail address: State: ZIP Code:

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6. Registered Agent name and address: Name: Mailing Address: Physical Address if Mailing Address is a Post Office Box: City: AK ZIP Code:

7. Name and Address of each alien affiliate or a statement that there are no alien affiliates: There are no alien affiliates Alien Affiliate Information: Name: Mailing Address: City: Country: Attach additional sheet if more than one alien affiliate. 8. Number of Authorized Shares: (Business and Cooperative Corporations) # of Authorized Shares # of Authorized Shares Class Class Series Series Par Value Par Value State: ZIP Code: Province:

9. Number of issued shares: # of Issued Shares # of Issued Shares Class Class Series Series Par Value Par Value

10. The names and mailing addresses of the officers and directors of the corporation: Title Name Mailing Address City State President Vice President Secretary Treasurer Director Director

ZIP Code

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If necessary, attach additional pages for continuation. Please do not include confidential information such as Social Security Numbers, driver license numbers or date of birth as this record is public information. 11. Name and address of each person owning 5% or more of the shares or 5% of any class of shares and the percentage of the shares owned by that person. Attach an additional page if necessary. Name Mailing Address City State ZIP Code % Shares
Held

12. If entity is a Cooperative Corporation, list the name and mailing address of at least one member residing in Alaska: Name: Mailing Address: City: AK ZIP Code:

The PRINTED name and SIGNATURE of the president or vice president of the corporation and by its secretary or an assistant secretary. Signed this day of , 20 .

By signing this application for Certificate of Authority, I attest that the information set forth above is true and correct. Signature of President or Vice President Printed Name

Signature of Secretary or Assistant Secretary

Printed Name

If you have specific legal questions or concerns about this filing, you are strongly advised to consult an attorney or other professional to assist you. Mail the filing and the $350.00 filing fee for Business and Cooperative Corporations and $50.00 for Non Profit Corporations (in U.S. dollars) to: State of Alaska Corporations Section PO Box 110808 Juneau, AK 99811 For additional information or forms please visit our web site at: www.corporations.alaska.gov

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DISCLOSURE OF CORPORATE PURPOSE USING THE NORTH AMERICAN INDUSTRY CLASSIFICATION SYSTEM (NAICS)
A separate Disclosure of Corporate Purpose must be attached to the Application for Certificate of Authority, which most closely describes the activities of the corporation. The NAICS Code must not conflict with the purpose listed in the Articles of Incorporation. You may view or search the NAICS codes at the website below: www.corporations.alaska.gov The 6 digit NAICS industry grouping code which most clearly describe the initial activities of the corporation is:

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INSTRUCTIONS
Application for Certificate of Authority If you need assistance in completing your filing, it is advised that you seek legal counsel. 1. The legal name of the corporation. A corporate name must contain the word "corporation," "company," "incorporated," or "limited," or an abbreviation of one of these words. The corporate name may not contain a word or phrase that indicates or implies that the corporation is organized for a purpose other than the purpose contained in its articles of incorporation. A corporate name must be distinguishable upon the record. 2. The name the corporation elects to use if the name in the state of domicile is already in use by another entity in Alaska. 3. The state of domicile, date of incorporation in the state of domicile and the duration of the incorporation, which may be perpetual. The period of duration is the length of time a corporation expects to exist. It may be a specific number of years or perpetual. 4. The purpose of the corporation that may include "any lawful", and the NAICS industry grouping code that most clearly describes the initial activities of the corporation. 5. The address of the principal office of the corporation in the state or country of domicile. 6. The Registered Agent of the corporation must have an address in Alaska. If the registered office mailing address is a post office box, the physical address of the registered office must be listed. A corporation shall continuously maintain in this state a registered agent and a registered office. The registered office may be the same as the place of business of the corporation. The registered agent may be either an individual resident of this state whose business office is the same as the registered office, or a domestic or foreign corporation authorized to transact business in this state whose business office is the same as the registered office. 7. An alien affiliate is defined in AS 10.06.990 as: Affiliate: a person that directly or indirectly through one or more intermediaries controls, or is controlled by, or is under common control with, a corporation subject to this chapter Alien: 1. An individual who is not a citizen or national of the United States, or who is not lawfully admitted to the United States for permanent residence, or paroled into the United States under the Immigration and Nationality Act (8 U.S.C. 1101 - 1525, as amended): 2. A person, other than an individual, that was not created or organized under the laws of the United States or of a state, or whose principal place of business is not located in any state; or 3. A person, other than an individual, that was created or organized under the laws of the United States or of a state, or whose principal place of business is located in a state, and that is controlled by a person described in (1) or (2) of this paragraph; 8. Provide the number, class and series of authorized shares. 9. Provide the number, class and series of issued shares. 10. List the names and mailing address of the officers and directors of the corporation. You may attach an additional 8½" x 11" page if necessary. Please do not include confidential information such as Social Security Numbers, driver license numbers or date of birth. 11. List the name and mailing address of persons owning 5% or more of the shares or 5% of any class of shares and the percentage owned by that person.
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12. If entity is a Cooperative Corporation, provide the name and mailing address of at least one member residing in Alaska.

Every corporation earning gross income from sources within the state, except for those corporations that are specifically exempted, must file a corporation net income tax return. A corporation may elect to file a consolidated Alaska return with its affiliates. The Alaska return is due 30 days after the due date of the Federal Tax Return. The tax due must be paid by the 15th day of the third month following the close of the tax year. Form 04-611 is the prescribed form on which the Alaska Corporation Net Income Tax is to be reported for most corporations. However, those corporations engaged in oil and gas production or pipeline transportation must use Form 04-650. The forms may be obtained by contacting the Alaska Department of Revenue, Tax Division, P.O. Box 110420, Juneau, Alaska, 99811-0420, Telephone (907) 465-2320.

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