Free Kentucky Secretary of State - Kentucky

Kentucky Secretary of State TREY GRAYSON
__________________________________________________________________________________________________________________

Division of Corporations BUSINESS FILINGS P.O. Box 718 Frankfort, KY 40602 (502) 564-3490 http://www.sos.ky.gov/

Application for Certificate of Authority

FCO

__________________________________________________________________________________________________________________

Pursuant to the provisions of KRS Chapter 271B, 273 or 274, the undersigned hereby applies for authority to transact business in Kentucky on behalf of the corporation named below and for that purpose submits the following statements: a business corporation (KRS 271B). a nonprofit corporation (KRS 273). a professional service corporation (KRS 274). 2. The name of the corporation is 1. The corporation is

____________________________________________________________________________.
3. The name of the corporation to be used in Kentucky is

____________________________________________________________________________.
(If "real name" is unavailable for use)

4. ________________________________ is the state or country under whose law the corporation is incorporated. 5. ________________________________ is the date of incorporation and the period of duration is ______________________. 6. The street address of the corporation's principal office is

_____________________________________________________________________________________.
Street City State Zip Code

7. The street address of the corporation's registered office in Kentucky is

_____________________________________________________________________________________
Street City State Zip Code

and the name of the registered agent at that office is

____________________________________________________________________________.
8. The names and usual business addresses of the corporation's current officers and directors are as follows: President___________________________ Vice-President________________________ Secretary___________________________ Treasurer___________________________ Directors___________________________

____________________________

______________________________________ ______________________________________ ______________________________________ ______________________________________ ______________________________________ ______________________________________

(Attach a continuation sheet, if necessary)

9. If a professional service corporation, all the individual shareholders, not less than one half of the directors, and all of the officers other than the secretary and treasurer are licensed in one or more states or territories of the United States or District of Columbia to render a professional service described in the statement of purposes of the corporation. 10. A certificate of existence duly authenticated by the Secretary of State accompanies this application. 11. This application will be effective upon filing, unless a delayed effective date and/or time is specified: ____________________
(Delayed effective date and/or time)

________________________________________________
Signature

________________________________________________
Type or Print Name & Title

Date: ______________________________________, 20_______
I, _____________________________________________________, consent to serve as the registered agent on behalf of the corporation.
Type or print name of registered agent

________________________________________________
Signature of Registered Agent

________________________________________________
Type or Print Name & Title

FCO (04/09)

(See attached sheet for instructions)

Application for Certificate of Authority Filing Instructions
TYPE OF CORPORATION The corporation must indicate if it is a business corporation (KRS 271B), a nonprofit corporation (KRS 273), or a professional service corporation (KRS 274) by checking the appropriate box. CORPORATE NAME The corporate name must contain the word "corporation," "incorporated," "company," or "limited," or an abbreviation thereof. The corporation must apply under its "real name" as filed in the state or country in which it is incorporated. If the "real name" is unavailable for use in Kentucky, the corporation must adopt a fictitious name for use in this state. If a fictitious name is adopted, a resolution of the corporation's board of directors, certified by the secretary, adopting the fictitious name must accompany this application. Professional Service Corporations (KRS 274) The name of a professional service corporation must contain the words "professional service corporation" or the abbreviation "P.S.C." DATE OF INCORPORATION AND DURATION The date of incorporation is the date articles of incorporation were filed with the secretary of state or other official having custody of corporate records. The period of duration of the corporation is that period which is stated in the articles of incorporation. (May be perpetual or a total number of years.) PRINCIPAL OFFICE ADDRESS The principal office is the address (in or out of this state) where the principal executive offices of the corporation are located. REGISTERED OFFICE AND REGISTERED AGENT The registered office of the corporation must be in Kentucky and contain a street address or other specific location (Highway, Rural Route, Building etc.). A post office box only is insufficient for the registered office address. Profit Corporation -The registered agent may be an individual resident of Kentucky, a Kentucky corporation, a Kentucky nonprofit corporation, a Kentucky limited liability company, a foreign corporation, a foreign nonprofit corporation, a foreign limited liability company authorized to transact business in Kentucky. Nonprofit Corporation ­ The registered agent may be an individual resident of Kentucky, a Kentucky corporation, a Kentucky nonprofit corporation, a foreign corporation or a foreign nonprofit corporation authorized to transact business in Kentucky. CONSENT OF REGISTERED AGENT The registered agent must give written consent to act as agent on behalf of the corporation. If the registered agent is a corporation (domestic or foreign) an officer or the chairman of the board of directors must sign on behalf of the corporation. If the registered agent is a limited liability company (domestic or foreign) and management of the company is vested in one or more managers, a manager must sign on behalf of the limited liability company. If management of the company is vested in its members, a member must sign. The representative signing on behalf of the business entity acting as agent must designate the title or capacity in which he or she signs. CERTIFICATE OF EXISTENCE A certificate of existence or document of similar import (for example, certificate of "good standing") must accompany this application. The certificate must be an original and must not be older than six (6) months. A copy of the certificate is not acceptable. Please contact the secretary of state's office of the domiciled state for a certificate of existence. EFFECTIVE DATE AND TIME The document will be effective on the date and time of filing, unless a delayed effective date and/or time is specified. A delayed effective date may not th be later than the 90 day after the date of filing. WHO MAY SIGN A corporate officer or the chairman of the board of directors must sign the application for certificate of authority. NUMBER OF COPIES Submit the original signed application and two exact or conformed copies. (May be photocopies.) Two file-stamped copies will be returned to the corporation as evidence of filing. One file-stamped copy must then be filed with the county clerk of the county in which the corporation's registered office is situated. NOTE: Your file-stamped copy shall serve as the Certificate of Authority. FILING FEES The filing fee for a business corporation or a professional service corporation is $90.00. The filing fee for a nonprofit corporation is $40.00. Your check should be made payable to the "Kentucky State Treasurer". MAILING ADDRESS Trey Grayson Secretary of State P. O. Box 718 Frankfort, KY 40602-0718 WEB SITE ADDRESS Our home page address is www.sos.ky.gov Click on "On Line Business Database" for information on status of all business entities in Kentucky. Forms are also available on our web site. For name availability, call (502) 564-3490. For further information, call (502) 564-3490 or try our web site. NOTE: If a Certificate of Authorization is needed, please attach a written request and submit an additional fee of $10.00 OFFICE LOCATION Room 154, Capitol Building 700 Capital Avenue Frankfort, KY 40601