CERTIFICATE OF AUTHORITY FOREIGN NONPROFIT CORPORATION
(Per Chapter 24.03 RCW)
F O R O F F I C E U S E O N L Y
· Please PRINT or TYPE in black ink · Sign, date and return original AND ONE COPY to: CORPORATIONS DIVISION 801 CAPITOL WAY SOUTH · PO BOX 40234 OLYMPIA, WA 98504-0234 · BE SURE TO INCLUDE FILING FEE. Checks should be made payable to "Secretary of State"
IMPORTANT! Person to contact about this filing
EXPEDITED (24-HOUR) SERVICE AVAILABLE $20 PER ENTITY INCLUDE FEE AND WRITE "EXPEDITE" IN BOLD LETTERS ON OUTSIDE OF ENVELOPE
FOR OFFICE USE ONLY
Daytime Phone Number (with area code)
NAME OF CORPORATION (As Recorded in the State/Country of Incorporation)
ORIGINALLY INCORPORATED IN: State/Country ON: Date
NOTE: If the name listed above is unavailable in Washington state or does not meet the requirements of 24.03 RCW, please provide the name the corporation adopts for use in Washington State. The name must NOT contain a corporate designation such as "Corporation" "Incorporated" or "Limited" or the abbreviation "Corp." "Inc." "Co." or "Ltd." You must also attach a Board of Directors Resolution approving the use of an alternate name. NAME THE CORPORATION ADOPTS FOR USE IN WASHINGTON STATE APPROVED BY DIRECTORS
PRINCIPAL OFFICE ADDRESS OF CORPORATION (Street Address Required - Please Do Not Use PO Box) Address City EFFECTIVE DATE OF CERTIFICATE OF AUTHORITY PERIOD OF DURATION (Check one only) CERTIFICATE OF EXISTENCE State or Country ZIP or Postal Code
(Specified effective date may be up to 90 days AFTER receipt of the document by the Secretary of State)
F O R O F F I C E U S E O N L Y
Specific Date: Perpetual Years (indicate number of years)
Upon filing by the Secretary of State
DATE CORPORATION BEGAN DOING BUSINESS IN WASHINGTON STATE Date
Attached is an original Certificate of Existence, issued no more than 60 days prior to this application, duly authenticated by the Secretary of State or other official having custody of corporate records in the state or country of incorporation.
PURPOSE(S) OF THIS CORPORATION'S BUSINESS IN WASHINGTON STATE (Attach additional information if necessary)
NAME AND ADDRESS OF WASHINGTON STATE REGISTERED AGENT Name Street Address (Required) PO Box (Optional Must be in same city as street address) City State ZIP
ZIP (If different than street ZIP)
I consent to serve as Registered Agent in the State of Washington for the above named corporation. I understand it will be my responsibility to accept Service of Process on behalf of the corporation; to forward mail to the corporation; and to immediately notify the Office of the Secretary of State if I resign or change the Registered Office Address.
Signature of Agent CURRENT OFFICERS AND DIRECTORS
F O R O F F I C E U S E O N L Y 010-004 (9/00)
Attached is a list of all current officers and directors of the corporation, including the address, city, state or country, and ZIP/Postal Code for each person.
SIGNATURE OF OFFICER OR CHAIRPERSON
This document is hereby executed under penalties of perjury, and is, to the best of my knowledge, true and correct.
Signature of Officer/Chairperson
CORPORATIONS INFORMATION AND ASSISTANCE 360/753-7115 (TDD 360/753-1485)