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Articles Of Incorporation Nonprofit Corporation Community Third Party Or Medicaid Pooled Trust N-15 - North Carolina
| Articles Of Incorporation Nonprofit Corporation Community Third Party Or Medicaid Pooled Trust Form. This is a North Carolina form and can be used in Nonprofit Corporation Secretary Of State . |
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State of North Carolina Department of the Secretary of State ARTICLES OF INCORPORATION NONPROFIT CORPORATION COMMUNITY THIRD PARTY OR MEDICAID POOLED TRUST Pursuant to §55A-2-02 and §36D of the General Statutes of North Carolina, the undersigned corporation does hereby submit these Articles of Incorporation for the purpose of forming a Community Third Party or Pooled Trust nonprofit corporation. 1. The name of the corporation is:_____________________________________________________________________________ 2. _______ (Check only if applicable.) The corporation is a charitable or religious corporation as defined in NCGS §55A-1-40(4). 3. The street address and county of the initial registered office of the corporation is: Number and Street_________________________________________________________________________________________ City, State, Zip Code___________________________________________________County______________________________ 4. The mailing address if different from the street address of the initial registered office is: ________________________________________________________________________________________________________ 5. The name of the initial registered agent is: ________________________________________________________________________________________________________ 6. The name, address, and relationship to the Beneficiary of each board member/incorporator is as follows: __________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ 7. (Check either a or b below.) a.___The corporation will have members. b.___The corporation will not have members. 8. Attached are provisions regarding the settlement of the corporation's assets upon its dissolution. 9. Any other provisions which the corporation elects to include are attached. 10. The requirements of §36D-4 have been met. 11. Attached is a copy of the By-laws adopted by the Board in the manner prescribed by law. 12. The street address and county of the principal office of the corporation is: ____________________________________________________________________County_____________________________ 13. The mailing address if different from the street address of the principal office is: ______________________________________________________________________________________________________ Revised July 2010 CORPORATIONS DIVISION P. O. BOX 29622 Form N-15 RALEIGH, NC 27626-0622 American LegalNet, Inc. www.FormsWorkFlow.com ARTICLES OF INCORPORATION NONPROFIT CORPORATION COMMUNITY THIRD PARTY OR MEDICAID POOLED TRUST Page Two 14. These articles will be effective upon filing, unless a later time and/or date is specified: _________________ This is the_____day of_____________ ,20____. _________________________________________________ _ Business Entity Name ________________________________________________ Signature of Incorporator _________________________________________________ Type or print Incorporator's name and title, if any NOTES: 1. Filing fee is $60. This document must be filed with the Secretary of State. Revised July 2010 CORPORATIONS DIVISION P. O. BOX 29622 Form N-15 RALEIGH, NC 27626-0622
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