Prescribed by J. Kenneth BlackwellMail Form to the Following: PO Box 130 Columbus, OH 43216Ohio Secretary of State Central Ohio: (614) 466-3910 Toll Free: 1-877-SOS-FILE (1-877-767-3453)www.state.oh.us/sos e-mail: busserv@sos.state.oh.usCERTIFICATION REQUESTREQUESTED INFORMATION: COMPANY NAME CHARTER / REGISTRATION NO.CERTIFICATESNumber of Certificates RequestedGood Standing CertificateCertificate of Full Force and Effect No Record CertificateCertificate Re: Name Change Long Form Good Standing CertificateCertificate Re: Merger (list all chartered filings)Cancellation CertificateCOPIESNumber of Copies RequestedPlain CopiesorCertified CopiesCorporationLimited Liability CompanyArticles of IncorporationArticles of OrganizationCertificate of Amendment / AmendedCertificate of Amendment /MiscellaneousRestatement or CorrectionEverything on RecordMiscellaneousEverything on RecordLimited Partnership or Partnership having Limited LiabilityTrade or Fictitious Name RegistrationApplication for RegistrationOriginal RegistrationCertificate of Amendment / CorrectionRenewal / RestatementMiscellaneous MiscellaneousEverything on Record Everything on RecordReturn information to:Name:Address:Address:City/State/Zip:Phone #:Last Revised: March 2003Page 1 of 1500Anerucan LegalNet, Inc. www.USCourtForms.comInstructions for Certification RequestCompany Name: List the name of the company pertaining to the information that is being requestedCharter / Registration No.: List the charter or registration number issued by the office of the Ohio Secretary of State Certificates: List the number of certificates requested (you will be charged per certificate)Copies: Copies requested can be plain or certified. State the number of copies that are being requested. Mark the box in the area pertaining to the type of company that information is being requested of. Return information:List the name, address, of the person requesting information. This is the address the Certification Request will be mailed to.Fees:Certificate of Good Standing No Record Certificate Long Form Good Standing Certificate of Full Force and Effect$5.00$5.00 $25.00$5.00$5.00 $10.00$5.00* Name Change Certificate Merger Certificate Cancellation Certificate* If the name change occurred through a Certificate of Merger the fee is $10.00 You may also order Certificates of Good Standing or Certificate of Full Force and Effect on line. Visit the Secretary of State's Website www.state.oh.us/sos/ for further details. Certified Copies: There is a $5.00 charge per set of copies requested. Copies that are over 101 pages will be billed an additional charge of $5.00 Plain Copies: Plain copies are free, there is no fee involved. Plain copies may also be obtained through the Ohio Secretary of State's website at www.state.oh.us/sos/ All checks should be made payable to: The Ohio Secretary of State. Everything on Record is defined as: All chartered documents; copies of the original filing, Amendments and Amended articles, Restatements, Certificate of Cancellation, Certificate of Dissolutions, Certificate of Withdrawals, Certificate of Surrenders, Mergers, and Consolidations Miscellaneous is defined as: Statutory Agent changes, Renewals, Annual or Biennial Reports, Reinstatements, Change of Ownership Name, Statement of Continued Existence, Trade Names, and Fictitious Names Chartered Documents/Filings are defined as: Documents or filings that makes a change to the original filing.Last Revised: March 2003Page 1 of 1500American LegalNet, Inc www.USCourtForms.com
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