Pennsylvania > Department Of State > Domestic Nonprofit Corporation
Annual Statement Nonprofit Corporation DSCB 15-5110 - Pennsylvania
| Annual Statement Nonprofit Corporation Form. This is a Pennsylvania form and can be used in Domestic Nonprofit Corporation Department Of State . |
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PENNSYLVANIA DEPARTMENT OF STATE BUREAU OF CORPORATIONS AND CHARITABLE ORGANIZATIONS Annual Statement-Nonprofit Corporation (15 Pa.C.S. § 5110) Name Address City State Zip Code Document will be returned to the name and address you enter to the left. Fee: None In compliance with the requirements of 15 Pa.C.S. § 5110 (relating to annual report), the undersigned domestic or qualified foreign nonprofit corporation, hereby states that: 1. The name of the corporation is: 2. The address of its principal office is: Number and street City State Zip County 3. The names and title of the persons who are its principal officers are: Names Titles IN TESTIMONY WHEREOF, the undersigned corporation has caused this Annual Statement to be signed by a duly authorized officer thereof this day of , . ____________________________________________________________________________________________ Name of Corporation Signature ___________________________________ Title American LegalNet, Inc. www.FormsWorkFlow.com Department of State Bureau of Corporations and Charitable Organizations P.O. Box 8722 Harrisburg, PA 17105-8722 (717) 787-1057 web site: www.dos.state.pa.us/corps Instructions for Completion of Form: A. Typewritten is preferred. If not, the form shall be completed in black or blue-black ink in order to permit reproduction. There is no filing fee with respect to this form. B. On or before April 30 of each year where there has been a change in corporate officers during the preceding calendar year, this form shall be filed by each domestic nonprofit corporation which effected any filing in the Department of State after December 31, 1972 and by each qualified nonprofit corporation. C. This form is not a substitute for form DSCB:15-1507/4144/5507/6144/8506 (Statement of Change of Registered Office), and the appropriate form shall be filed to reflect a change in Pennsylvania registered office address. D. This form and all accompanying documents shall be mailed to the above stated address. American LegalNet, Inc. www.FormsWorkFlow.com
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