Tennessee > Secretary Of State > Corporation
Application For Certificate Of Authority (Nonprofit) SS-4432 - Tennessee
| Application For Certificate Of Authority (Nonprofit) Form. This is a Tennessee form and can be used in Corporation Secretary Of State . |
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For Office Use Only APPLICATION FOR CERTIFICATE OF AUTHORITY Corporate Filings 312 Eighth Avenue North (NONPROFIT) 6th Floor, William R. Snodgrass Tower Nashville, TN 37243 Pursuant to the provisions of Section 48-65-103 of the Tennessee Nonprofit Corporation Act, the undersigned corporation hereby applies for acertificate of authority to transact business or conduct affairs in the State of Tennessee, and for that purpose sets forth: 1. The name of the corporation is *If different, the name under which the certificate of authority is to be obtained is [NOTES: The Secretary of State of the State of Tennessee may not issue a certificate of authority to a nonprofit foreign corporation if its name does not complywith the requirements of 48-54-101 of the Tennessee Nonprofit Corporation Act. *If obtaining a certificate of authority under a different corporate name, thisapplication must be accompanied by an application for registration of assumed corporate name filed pursuant to 48-54-101(d) with an additional $20.00 fee.] 2. The state or country under whose law it is incorporated is 3. The date of its incorporation is (must be month, day, and year), and the period of duration, ifother than perpetual, is . 4. The complete street address (including zip code) of its principal office is Street City State/Country Zip Code 5. The complete street address (including the county and the zip code) of its registered office in Tennessee and the name of its registered agent at that office is: Street City County Zip Code Registered agent 6. The names and complete business addresses (including zip code) of its current officers are: (Attach separate sheet if necessary.) 7. The names and complete business addresses (including zip code) of its current board of directors are: (Attach separate sheet if necessary.) 8. If the corporation commenced doing business in Tennessee prior to the approval of this application, the date of commencement(month, day, and year) . 9. The corporation has members. The corporation has no members. [NOTE: Please mark the applicable statement] 10. The corporation is a nonprofit corporation. 11. If the corporation had been incorporated in Tennessee, it would be a public benefit corporation, or a mutual benefitcorporation. [NOTE: Please mark the applicable statement.] 12. If the document is not to be effective upon filing by the Secretary of State, the delayed effective date/time is (date) , (time). [NOTE: A delayed effective date shall not be later than the 90th day after the date this document is filed by the Secretary of S.]tate[NOTE: This application must be accompanied by a certificate of existence (or a document of similar import) duly authenticated by the Secretary of State orother official having custody of corporate records in the state or country under whose law it is incorporated. The certificate shall not bear a date of more thanshall not bear a date of more thanSecretary of State ortwo (2) months prior to the date the application is successfully filed in other official having custody of corporate records in the state or country under whose law it is incorporated. The certificate This application must be accompanied by a certificate of existence (or a document of similar import) duly authenticated by the NOTE: Tennessee.] Signature Date Name of Corporation Signers Capacity Signature Name (typed or printed) SS-4432 (Rev.10/03) Filing Fee: $600 RDA 1678
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