Non Profit Certificate Of Disclosure {CF0001} | Pdf Fpdf Doc Docx | Arizona

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Non Profit Certificate Of Disclosure {CF0001} | Pdf Fpdf Doc Docx | Arizona

Non Profit Certificate Of Disclosure {CF0001}

This is a Arizona form that can be used for Corporation within Secretary Of State.

Alternate TextLast updated: 5/2/2006

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ARIZONA CORPORATION COMMISSION CORPORATIONS DIVISION Phoenix Address: 1300 West Washington Tucson Address: 400 West Congress Phoenix, Arizona 85007-2929 Tucson, Arizona 85701-1347 NONPROFIT CERTIFICATE OF DISCLOSURE A.R.S. Section 10-3202.D. EXACT CORPORATE NAME A. Has any person serving either by election or appointment as officer, director, trustee, or incorporator in the co:rporation 1. Been convicted of a felony involving a transaction in sitiesecur, consumer fraud or antitrust in any state or federal jurisdiction within the seven-year period immediately preceding the execution of this Certificate? 2. Been convicted of a felony, the essential elements of which consisted of fraud, misrepresentation, theft by false preor rteenssterasin, t of trade or monopoly in any state or federal jurisdiction within the seven-year period immediately preceding the execution of this Certifate?ic 3. Been or are subject to an injunction, judgment, decree or permanent order of any state or federal court entered wivethn-yein thaer s pee riod immediately preceding the execution of this Ceirtcatif e wherein such injunction, judgment, decree or permanent order: (a) Involved the violation of fraud or registration provisions of theities sec lawur s of that jurisdiction?; or (b) Involved the violation of the consumer fraud laws of that jurisdiction?; or (c) Involved the violation of thetitr aunst or restraint of trade laws of that jurisdiction? Yes No B. IF YES, the following information MUST be attach:ed 1. Full name and prior name(s) used. 6. Social Security number. 2. Full birth name. 7. The nature and description of each conviction or judicial action, 3. Present home address. date and location, the court and public agency involved and file or 4. Prior addresses (for immediate preceding 7-year period). cause number of case. 5. Date and location of birth. C. Has any person serving either by election or appointment as an officer, director, trustee or incorporator of the co serrporavedtion, in any such capacity or held such interest in any other corporation which has been placed inbankrupt cy or receivership or had its charter revoked, or administratively dissolved by any jurisdiction? Yes No IF YOUR ANSWER TO THE ABOVE QUESTION IS "YES", YOU MUST ATTACH THE FOLLOWING INFORMATION FOR EACH CORPORATION: 1. Name and address of the corporation. 4. Dates of corporate operation. 2. Full name, including alias and address of each person involved. 5. A description of the bankruptcy, receivership or charter revocation, 3. State(s) in which the corporation: including the date, court or agency and the file or cause number of (a) Was incorporated. the case. (b) Has transacted business. D. The fiscal year end adopted by the corporation is . Under penalties of law, thundee rsigned incorporators/officers declare that we have examined this Certificate, including any attachments, and to tfhe best oour knowledge and belief it is true, correct and complete, and hereby declare as indicated above. THE SIGNATURE(S) MUST BEDE D WIATTHINTHIRTY (30) DAYS OF THE DELIVERY DATE. BY DATE BY DATE TITLE TITLE BY DATE BY DATE TITLE TITLE DOMESTIC CORPORATIONS: ALL INCORPORATORS MUST SIGN THE INITIAL CERTIFICATE OF DISCLOSURE. (If more than fourIncorporators, please attach remaining signatures on a separate sheet of paper.) If within sixty days, any person becomes an officer, director, or trustee and the person was not included in this dihscel ocsourporare, t tion must file anAMENDED certificate signed by all incorporators, or if officers have been elected, by a duly authorized officer.FOREIGN CORPORATIONS: MUST BE SIGNED BY AT LEAST ONE DULY AUTHORIZED OFFICER OF THE CORPORATION. CF: 0001 - Non-Profit Rev: 4/04

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