Certificate Of Type Of Not-For-Profit Corporation {DOS-0640-f-l}

New York State Department of State Division of Corporations, State Records and Uniform Commercial Code One Commerce Plaza, 99 Washington Avenue Albany, NY 12231 www.dos.ny.gov CERTIFICATE OF TYPE OF NOT-FOR-PROFIT CORPORATION OF (Exact Name of Corporation) Under Section 113 of the Not-for-Profit Corporation Law The present name of the corporation is: If the name of the corporation has been changed, the name under which the corporation was formed is: The certificate of incorporation was filed by the Department of State on: (Must include month, day and year) The corporation was formed pursuant to: (Cite incorporation statute) The Secretary of State is designated as agent of the corporation upon whom process against it may be served. The address to which the Secretary of State shall mail a copy of such process is: THAT under Section 201, it is a Type (A,B,C or D) not-for-profit corporation as defined in this chapter. To be signed pursuant to Section 104(d) of the NPCL. X (Signature) (Type or Print Name) (Title or Capacity of Signer) DOS-0640-f-l (Rev. 02/12) Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com CERTIFICATE OF TYPE OF NOT-FOR-PROFIT CORPORATION OF (Exact Name of Corporation) Under Section 113 of the Not-for-Profit Corporation Law Filed By: Name: Address: City, State and Zip Code: NOTE: The fee for filing this certificate is $30. Check or money order should be made payable to the Department of State. Every corporation required to file under Paragraph (a) of Section 113 of the NPCL will be considered a Type B corporation until it has filed a certificate of type. For Office Use Only DOS-0640-f-l (Rev. 02/12) Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com