Application For Reinstatement (Domestic Cooperative)

domesticcooperativereinstatement Secretary of State Office 500 E Capitol Ave Pierre, SD 57501 (605)773-4845 corpinfo@state.sd.us 1.The Name and Business ID of the Cooperative is: Name (Note: This must be the exact name as registered.) Business ID 2.The effective date of its administrative dissolution: Any cooperative administratively dissolved may apply to the Secretary of State forreinstatement within 2 years after the effective date of dissolution. 3.State that the ground or grounds for revocation either did not exist, or have been eliminated by filing allrequired reports and paying all fees and penalties. 4.Attached hereto are ALL documents, fees, and penalties required for reinstatement:Annual Reports Registered Agent and Registered Office Information Filing Fees Penalties 5.SDCL 47-18-16.2 imposes a $20 fee for each year the cooperative has been expired. This application must be signed by a partner. No person may execute this report knowing it is false in any material respect. Any violation may be subject to a criminal penalty (SDCL 22-39-36). Dated Signature of an authorized person Email (Optional) Printed Name APPLICATION FOR REINSTATEMENT DOMESTIC COOPERATIVE SDCL 47-18-16.2; 47-18-16.5 FILING FEE: $300 yable to SECRETARY OF STATE American LegalNet, Inc. www.FormsWorkFlow.com