ARTICLES OF INCORPORATION
DOMESTIC NONPROFIT CORPORATION
State Form 4162 (R15 / 6-16)
Approved by State Board of Accounts, 2016
SECRETARY OF STATE
BUSINESS SERVICES DIVISION
302 West Washington Street, Room E018
Indianapolis, IN 46204
Telephone: (317) 232-6576
www.sos.in.gov
INSTRUCTIONS: 1. Use 8 ½”x11 white paper for attachments.
2. Please TYPE
or PRINT in INK.
3. Please visit our office at www.sos.IN.gov
4. Make check or money order payable to the Secretary of State.
5. Submit original completed paperwork to: 302 West Washington Street, Room E-018, Indianapolis, IN 46204.
REQUIREMENTS: 1. Nonprofit corporations must qualify with the Internal Revenue Service and the Indiana Department of Revenue.
It is strongly suggested you do not complete or file this form before contacting both agencies.
2. Article VII MUST be completed appropriately. Please see (1) above.
INFORMATION CONTAINED ON THIS PAGE IS NOT PART OF THE PUBLIC RECORD.
Name of business
E-mail address of business (SOS use only)
RETURN DOCUMENTS TO:
Name
Street address, line 1
Street address, line 2
City
State
ZIP code
Telephone number
( )
E-mail address (If different from above – SOS use only)
Reset Form
ARTICLES OF INCORPORATION
DOMESTIC NONPROFIT CORPORATION
State Form 4162 (R15 / 6-16)
Approved by State Board of Accounts, 2016
Indiana Code 23-17-3-2
23-17-29-3
FILING FEE: $50.00
ARTICLES OF INCORPORATION
The undersigned, desiring to form a Corporation (hereinafter referred to as the “Corporation”) pursuant to the provisions of the Indiana Nonprofit
Corporation Act of 1991 (hereinafter referred to as the “Act”), execute the following Articles of Incorporation:
ARTICLE I – NAME AND PRINCIPAL OFFICE
Name of the Corporation: (The name must include the word Corporation, Incorporated, Limited, Company or an abbreviation thereof.)
Address of Principal Office (number and street)
City
State
ZIP code
ARTICLE II – STATEMENT OF PURPOSE
The purposes for which the Corporation is formed are:
Specific language is required by the IRS in this article in order to be approved for 501(c) status. Contact the IRS for assistance.
ARTICLE III – TYPE OF CORPORATION (CHECK ONLY ONE.)
The Corporation is a:
public benefit corporation, which is organized for a public or charitable purpose;
religious corporation, which is organized primarily or exclusively for religious purposes; or
mutual benefit corporation (all others).
ARTICLE IV – REGISTERED OFFICE AND AGENT
Registered Agent: The name and street address of the Corporation’s Registered Agent and Registered Office for service of process are:
Name of Registered Agent (Cannot be the Corporation itself.)
Address of Registered Office (number and street – PO box not accepted)
City
State
IN
ZIP code
Required:
By checking the box, the Signator(s) represent(s) that the Registered Agent named in the application has consented to the appointment
of Registered Agent.
ARTICLE V – MEMBERSHIP
Indicate if Corporation will have members. Yes No members
ARTICLE VI – INCORPORATOR(S) (INCORPORATORS MAY NEVER BE AMENDED.)
The names and addresses of the officers of the Incorporators is/are as follows:
Name Number and Street or Building City State ZIP code
(Continued on the next page.)
ARTICLE VII – DISTRIBUTION OF ASSETS ON DISSOLUTION OR FINAL LIQUIDATION
Please note: This section must be completed.
Refer to Indiana Code 23-17-22-5 for permitted activities following Dissolution:
Specific language is required by the IRS in this article in order to be approved for 501(c) status. Contact the IRS for assistance.
SIGNATURE
In witness whereof, the undersigned incorporator(s) of said Corporation execute(s) this document, and verify(ies) subject to penalties of perjury,
that the facts contained herein are true, this ______ day of ________________________, 20______.
Signature Printed name
Signature Printed name
Signature Printed name
This instrument was prepared by (name):
Address (number and street, city, state, and ZIP code)