Request for Certificate
Secretary of State - Corporation Division - 255 Capitol St. NE, Suite 151 - Salem, OR 97310-1327 - http://www.FilingInOregon.com - Phone: (503) 986-2200
Method of payment:
Expiration Date:
Please provide the following information, in case there are questions concerning your filing.
Cardholder Name:
Billing Address:
City, State, Zip Code:
Phone Number:
Business Name:
Request for Certificate (08/14)
REQUESTER INFORMATION:
Name of Requester:
Mailing Address: (Street Address or PO Box) (City, State) (Zip Code)
Area Code and Phone Number:
DELIVERY: Choose Delivery Option(s) (Please note: There is a separate charge per delivery.)
Pick up in person.
Mail to above address.
Fax:
(USA Only - Area Code & Fax Number)
For all overnight/express service delivery, a prepaid airbill must be provided.
CERTIFICATE ATTESTING TO:
STATUS/EXISTENCE - $10 MERGER - $10
NAME CHANGE - $10
NO RECORD - $10
If document is going out of the Country: (Additional $10 for Authentication)
What Country?
ENTITY NAME/REGISTRY NUMBER: Information is located at http://egov.sos.state.or.us/br/pkg_web_name_srch_inq.login
Entity Name: Registry Number:
Copy Request Fax: 503-378-6520
CREDIT CARD NUMBER:
CREDIT CARD NUMBER:
MasterCard VISA Discover
American Express
Requests are processed in the order they are received and within three business days.
For more information about the certificates that we provide, visit http://sos.oregon.gov/business/Pages/business-registry-certificates.aspx
