INSTRUCTIONS
1. NAME OF CORPORATION: Please provide the name of the corporation. The name of the corporation must contain
one of the following designations: "corporation", "incorporated", or "company", or the abbreviation "corp.", "inc." or
"co.", or words or abbreviations of like import in another language. The name must also be distinguishable from
other business names on the records of the Secretary of the State.
2. PLACE A CHECK NEXT TO THE APPROPRIATE STATEMENT: Please provide required membership information
by making the appropriate selection. Note: if (D) is selected, the corporation must designate each class of members
in the space provide or in an attachment.
3. APPOINTMENT OF REGISTERED AGENT: The corporation may not appoint itself as its registered agent. The
corporation may appoint either a natural person who is a resident of Connecticut; a Connecticut corporation, limited
liability company, limited liability partnership, or statutory trust; or a foreign corporation, limited liability company,
limited liability partnership or statutory trust which has procured a certificate of authority to transact business in
Connecticut. Please note the following: if the agent being appointed is a natural person, that person's business
address must be provided under the heading Business office address and their residence address under the heading
Residence address; if the agent appointed is an entity, it must provide its principal office address under the Business
office address heading; the agent must sign accepting the appointment in the space provided; the signatory must
Print their name and the capacity under which they sign if signing on behalf of an entity; and all addresses must
include a street number, street name, city, state, postal code. P.O. box addresses are acceptable ONLY as
additional information.
4. THE NATURE OF THE ACTIVITIES TO BE CONDUCTED OR THE PURPOSES TO BE PROMOTED BY THE
CORPORATION: Please provide the purpose for which the corporation is formed. Nonstock corporations are
permitted to state that the purpose of the corporation is to engage in any lawful act or activity for which corporations
may be formed under the Connecticut Revised Nonstock Corporation Act in lieu of or in addition to a specific
purpose.
5. OTHER INFORMATION: Please present in the space provided or on an attachment any information which a
nonstock corporation is permitted but not required to provide.
6. CORPORATION EMAIL ADDRESS: REQUIRED. (If none, must state "NONE".) The Secretary must notify
entities via email when their Annual Reports are due.
7. EXECUTION: The document must be executed by one or more incorporators, each of whom must provide an
address containing a street and number, city, state and a postal code. The execution constitutes legal statement
under the penalties of false statement that the information provided in the document is true.
INCORPORATION OF A CONNECTICUT NONSTOCK CORPORATION
ANY QUESTIONS CONCERNING THE COMPLETION OF THIS FORM, OR THE INCORPORATION PROCESS
SHOULD BE DIRECTED TO YOUR LEGAL COUNSEL.
Note: Please contact the Department of Revenue Services or your tax advisor as to any potential tax liability relating to
your business.
Please note that the filing of the above referenced documents represent the bare essentials of incorporating a
non-stock, nonprofit company in Connecticut. There are many other considerations to consider. For example, if you
wish the corporation to be exempt from federal taxes, you should contact the Internal Revenue Service prior to filing to
determine whether the corporation's Certificate of Incorporation should contain any specific provisions. Further, any
person or organization planning to grant college credit or call itself a college or university must first comply with Section
10a-34 of the Connecticut General Statutes before it will be accepted as a corporation.
Please make check(s) or money order(s) payable to: SECRETARY OF THE STATE
FORM CIN-1-1.0
Rev. 1/1/2015
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INSTRUCTIONS
