CERTIFICATE OF INCORPORATION
STOCK CORPORATION
SECRETARY OF THE STATE OF CONNECTICUT
MAILING ADDRESS: COMMERCIAL RECORDING DIVISION, CONNECTICUT SECRETARY OF THE STATE, P.O. BOX 150470, HARTFORD, CT 06115-0470
DELIVERY ADDRESS: COMMERCIAL RECORDING DIVISION, CONNECTICUT SECRETARY OF THE STATE, 30 TRINITY STREET, HARTFORD, CT 06106
PHONE:
860-509-6003 WEBSITE: www.concord-sots.ct.gov
USE INK. COMPLETE ALL SECTIONS. PRINT OR TYPE. ATTACH 81/2 X 11 SHEETS IF NECESSARY.
ADDRESS:
CITY:
STATE: ZIP:
FILING PARTY (CONFIRMATION WILL BE SENT TO THIS ADDRESS):
NAME:
FILING FEE: $250
INCLUDES FRANCHISE TAX UP TO 20,000
SHARES
MAKE CHECKS PAYABLE TO "SECRETARY
OF STATE"
1. NAME OF CORPORATION:
2. TOTAL NUMBER OF AUTHORIZED SHARES:
IF THE CORPORATION HAS MORE THAN ONE CLASS OF SHARES, IT MUST DESIGNATE EACH CLASS AND THE NUMBER OF SHARES
AUTHORIZED WITHIN EACH CLASS BELOW.
CLASS: NUMBER OF SHARES PER CLASS:
3. TERMS, LIMITATIONS, RELATIVE RIGHTS AND PREFERENCES OF EACH CLASS OF SHARES AND SERIES
THEREOF PURSUANT TO CONN. GEN. STAT. SECTION 33-665:
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FORM CIS-1-1.0
Rev. 1/1/2015
ACCEPTANCE OF APPOINTMENT
SIGNATURE OF AGENT:
5. ELECTION OF BENEFIT CORPORATION STATUS (MUST check box if applicable.):
The Corporation elects to be a Benefit Corporation. In addition to any other stated purposes for which the corporation is
formed, the corporation shall also have the purpose to create a general public benefit as defined in the Connecticut
Benefit Corporation Act. [NOTE: If the corporation also seeks to have one or more specific public benefit(s) in addition to
the general public benefit, then the corporation must set forth the specific public benefit(s), if any, in Box 6, below, under
“Other Provisions”.]
6. OTHER PROVISIONS:
7. CORPORATION EMAIL ADDRESS - REQUIRED: (IF NONE, MUST STATE "NONE.")
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FORM CIS-1-1.0
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4. APPOINTMENT OF REGISTERED AGENT:[PLEASE SELECT ONLY ONE (A OR B) AND PRINT OR TYPE NAME OF AGENT.]
A. INDIVIDUAL'S AGENT NAME:
ADDRESS:
CITY:
STATE: ZIP:
BUSINESS ADDRESS: (P.O.BOX UNACCEPTABLE)
ADDRESS:
CITY:
STATE: ZIP:
RESIDENCE ADDRESS: (P.O.BOX UNACCEPTABLE)
B. BUSINESS ENTITY:
STATE: ZIP:
CITY:
ADDRESS:
ADDRESS: (P.O.BOX UNACCEPTABLE)
NAME OF INCORPORATOR(S)
(print or type)
ADDRESS
SIGNATURE(S)
8. EXECUTION: CERTIFICATE MUST BE SIGNED BY EACH INCORPORATOR
,20
DAY OFDATED THIS
ZIP:STATE:
CITY:
ADDRESS:
CITY:
STATE: ZIP:
ADDRESS:
CITY:
STATE: ZIP:
ADDRESS:
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FORM CIS-1-1.0
Rev. 1/12015
INSTRUCTIONS FOR COMPLETION OF THE CERTIFICATE
OF INCORPORATION STOCK CORPORATION
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", "company" "Societa per Azioni", or "limited", or the
abbreviation "corp.", "inc.", "co.", "S.p.A.", or "ltd.", 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. TOTAL NUMBER OF AUTHORIZED SHARES: Please provide the total number of shares the corporation is
authorized to issue. Refer to Fee Schedule for amount due.
3. TERMS, LIMITATIONS, RELATIVE RIGHTS AND PREFERENCES OF EACH CLASS OF SHARES AND SERIES
THEREOF PURSUANT TO CONN. GEN. STAT. SECTION 33-665: Please set forth all information required by
section 33-665 as amended for each class of stock authorized in item number 3.
4. APPOINTMENT OF 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 address
Their residence address under the heading Residence address; if the agent appointed is a business, it must provide
its principal office under Business 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 a
business; the corporation may not appoint itself as its registered agent and; all addresses must include a street
number, street name, city, state, postal code.
5. ELECTION OF BENEFIT CORPORATION STATUS: This box must be checked if the corporation elects to be a
Benefit Corporation under the Connecticut Benefit Corporation Act. If the Benefit Corporation has one or more
specific public benefit(s), in addition to the required general public benefit, then specific public benefits must be set
forth in Box 6 "OTHER PROVISIONS", below Box 5 on the form.
6. OTHER PROVISIONS: Please present in the space provided or on an attachment any information which a
stock corporation is permitted but not required to provide. If the corporation is a Benefit Corporation, any specific
public benefits (beyond the required general public benefit) must be listed here.
7. CORPORATION EMAIL ADDRESS: REQUIRED. (If none, must state "NONE".) The Secretary must notify entities
via email when their Annual Reports are due.
8. 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.
FORM CIS-1-1.0
Rev. 1/1/2015
DO NOT SCAN THIS PAGE
INSTRUCTIONS
INCORPORATION OF A CONNECTICUT STOCK CORPORATION
We are pleased to enclose the form to incorporate a stock corporation in the State of Connecticut. Note that an
Organization & First Report form must also be filed to record the officers and directors of the corporation. The fees for filing
the Organization & First Report can be found on the fee schedule. Before filing the forms described above, you may reserve
the name you wish for your corporation. **If a name reservation is submitted for filing it would be prudent to wait until after a
confirmation of filing has been issued to file incorporation documents.
The filing of the above referenced documents represent the bare essentials of incorporation in Connecticut. There
are many other considerations to take into account when forming a corporation. For this reason, we recommend
that an attorney and/or other competent advisor be consulted. Please contact the Department of Revenue Services
or your tax advisor as to any potential tax liability relating to your business.
* The minimum franchise tax must be paid by corporations, which authorize 20,000 shares or less upon incorporation.
Corporations which authorize more than 20,000 shares must pay a franchise tax calculated on a sliding scale which can
be found on the Fee Schedule.
**The fee to reserve a corporate name for 120 days can be found on the Fee Schedule. See enclosed form instructions
for more specifics filing details.
MAKE CHECKS PAYABLE TO THE SECRETARY OF THE STATE
OFFICE OF THE SECRETARY OF THE STATE
MAILING ADDRESS:
COMMERCIAL RECORDING DIVISION
CONNECTICUT SECRETARY OF THE STATE
P.O. BOX 150470
HARTFORD, CT 06115-0470
DELIVERY ADDRESS:
COMMERCIAL RECORDING DIVISION
CONNECTICUT SECRETARY OF THE STATE
30 TRINITY STREET
HARTFORD, CT 06106
PHONE: 860-509-6003
WEBSITE: www.concord-sots.ct.gov
FORM CIS-1-1.0
Rev. 1/1/2015
DO NOT SCAN THIS PAGE
INSTRUCTIONS