South Dakota Secretary of State
Certificate Request Form
Secretary of State
Capitol Building
500 East Capitol Avenue Ste 204
Pierre SD 57501-5070
PLEASE TYPE OR PRINT CLEARLY IN INK
Name of the Company or Individual Requesting Information________________________________________________________
Telephone No. _____________________________________
Contact Person ____________________________________
Mailing Address to Send Completed Request
_________________________________________________________________________________________________________
Street Address City State ZIP+4
_________________________________________________________________________________________________________
Mailing Address City State ZIP+4
______________________________________________________________________________________________________________________
Email Address
REQUEST INFORMATION
REQUESTED FORMS
Corporate ID
Entity Name
Form Name # of Forms Requested Cost of Form Total
Certificate of Good Standing
$20
Expedited Request Fee
$50
Fax or Email Processing(SOS Fax 605-773-4550)
(Enter Fax Number or Email Address if different from the one above)
$5
Return Using My FedEx/UPS Account
(Please Enter Your FedEx/UPS account number.)
Total Amount Owed
CREDIT CARD INFORMATION
Visa Discover Master Card
Name As It Appears On Card
Card Number
Billing Address
Expiration Date
CCV Code (three digit number on back of card)
Search for Corporate ID, Name and Agent
$0.00
$0.00
$0.00
$0.00
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