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Corporation-domestic-amendedannualreport Domestic Business Corp - Amended Annual Report

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amendedannualreportdomestic Feb 2018
Enter Filing Year
Secretary of State Office
500 E Capitol Ave
Pierre, SD 57501
AMENDED ANNUAL REPORT
DOMESTIC BUSINESS CORPORATION
SDCL 47-34A-211; 47-1A-122;
59-11-24, 24.1
(605) 773-4845
corpinfo@state.sd.us
FILING FEE: $25
Make check payable to SECRETARY OF STATE
1.
Business ID and Name:
Business ID
Business Name
You may amend any of the information below. If you are not amending a section, please leave that
section blank.
2.
The address of the principal executive office (business address).
Actual Street Address City State ZIP+4
Mailing Address, if Different from Street Address City State ZIP+4
Email Address (Optional)
3. The names and business addresses of its principal officers and directors (governors). If, pursuant to SDCL 47-1A-
732(1), the board of directors has been eliminated, list the names of the shareholders.
Shareholder/Governor Actual Street Address City State ZIP+4
Shareholder/Governor Actual Street Address City State ZIP+4
Shareholder/Governor Actual Street Address City State ZIP+4
4. Beneficial Interest (optional)
Owner Description of Ownership Percentage/Value
Owner Description of Ownership Percentage/Value
No person may execute this report knowing it is false in any material respect. Any violation may be subject to a criminal
penalty (SDCL 22-39-36).
Dated
Signature of an authorized person
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(Optional) Printed Name
Title
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Corporation-domestic-amendedannualreport Domestic Business Corp - Amended Annual Report

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Completed 3 July 2020

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