Fillable Corporation-domestic-farmqualification Domestic Business Corp - Farm Qualification

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Corporation-domestic-farmqualification Domestic Business Corp - Farm Qualification

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Page 1 of 2
Secretary of State Office
500 E Capitol Ave
P
ierre, SD 57501
(605)773-4845
corpinfo@state.sd.us
1. The N
ame and Business ID of the corporation is:
Name (Note: This must be the exact corporate name as registered.) Business ID
2. The
state of incorporation:
South
Dakota
3. The South Dakota Registered Agent’s name
South Dakot
a law permits the registered agent to be either: A) a noncommercial registered agent (this may be an
individual), B) a commercial registered agent, or C) an office holder. Complete only one below, either (a) or (b) or (c).
(a) The South Dakota Noncommercial Registered Agent’s name
Actual Street Address in this State City State ZIP+4
Mailing Address in this State, if Different from Street Address City State ZIP+4
_____________________________________________________________________________________________________________________
Email Address (Optional)
(b) When listing a Commercial Registered Agent, please state their CRA#. This number can be obtained from the
Commercial Registered Agent.
Commercial Registered Agent Name CRA#
(c) Title of the office or other position with the corporation
Business Office’s Actual Street Address in this State City State ZIP+4
Mailing Address in this State, if Different from Street Address City State ZIP+4
_____________________________________________________________________________________________________________________
Email Address (Optional)
4. Lis
t the acreage and location by section, township and county of each lot or parcel of land in this state owned or leased
by the corporation and used for the growing of crops or the keeping or feeding of poultry or livestock (You may attach
additional pages if necessary).
Acres Section Township County
Acres Section Township County
Acres Section Township County
Acres Section Township County
QUALIFICATION FOR FARMING
D
OMESTIC BUSINESS CORPORATION
SDCL 47-9A
Pl
ease Type or Print Clearly in Ink
NO FILING FEE
Page 2 of 2
corporationfarmqualification Nov
2016
5. Is the majority of the voting stock held by members of a family, an estate of a family member, or a trust that benefits
members of the family?
Yes No
6. Is at least one of the stockholders:
(a) a person residing on the farm? Yes No
(b)
a per
son actively operating the farm
? Ye
s No
(c)
a per
son who has resided on the farm? Yes No
(d) a person who has actively operated the farm? Yes No
7. S
tate the number of shares owned by persons residing on the farm or actively engaged in farming or their relatives
within the third degree of kindred (You may attach additional pages if necessary).
Name Address City State Zip Shares DOK
Name Address City State Zip Shares DOK
Name Address City State Zip Shares DOK
Name Address City State Zip Shares DOK
Name Address City State Zip Shares DOK
8. Are all the shareholders either natural persons, estates of a family member, or a trust that benefits members of the
f
amily?
Yes No
9. T
he percentage of gross receipts of the corporation derived from rent, royalties, dividends, interest, and annuities:
_____%
10. S
tate the number of shareholders. _____
11. I
s there more than one class of stock? Yes No
12. A
s to each shareholder state the name, address, number of shares owned, and degree of kindred (DOK).
Name Address City State Zip Shares DOK
Name Address City State Zip Shares DOK
Name Address City State Zip Shares DOK
No person may execute this report knowing it is false in any material respect. Any violation may be subject to a civil and/or
criminal penalty (SDCL 47-1A-129; 22-39-36).
Dated
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Corporation-domestic-farmqualification Domestic Business Corp - Farm Qualification

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Completed 3 July 2020

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