Secretary of State
OFFICE OF SECRETARY OF STATE
CORPORATIONS DIVISION
2 Martin Luther King Jr. Dr. SE
Suite 313 West Tower
Atlanta, Georgia 30334
(404) 656-2817
sos.georgia.gov/corporations
APPLICATION FOR CERTIFICATE OF AUTHORITY FOR
FOREIGN PROFIT OR NONPROFIT CORPORATION
IMPORTANT
: Please provide the entity’s primary email address when
completing
this
form.
Primary Email Address:
NOTICE TO APPLICANT: PRINT PLAINLY OR TYPE REMAINDER OF THIS FORM
1.
Name of Corporation Name Reservation Number (Optional)
Date business commenced (or proposed to commence) in Georgia:
(NOTE: (1) Profit Corporations: If the date provided here is more than 30 days prior to the effective date of this application, a $500 penalty must be paid. Penalty is statutory
and cannot be waived by Secretary of State. (2) Nonprofit Corporations: There is no late filing penalty.)
2.
Name* of Filing Person
Address City State Zip Code
Filer’s Email Address Telephone Number
3.
Principal Office Mailing Address (may be P.O. Box) City State Zip Code
4.
Name* of Registered Agent in Georgia Registered Agent’s Email Address
Registered Office Street Address in Georgia (post office box or mail drop not acceptable for registered office address)
GA
City County State Zip Code
5.
Corporation’s Name in State or Country of Incorporation (Must match name on certificate of existence)
Check ONE:
Jurisdiction (Home State or Country):
Date of Incorporation in Home Jurisdiction:
PROFIT NONPROFIT
6.
Name* of Officer / CEO Address City State Zip Code
Name* of Officer / CFO Address City State Zip Code
Name* of Officer / Secretary Address City State Zip Code
7. Effective Date: (Choose one) Upon filing Delayed effective date and/or time:
(A delayed effective date must be within 90 days of the filing date.)
8. NOTICE: Mail the following items to the Secretary of State at the above address.
(1) This
application;
(2) An ORIGINAL certificate of existence or good standing, not more than 90 days old, certified by the home state or country. (Certificate from home
state may not be more than 90 days old; copy of articles of incorporation from home state should NOT be submitted.); and
(3) Filing fee of $235.00 ($225 filing fee + $10 paper filing service charge) payable to
“Secretary
of State.” Filing fees are non
-refundable.
(4) If applicable, a copy of the resolution of the board of directors, certified by corporation’s secretary, adopting a fictitious or trade name.
Signature of Authorized Person Date
Print Name* Title
* Enter individual’s legal name, i.e. first and last name without use of initials or nicknames. Middle names or initials may be included.
FORM CD 236
(Rev. 10/2019)
