PENNSYLVANIA DEPARTMENT OF STATE
BUREAU OF CORPORATIONS AND CHARITABLE ORGANIZATIONS
Read all instructions prior to completing.
Copies and certifications of most filed documents may be obtained online at https://www.corporations.pa.gov/.
1. The requested entity name(s) and number(s), if known, is(are):
Name Entity Number
Name Entity Number
Name Entity Number
Name Entity Number
2. The document and quantity requested is:
____ Subsistence Certificate (for domestic entity)
____ Certificate of Registration (for registered foreign association)
____ Engrossed Certificate (custom certification) attesting to:________________________________________________
____ Plain or ____ Certified Index and Docket report (written search)
____ Plain or ____ Certified copies of all documents on record for the above identified entity(ies)
____ Plain or ____ Certified copies of _________________________________________________________________
Indicate specific documents requested for the above identified entity(ies)
3. Method of payment:
____ Check/money order Deposit Account Number _____________________
Return document by mail to:
Name
Address
City State Zip Code
Return document by email to: _________________________________
Copy/Certification Request
DSCB:15-133/145/153
(7/1/2015)
*13353*
13353
DSCB: 15-133/145/153Instructions
Pennsylvania Department of State
Bureau of Corporations and Charitable Organizations
P.O. Box 8722
Harrisburg, PA 17105-8722
(717) 787-1057
Web site: www.dos.pa.gov/corps
General Information
Typewritten is preferred. If not typed, the form must be
legible and completed in black or blue-black ink in order to
permit reproduction.
The fees vary based on the document requested and number of
pages. The statutory fees are available on the Bureau’s web
site at www.dos.pa.gov/corps
and in statute at 15 Pa.C.S.
§ 153 and are identified below. Statutes are available on the
Pennsylvania General Assembly website,
www.legis.state.pa.us
, by following the link for Statutes.
Checks should be made payable to the Department of State
and must contain a commercially pre-printed name and
address. The requestor agrees to pay all statutory fees with
respect to this request in advance of receiving the information
and/or documents.
If the total fee is unable to be calculated, the initial search fee
of $15 (per entity name) must be received before the Bureau
will begin processing the request. If the fee cannot be
calculated in advance or if insufficient funds are submitted,
the Bureau will return an invoice indicating additional fees
due. All fees must be paid prior to the Bureau releasing the
requested documents.
Expedited Service of copy and certification requests may be
obtained by submitting DSCB:15-153(a)(15) (Expedited
Service Request), together with this form and required fees.
This form and payment should be mailed or delivered to the
address above.
Form Instructions
Enter the name and mailing address to which any
correspondence regarding this request should be sent. This
field must be completed for the Bureau to return the requested
copies. If the copies/certifications are to be returned by email,
an email address must be provided. An email will be sent to
address provided, containing a link and instructions on how
the requested document may be downloaded.
1. Give the entity name(s) and the entity number, if known,
for which information is being requested. Up to four entities
may be listed per form.
2. Give the quantity of documents requested, and if
applicable, identify the specific documents or information
requested (i.e. Articles of Incorporation, Statement of Merger
etc.) Multiple documents may be selected on one form.
3. Check the appropriate payment type and provide the
customer deposit account number, if applicable.
4. Check the appropriate method of expedited service, if
applicable. Expedited fees are in addition to the statutory fees
for the requested documents. Expedited fees are per
document and/or entity requested. Expedited requests must be
submitted to the Bureau in person.
Fees
Subsistence Certificate $ 40.00
Certificate of Registration $ 40.00
Engrossed Certificate $125.00
Certification $ 40.00
Search Fee $ 15.00
Copy Fee (per page furnished) $ 3.00
Certified Index and Docket $ 55.00
Plain Index and Docket $ 15.00