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nonprofitforeignamendedannualreport Feb 2018
Enter Filing Year
Secretary of State Office
500 E Capitol Ave
Pierre, SD 57501
(605) 773-4845
corpinfo@state.sd.us
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 ad
dress 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).
Principal Officer/Director/Governor Actual Street Address City State ZIP+4
Principal Officer/Director/Governor Actual Street Address City State ZIP+4
Principal Officer/Director/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 pers
on 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 22-39-36).
Dated
Signature of an authorized person
Email
(Optional) Printed Name
AMENDED ANNUAL REPORT
FOREIGN NONPROFIT CORPORATION
SDCL 47-27-18
FILING FEE: $25
Make check payable to SECRETARY OF STATE
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Completed 4 July 2020

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