Fillable Nonprofitforeignamendedcertificateofauthority20180215 RETURN TO

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Page 1 of 2
Secretary of State Office
500 E Capitol Ave
Pierre, SD 57501
(605)773-4845
corpinfo@state.sd.us
1. The
Name and Business ID of the corporation is:
Name (Note: This must be the exact corporate name as registered.) Business ID
2. The Name of the corporation as amended:
3. The name of the state or other jurisdiction under whose laws it is incorporated:
4. The address of its principal office (this is the address of the executive offices of the company):
Street Address
City State
ZIP+4
Mailing Address if different from street address
City State
ZIP+4
Email Address (Optional)
5.
The South Dakota Registered Agent’s name:
South Dakota 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 business:
____________
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)
NON-STOCK APPLICATION FOR
AMENDED CERTIFICATE OF
AUTHORITY
FOREIGN NONPROFIT CORPORATION
FILING FEE: $25
Make check payable to SECRETARY OF STATE
Page 2 of 2
Foreignnonprofitamendedcertificateofauthority Feb 2018
6. The purpose(s) that the corporation is engaging in business in South Dakota:
7. The names and usual business addresses of its principal officers and directors. Place a check mark next to the name
if the principal officer serves as a director.
____________
President Street Address City State ZIP+4
____________
Vice President Street Address City State ZIP+4
____________
Secretary Street Address City State ZIP+4
____________
Treasurer Street Address City State ZIP+4
____________
Director Street Address City State ZIP+4
____________
Director Street Address City State ZIP+4
____________
Director Street Address City State ZIP+4
8. The foreign corporation shall deliver with the completed application an Original Certificate of Existence or a document
of similar import, duly authenticated by the Secretary of State or other official having custody of corporate records in the
state or other jurisdiction under whose law it is incorporated.
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 22-39-36).
Dated
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Title
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Completed 4 July 2020

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