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Page 1 of 2
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
2.
The jurisdiction under whose law it is formed
3.
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)
4. 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)
ANNUAL REPORT
FOREIGN NONPROFIT CORPORATION
SDCL 47-27-18, 59-11-24 to 26
FILING FEE: $10
Make check payable to SECRETARY OF STATE
Page 2 of 2
annualreportforeignnonprofit
Feb 2018
5. The names and 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
Principal Officer/Director/Governor Actual Street Address City State
ZIP+4
6. B
eneficial Interest
(optional)
Owner Description of Ownership Percentage/Value
Owner Description of Ownership Percentage/Value
No per
son 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
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Completed 4 July 2020

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