Instructions For Completing Form SI-200
For faster processing, the required statement for most corporations can be filed online at https://businessfilings.sos.ca.gov.
Every domestic stock and agricultural cooperative corporation must file a Statement of Information with the California Secretary of State, within
90 days after the filing of its initial Articles of Incorporation, and annually thereafter during the applicable filing period. The applicable filing period for
a domestic corporation is the calendar month during which the initial Articles of Incorporation were filed and the immediately preceding five calendar
months. A corporation is required to file this statement even though it may not be actively engaged in business at the time this statement is due.
Changes to information contained in a previously filed statement can be made by filing a new form, completed in its entirety.
Legal Authority: Statutory filing provisions are found in California Corporations Code section 1502 or California Food and Agricultural Code section
54040, unless otherwise indicated. All subsequent statutory references are to the California Corporations Code, unless otherwise stated. Failure to
file this Statement of Information by the due date will result in the assessment of a $250.00 penalty. (Section 2204; California Revenue and Taxation
Code section 19141.)
Fees: The Statement of Information must be accompanied by a $20.00 filing fee and $5.00 disclosure fee. The filing fee and the disclosure fee may
be included in a single check made payable to the Secretary of State. All domestic stock and agricultural cooperative corporations must pay a
total of $25.00 at the time of filing the statement. If this statement is being filed to amend any information on a previously filed statement and is
being filed outside the applicable filing period, as defined above, no fee is required.
Copies: To get a copy of the filed statement, include a separate request and payment for copy fees when the statement is submitted. Copy fees
are $1.00 for the first page and $.50 for each additional page. For certified copies, there is an additional $5.00 certification fee, per copy.
Publicly Traded Corporations: Every publicly traded corporation also must file a Corporate Disclosure Statement (Form SI-PT) annually, within
150 days after the end of its fiscal year. A “publicly traded corporation” is a corporation, as defined in Section 162, that is an issuer as defined in
Section 3 of the Securities Exchange Act of 1934, as amended (United States Code, Title 15, section 78c), and has at least one class of securities
listed or admitted for trading on a national securities exchange, on the OTC-Bulletin Board, or on the electronic service operated by Pink OTC
Markets Inc. Form SI-PT may be obtained from the Secretary of State’s website at www.sos.ca.gov/business/be/statements.htm or by calling the
Statement of Information Unit at (916) 657-5448.
Complete the Statement of Information (Form SI-200) as follows:
Item 1. Enter the name of the corporation exactly as it is of record with the California Secretary of State.
Item 2. Enter the corporation number issued by the California Secretary of State.
Item 3. If there has been no change to the information contained in the last Statement of Information filed with the California Secretary of State,
check the box
and proceed to
Item 17. Note: A P.O. Box address is not an acceptable address for the agent for service of process.
Therefore, if the last listed address for the agent for service of process is a P.O. Box address, this form must be completed in its entirety.
If there has been any
change to the last Statement of Information filed with the California Secretary of State, including a change to any
address, or no statement has ever been filed, complete this form in its entirety.
Item 4. Enter the complete street address, city, state and zip code of the principal executive office. Please do not enter a P.O. Box or abbreviate
the name of the city.
Item 5. Enter the complete street address, city and zip code of the corporation's principal office in California, if any. Please do not enter a P.O.
Box or abbreviate the name of the city. Complete this item only if the address in Item 4 is outside of California.
Item 6. Enter the mailing address of the corporation, if different from the street address of the principal executive office.
Enter the name and complete business or residential address of the corporation's chief executive officer (i.e., president), secretary and
chief financial officer (i.e., treasurer). Please do not abbreviate the name of the city. The corporation must have these three officers
(Section 312(a).) Any number of offices may be held by the same person unless the articles or bylaws provide otherwise, except, in the
case of an agricultural cooperative, neither the president nor the secretary may be the same person. (California Food and Agricultural
Code section 54149.) Please note, unless the articles or bylaws provide otherwise, the president, or if there is no president, the chairman
of the board, is the chief executive officer of the corporation. A comparable title for the specific officer may be added; however, the
preprinted titles on this form must not be altered.
Enter the name and complete business or residential address of each incumbent director. If there are more than three directors, please
attach additional pages. Please do not abbreviate the name of the city. The corporation must have at least one director. (Section 212(a).)
Item 13. Enter the number of vacancies on the board of directors, if any.
Item 14. Enter the name of the agent for service of process in California. An agent is an individual (director, officer or any other person, whether or
not affiliated with the corporation) who resides in California or another corporation designated to accept service of process if the
corporation is sued. The agent must agree to accept service of process on behalf of the corporation prior to designation.
If an individual is designated as agent, complete Items 14 and 15. If another corporation is designated as agent, complete Item 14 and
proceed to Item 16 (do not complete Item 15).
Note: Before another corporation may be designated as agent, that corporation must have previously filed with the California Secretary of
State, a certificate pursuant to Section 1505. A corporation cannot act as its own agent and no domestic or foreign corporation may
file pursuant to Section 1505 unless the corporation is currently authorized to engage in business in California and is in good standing in
the records of the California Secretary of State.
Item 15. If an individual is designated as agent for service of process, enter a business or residential street address in California (a P.O. Box
address is not acceptable). Please do not enter “in care of” (c/o) or abbreviate the name of the city. If another corporation is designated
as agent, leave Item 15 blank and proceed to Item 16.
Briefly describe the general type of business that constitutes the princip
al business activity of the corporation.
Item 17. Type or print the name and title of the person completing this form and enter the date this form was completed. By submitting this
Statement of Information to the California Secretary of State, the corporation certifies the information contained herein, including any
attachments, is true and correct.
Completed forms along with the applicable fees can be mailed to Secretary of State, Statement of Information Unit, P.O. Box 944230, Sacramento,
CA 94244-2300 or delivered in person (drop off) to the Sacramento office, 1500 11th Street, Sacramento, CA 95814. If you are not completing this
form online, please type or legibly print in black or blue ink. This form must not be altered. This form is filed only in the Sacramento office.