Delaware Division of Corporations
401 Federal Street – Suite 4
Dover, DE 19901
Phone: 302-739-3073
Fax: 302-739-3812
Foreign Qualification
Dear Sir or Madam: Enclosed please find a copy of the Foreign Qualification to be filed in accordance with the General Corporation Law of the State of Delaware. The fee to file the Certificate is $160.00. Please be sure to enclose a Good Standing Certificate that is less than 6 months old from the State from which you are domesticated with the qualification form. You will receive a Certificate of Qualification once your document has been filed. Expedited services are available. Please contact our office concerning these fees. Please make your check payable to the “Delaware Secretary of State”. For the convenience of processing your order in a timely manner, please include a cover letter with your name, address and telephone/fax number to enable us to contact you if necessary. Please make sure you thoroughly complete all information requested on this form. It is important that the execution be legible, we request that you print or type your name under the signature line. Thank you for choosing Delaware as your corporate home. Should you require further assistance in this or any other matter, please don’t hesitate to call us at (302) 7393073. Sincerely, Department of State Division of Corporations encl. rev. 07/04
STATE of DELAWARE
FOREIGN CORPORATION CERTIFICATE
• The Undersigned, a corporation duly organized and existing under the laws of the State of _____________________, in accordance with the provisions of Section 371 of Title 8 of the Delaware Code, does hereby certify: • First: That _______________________________________________________is a corporation duly organized and existing under the laws of the State of __________ ___________________ and is filing herewith a certificate evidencing its corporate existence. • Second: That the name and address of its Registered Agent in said State of Delaware upon whom service of process may be had is
• Third: That the assets of said corporation are $_______________and the liabilities thereof are $______________. The assets and liabilities indicated are as of a date within six months prior to the filing date of this Certificate. • Fourth: That the business which it proposes to do in the State of Delaware is as follows:
• Fifth: That the business which it proposes to do in the state of Delaware is the business it is authorized to do in the jurisdiction of its incorporation. • In Witness Whereof, said corporation has caused this Certificate to be signed on its behalf this ______day of _____________, 20_______.
By:__________________________ (Authorized Officer) Name:________________________ (Typed or Printed)