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Application for Authority to Transact Business--Nonprofit (Oregon)

This is for authority of a nonprofit corporation to transact business in Oregon. The form provided here is simply a sample of what the actual Form CR122 looks like.

CR122

Phone: (503) 986-2200
Fax: (503) 378-4381
Secretary of State
Corporation Division
255 Capitol St. NE, Suite 151
Salem, OR 97310-1327

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For office use only

Registry Number: ________________________________

Attach Additional Sheet if Necessary
Please Type or Print Legibly in Black Ink

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Application for Authority to Transact Business--Nonprofit

1) Name of Corporation ___________________________________

NOTE: Must be identical to the name on the Certificate of Existence. See #2)

2) Certificate of Existence. (This application must be accompanied by a certificate of existence, current within 60 days of deliver to this Division, authenticated by the official having custody of the corporate records in the jurisdiction of incorporation.)

____ Certificate attached

3) Date of Incorporation ___________________________________

Duration, if Not Perpetual ___________________________________

4) State or Country of Organization ________________________

5) Type of Corporation

____ Public Benefit

____ Mutual Benefit

____ Religious

6) Will the Corporation Have Members? ____ Yes ____ No

____ CHECK HERE TO INDICATE ON YOUR REGISTRATION THAT YOU DO NOT WANT MAIL SOLICITATION. PLEASE NOTE, THERE IS NO OBLIGATION ON THE PART OF PERSONS USING OUR LISTS TO REFRAIN FROM MAILING SOLICITATIONS. THE MARK IS SIMPLY INFORMATIONAL. ORS 56.022

7) Address of Principal Office of the Business

Address ____________________________________

City ____________________________________

State ____________________________________

Zip ____________________________________

8) Name of Oregon Registered Agent _______________________

9) Address of the Oregon Registered Office (Must be an Oregon Street Address which is identical to the registered agent's business office.)

Address ____________________________________

City ____________________________________

State ____________________________________

Zip ____________________________________

10) Address for Mailing Notices

Address ____________________________________

City ____________________________________

State ____________________________________

Zip ____________________________________

11) Name and Address of President and Secretary

President ____________________________________

Address ____________________________________

City ____________________________________

State ____________________________________

Zip ____________________________________


Secretary ____________________________________

Street Address ____________________________________

City ____________________________________

State ____________________________________

Zip ____________________________________

12) Execution

Printed Name ____________________________________

Signature ____________________________________

Title ____________________________________

13) Contact Name ____________________________________

Daytime Phone Number--Including Area Code ________________________


FEES

Please make check for $40 payable to "Corporation Division."

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