PDF document
- 1 -
                                                                       COVER LETTER 

Department of State 

Division of Corporations 

P.O. Box 6327 

Tallahassee, FL  32314 

SUBJECT:                                                                                             

Enclosed is an original and one (1) copy of the Articles of Domestication and a check: 

FEES: 

      Certificate of Domestication                                            $  50.00 
      Articles of Incorporation and Certified Copy  $  78.75 

      Total filing fee                                                                 $128.75 

OPTIONAL: 

      Certificate of Status                                                   $   8.75 
       
      From: 
                                                                                                  
                                                                       Name (printed or typed) 
                                                                                                  
                                                                          Address 

                                                                         City, State & Zip 
                                                                              
                               Daytime Telephone Number 

                            E-mail address: (to be used for future annual report notification) 
                                                                              
INHS53 (3/20)                                                             



- 2 -
                          Articles of Domestication 

                Foreign Corporation Domesticating to Florida 

The undersigned,                                     ,                                                                           
                                  (Name)                       (Title) 

of                                                                     , a foreign 
corporation, in accordance with s. 607.11922, Florida Statutes, submit these Articles of 
Domestication. 

 1. Then name of the domesticating corporation is                                                                                  
                                                                                                          (Foreign Corporation) 
                                                            . 
      
 2. The jurisdiction and date of its formation is                                                                                  
      
 3. The name of the domesticated corporation is                                                                                    

                                                                                                                                . 

 4. The jurisdiction of formation of the domesticated corporation is Florida 
      
 5. The domestication corporation is a foreign corporation and the domestication was 
     approved in accordance with its organic law. 
      
 6. Attached are Florida Articles of Incorporation to complete the domestication 
     requirements pursuant to s.607.0202, F.S. 

I certify I am authorized to sign these Articles of Domestication on behalf of the corporation. 

                                         (Authorized Signature) 




- 3 -
                           ARTICLES   OF INCORPORATION 
                      IN COMPLIANCE WITH  HAPTER C     607, F.S.  
 
ARTICLE I       NAME 
THE NAME OF THE CORPORATION SHALL BE: 
 
ARTICLE II      PRINCIPAL OFFICE 
THE PRINCIPAL PLACE OF BUSINESS MAILING ADDRESS IS/ : 
 
                   Principal Address                                                Mailing Address 
                                                                                                          
ARTICLE III      PURPOSE 
THE PURPOSE FOR WHICH THE CORPORATION IS ORGANIZED: 
                                                                                                             
ARTICLE IV       SHARES 
THE NUMBER OF SHARES OF STOCK IS:  ______________________________ 
 
ARTICLE VI        REGISTERED AGENT AND STREET ADDRESS 
THE NAME AND FLORIDA STREET ADDRESS  P O  BOX ( . . NOT ACCEPTABLE  OF THE REGISTERED AGENT IS)              : 
 
_________________________________________ 
 
_________________________________________ 
 
_________________________________________ 
 
HAVING BEEN NAMED AS REGISTERED AGENT AND TO ACCEPT SERVICE OF PROCESS FOR THE 
ABOVE STATED CORPORATION AT THE PLACE DESIGNATED IN THIS CERTIFICATE   , I                               AM FAMILIAR 
WITH AND ACCEPT THE APPOINTMENT AS REGISTERED AGENT AND AGREE TO ACT IN THIS 
CAPACITY. 
 
Signature/Registered Agent                                                                          Date 



- 4 -
ARTICLE       V    DIRECTORS      AND/ OR OFFICERS 
 
THE NAME S  AND ADDRESS ES  AND SPECIFIC TITLES( ) ( ) : 
  
 Name & Title:                                        Name & Title:                                  
  
 Address:                                             Address:                                       
  
 Name & Title:                                        Name & Title:                                  
  
 Address:                                             Address:                                       
  
 Name & Title:                                       Name & Title:                                   
  
 Address:                                             Address:                                       
  
 Name & Title:                                      Name & Title:                                    
  
 Address:                                            Address:                                        
  
I submit this document and affirm that the facts stated herein are true.  I am aware that false 
information submitted in a document to the Department of State constitutes a third degree felony as 
provided for in s.817.155.F.S. 
 
Signature/Authorized Person                                                        Date 
  






PDF file checksum: 1931394766

(Plugin #1/9.12/13.0)