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Secretary of State Office     APPLICATION FOR REINSTATEMENT 
500 E Capitol Ave 
                                  DOMESTIC NONPROFIT  ORPORATIONC                      
Pierre, SD 57501                                                     SDCL 47-24-14 
(605)773-4845
corpinfo@state.sd.us                              FILING FEE: $30 
                                   Make check payable to SECRETARY OF STATE

1. The Name and Business ID of the corporation is:

   Name (Note: This must be the exact corporate name as registered.)                  Business ID 

2. The effective date of its administrative dissolution:   _____________________________________________________

3. State that the ground or grounds for dissolution either did not exist, or have been eliminated by filing all
   required reports and paying all fees and penalties.

4. Attached hereto are ALL documents, fees, and penalties required for reinstatement:

                  Annual Reports                  Registered Agent and Registered Office Information 

                  Filing Fees                     Corporation’s period of duration as stated in the Articles of  
                                                      Incorporation has been amended  
                  Penalties 

The application may be signed by any authorized officer of the corporation. 

No person 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 officer 

Email 
     (Optional)                                                      Printed Name 

                                                                     Title 

                                                                                      nonprofitapplicationreinstatement Feb 2018 






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