Secretary of State Office 
500 E Capitol Ave                                APPLICATION FOR 
Pierre, SD  57501                   CERTIFICATE OF AUTHORITY
(605)773-4845
                                    FOREIGN BUSINESS  ORPORATIONC                         
corpinfo@state.sd.us                                            SDCL 47-1A-1501, 1503 

                                                 FILING FEE: $765 
                                                 Make check payable to SECRETARY OF STATE

Application must be accompanied by a one page Original Certificate of Existence issued by the Secretary of State or 
other official having custody of the corporate records in the state or other jurisdiction under whose law it is incorporated. 

1. The Name of the Corporation:

Note: The name must include the term corporation, incorporated, company, limited or the applicable abbreviation (SDCL 47-1A-401 to 47-1A-401.3) 

2. If the name is unavailable for use in this state, a corporate name that satisfies the requirements of §§ 47-1A-1506 to 47-
1A-1506.4, inclusive:

3. The name of the state or other jurisdiction under whose laws it is incorporated:

4. The date of incorporation:

5. The period of duration of incorporation:

6. The address of its principal office (this is the address of the executive offices of the company):

Street Address                                                             City           State      ZIP+4 

Mailing Address if different from street address                           City           State      ZIP+4 

Email Address (Optional) 

7. The South Dakota Registered Agent’s name:
South Dakota law permits the registered agent to be either: A) noncommercial registered agent (this may be an
individual), B) a commercial registered agent, or C) an office holder.  Complete only one below, either (a) or (b) or (c).

(a) The South Dakota Noncommercial Registered Agent’s name

Actual Street Address in this State                                    City               State      ZIP+4 

Mailing Address in this State, if Different from Street Address        City               State      ZIP+4 

Email Address (Optional) 

(b) When listing a Commercial Registered Agent, please state their CRA#. This number can be obtained from the
    Commercial Registered Agent.

Commercial Registered Agent Name                                                          CRA# 

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(c)   Title of the office or other position with the Corporation

Business Office’s Actual Street Address in this State                  City                              State ZIP+4 

Mailing Address in this State, if Different from Street Address        City                              State ZIP+4 

Email Address (Optional) 

8. The names and usual business addresses of its principal officers and directors. Place a check mark next to the name if
the principal officer serves as a director.
                                                                                                                ____________ 
President                Street Address                                             City                 State ZIP+4 
                                                                                                                ____________ 
Vice President           Street Address                                             City                 State ZIP+4 
                                                                                                                ____________ 
Secretary                Street Address                                             City                 State ZIP+4 
                                                                                                                ____________ 
Treasurer                Street Address                                             City                 State ZIP+4 
                                                                                                                ____________ 
Director                 Street Address                                             City                 State ZIP+4 
                                                                                                                ____________ 
Director                 Street Address                                             City                 State ZIP+4 
                                                                                                                ____________ 
Director                 Street Address                                             City                 State ZIP+4 

9. The foreign corporation shall deliver with the completed application an Original Certificate of Existence or a document
of similar import, duly authenticated by the Secretary of State or other official having custody of corporate records in the
state or other jurisdiction under whose law it is incorporated.

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 47-1A-129; 22-39-36). 

Dated 
                                                                       Signature of an authorized person 

Email 
      (Optional)                                                       Printed Name 

                                                                       Title 

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                                                                                         Foreigncertificateofauthority Feb 2018