P       rofit         Corporation                    Instructions 

                               Wyoming Secretary of State 
Herschler Building East, Suite 101   122 W 25th Street   Cheyenne,WY 82002-0020   

                         307.777.7311   Business@wyo.gov 
Before Filing Please Note  __________________________________________________________________  
 Filing fee of $150.00. Make check or money order payable to Wyoming Secretary of State.

 Under the circumstance specified in W.S. 17-28-104(e), an email address is required.

 The application must be accompanied by an           original certificate of existence/good standing,
  dated not more than sixty (60) days prior to filing in Wyoming, authenticated by the Secretary
  of State or official having custody of corporate records in the state or country of formation.

 If your out-of-state business name is not available for use in Wyoming, a Use of Fictitious Name form
  is required with the Application for Certificate of Authority.

 Annual reports are due every year on the first day of the anniversary month of formation. If
  not paid within 60 days of the due date the entity will be subject to dissolution.

 Please review the form prior to submission. The Secretary of State’s Office is unable to
  process incomplete forms.

                              You’re Ready to Mail in Your Documents!

 Processing time is up to 15 business days following the date of receipt in our office.
 Wyoming statutes do not allow for expedited filing at this time. Your filing will be processed in the
  order it is received.
 You can visit our website at http://wyobiz.wyo.gov to see what day is currently being processed.

Additional Contact Information   ____________________________________________________________  

 Department of Revenue (Sales and Use Tax Information)
  o       Ph. 307.777.5200 OR https://revenue.state.wy.us/
 Department of Workforce Services (Workers’ Compensation or Unemployment Insurance)
  o       Ph. 307.777.8650 OR http://www.wyomingworkforce.org/
 Internal Revenue Service (Tax ID Information)
  o       https://www.irs.gov/Filing

FP-CertificateAuthorityInstructions – Revised May 2022

                                  Wyoming Secretary of State 
                                  Herschler Building East, Suite 101
                                                                                            For Office Use Only 
                                           122 W 25th Street
                                   Cheyenne, WY 82002-0020 
                                           Ph. 307.777.7311 
                                  Email: Business@wyo.gov  

                                           Foreign Profit Corporation 
                                  Application for Certificate of Authority 

Pursuant to W.S. 17-16-1503 the undersigned corporation hereby applies for a Certificate of Authority to transact 
business in the state of Wyoming. 

1. Name of the Corporation as incorporated:

2. Incorporated under the laws of:
                                  (State or country) 

3. Date of incorporation:                       (This date must match the date listed on the certificate of existence/good standing.) 
                            (Date – mm/dd/yyyy) 

4. Period of duration:
(This is referring to the length of time the corporation intends to exist and not the length of time it has been in existence. The most common 
term used is “perpetual.”) 

5. Mailing address of the corporation:

6. Principal office address:

7. Name and physical address of its registered agent:
(The registered agent may be an individual resident in Wyoming or a domestic or foreign business entity authorized to transact business in 
Wyoming. The registered agent must have a physical address in Wyoming. If the registered office includes a suite number, it must be 
included in the registered office address. A Drop Box is not acceptable. A PO Box is acceptable if listed in addition to a physical address.) 

Name:     

Address: 

                               (If mail is received at a Post Office Box, please list above in addition to the physical address.) 

FP-CertificateAuthority – Revised June 2021

8. Names and usual business addresses of its current officers and directors:

Office             Name                           Address

President

Vice President

Secretary

Treasurer

Director

Director

Director

9. State the date this  corporation  began doing  business in Wyoming or the date it  will begin  to do  business in
Wyoming. (Please note that a corporation doing business in Wyoming for greater than forty-five (45) calendar days without a Certificate 
of Authority shall be subject to back taxes and penalties pursuant to W.S. 17-16-1502(d) due at the time of qualification.): 

                                  (Date - mm/dd/yyyy) 
10. The corporation accepts the constitution of the state of Wyoming in compliance with the requirement of
Article 10, Section 5 of the Wyoming Constitution.

11. Certification. (Please check the box to complete the required certification.)

       I consent on behalf of the business entity to accept electronic service of process at the required email address 
provided on the form under the circumstances specified in W.S. 17-28-104(e).

Signature: ___________________________________________                           Date: 
(May be executed by Chairman of Board, President or another of its officers.)          (mm/dd/yyyy) 
                                                  Contact Person: 
Print Name: 

Title:                                            Daytime Phone Number: 

Email:
(An email address is required. Email(s) provided will receive important reminders, notices and filing evidence.)

        REQUIRED ATTACHMENT TO INCLUDE WITH THE FILING 
        The application must be accompanied by an original certificate of existence/good standing,              dated not more than 
        sixty (60) days  prior to filing in  Wyoming, authenticated by the Secretary of  State or official having custody of 
        corporate records in the state or country of formation. 

FP-CertificateAuthority – Revised June 2021

                                                                                               Wyoming Secretary of State 
                                                                                  Herschler Building East, Suite 101 
                                                                                                         122 W 25th Street 
                                                                                               Cheyenne, WY 82002-0020 
                                                                                                                  Ph. 307.777.7311 
                                                                                               Email: Business@wyo.gov

                            Consent to Appointment by Registered Agent 

I,                                                                                    , registered office located at 
                            (name of registered agent) 

                                                                                    voluntarily consent to serve 

       *(registered office physical address, city, state, & zip)

as the registered agent for 
                                     (name of business entity) 

I hereby certify that I am in compliance with the requirements of W.S. 17-28-101 through W.S. 17-28-111. 

Signature:__________________________________________                   Date: 
                   (Shall be executed by the registered agent.)                                 (mm/dd/yyyy) 

Print Name:                                          Daytime Phone: 

Title:                                               Email: 
                                                                (An email address is required. Email(s) provided will receive 
                                                                important reminders, notices and filing evidence.)

Registered Agent Mailing Address 
 (if different than above):

IMPORTANT:   If you are an existing registered agent and your existing address on record does not match what 
is provided on this form, a Registered Agent Information Update form is also required.  

RAConsent – Revised December 2021