State of Alaska 
                          Division of Corporations, Business and Professional Licensing 
                          CORPORATIONS SECTION 
                          PO Box 110806 
                          Juneau, AK  99811-0806 
                          Phone: (907) 465-2550 
                          Fax: (907) 465-2974 
                          Website: www.commerce.alaska.gov/occ 
                                                             
                            CERTIFICATE OF AUTHORITY 
                              Foreign Cooperative Corporation 
                                              AS 10.15.525 
 Filing Fee: $250.00    
  
 INSTRUCTIONS (Please retain for your records): 
 Refer to Alaska Statutes 10.15.525. If you need assistance in completing your filing, it is advised that 
 you seek legal counsel. Please be aware that this filing will become public information. 
 ITEM 1: Legal Name of Corporation 
 A corporate name must contain the word "corporation," "company," "incorporated," or "limited," or an 
 abbreviation of one of these words. The corporate name may not contain a word or phrase that indicates or 
 implies that the corporation is organized for a purpose other than the purpose contained in its articles of 
 incorporation. A corporate name must be distinguishable upon the record. To search the availability of the legal 
 name of the corporation in the State of Alaska go to the Corporations Section at 
 www.commerce.alaska.gov/occ and select Search Corporations Database.  
  
 The entity must be in good standing in their state of domicile and the foreign cooperative must have at least 
 one member residing in the state of Alaska before we can issue a certificate of authority, please check both 
 boxes  
  
 ITEM 2: Assumed Name 
 The name the corporation elects to use if the name in the state of domicile is already in use by another entity in 
 Alaska. To search the availability of the legal name of the corporation in the state of Alaska, go to the 
 Corporations Section at www.commerce.alaska.gov/occ and Search Corporations Database. 
  
 ITEM 3: State of Domicile, Date of Incorporation, Duration 
 Indicate the state of domicile, or “home state”; date of incorporation in the state of domicile (mm/dd/yyyy 
 format); and the duration. Duration is the life expectancy of the corporation and may be a specific future date of 
 less than 100 years. If there is no expected end date, select the “perpetual” box, indicating the corporation 
 plans to transact business uninterrupted for an undeterminable amount of time. 
  
 ITEM 4: Disclosure of Corporate Purposes 
 The purpose describes activities of the corporation at the time of the initial filing and may include “any lawful.” 
 In addition to purpose, also include the NAICS code where indicated. NAICS code may not conflict with the 
 purpose listed. A complete list of NAICS codes is available online under the Corporations Section at 
 www.commerce.alaska.gov/occ. 
  
 08-474 (Rev. 04/03/2013)          Certificate of Authority Instructions  
  

ITEM 5: Registered Agent 
The registered agent of this foreign cooperative corporation must be an individual who is a resident of Alaska, 
or a corporation (excluding LLC, LP and LLP) registered and in good standing with this office.   The registered 
agent is statutorily responsible for receiving and forwarding processes, notices, or demands on to the last 
known address of the entity.   A corporation may not act as its own registered agent.   A physical address and 
a mailing address in the State of Alaska must be given.   
 
ITEM 6: Principal Office Address 
Address of the corporation in the state or country of domicile. 
 
ITEM 7: Alien Affiliate 
Defined in AS 10.06990 as a person that directly or indirectly through one or more intermediaries controls, or is 
controlled by, or is under common control with, a corporation subject to this chapter:  
 An individual who is not a citizen or national of the United States, or who is not lawfully admitted to the 
 United States for permanent residence, or paroled into the United States under the Immigration and 
 Nationality Act (8 U.S.C. 1101 – 1525, as amended): 
 1.  A person, other than an individual, that was not created or organized under the laws of the United 
 States or of a state, or whose principal place of business is not located in any state; or 
 2.  A person, other than an individual, that was created or organized under the laws of the United States of 
 a state, or whose principal place of business is located in a state, and that is controlled by a person 
 described in (1) or (2) of this paragraph[.] 
 
ITEM 8: Authorized Shares 
All cooperative corporations must provide the number of authorized shares, if any. If there is more than one 
class or series of authorized shares, please provide this information.  
 
ITEM 9: Issued Shares 
Provide the number, class, and series of issued shares, if any. If shares have been issued, you must complete 
Item 10: Shareholders.  
 
ITEM 10: Shareholders 
List the names and mailing addresses of persons owning 5% or more of any class of shares, and the 
percentage owned by each person. If there are authorized shares, you must complete Item 9: Issued Shares. 
 
ITEM 11: Officers and Directors 
List the names and mailing addresses of the officers and directors of the corporation. You may attach an 
additional 81/2” x 11” page, if necessary. Please note: do not include confidential information such as Social 
Security Numbers, driver’s license numbers or date of birth, as this record is public information.  
 
ITEM 12: Signatures 
The printed name and signatures of the president or vice president of the corporation, and its secretary or 
assistant secretary are required. If the same person holds two of these positions, two different people must 
sign the application, unless that person holds all positions.  
 
Mail the Application for Certificate of Authority and the $250.00 filing fee in U.S. dollars to: 
State of Alaska, Corporations Section, PO Box 110806, Juneau, AK  99811-0806 
 
STANDARD PROCESSING TIME for complete and correct applications submitted to this office is 
approximately 10-15 business days. All applications are reviewed in the date order they are received. To file 
your application online for immediate processing, visit our website at: www.commerce.alaska.gov/occ. 
 
ADDITIONAL RESOURCES: 

08-474 (Rev. 04/03/2013)         Certificate of Authority Instructions   
 

  Professional License:  

 For information regarding what professions require a Professional License, statutes, how to obtain a 
 Professional License, and/or the expiration date if you already have a Professional License, go to the 
 Professional License Section of our website at www.commerce.alaska.gov/occ.  

  Business License:  

 For the privilege of engaging in a business in the State of Alaska, a Business License is required for a new 
 entity. For information regarding business licenses, statutes, and how to obtain a Business License, go to 
 the Business License Section of our website at www.commerce.alaska.gov/occ.  

  Alaska Corporate Net Income Tax 
 Every corporation earning gross income from sources within the state, except for those corporations that 
 are specifically exempted, must file a corporation net income tax return. Contact the Alaska Department of 
 Revenue, Tax Division, PO Box 110420, Juneau, Alaska, 99811-0420, telephone number (907) 465-2320 
 for more information.     
 
08-474 (Rev. 04/03/2013)   Certificate of Authority Instructions  
 

              State of Alaska 
                                                                                   DO NOT STAMP ABOVE THIS BOX 
              Division of Corporations, Business and Professional Licensing 
                                                                                   Office Use Only       CORP 
              CORPORATIONS SECTION 
              PO Box 110806 
              Juneau, AK  99811-0806 
              Phone: (907) 465-2550 
              Fax: (907) 465-2974 
              Website: www.commerce.alaska.gov/occ                                                                    
                                                                                                                      
                              CERTIFICATE OF AUTHORITY                                             
                              Foreign Cooperative Corporation 
                                     AS 10.15.525 
                                                                                    
      $250.00 Filing Fee 

 Pursuant to Alaska Statutes 10.15.525, the undersigned cooperative applies for a Certificate of Authority and, 
 for that purpose, submits the following statement:  
  
 ITEM 1:  Legal name of the corporation must contain the word “corporation”, “company”, “incorporated”, 
 “limited” or an abbreviation of one of these words. 
    
        The foreign entity is active and in good standing in the state/country of domicile  

        The foreign entity has at least one member residing in the State of Alaska 
  
 ITEM 2: The assumed name the corporation elects to use in Alaska if the legal name is not available: 
    
 ITEM 3: The state of domicile, or “home state”; date of incorporation in the state of domicile (mm/dd/yyyy format); 
 and the duration, or “life expectancy” of the corporation: 
   State of domicile:                Date of Incorporation:                 Duration: ___/___/_____ 
                                     ___/___/_____                              Perpetual  
  
 ITEM 4: The purpose of the corporation (may include “any lawful”) and the 6 digit NAICS Industry Grouping 
 Code that most clearly describes the initial activities of the company: 
   Purpose:                                                              NAICS            
                                                                         code: 
  
 ITEM 5:  Registered agent name and address (must include a physical and mailing address in Alaska): 
   Name: 
   Physical address:                                        City:                  AK  Zip Code:  
   Mailing address:                                         City:                  AK  Zip Code:  
  
 ITEM 6  : Principal office address of the corporation wherever located: 
   Name: 

   Physical address: 

   Mailing address: 

 08-474 (Rev. 04/03/2013)                            Page 1of 3              

ITEM 7  : Name and address of each alien affiliate (if there are no alien affiliates, indicate “none”): 
 Name: 

 Mailing address: 

 City:                         State/Province:                        Country:
Attach additional sheet if more than one alien affiliate. 
 
ITEM 8   : Number of authorized shares, if any: 
                          Common                            
                          Preferred 
# of Authorized shares   Class                            Series               Par value
                          Common                            
                          Preferred 
# of Authorized Shares   Class                            Series               Par value
 
ITEM 9   : Number of issued shares; if shares have been issued, complete item #10, Shareholders: 
                                                                               
# of Issued Shares       Class                            Series              Par Value 
                                                                               
# of Issued Shares       Class                            Series              Par Value 
 
ITEM 10: Name and address of each person/entity owning 5% or more of the issued shares or 5% of any class 
of issued shares and the percentage of the issued shares owned by that person. If there are no 
persons/entities owning 5% or more please indicate with “NONE”. If you have shareholders Item #9 must be 
completed. 
 Name                    Mailing address                  City        State   ZIP code                  % Issued 
                                                                                                        shares held 
                                                              
Attach additional sheet if necessary.  
 
ITEM 11   : The names and mailing addresses of the officers and directors of the corporation: 
 Title            Name                 Mailing address           City         State                    ZIP code 
 President

 Vice President                                                                                         

 Secretary

 Treasurer

 Director

 Director

If necessary, attach additional pages for continuation.  Please do not include confidential information such as 
Social Security Numbers, driver license numbers or date of birth as this record is public information. 
 
08-474 (Rev. 04/03/2013)                        Page 2of       3       

ITEM 12: The printed name and signature of the president or vice president, and secretary or assistant 
secretary. If the same person holds two of these positions, two different people must sign the application, 
unless that person holds all positions. 
 
Signature of President or Vice President      Printed name of President or Vice President        Date 
    
Signature of Secretary or Assistant Secretary Printed name of Secretary or Asst. Secretary       Date 
 
NOTE: Persons who sign documents filed with the commissioner that are known to the person to be false in 
material respects, is guilty of a class A misdemeanor.  
 
Mail the Application for Certificate of Authority and the $250.00 filing fee in U.S. dollars to: 
State of Alaska, Corporations Section, PO Box 110806, Juneau, AK  99811-0806 
 
STANDARD PROCESSING TIME for complete and correct applications submitted to this office is 
approximately 10-15 business days. All applications are reviewed in the date order they are received. To file 
your application online for immediate processing, visit our website at: www.commerce.alaska.gov/occ. 

08-474 (Rev. 04/03/2013)                      Page 3of  3                

               State of Alaska 
                                                                                 DO NOT STAMP ABOVE THIS BOX 
               Division of Corporations, Business and Professional Licensing 
                                                                                 Office Use Only       CORP 
               CORPORATIONS SECTION 
               PO Box 110806 
               Juneau, AK  99811-0806 
               Phone: (907) 465-2550 
               Fax: (907) 465-2974 
               Website: www.commerce.alaska.gov/occ                                                                      
                                                                                                                         
                            CONTACT INFORMATION SHEET  

 Please return this document with your filing. This information will only be used to resolve questions with the filings 
 attached. NOTE: this form will not be filed for record or appear online. 
  
 Name of entity as it appears on filing: 
   
 To resolve questions with this filing, contact: 
  Name: 

  Email:                                                                  Phone:

  Mailing address: 

 Return documents to: 
  Name: 

  Company: 

  Mailing address: 
  
 Attach this form to your filings. Send all documents to: 
 State of Alaska, Corporations Section, PO Box 110806, Juneau, AK  99811-0806 
  
 STANDARD PROCESSING TIME for complete and correct applications submitted to this office is 
 approximately 10-15 business days. All applications are reviewed in the date order they are received.  

  08-561 (Rev. 02/01/2012)                       Page  1of 1