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                                        S                                                                  (225) 925-4704
                                              TATE OF LOUISIANA                                            Commercial Division    
                                        SECRETARY OF STATE
Nancy Landry                                                                                               Fax Numbers 
SECRETARY OF STATE                                                                                         (225) 932-5314 Corporations
                                                                                                           (225) 932-5317 Legal Services
                                                                                                           (225) 932-5318 UCC

                            TRANSMITTAL INFORMATION 
                                  For All Business Filings

Please indicate below the level of service requested, payment and contact information

     Routine         Expedite $30                         Priority Expedite $50
                     24 hour processing                  2-4 hour processing

     Check or Money Order Enclosed

*Do not put credit card information on this form. You may save payment information in your geauxBIZ profile under master account.

Business Name (List  exactly  as it appears in documents)

Name of person filing document (evidence of filing will be mailed to this person, at address below)

Address

City                                     State                                                     Zip Code

Daytime phone number                    Fax number                                                 Email address

NOTE:  Louisiana Law requires all Louisiana notaries to print or type their name and notary or 
              bar roll number on the document.

                     Mailing Address:  P. O. Box 94125, Baton Rouge, LA * 70804-9125      
                     Office Location: 8585 Archives Ave.,  Baton Rouge, LA * 70809          
                                  Web Site Address:   www.sos.la.gov

 SS984  Rev. 01/24

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Nancy Landry APPLICATION FOR AUTHORITY
Secretary of State TO TRANSACT BUSINESS IN LOUISIANA
(R.S. 12:304)
Foreign Corporation Return to: Commercial Division
Enclose $125 filing fee P.O. Box 94125
Make remittance payable to Baton Rouge, LA 70804-9125
Secretary of State (225) 925-4704
Do Not Send Cash www.sos.la.gov
STATE OF Check one: ( ) Non Profit Check one: ( ) Original Application
( ) Business ( ) Amended Application
PARISH/COUNTY OF
1. Corporation name:
2. Previous name:
3. Principal office address in state or country of incorporation:

4. Federal tax identification number:
5. Principal business office address:
PLEASE INCLUDE COMPLETE STREET ADDRESSES FOR THE FOLLOWING
6. Principal business establishment in Louisiana:

7. Registered office address in Louisiana:

8. Registered agent’s name and address in Louisiana:

9. Nature of business to be transacted in Louisiana:

10. Names and addresses of directors and officers:

To be signed by any officer Title and Date

Sworn to and subscribed before me, the undersigned Notary Public, on this date:

Notary
AGENT’S ACCEPTANCE AND ACKNOWLEDGEMENT OF APPOINTMENT
I hereby acknowledge and accept the appointment of registered agent for and on behalf of the above named corporation.

Registered Agent
Sworn to and subscribed before me on this date:

Notary
SS326 Rev. 01/24

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STATE OF LOUISIANA

SECRETARY OF STATE
Nancy Landry
Secretary of State

IMPORTANT NOTICE

The instructions from the Secretary of State’s Office in order to qualify a foreign
corporation to do business in the state of Louisiana are the following:

1. The name must be identical to the name on certificate of existence or good standing from
incorporating jurisdiction. The certificate must be dated within 90 days of its submission.(In the
states of Texas and Alabama, obtain a certificate of existence from the Secretary of State, not a
good standing from the Comptroller/Department of Revenue.)

2. The name must be identical to the name on the certificate of fact evidencing the name change
issued by the proper official of the incorporating jurisdiction.

3. The street address of the principal office of the corporation in the state or country under the laws
of which it is incorporated.

4. The failure to include the federal taxpayer identification number of the corporation shall not
invalidate nor cause the Secretary of State to reject theapplication.

5. The street address or intended street address of its principal business office wherever located. If
you do not have one, write none in this space.

6. If none, registered agent’s address is deemed to be the principal business establishment.

7. This address shall be the street address of your registered agent if the agent is an individual
or corporation.

8. The agent must be an individual resident in Louisiana, an individual attorney or a partnership
which is authorized to practice law in Louisiana or a domestic or foreign corporation authorized
to act as registered agent for other corporations.

9. To be completed only if the corporation proposes to limit its authority in Louisiana.

10. Attach addendum if needed for additional officers and directors.

NOTE: If the corporation includes in its name the words "engineer ," "engineering ,"surveyor" ,"
or “surveying ,"please contact the Louisiana Professional Engineering and Land Surveying
Board prior to submitting the application for authority. They can be contacted by phone (225)
925-6291, by mail at 9643 Brookline Ave., Suite 121, Baton Rouge, LA 70809 or online at
www.lapels.com.

Mailing Address :P.O. Box 94125, Baton Rouge, LA 70804-9125
Physical Address: 8585 Archives Ave., Baton Rouge, LA 70809
SS325 Rev. 01/24 www.sos.la.gov

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