PDF document

- 1 -

Nonprofit 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 $50.00. Make check or money order payable to Wyoming Secretary of State.

 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.

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

 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

FNP-CertificateAuthorityInstructions – RevisedMay 20 22

- 2 -

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 Nonprofit Corporation
Application for Certificate of Authority

Pursuant to W.S. 17-19-1503 the undersigned corporation hereby applies for a Certificate of Authority to transact
business in the state of Wyoming.

1. Name of the nonprofit corporation as incorporated:

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

3. Date of incorporation:
(mm/dd/yyyy)

4. Period of duration:
(This is referring to the length of time the nonprofit 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 nonprofit 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:

Addresss:

(If mail is received at a Post Office Box, please list above in addition to the physical address.)
FNP-CertificateAuthority – Revised June 2021

- 3 -

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

Office Name Address

President

Vice President

Secretary

Treasurer

Director

9. Does this corporation have members? Yes No

10. If this corporation had been incorporated under the laws of this state, would it be (Check one appropriate choice.):

a. Public benefit corporation
b. Mutual benefit corporation
c. Religious corporation

11. The corporation accepts the constitution of the state of Wyoming in compliance with the requirement of
Article 10, Section 5 of the Wyoming Constitution.

12. 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)

Print Name: Contact Person:

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 completed 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.

FNP-CertificateAuthority – Revised June 2021

- 4 -

                                                                                               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

PDF file checksum: 2903335462

(Plugin #1/9.12/13.0)