Arkansas Secretary of State
                                                                                     1401W.Capitol,   Suite 250, LittleRock       , AR 72201
                                                                                             501-682-3409 • www.sos.arkansas.gov
                    John Thurston 

               APPLICATION FOR FOREIGN NONPROFIT CORPORATION
        SEEKING AUTHORIZATION TO DO BUSINESS IN ARKANSAS 
                                              (PLEASE TYPE OR PRINT CLEARLY IN INK) 

Pursuant to Act 1147 of 1993 and Arkansas Code Annotated § 4-33-1501, the undersigned Foreign Nonprofit Corporation 
submits the following: 
1a. The name of the corporation is:_____________________________________________________________________ 
1b. If the corporation is doing business in this state under another name, please state:_____________________________
2.The state, territory, or foreign country under whose laws the corporation was incorporated is:_____________________
3. The date of incorporation is:________________________________________________________________________

4. The period of duration is: __________________________________________________________________________

5. The address of its principal office or place of business is: ____________________________________________
                                                                              Street Address
   ______________________              _____________________________                        _____________________________
   City                                     State                                           ZIP Code
6.The name and address of its registered agent for service of process in Arkansas is:
   Name:_________________________________________________________________________________________
   ___________________________________    _____________________________    ______________      __________
   Street Address                                                       City                                  State                     ZIP Code
7. The names and addresses of the corporation’s current directors are:

   Name

   Street Address                                         City                              State                   ZIP Code
Name

   Street Address                                         City                              State                   ZIP Code

   Name

   Street Address                                         City                              State                   ZIP Code
8. Check the box if the corporation has members.

9.Had this corporation been incorporated in Arkansas, check the appropriate box to indicate what type ofcorporation                             it
would have been: (A.C.A. §4-32-1707)
                   Public-Benefit Corporation             Mutual-Benefit Corporation         Religious Corporation

 I understand that knowingly signing a false document with the intent to file with the Arkansas Secretary of 
State is a Class C misdemeanor and is punishable by a fine up to $100.00 and /or imprisonment up to 30 days. 

Executed this ___________ day of _____________,__________________                    . 

_______________________________________________   ______________________________________________ 
Signature of Presiding Director or Officer                                         Presiding Director or Officer (Type or Print) 

An original certificate of existence from the state of origin, dated in the past 30 days, must accompany the 
application. 

$300.00 Filing Fee payable to Arkansas Secretary of State                                                                         NPF-1Rev.      11/18

                 Arkansas Secretary of State
                                                               1401W.Capitol,   Suite 250, LittleRock            , AR 72201
                                                                      501-682-3409 • www.sos.arkansas.gov
                 John Thurston 

                                Annual Report – Contact Information 
                                             Nonprofit 
                                         PLEASE TYPE OR PRINT CLEARLY IN INK 

                                         JURISDICTION (SELECT ONE) 

                                         DOMESTIC              FOREIGN

In order for this entity to receive its annual reporting form, please complete and file with the Office of the Secretary of 
State at the time of filing. 

_____________________________________________________ __________________________________________________ 
Entity name as used in Arkansas                       Contact Person 

_____________________________________________________ __________________________________________________ 
Street Address or Post Office Box Number              City, State Zip 

_____________________________________________________ __________________________________________________ 
Telephone Number                                      E-mail Address

                                             st
NOTE: Annual Reports will be due on or before August 1  the year following filing or qualification in this state.

I understand that knowingly signing a false document with the intent to file with the Arkansas Secretary of State is a Class 
C misdemeanor and is punishable by a fine up to $100.00 and/or imprisonment up to 30 days. 

Executed this___________ day of_____________,__________________. 

_____________________________________________________ __________________________________________________ 
Signature                                             Authorized Officer (Type or Print) 

                                                                                           NPF-1/Rev. 11/18