Application for Authority to Transact Business - Nonprofit 
                     Secretary of State - Corporation Division - 255 Capitol St. NE, Suite 151 - Salem, OR 97310-1327 – sos.oregon.gov/business - Phone: (503) 986-2200 
 
 REGISTRY NUMBER        :                                                  
                          For office use only 
 
 In accordance with Oregon Revised Statute 192.410-192.490, the information on this application is public record. 
 We must release this information to all parties upon request and it will be posted on our website.                                                                                 For office use only 
 Please Type or Print Legibly in Black Ink. Attach Additional Sheet if Necessary. 
 
 1)   NAME OF CORPORATION:                                                                                                                                                                               
      NOTE: Must be identical to the name of record in home jurisdiction. 
 
 2)   REGISTRY NUMBER   IN   HOME JURISDICTION                                                                                                                   
                                                                                                      7)  A DDRESS OF PRINCIPAL OFFICE OF THE                   BUSINESS: 
      OR:        CERTIFICATE OF EXISTENCE                   (ATTACHED)                                    (Address, city, state, zip) 
 
      (Please provide a web-verifiable registry number from the entity’s home 
      jurisdiction. Certain states, such as Delaware and New Jersey, do not provide 
      status information online. Entities from such places must instead attach an 
      official certificate of existence, current within 60 days of delivery to this office.) 
 
 3)   DATE OF INCORPORATION      :      DURATION,F IOT N      ERPETUALP                      :        8)  NAME OF OREGON  EGISTERED R            GENTA         : 
 
                                                                                                      9)  REGISTERED AGENT S ' PUBLICLY  VAILABLE A                  DDRESSA        :  (Must be an 
 4)   STATE OR COUNTRY OF  NCORPORATIONI          :                                                       Oregon Street Address which is identical to the registered agent’s business office.) 
 
 5)   TYPE OF CORPORATION     : 
 
       PUBLIC BENEFIT            MUTUAL BENEFIT               RELIGIOUS                               10) ADDRESS FORM        AILING NOTICES     : 
 
 6)   WILL THE CORPORATION  AVEH        MEMBERS? 
 
       YES           NO 
      ORS 65.001(28) 
      (a) “Member”11)                                                                                     NAME AND ADDRESS OF  RESIDENTP                AND  ECRETARYS            :                      means any person or persons entitled, pursuant to a domestic or foreign 
      corporation’s articles or bylaws, without regard to what a person is called in the articles or  
      bylaws, to vote on more than one occasion for the election of a director or directors.              President:                                                                                     
      (b) A person is not a member by virtue of any of the following rights the person has: 
       (A) As a delegate;                                                                                 Address:                                                                                       
       (B) To designate or appoint a director or directors; 
       (C) As a director; or                                                                          
       (D) As a holder of an evidence of indebtedness issued or to be issued by the 
       corporation.                                                                                       Secretary: 
      (c) Notwithstanding the provisions of paragraph (a) of this subsection, a person is not a 
      member if the person’s membership rights have been eliminated as provided in ORS                    Address: 
      65.164 or 65.167. 
 
 12)  EXECUTION: (Must be signed by at least one officer or director.) 
      I declare as an authorized signer, under penalty of perjury, that this document does not fraudulently conceal, obscure, alter, or otherwise misrepresent the 
      identity of any person including officers, directors, employees, members, managers or agents.  This filing has been examined by me and is, to the best of my 
      knowledge and belief, true, correct and complete.  Making false statements in this document is against the law and may be penalized by fines, imprisonment, 
      or both. 

      Signature:                                               Printed Name:                                                                     Title: 
 
 CONTACT NAME    :(To resolve questions with this filing.)                                                FEES 
 
                                                                                                          Required Processing Fee      $50 
                                                                                                           
 PHONE NUMBER    :(Include area code.)                                                                    Processing Fees are nonrefundable.     Please make check payable to “Corporation Division.” 
                                                                                                           
                                                                                                          Free copies are available at sos.oregon.gov/business using the Business Name Search program. 
  60 - Application for Authority to Transact Business - Nonprofit (11/17) 

                     NONPROFIT CORPORATION TYPE – Article 5 
                                  PLEASE READ CAREFULLY 
 
 Nonprofit corporations are required to be classified in one of three categories. For most nonprofit 
 corporations, the following tests apply: 
 
 1. "Religious" corporation means a corporation which is organized primarily or exclusively for 
 religious purposes. These corporations may be tax-exempt under 501(c)(3). 
 
 2. "Public benefit" corporation means a corporation which: 
 
 (a) is tax exempt under section 501(c)(3) of the Internal Revenue Code or is organized for a public or 
 charitable purpose; 
 
 (b) on dissolution must distribute its assets to an organization organized for public or charitable 
 purpose, to a religious corporation, to the United States, to a state or to an organization which is tax 
 exempt under section 501(c)(3) of the Internal Revenue Code; and 
 
 (c) does not come within the definition of religious corporation. 
 
 3. "Mutual benefit" corporation means a corporation which is organized to provide benefits for their 
 members or a small group of people, and does not come within the definition of public benefit or 
 religious corporation. These corporations are not tax-exempt under 501(c)(3), but may be tax-exempt 
 under some other section of law. 

 60 - Application for Authority to Transact Business - Nonprofit (11/17)