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                              District of Columbia Government 
                                              Corporations Division
                              Transfer of Registration for Foreign Filing Entity. 
                                              Form FN-5, Ver. 3, April 2018. 
Use this form to transfer registration for a foreign filing entity registered to do business in the District that merges with or 
converts to a foreign entity required to register to do business in the District. 
                      ENTITY TYPE / AUTHORITY                                               FILING FEE 
                  Foreign Filing Entity: § 29–105.10.                       Refer to Corporate Fee Schedule posted online; 
Under the provisions of the Title 29 of D.C. Code (Business Organizations Act), the foreign filing entity listed below 
hereby applies for a Certificate of Transfer of Registration and for that purpose submits the statement below. 
1.1. Entity Name. 

2. Date of Issuance of Certificate of Foreign Registration.

3. The type of entity that the foreign entity was before the merger / conversion.

4. Name of the entity into which it has merged or to which it has been converted.

5. Type of entity into which it has merged or to which it has been    6. Name of State / Country whose laws govern converted /
converted.                                                            merged filing entity’s internal affairs.

7. Answer 7A-B if information is different from the information for the applicant entity.

7A. Principal Office Address. 

7B. Name and Address of the Registered Agent in the District of Columbia. 

8. Attach certified copy of the statement evidencing the merger/conversion from Registration Authority in the
State/Province/Country of Incorporation  that is not over 90 days old.
If you sign this form you agree that anyone who makes a false statement can be punished by criminal penalties 
                      of a fine up to $1000, imprisonment up to 180 days, or both, under DCOC § 22-2405; 
9. Name of the Governor or Authorized Person:                         9A. Signature of the Governor or Authorized Person. 

Mail all forms and required payment to:                            Corporate Online Services Information: 
Department of Consumer and Regulatory Affairs                      Many corporate filings are available by using CorpOnline 
Corporations Division                                              Service. 
PO Box 92300                                                       Go to CorpOnline site at https://corponline.dcra.dc.gov, create 
Washington, DC 20090                                               the profile, access the online services main page and proceed. 
                                                                   Online filers must pay by using the credit card. 
Phone: (202) 442-4432