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                  State of Missouri
                  John R. Ashcroft, Secretary of State

                  Corporations Division
                  PO Box 778 / 600 W. Main St., Rm. 322
                  Jefferson City, MO 65102

                                                    Application for Certificate of Authority
                                                    For a Foreign For-Profit Corporation
                                                       (Submit with filing fee of $155.00)

1.  The corporation’s name is 

    and it is organized and existing under the laws of 

2.  The name it will use in Missouri is 

3.  The date of its incorporation was                                               , and the period of its duration is
                                                    month/day/year

4.  The address of its principal place of business is
                                                                                                                              Address                                                                                   City/State/Zip 

5.  The name and physical address of its registered agent and office in the State of Missouri is

      Name                                                                                             Address                                                                                               City/State/Zip 

6.  The specific purpose(s) of its business in Missouri are:

7.  The name of its officers and directors and their business addresses are as follows:
Officers                                            Name                                                Address                                             City/State/Zip
    President
    Vice President
    Secretary
    Treasurer

Board of Directors
Director
Director
Director
Director
Director
                                                       (Please see next page)

Name and address to return filed document:

Name:

Address:

City, State, and Zip Code:
                                                                                                                       Corp. 42 (01/2017)

8.  Check box if you will be registered with the Department of Agriculture as a Family Farm or Authorized Farm Corporation as
    defined by section 350.010 RSMo.

9.  The effective date of this document is the date it is filed by the Secretary of State of Missouri unless a future date is otherwise

    indicated:
                                    (Date may not be more than 90 days after the filing date in this office)

In Affirmation thereof, the facts stated above are true and correct:
(The undersigned understands that false statements made in this filing are subject to the penalties provided under Section 575.040, RSMo)

Must be an Officer or Chairman listed in #7                                    Printed Name                                                             Title                                                     Date

Note: A current (not more than 60 days old) original certificate of good standing or certificate of existence must be submitted with this
    application. This may be obtained from the Secretary of State or other authority that issues corporate charters in the state of domi-
    cile.

                                                                                                            Corp. 42 (01/2017)