State of Alaska Division of Corporations, Business and Professional Licensing CORPORATIONS SECTION PO Box 110806 Juneau, AK 99811-0806 Phone: (907) 465-2550 Fax: (907) 465-2974 Website: www.commerce.alaska.gov/occ CERTIFICATE OF AUTHORITY Foreign Cooperative Corporation AS 10.15.525 Filing Fee: $250.00 INSTRUCTIONS (Please retain for your records): Refer to Alaska Statutes 10.15.525. If you need assistance in completing your filing, it is advised that you seek legal counsel. Please be aware that this filing will become public information. ITEM 1: Legal Name of Corporation A corporate name must contain the word "corporation," "company," "incorporated," or "limited," or an abbreviation of one of these words. The corporate name may not contain a word or phrase that indicates or implies that the corporation is organized for a purpose other than the purpose contained in its articles of incorporation. A corporate name must be distinguishable upon the record. To search the availability of the legal name of the corporation in the State of Alaska go to the Corporations Section at www.commerce.alaska.gov/occ and select Search Corporations Database. The entity must be in good standing in their state of domicile, before we can issue a certificate of authority, please check the box. ITEM 2: Assumed Name The name the corporation elects to use if the name in the state of domicile is already in use by another entity in Alaska. To search the availability of the legal name of the corporation in the state of Alaska, go to the Corporations Section at www.commerce.alaska.gov/occ and Search Corporations Database. ITEM 3: State of Domicile, Date of Incorporation, Duration Indicate the state of domicile, or “home state”; date of incorporation in the state of domicile (mm/dd/yyyy format); and the duration. Duration is the life expectancy of the corporation and may be a specific future date of less than 100 years. If there is no expected end date, select the “perpetual” box, indicating the corporation plans to transact business uninterrupted for an undeterminable amount of time. ITEM 4: Disclosure of Corporate Purposes The purpose describes activities of the corporation at the time of the initial filing and may include “any lawful.” In addition to purpose, also include the NAICS code where indicated. NAICS code may not conflict with the purpose listed. A complete list of NAICS codes is available online under the Corporations Section at www.commerce.alaska.gov/occ. ITEM 5: Registered Agent The registered agent of the corporation must be an individual who is a resident of Alaska, or a corporation (excluding LLC, LP, LLP) registered and in good standing with this office. A corporation may not act as its own registered agent. A physical address must be given for the registered office address for services of process. A post office box number may be designated as a mailing address in addition to the physical address. 08-474 (Rev. 02/01/2012) Certificate of Authority Instructions American LegalNet, Inc. www.FormsWorkFlow.com ITEM 6: Principal Office Address Address of the corporation in the state or country of domicile. ITEM 7: Alien Affiliate Defined in AS 10.06990 as a person that directly or indirectly through one or more intermediaries controls, or is controlled by, or is under common control with, a corporation subject to this chapter: An individual who is not a citizen or national of the United States, or who is not lawfully admitted to the United States for permanent residence, or paroled into the United States under the Immigration and Nationality Act (8 U.S.C. 1101 – 1525, as amended): 1. A person, other than an individual, that was not created or organized under the laws of the United States or of a state, or whose principal place of business is not located in any state; or 2. A person, other than an individual, that was created or organized under the laws of the United States of a state, or whose principal place of business is located in a state, and that is controlled by a person described in (1) or (2) of this paragraph[.] ITEM 8: Authorized Shares All cooperative corporations must provide the number of authorized shares, if any. If there is more than one class or series of authorized shares, please provide this information. ITEM 9: Issued Shares Provide the number, class, and series of issued shares, if any. If shares have been issued, you must complete Item 10: Shareholders. ITEM 10: Shareholders List the names and mailing addresses of persons owning 5% or more of any class of shares, and the percentage owned by each person. If there are authorized shares, you must complete Item 9: Issued Shares. ITEM 11: Officers and Directors List the names and mailing addresses of the officers and directors of the corporation. You may attach an additional 81/2” x 11” page, if necessary. Please note: do not include confidential information such as Social Security Numbers, driver’s license numbers or date of birth, as this record is public information. ITEM 12: Signatures The printed name and signatures of the president or vice president of the corporation, and its secretary or assistant secretary are required. If the same person holds two of these positions, two different people must sign the application, unless that person holds all positions. Mail the Application for Certificate of Authority and the $250.00 filing fee in U.S. dollars to: State of Alaska, Corporations Section, PO Box 110806, Juneau, AK 99811-0806 STANDARD PROCESSING TIME for complete and correct applications submitted to this office is approximately 10-15 business days. All applications are reviewed in the date order they are received. To file your application online for immediate processing, visit our website at: www.commerce.alaska.gov/occ. ADDITIONAL RESOURCES:  Professional License: For information regarding what professions require a Professional License, statutes, how to obtain a Professional License, and/or the expiration date if you already have a Professional License, go to the Professional License Section of our website at www.commerce.alaska.gov/occ. 08-474 (Rev. 02/01/2012) Certificate of Authority Instructions American LegalNet, Inc. www.FormsWorkFlow.com  Business License: For the privilege of engaging in a business in the State of Alaska, a Business License is required for a new entity. For information regarding business licenses, statutes, and how to obtain a Business License, go to the Business License Section of our website at www.commerce.alaska.gov/occ.  Alaska Corporate Net Income Tax Every corporation earning gross income from sources within the state, except for those corporations that are specifically exempted, must file a corporation net income tax return. Contact the Alaska Department of Revenue, Tax Division, PO Box 110420, Juneau, Alaska, 99811-0420, telephone number (907) 465-2320 for more information. 08-474 (Rev. 02/01/2012) Certificate of Authority Instructions American LegalNet, Inc. www.FormsWorkFlow.com State of Alaska Division of Corporations, Business and Professional Licensing CORPORATIONS SECTION PO Box 110806 Juneau, AK 99811-0806 Phone: (907) 465-2550 Fax: (907) 465-2974 Website: www.commerce.alaska.gov/occ DO NOT STAMP ABOVE THIS BOX Office Use Only CORP CERTIFICATE OF AUTHORITY Foreign Cooperative Corporation AS 10.15.525 $250.00 Filing Fee Pursuant to Alaska Statutes 10.15.525, the undersigned cooperative applies for a Certificate of Authority and, for that purpose, submits the following statement: ITEM 1: Legal name of the corporation must contain the word “corporation”, “company”, “incorporated”, “limited” or an abbreviation of one of these words. The entity is in good standing in the state of domicile ITEM 2: The assumed name the corporation elects to use in Alaska if the legal name is not available: ITEM 3: The state of domicile, or “home state”; date of incorporation in the state of domicile (mm/dd/yyyy format); and the duration, or “life expectancy” of the corporation: State of domicile: Date of Incorporation: Duration: ___/___/_____ ___/___/_____ Perpetual ITEM 4: The purpose of the corporation (may include “any lawful”) and the 6 digit NAICS Industry Grouping Code that most clearly describes the initial activities of the company: Purpose: NAICS code: ITEM 5: Registered agent name and address (must include a physical address in Alaska): Name: Physical address: Mailing address: ITEM 6: Principal office address of the corporation wherever located: Name: Physical address: Mailing address: 08-474 (Rev. 02/01/2012) Page 1 of 3 American LegalNet, Inc. www.FormsWorkFlow.com ITEM 7: Name and address of each alien affiliate (if there are no alien affiliates, indicate “none”): Name: Mailing address: City: State/Province: Country: Attach additional sheet if more than one alien affiliate. ITEM 8: Number of authorized shares, if any: Common Preferred # of Authorized shares Class Common Preferred # of Authorized Shares Class Series Par value Series Par value ITEM 9: Number of issued shares; if shares have been issued, complete item #10, Shareholders: # of Issued Shares Class Series Par Value # of Issued Shares Class Series Par Value ITEM 10: Name and address of each person/entity owning 5% or more of the issued shares or 5% of any class of issued shares and the percentage of the issued shares owned by that person. If there are no persons/entities owning 5% or more please indicate with “NONE”. If you have shareholders Item #9 must be completed. Name Mailing address City State ZIP code % Issued shares held Attach additional sheet if necessary. ITEM 11: The names and mailing addresses of the officers and directors of the corporation: Title Name Mailing address City State ZIP code President Vice President Secretary Treasurer Director Director If necessary, attach additional pages for continuation. Please do not include confidential information such as Social Security Numbers, driver license numbers or date of birth as this record is public information. 08-474 (Rev. 02/01/2012) Page 2 of 3 American LegalNet, Inc. www.FormsWorkFlow.com ITEM 12: The printed name and signature of the president or vice president, and secretary or assistant secretary. If the same person holds two of these positions, two different people must sign the application, unless that person holds all positions. Signature of President or Vice President Printed name of President or Vice President Date Signature of Secretary or Assistant Secretary Printed name of Secretary or Asst. Secretary Date NOTE: Persons who sign documents filed with the commissioner that are known to the person to be false in material respects, is guilty of a class A misdemeanor. Mail the Application for Certificate of Authority and the $250.00 filing fee in U.S. dollars to: State of Alaska, Corporations Section, PO Box 110806, Juneau, AK 99811-0806 STANDARD PROCESSING TIME for complete and correct applications submitted to this office is approximately 10-15 business days. All applications are reviewed in the date order they are received. To file your application online for immediate processing, visit our website at: www.commerce.alaska.gov/occ. 08-474 (Rev. 02/01/2012) Page 3 of 3 American LegalNet, Inc. www.FormsWorkFlow.com State of Alaska Division of Corporations, Business and Professional Licensing CORPORATIONS SECTION PO Box 110806 Juneau, AK 99811-0806 Phone: (907) 465-2550 Fax: (907) 465-2974 Website: www.commerce.alaska.gov/occ DO NOT STAMP ABOVE THIS BOX Office Use Only CORP CONTACT INFORMATION SHEET Please return this document with your filing. This information will only be used to resolve questions with the filings attached. NOTE: this form will not be filed for record or appear online. Name of entity as it appears on filing: To resolve questions with this filing, contact: Name: Email: Phone: Mailing address: Return documents to: Name: Company: Mailing address: Attach this form to your filings. Send all documents to: State of Alaska, Corporations Section, PO Box 110806, Juneau, AK 99811-0806 STANDARD PROCESSING TIME for complete and correct applications submitted to this office is approximately 10-15 business days. All applications are reviewed in the date order they are received. 08-561 (Rev. 02/01/2012) Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com