08-457 Rev F Non-Profit Change of Officials 1 of 2 Foreign Non-Profit Corporation (AS 10.20) This Notice of Change of Officials form is only for Foreign Non-Profit Corporations and is used to reportchanges in officers and directors information between biennial reporting periods. This Notice of Change of Officials will not be filed if the entity222s biennial report is not current. To verify theentity222s biennial report due date, go online to www.Corporations.Alaska.Gov and select, SearchCorporations Database Standard processing time for complete and correct filings submitted to this office is approximately 10-15business days. All filings are reviewed in the date order they are received. The information you submit is a public record and will be posted on the State222s website. COR Corporations Section State Office Building, 333 Willoughby Avenue, 9th Floor PO Box 110806, Juneau, AK 99811-0806 Phone: (907) 465-2550 225 Fax: (907) 465-2974 Email: corporations@alaska.gov Website: Corporations.Alaska.Gov Notice of Change of Officials 1. Important: AS 10.20.631 Each Foreign Non-Profit Corporation is required to notify this office when there is a change of officials. 227 AS 10.20.631 Failure to meet this requirement may result in revocation of the entity222s authority to transact business in the State of Alaska. 227 AS 10.20.325(7) The Foreign Non-Profit Corporation is to keep and make available the records of the official(s) changes. 227 AS 10.20.131 2. Fee: $25 Nonrefundable Filing Fee (CORF) 3 AAC 16.050(c) Mail this form and the non-refundable $25 filing fee in U.S. dollars to the letterhead address. Make the check or money order payable to the State of Alaska, or use the attached credit card payment form. 3. Entity Information: AS 10.20.631 Entity Name: Alaska Entity Number: FOR DIVISION USE ONLY T HE S TATE ALASKA of Department of Commerce, Community and Economic Development Division of Corporations, Business and Professional Licensing American LegalNet, Inc. www.FormsWorkFlow.com 08-457 Rev F Non-Profit Change of Officials 2 of 2 4. REMOVE from Record: AS 10.20.631(b) The following officials (officers and directors) will be completely removed from the record as a result of this filing: Name: Name: Name: Name: If an official is not being removed from record, then list them in Item #5 below (with their current information). 5. ALL Current Officials: AS 10. 20 . 63 1 (b) and AS 10. 20.705 The following is a complete list of ALL remaining and new officials who will be on record as a result of this filing. For signing authority and future filing purposes, a Foreign Non-Profit Corporation may need to have at least a President or Vice-President and Secretary or Assistant Secretary on record with this office. Two or more offices may be held by the same person, except the offices of President and Secretary which cannot be the same person. 227 AS 10.20.086 and AS 10.20.121 List ALL officials and their current information to be on record. BOLD FIELDS ARE REQUIRED. President Vice - President Secretary Treasurer Director Assistant Secretary Assistant Treasurer FULL LEGAL NAME COMPLETE MAILING ADDRESS If necessary, use the following supplement page and include all information required above in Item #5. 6. Required Signature: AS 10. 20 . 631(b) and AS 10.20.650 The Notice of Change of Officials must be signed by an officer of the non-profit corporation. A Director is not an authorized signer. Persons who sign documents filed with the commissioner that are known to the person to be false in material respects are guilty of a class A misdemeanor. Signature: Date: Printed Name: Title of Authorized Signer: (Must be signed by an officer of the non - profit. A director is not an authorized signer.) USE ONLY TITLES PROVIDED American LegalNet, Inc. www.FormsWorkFlow.com 08-457a Rev F Non-Profit Change of Officials (SUPPLEMENT) If used, this supplement must be returned with Form 08-457 Notice of Change of Officials SUPPLEMENT Entity Name: Alaska Entity Number: 4. REMOVE from Record (continued from Page 2): AS 10.20.631(b) The following officials (officers and directors) will be completely removed from the record as a result of this filing: Name: Name: Name: Name: If an official is not being removed from record, then list them in Item #5 below (with their current information). 5. ALL Current Officials (continued from Page 2): AS 10. 20 . 631(b) and AS 10. 20.705 The following is a complete list of ALL remaining and new officials who will be on record as a result of this filing. For signing authority and future filing purposes, a Foreign Non-Profit Corporation may need to have at least a President or Vice-President and Secretary or Assistant Secretary on record with this office. Two or more offices may be held by the same person, except the offices of President and Secretary which cannot be the same person. 227 AS 10.20.086 and AS 10.20.121 List ALL officials and their current information to be on record. BOLD FIELDS ARE REQUIRED. President Vice - President Secretary Treasurer Director Assistant Secretary Assistant Treasurer FULL LEGAL NAME COMPLETE MAILING ADDRESS USE ONLY TITLES PROVIDED If necessary to complete Items #4 and #5, make copies of this SUPPLEMENT page. American LegalNet, Inc. www.FormsWorkFlow.com 08-561 Rev 7/14/16 Contact Information Return this form with your filing This information may be used by the Division to assist with processing your attached filings This form will not be filed for record, or appear online COR Corporations Section State Office Building, 333 Willoughby Avenue, 9th Floor PO Box 110806, Juneau, AK 99811-0806 Phone: (907) 465-2550 Fax: (907) 465-2974 Email: corporations@alaska.gov Website: Corporations.Alaska.Gov Contact Information Entity Information Enter your entity information as it appears on this filing. Entity Name: AK Entity #: Contact Person Whom may we contact with any questions or problems with this filing? Company: Contact: Mailing Address: Address: City: State: ZIP: Phone: Email: Document Return Address Provide an address for the return of your filed documents. Return my filings to the address provided ABOVE Return my filings to this address provided BELOW Company: Contact: Mailing Address: Address: City: State: ZIP: FOR DIVISION USE ONLY T HE S TATE ALASKA of Department of Commerce, Community and Economic Development Division of Corporations, Business and Professional Licensing American LegalNet, Inc. www.FormsWorkFlow.com All major credit cards are accepted. For security purposes, do not email credit card information. Include this credit card payment form with your application. Name of Applicant or Licensee: Program Type: License Number (if applicable): I wish to make payment by credit card for the following State of Alaska Department of Commerce, Community, and Economic Development Division of Corporations, Business and Professional Licensing PO Box 110806, Juneau, AK 99811 Phone: (907) 465-2550 Credit Card Payment Form CREDIT CARD INFO: Your payment cannot be processed unless all fields are completed! All four fields MUST be completed! This section will be destroyed after the payment is processed. 1. Account Number : 2. Expiration Date: 3. Billing ZIP Code: 4 . Security Code : FOR DIVISION USE ONLY T HE S TATE ALASKA of Department of Commerce, Community , and Economic Development Division of Corporations, Business and Professional Licensing