MINNESOTA SECRETARY OF STATE MINNESOTA NONPROFIT CORPORATION ANNUAL RENEWAL Minnesota Statutes Chapter 317A Must be filed by December 31 _____________________________________________________________________________________ _______ READ THE INSTRUCTIONS BEFORE COMPLETING THIS FORM___________ __________________________________________________________ 1. File #:_____________________________________________________________________________ 2. Corporate Name: (Required) ____________________________________________________________________________________ 3. Registered Office Address: (Required) Street: ______________________________________________________________________________ (A PO Box by itself is not acceptable) City:______________________________________ State:________ Zip:___________ Agent Name: (if applicable):__________________________________________________________ 4. Name and business address of the Corporate President: (Required) Name: __________________________________________________________________________ Street: __________________________________________________________________________ City:______________________________________ State:________ Zip:___________ 5. Does this corporation own, lease, or have any financial interest in agricultural land or land capable of being farmed? Yes ____ No ____ 6. Name, daytime telephone number and e-mail address of contact person for the corporation: Name: ___________________________________ Phone ___________________________ Ext. ______ E-Mail Address: ______________________________________________________________________ NOTICE: Failure to file this form by December 31 of this year will result in the dissolution of this corporation without further notice from the Secretary of State, pursuant to Minnesota Statutes, section 317A.823, subdivision 2, paragraph (b). INSTRUCTIONS FOR COMPLETING THIS FORM All nonprofit corporations governed under Minnesota Statutes 317A are required to file an annual renewal once every calendar year. Items 2 and 3 are filed within the articles of incorporation, if there is a change to this information you must amend your articles of incorporation. If you are amending the business or agent name, submit that amendment along with the $35.00 filing fee. If you are changing the address only, then use the "Notice of Change of Registered Office/Registered Agent form:” no fee is required. All changes must be submitted at the same time as your annual renewal. You cannot use the annual renewal form to make changes to the articles of incorporation. Items 4 through 6 can be changed once a year by filing the annual renewal form with our office. 1. File Number: Provide the corporate charter number issued by the Minnesota Secretary of State. 2. Corporate Name: (Required) If changes to the corporate name are necessary an amendment form and $35 fee must be included with the annual renewal. 3. Registered Agent, if any and Registered Office Address: (Required) If changes to the registered agent name are necessary an amendment form and $35 fee must be included with your annual. If only the registered office address is changing, send in the "Notice of Change of Registered Office Registered Agent" form, no fee is required. 4. Name and Business Address of Corporate President: (Required) Fill in the name and complete business address of the corporate president or person in charge of day to day activities, meetings, and/or who signs documents on behalf of the corporation. 5. Does the corporation own, lease, or have any financial interest in agricultural land or land capable of being farmed? This question is optional. Check Yes or No. 6. Name and daytime telephone number and/or e-mail address of contact person for the corporation: This information is optional. Please list a name and daytime telephone number or e-mail address of a person who can be contacted about this form. A non-profit corporation that has been statutorily dissolved by our office may retroactively reinstate its existence by filing the current year's renewal. Please submit all items together and mail to the address below: FILE IN-PERSON OR MAIL TO: Minnesota Secretary of State - Renewals Retirement Systems of Minnesota Building 60 Empire Drive, Suite 100 St Paul, MN 55103 (Staffed 8:00 - 4:00, Monday - Friday, excluding holidays) Phone Lines: (9:00 a.m. - 4 p.m., M-F) Metro Area 651-296-2803; Greater MN 1-877-551-6767 All of the information on this form is public. Minnesota law requires certain information to be provided for this type of filing. If that information is not included, your document may be returned unfiled. This document can be made available in alternative formats, such as large print, Braille or audio tape, by calling (651)296-2803/voice. For a TTY/TTD (deaf and hard of hearing) communication, contact the Minnesota Relay Service at 1-800-627-3529 and ask them to place a call to (651)296-2803. The Secretary of State's Office does not discriminate on the basis of race, creed, color, sex, sexual orientation, national origin, age, marital status, disability, religion, reliance on public assistance or political opinions or affiliations in employment or the provision of service. NonprofitRenewalRev09/06/11