DOS - 1555 - f - a (Rev. 02 /1 6 ) Page 1 of 3 APPLICATION FOR AUTHORITY OF (Name of Foreign Corporation) Under Section 1304 of the Not-for-Profit Corporation Law FIRST: The name of the foreign corporation is: If the name of the corporation does not contain a required word or abbreviation indicating corporate character, the corporation agrees to add the following word or abbreviation to the end of its name for use in New York State: If the true name is not available for use in New York State pursuant to 247301 and 247302 of the Not-for-Profit Corporation Law, the fictitious name the corporation agrees to use in this state is: SECOND: The jurisdiction in which the corporation was organized is: The date of its incorporation is: THIRD: The corporation is a foreign corporation as defined in subparagraph (7) of paragraph (a) Section 102 of the Not-for-Profit Corporation Law. FOURTH: If formed in New York State, the corporation would be a (check the appropriate box) charitable corporation non-charitable corporation. FIFTH: A. The purposes to be pursued in this state are: American LegalNet, Inc. www.FormsWorkFlow.com DOS - 1555 - f - a (Rev. 02 /1 6 ) Page 2 of 3 A. Continued. B. The activities which it proposes to conduct in this State are: The corporation is authorized to conduct the above activities in its jurisdiction of incorporation. SIXTH: The county within this state in which the office of the corporation is to be located is: . (A county in New York State must be stated. Please note that the corporation is not required to have an actual physical office in this state.) SEVENTH: The Secretary of State is designated as agent of the corporation upon whom process against the corporation may be served. The address to which the Secretary of State shall forward copies of process accepted on behalf of the corporation is: EIGHTH: (Please check the appropriate statement.) The corporation has not, since its incorporation or since the date its authority to conduct activities in New York was last surrendered, engaged in any activity in this state except as set forth in paragraph (b) of Section 1301 of the Not-for-Profit Corporation Law. The consent of the State Tax Commission is attached. X (Signature) (Capacity of Signer) (Print or Type Name) American LegalNet, Inc. www.FormsWorkFlow.com DOS - 1555 - f - a (Rev. 02 /1 6 ) Page 3 of 3 APPLICATION FOR AUTHORITY OF (Name of Foreign Corporation) Under Section 1304 of the Not-for-Profit Corporation Law Name Address City, State and Zip Code NOTES: 1. The certificate must be submitted with a $135 filing fee. 2. This form was prepared by the New York State Department of State. It does not contain all optional provisions under the law. You are not required to use this form. You may draft your own form or use forms available at legal stationery stores. 3. The Department of State recommends that all documents be prepared under the guidance of an attorney. 4. Attached to the Application for Authority must be a Certificate of Existence/Good Standing/Status from the official who files and maintains corporate records in the jurisdiction of the corporation. (Please Note: This official is generally the Secretary of State.) 5. Please be sure to review Section 404 of the Not-for-Profit Corporation Law to determine if any consents or approvals are required to be attached to this application for authority. For Office Use Only American LegalNet, Inc. www.FormsWorkFlow.com