Corporation Application Form. This is a Ohio form and can be use in Department Of Commerce Statewide.
Tags: Corporation Application, COM 3573, Ohio Statewide, Department Of Commerce
Please visit our website at www.com.ohio.gov/real 614 | 466-4100 Fax 614 | 644-0584 TTY/TDD: 800 | 750-0750 CORPORATION APPLICATION REAL ESTATE Complete this form only if the company in question has a new charter number issued by the Ohio Secretary of State’s office. If you are changing a company’s name and the Ohio Secretary of State’s office issues the same charter number as your previous company, use the “Change Application – Business [COM 3044]” form to complete your request. FEE: $100 FOR DIVISION USE ONLY FILE NUMBER This form is interactive; type the required information into the form, print, sign, date and forward to the Division for processing. A check or money order for $100.00 made payable to: Division of Real Estate & Professional Licensing, must be remitted with this form. Cash will not be accepted. This form may also be typewritten or handwritten (legibly to prevent delays in processing - black ink). NOTE: Incomplete applications and applications that are filled out incorrectly will be returned for correction. COMPLETE THE STEPS BELOW BEFORE SUBMITTING THIS FORM TO THE DIVISION • Prior to submitting this application, a new corporation must have its Doing Business As (DBA) name approved by this Division and the Secretary of State. A name can be reserved by completing the Name Reservation Application – Business [COM 3044]. • Once your business name has been properly registered, complete this form and attach the following documents: 1) a copy of the corporate certificate from the Secretary of State (this proves the corporation is properly registered); 2) a list of all officers in the corporation; 3) an original signed affidavit from any officer or member who is not a broker that states he/she will not act as a broker for the corporation; 4) a letter from the bank in which the company’s trust or special account is held that includes the account D.B.A. name, account number, and a statement that the account is a non-interest bearing trust or special account. Nonresidents of Ohio must attach the Non-Resident Real Estate Applicant’s Consent to Service of Process [COM 3637]. • To transfer more than one broker or one or more salespersons into this corporation from another entity, complete and attach the Multiple License Transfer Affidavit [COM 3683]. NOTE: This application and the information contained therein, except for social security numbers, is public record pursuant to O.R.C. 149.43. NOTE: New Brokers – Your original salesperson license must be returned before your broker license will be issued. If you have just passed both parts of the broker examination, you must submit a Broker Transfer/Reactivation Application [COM 3576] to activate your broker license. An existing Broker or other Business Entity license must be returned before the corporation license will be issued. CORPORATION INFORMATION NAME OF CORPORATION DOING BUSINESS AS (D.B.A.) NAME MAIN BUSINESS ADDRESS CITY FEDERAL TAX ID NUMBER STATE ZIP CODE + 4 BUSINESS PHONE ( PRESIDENT FULL NAME SECRETARY FULL NAME ) VICE PRESIDENT FULL NAME TREASURER FULL NAME TRUST OR SPECIAL ACCOUNT INFORMATION BANK NAME ACCOUNT NAME BANK ADDRESS ACCOUNT NUMBER CITY STATE ZIP CODE + 4 THE BROKER WHO WILL ACT ON BEHALF OF AND IN THE NAME OF THE APPLICANT MUST COMPLETE THE FOLLOWING CERTIFICATION I certify that all of the statements on this application and all of the attached materials are complete and accurate. I understand that any false statement on this form or any of the attached materials may subject me to criminal prosecution and the loss of my Ohio real estate license. ____________________________ ___________________ ___________________________________ _______________ NAME OF BROKER (TYPED OR PRINTED) BROKER FILE NUMBER SIGNATURE OF BROKER DATE THE COMPANY OFFICER AUTHORIZED TO BIND THE APPLICANT/CORPORATION MUST COMPLETE THE FOLLOWING CERTIFICATION I certify that all of the statements on this application and all of the attached materials are complete and accurate. I understand that any false statement on this form or any of the attached materials may subject me to criminal prosecution. ___________________________________ ___________________________________ _______________ NAME OF OFFICER (TYPED OR PRINTED) SIGNATURE OF OFFICER COM 3573 (Rev. 04/2010) “An Equal Opportunity Employer and Service Provider” DATE Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com