This Box For Office Use Only Page 1 of 1 Corporation Sole See attached detailed instructions □ Filing Fee $10.00 □ Filing Fee with Expedited Service $60.00 UBI Number: Corporation Sole Annual Report 24.12 RCW SECTION 1 NAME OF CORPORATION SOLE: (as currently recorded with the Office of the Secretary of State) SECTION 2 ADDRESS OF THE PRINCIPAL PLACE OF BUSINESS: (Where records are maintained, see instructions page) Address City State, WA Zip NAME, ADDRESS, AND SIGNATURE OF THE CURRENT BISHOP, OVERSEER, OR PRESIDING ELDER: Name: Address: City State Zip Code X Signature Corporation Sole – Annual Report Printed Name/Title Washington Secretary of State Date Phone Revised 07/10 American LegalNet, Inc. www.FormsWorkFlow.com INSTRUCTIONS – CORPORATION SOLE ANNUAL REPORT Please complete all sections of the Corporation Sole Annual Report. USE DARK INK ONLY. For an electronic version of this form, please visit our website at www.sos.wa.gov/corps UBI Number: Please enter your existing Unified Business Identifier (UBI Number) as currently recorded with the Office of the Secretary of State, in the box in the upper right hand corner of page 1. Section 1 Indicate the Corporation Sole name as currently registered with the Office of the Secretary of State. Section 2 Enter the Washington address of the Corporation Sole principal place of business where records are maintained. Section 3 Provide the name of the Current Bishop, Overseer, or Presiding Bishop. FEES: The filing fee for a Corporation Sole Annual Report is $10.00. If expedited service is requested, include an additional $50.00 and write “EXPEDITE” on the outside of the envelope. Make the checks or money orders payable to “Secretary of State”. (All fees are non-refundable) Mail completed forms and payment to: Secretary of State Corporation Division 801 Capitol Way S PO Box 40234 Olympia WA 98504-0234 If you have questions, need assistance or would like to provide feedback please visit the Corporations Division website at www.sos.wa.gov/corps or call 360-725-0377. HB 1592 – 24.12 RCW Effective August 1, 2009 1. Corporation soles are now required to file an annual report each year in the month of the original incorporation. While the Secretary of State is required to send a notice of this filing requirement 30 days before the due date, the corporation sole is responsible for filing this report whether the notice is received or not. 2. The annual report must include a physical address of the principle place of business and the name of the current bishop, overseer, or presiding elder. 3. Failure to file this annual report will be cause for administrative dissolution of the corporation sole by our office. 4. If dissolution occurs, the corporation sole may seek relief and reinstatement through a prescribed process. 5. No new corporation soles may be formed under this chapter from August 1, 2009 forward Corporation Sole – Annual Report Washington Secretary of State Print Form Revised 07/10 American LegalNet, Inc. www.FormsWorkFlow.com