Corporate Information1.The name of the corporation applying to do business in WV:2.The company was incorporated under the laws of the State of: Date of Incorporation: The address of the principal office of the organization is: 3.6.Are on site contractual services provided to another business located in WV? YES / NO If yes, please describe: State: Street: Name: Zip Code:7.Will you maintain an office in WV? If "Yes," where? City: NoYes, at: Will you apply for a contractor222s license for construction work? NoYes Is the business in the state limited to sales? If "Yes," answer a-d. NoYes a.Does any salesperson reside in the state? NoYes b.Will any salesperson need WV Workers222 Comp. coverage?The type of business to be conducted in WV is:5.Business/Employees in WV: No Yes c.Does your salesperson have authority to finalize a contract? No Yes .d.How are goods shipped to your customers? Common Carrier 10.Do you expect work to be limited to only one occasion8.9.No, we plan on multiple jobs or on-going business.of no more than one month?Yes, Beginning: Ending:11.Will you have employees, other than sales people, working within the state? If "Yes," answer a-c.No a.Will WV taxes be withheld?b.Will they have WV Unemployment Coverage? NoYesYesYes Company Vehicles No Yes Control #FILING FEE:FILE ONE ORIGINAL (Two if you want a filed stamped copy returned to you.)$25.00APPLICATION FOR EXEMPTION FROM CERTIFICATE OF AUTHORITY 4.The name and address of the Agent(person or company) to whomnotice of process may be sent,if any, will be:c.Will they have WV Workers' Compensation Coverage?No Street: State: Zip Code: City: Continued on page 2 of this application.Form CF-2 Rev. 11/2017West Virginia Secretary of State Business & Licensing Division Tel: (304)558-8000 Fax: (304)558-8381 Website: www.wvsos.gov List section number(s) of the WV Code12.Basis for Claiming Exemption: Code Number: Date:Contact phone number (w/ area code): Title/Capacity:Print name of signer:13. Signature:Page 224731D-15-1501(for profit entities) or WV Code 24731E-14-1401 (non-profit entities) or WV Code which makes your business exempt from being required to maintain a certificate of authority.Enter the appropriate Code Number from the attached list of codes in the blank space provided below. (for profit entities) (non-profit entities)Other [see section (c) of the Code in the attached list for profit and non-profit entities]:Application for Exemption from Certificate of Authority Instructions for Applying for Exemption from Certificate of Authority Before completing this application please review the provision of the West Virginia Code. If you believe the nature and extent of your corporation's activity in West Virginia Will qualify your company to conduct business without obtaining a certificate of authority under one of the listed exemptions, you may apply for an exemption by completing the Exemption application and mailing this form to the business address in the upper left corner of the application. A fee of $25 for anexemption certificate is required. The Secretary of State will determine, based on the information you provide, whether an exemption may be granted or whether your company will be required to obtain a certificate of authority prior to beginning business. Please note that a corporation may not obtain other licenses and permit without first obtaining either an exemption or a certificate of authority. If your company is not eligible for an exemption, then the exemption application will be returned to you and you will have to file for a certificate of authority. File with the Secretary of State one original signed application. If you would like a filed, date-stamped copy returned to you, submit one original and one copy of the application. Filing fee is $25. Please make check payable to the West Virginia Secretary of State. The application must be signed by an officer of the corporation or by the chairman of the board of directors of the corporation (See below *Important Legal Notice Regarding Signature). *Important Legal Notice Regarding Signature: Per West Virginia Code 24731D-1-129 . Penalty for signing falsedocument. Any person who signs a document he or she knows is false in any material respect and knows that the document is to be delivered to the secretary of state for filing is guilty of a misdemeanor and, upon conviction thereof, shall be fined not more than one thousand dollars or confined in the county or regional jail not more than one year, or both. WEST VIRGINIA CODE ON OBTAINING AN EXEMPTION FOR A PROFIT CORPORATION 24731D-15-1501Authority to transact business and jurisdiction over foreign corporations. that this exemption does not include debts collected by collection agenciesProvided, the debts: (7) Securing or collecting debts or enforcing mortgages and security interests in property securing property; (6) Creating or acquiring indebtedness, mortgages and security interests in real or personal if the orders require acceptance outside this state before they become contracts;(5) Soliciting or obtaining orders, whether by mail or through employees or agents or otherwise,(4) Selling through independent contractors; (3) Maintaining bank accounts; concerning internal corporate affairs; (2) Holding meetings of the board of directors or shareholders or carrying on other activities(1) Maintaining, defending or settling any proceeding; subsection (a) of this section: (b) The following activities, among others, do not constitute conducting affairs within the meaning of from the Secretary of State. (a) A foreign corporation may not conduct affairs in this state until it obtains a certificate of authority the course of repeated transactions of a like nature; (9) Conducting an isolated transaction that is completed within thirty days and that is not one in(8) Owning, without more, real or personal property; as defined in subdivision (b), section two, article sixteen, chapter forty-seven of this code;(10) Conducting affairs in interstate commerce; (11) Granting funds or other gifts; conduct business in the State of West Virginia. that the foreign corporation does not produce goods, services or otherwise Provided,corporation authorized to transact business in the State of West Virginia: (18) Holding all, or a portion thereof, of the outstanding stock of another Virginia who works for the foreign corporation in another state; and (17) Applying for withholding tax on an employee residing in the State of West foreclosure sale or by agreement in lieu of foreclosure sale; renting or otherwise dealing with selling or disposing of property acquired under (16) The management, rental, maintenance and sale or the operating, maintaining, secured by property in West Virginia; deeds of trust, or mortgages and negotiations for the purchase of loans (15) Physical inspection and appraisal of property in West Virginia as security for (14) The acquisition by purchase of lands secured by mortgage or deeds; (13) Effecting sales through independent contractors; (12) Distributing information to its shareholders or members; validity as process duly served on that corporation in this state. or sale, offer of sale or supply of the defective product has the same legal force and that foreign corporation arising from, or growing out of, contract, tort or manufacture process served upon, or accepted by, the Secretary of State in a proceeding against section is deemed to be the agreement of that foreign corporation that any notice or offer of sale or supply of defective product as described in subsection (d) of this (e) A foreign corporation's making of a contract, the committing of a manufacture or sale, servants or employees or contacts within this state at the time of the injury. within this state notwithstanding the fact that the corporation had no agents, a defective condition and that product causes injury to any person or property (3) The corporation manufactures, sells, offers for sale or supplies any product in (2) The corporation commits a tort, in whole or in part, in this state; or party thereto in this state; (1) The corporation makes a contract to be performed, in whole or in part, by any