FILE ONE ORIGINAL (Two if you want a filed stamped copy returned to you.)FILING FEE: $100 (profit) $50 (non-profit) * Fee Waived for Veteran-owned corporationControl # *** The undersigned, having authority to transact business on behalf of a foreign (out-of-state) registered entity, agrees to *** comply with the requirements of WV Code 24731D-15 to apply for Certificate of Authority. 1. Home State Information: a. Principal office address of the corporation is: No. & Street: City: State: Zip Code: b. Mailing address, if different from above address:b. Designated (physical) office address in West Virginia, if any: Zip Code: State: City: Zip Code: State: City: c. Located in the County of: CHECK HERE to indicate you have obtained and submitted with this application a CERTIFICATE OF EXISTENCE (GOOD STANDING), dated during the current tax year, from your home state of original incorporation as required to process your application. The certificate may be obtained by contacting the Secretary of State's Office in the home state of original incorporation. Street/PO Box:2. Principal Office Information:a. The name of the corporation as it is registered in its home state is:3. West Virginia Office Information: b. State of Date of Incorporation: Duration (no. yrs. or perpetual): c. NAIC# (if an insurance company): a. Corporate name to be used in WV: [The name must contain one of the required terms such as "Corporation," "Corp." or "Inc." See instructions for complete list of acceptable terms and requirements for use of Trade Name.] No. & Street:Home state name as listed on line 1a. above, if available. (If name is not available, check DBA Name box below and follow special instructions under Section 3a. attached to this application.) DBA Name: (See special instructions in Section 3a. regarding the Letter of Resolution approving use of a "forced DBA Name" attached to this application. Click here to see a sample Letter of Resolution.) County: Zip Code: State: City: Street/PO Box: d. Mailing address in West Virginia, if different from above:West Virginia Secretary of State Business & Licensing Division Tel: (304)558-8000 Fax: (304)558-8381 Website: www.wvsos.gov Form CF-1 Rev. 12/2017 APPLICATION FOR CERTIFICATE OF AUTHORITY American LegalNet, Inc. www.FormsWorkFlow.com [If "Yes," the corporation must be formed FOR PROFIT and the purpose(s) indicated in Section 10a. above must include a "general public benefit" as set forth in 24731F-3-301(a) of the West Virginia Code. Per 24731F-1-102(c) , 223general public benefit224 means 223a material positive impact on society and the environment taken as a whole, as measured by a third-party standard, from the business and operations of a benefit corporation."]. b. Will the incorporation elect to be organized for purposes as a 223Benefit Corporation224 per West Virginia Code 24731F ? ONLY applicable to "FOR PROFIT" corporations; "NON-PROFIT" corporations CANNOT elect this status. Page 26. Website address of the business, if any (ex: yourdomainname.com): 5. E-mail address where business correspondence may be received:APPLICATION FOR CERTIFICATE OF AUTHORITY Zip Code: State: City: No. & Street: 4. Agent for Service of Process: Properly designated person to whom notice of legal process may be sent, if any. Name: 8. a. Proposed purpose(s) for transaction of business in West Virginia is(are): *NOTE - "Professional" business organizations must attach to this Certificate of Authority application the Verification of Eligibility (Form VOE ) authorized by your professional state licensing board (see attached instructions and CHECK BOX below). [In the space below, describe the type(s) of business activity which will be conducted, for example, 223agricultural production of grain and poultry,224 223construction of residential and commercial buildings." Purpose may conclude with words 223205including the transaction of any or all lawful business for which corporations may be incorporated in West Virginia.224] Yes No [Proceed to Section 9.] b. Located in how many West Virginia counties? If "Yes"... a. How many businesses? Yes No Decline to answer* Answer a. and b. below. 7. Do you own or operate more than one business in West Virginia? b. Officers and Directors: (add additional pages if necessary; please list all officers) For Profit Non-Profita. Corporation is organized as (check one):10. Corporate Status Information: Yes No [Proceed to Section 10.][If "Yes," you must complete the Scrap Metal Dealer Registration Form (Form SMD-1 ) and proceed to Section 10.]9. Is the business a Scrap Metal Dealer? Officer Title Officer Name No. & Street Address City State Zip Code Professional business organizations: CHECK BOX indicating you have attached the state licensing board Verification of Eligibility (Form VOE) to this Certificate of Authority application if your profession meets the requirements as defined by Chapter 30 of the WV Code. See Section 8 of the attached instructions for a list of professions. Your application will be rejected if the VOE is not attached. American LegalNet, Inc. www.FormsWorkFlow.com Page 3 Date: c. Signature: b. Print or type name of signer: a. Contact person to reach in case there is a problem with filing: 13. Contact and Signature Information* (See below Important Legal Notice Regarding Signature): 12. The number of acres of land it holds or expects to hold in West Virginia is: Phone:APPLICATION FOR CERTIFICATE OF AUTHORITY Title/Capacity of signer: *Important Legal Notice Regarding Signature: Per West Virginia Code 24731D-1-129. Penalty for signing false document. 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. Important Note: This form is a public document. Please do NOT provide any personal identifiable information on this form such as social security number, bank account numbers, credit card numbers, tax identification or driver's license numbers.11. Is the organization a "veteran-owned" organization? National Personnel Records Center Military Personnel Records 1 Archives Drive St. Louis, MO 63138 Toll free: 1-86-NARA-NARA or 1-866-272-6272 Phone: 314-801-0800 www.archives.gov/veterans/military-service-recordsYou may obtain a copy of your Veterans Affairs Form DD214 by contacting: Yes (If "Yes," attach Form DD214) No CHECK BOX indicating you have attached Veteran Affairs Form DD214 Effective JULY 1, 2015, to meet the requirements for a 223veteran-owned224 organization, the entity filing the registration must meet the following criteria per West Virginia Code 24759-1-2a : 1. A 223veteran224 must be honorably discharged or under honorable conditions, and 2. A 223veteran-owned business224 means a business that meets one of the following criteria: o Is at least fifty-one percent (51%) unconditionally owned by one or more veterans; or o In the case of a publicly owned business, at least fifty-one percent (51%) of the stock is unconditionally owned by one or more veterans.Per WV Code 59-1-2(j) effective July 1, 2015, the registration fee is waived for entities that meet the requirements as a "veteran-owned" organization. See attached instructions to determine if the organization qualifies for this waiver. In addition, a "veteran-owned" entity will have four (4) consecutive years of Annual Report fees waived AFTER the organization's initial formation [see WV Code 59-1-2a(m) ]. American LegalNet, Inc. www.FormsWorkFlow.com Complete one original application according to the instructions below. If you would like a 223filed date-stamped224 copy returned to you, then submit two original applications. Incomplete applications will be returned to you for correction. Mail or deliver to the Secretary of State the following as a packet: INSTRUCTIONS FOR FILING WEST VIRGINIA APPLICATION FOR CERTIFICATE OF AUTHORITY Check for availability of the corporate name in West Virginia. Preliminary information is available by phone at 30