FLORIDA DEPARTMENT OF STATE  
                        DIVISION OF CORPORATIONS 
 
Attached is the information relating to the registration of a foreign not for profit corporate name in 
Florida. This application does not register the foreign not for profit corporation to conduct its affairs 
in Florida. It merely reserves the name for future use in this state.  Pursuant to section 617.0403, 
Florida Statutes, the requirements for registering a foreign corporate name in the state of Florida are 
listed below. 
 
      Application for the registration of a foreign corporate name containing all the information 
       requested by the form printed on the reverse side of this letter.  You may use this printed 
       form. 
 
      A certificate of existence from the state or country of incorporation, or a certificate stating 
       that the corporation is in good standing under the laws of the state or country wherein it is 
       organized, must accompany the application.  The date of issuance of the certificate cannot 
       be more than 90 days prior to the delivery of the application to the Department of State. 
 
       Fees: 
 
             Application Fee:                           $   87.50   
       Certified Copy (optional):           $   8.75 (plus $1 per page for each page over 8, not to exceed 
                                                                    a maximum of  $52.50). 
 
       Send one check for the total amount made payable to the Department of State. 
 
      Please be sure to include a cover letter with your documents and check.  The cover letter 
       should include the name of the contact person and his/her telephone number during the day 
       and the name and address to which the acknowledgment should be addressed. 
 
A letter of acknowledgment is issued free of charge upon registration and said registration shall be 
effective until the close of the calendar year in which the application for registration is filed. 
 
A foreign name registration may be renewed from year to year by annually filing a renewal 
application between October 1 and December 31 proceeding the year of renewal.  The fee to file a 
renewal application is $87.50, and the registration is renewed for the following calendar year. 
 
Any further questions concerning a foreign name registration should be directed to the Registration 
Section by calling (850) 245-6051 or by writing Division of Corporations, P. O. Box 6327, 
Tallahassee, FL 32314. 
 
CR2E026 (9/15) 

                                     COVER LETTER 
                                                
TO: Registration Section 
    Division of Corporations 
 
SUBJECT:                                                                                 
                             Name of Foreign Not For Profit Corporation 
                                                
Dear Sir or Madam: 
 
The enclosed Foreign Not for Profit Name Registration, certificate and fee(s) are submitted for filing. 
 
Please return all correspondence concerning this matter to the following: 
 
                     Name of Person 
 
                     Firm/Company 
 
                   Address 
 
          City/State and Zip Code 
 
         E-mail address: (to be used for future annual report notification) 
 
For further information concerning this matter, please call: 
 
                                                at (         )                           
          Name of Person                           Area Code & Daytime Telephone Number 
 
    Mailing Address:                                 Street Address: 
    Registration Section                             Registration Section 
    Division of Corporations                         Division of Corporations 
    P.O. Box 6327                                    The Centre of Tallahassee 
    Tallahassee, FL 32314                            2415 N. Monroe Street, Suite 810 
                                                     Tallahassee, FL 32303 
                                  
Enclosed is a check for the following amount: 
 
☐ $87.50 Filing Fee                                  ☐ $96.25 Filing Fee & Certified Copy          
                              

      APPLICATION FOR THE REGISTRATION OF A FOREIGN 
      CORPORATE NAME FOR FOREIGN NOT FOR PROFIT 
                            CORPORATION 
 
 IN COMPLIANCE WITH SECTION 617.0403, FLORIDA STATUTES, THE FOLLOWING IS 
       SUBMITTED TO REGISTER A FOREIGN CORPORATE NAME: 
 
1.                                                                                                      
(Name of corporation: must include the word "INCORPORATED"  or "CORPORATION" or words or abbreviations of like import 
in language as will clearly indicate that it is a corporation instead of a natural person or partnership if not so contained in the name at 
present.  "Company" or "Co." may not be used as a corporate suffix by a nonprofit corporation.) 
 
2.                                                                                                      
                           (State or country under the laws of which it is incorporated) 
 
3.                                                                                                      
                             (Date of Incorporation) 
 
4.                                                                                                      
                           (Federal Employer Identification number, if applicable) 
 
5.                                                                                                      
 
                             (Current mailing address) 
 
6.                                                                                                      
       (Brief description of the nature of the business in which it is engaged) 
 
7.  Attached is a certificate of existence from the state or country of incorporation or a certificate 
  setting forth that the corporation is in good standing under the laws of the state or country 
  wherein it is organized. 
 
8.                                                                                                      
                           (Signature of Chairman, Vice Chairman, or officer) 
 
9.                                                                                                      
        (Typed or printed name and capacity of person signing application)