FLORIDA DEPARTMENT OF STATE  
                                   DIVISION OF CORPORATIONS 
 
Attached are the forms and instructions to register a foreign not for profit corporation to conduct its 
affairs in Florida.  The requirements are as follows: 
 
       Pursuant to section 617.1503(1), Florida  Statutes, the attached application must be 
        completed in its entirety. 
 
       The corporation must submit an original certificate of existence, no more than 90 days old, 
        duly authenticated by the Secretary of State or the proper official having custody of 
        corporate records in the state or country under the law of which it is incorporated.  A 
        photocopy is not acceptable. If the certificate is in a foreign language, a translation of the 
        certificate under oath of the translator must be submitted. 
 
       There is a $70.00 registration fee and a letter of acknowledgment will be issued free of  
        charge upon registration. 
 
       Certification fees are optional.  Please submit an additional $8.75 if a certificate of status is 
        needed.  The fee for a certified copy of the application is $8.75 each (plus $1 per page for 
        each page over 8, not to exceed a maximum of $52.50).  Please check the appropriate box on 
        the cover letter and send one check for the total amount made payable to the Florida 
        Department of State. 
 
       The cover letter should be completed and submitted along with the certificate, application  
        and check.  Both the mailing address and street address are noted in the cover letter. 
 
Any further inquiries concerning this matter should be directed to the Registration Section by calling 
(850) 245-6051 or writing the Registration Section, Division of Corporations,    
P. O. Box 6327, Tallahassee, FL  32314. 
 
CR2E021 (1/19) 
 

                                  COVER LETTER 
                                                              
TO: Registration Section 
    Division of Corporations 
 
SUBJECT:                                                                                                  
                                 Name of Corporation – must include suffix 
 
Dear Sir or Madam: 
 
The enclosed "Application by Foreign Not for Profit Corporation for Authorization to Conduct its 
Affairs in Florida", "Certificate of Existence", or “Certificate of Status” and check are submitted to 
register the above referenced not for profit corporation to conduct its affairs in Florida. 
 
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: 
Please make check payable to: FLORIDA DEPARTMENT OF STATE 
☐ $70.00 Filing Fee          ☐$78.75 Filing Fee &             ☐$78.75 Filing Fee &                  ☐$87.50 Filing Fee, 
                               Certificate of Status             Certified Copy                      Certificate of Status & 
                                                                                                     Certified Copy 

 APPLICATION BY FOREIGN NOT FOR PROFIT CORPORATION FOR AUTHORIZATION TO 
                                  CONDUCT ITS AFFAIRS IN FLORIDA 
 
IN COMPLIANCE WITH SECTION 617.1503, FLORIDA STATUTES, THE FOLLOWING IS SUBMITTED TO 
REGISTER A FOREIGN NOT FOR PROFIT CORPORATION FOR AUTHORIZATION TO CONDUCT ITS AFFAIRS IN 
THE STATE OF FLORIDA: 
 
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.) 
 
     (If name unavailable in Florida, enter alternate corporate name adopted for the purpose of transacting business in Florida) 
 
2.                                                                                         3.______________________________________                  
     (State or country under the law of which it is incorporated)                                 (FEI number, if applicable)                       
 
4.                                                                                         5.                                                       
                       (Date of Incorporation)                                            (Date of duration, if other than perpetual) 
 
6.                                                                                                                                                  
 (Date first conducted affairs in Florida if prior to registration. See sections 617.1501  & 617.1502, F.S, to determine penalty liability.) 
 
7.                                                                                                                                                   
                                                   (Principal office street address) 
 
                                               (Current mailing address, if different) 
 
8.                                                                                                                                                   
    (Purpose(s) of corporation authorized in home state or country to be carried out in the state of Florida) 
 
9. Name and street address of Florida registered agent:         (P.O. BoxNOT acceptable) 
 
      Name:                                                                                                                             
                                                                                                
Office Address:                                                                                                                         
                                                                                                
                                                                                  , Florida                                             
                                   (City)                                                                                 (Zip Code) 
 
 10.  Registered agent's acceptance: 
Having been named as registered agent and to accept service of process for the above stated corporation at the place  
designated in this application, I hereby accept the appointment as registered agent and agree to act in this capacity.  I 
further agree to comply with the provisions of all statutes relative to the proper and complete performance of my duties, 
and I am familiar with and accept the obligations of my position as registered agent. 
 
                                                               (Registered agent's signature) 
 
11. Attached is a certificate of existence duly authenticated, not more than 90 days prior to delivery of this application to 
     the Department of State, by the Secretary of State or other official having custody of corporate records in the 
     jurisdiction under the law of which it is incorporated.   
 

12.  For initial indexing purposes, list names, titles and addresses of the primary officers and/or directors [up to six (6) 
total]: 
 
A.  DIRECTORS  
☐Chairman           Name:                 ☐Chairman        Name:                                                                    

☐Vice Chairman     Address:               ☐Vice Chairman     Address:                                                               

☐Director                                 ☐Director                                                                                 

☐President                                ☐President                                                                                

☐Vice President                           ☐Vice President                                                                           

☐Secretary                   ☐Treasurer   ☐Secretary                                     ☐Treasurer 

☐Other:                      ☐ Other:      ☐Other:                                        ☐Other:                                   

☐Chairman           Name:                 ☐Chairman        Name:                                                                    

☐Vice Chairman     Address:               ☐Vice Chairman     Address:                                                               

☐Director                                 ☐Director                                                                                 

☐President                                ☐President                                                                                

☐Vice President                           ☐Vice President                                                                           

☐Secretary                   ☐Treasurer   ☐Secretary                                     ☐Treasurer 

☐Other:                      ☐ Other:      ☐Other:                                        ☐Other:                                   

☐Chairman           Name:                 ☐Chairman        Name:                                                                    

☐Vice Chairman     Address:               ☐Vice Chairman     Address:                                                               

☐Director                                 ☐Director                                                                                 

☐President                                ☐President                                                                                

☐Vice President                           ☐Vice President                                                                           

☐Secretary                   ☐Treasurer   ☐Secretary                                     ☐Treasurer 

☐Other:                      ☐ Other:      ☐Other:                                        ☐Other:                                   

NOTE:  Important Notice: Use an attachment to report more than six (6). The attachment will be imaged for reporting purposes only. 
Non-indexed individuals may be added to the index when filing your Florida Department of State Annual Report form.  
 
13.                                                                                                                  
                (Signature of Chairman, Vice Chairman, or any officer listed in number 12 of the application) 
 
14.                                                                                                                                                                          
                     (Typed or printed name and capacity of person signing application)