Request for Copy
        Secretary of State - Corporation Division - 255 Capitol St. NE, Suite 151 - Salem, OR 97310-1327 - sos.oregon.gov/business - Phone:  (503) 986-2200

                                     Copy Request Fax:      503-378-6520  
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REQUESTER INFORMATION:
Name of Requester:

Mailing Address:  (Street Address or PO Box)                     (City, State)                                                    (Zip Code)

Area Code and Phone Number:

ENTITY NAME/REGISTRY NUMBER: Information is located at http://sos.oregon.gov/bizsearch

Entity Name:                                                                     Registry Number:
DOCUMENT FILE REQUEST:
        Choose appropriate document type and if you are ordering certified or plain copies.
Document File (The original filing and any supplemental filings.)
        Certified Copy ($15 each) or         Plain Copy ($5 each) 
Assumed Business Name File (The original application and any additional filings.)
        Certified Copy ($15 each) or         Plain Copy ($5 each)                                                                 Specific documents are any 
                                                                                                                                  document including annual 
                                                                                                                                  reports (January 2003 
SPECIFIC DOCUMENT REQUEST:                                                                                                        forward) and registered agent 
                                                                                                                                  changes.
Specific Document 
        Certified Copy ($15 each) or         Plain Copy ($5 each) 

If document is going out of the Country: (Additional $10 for Authentication) What Country?
DELIVERY: Choose Delivery Option(s)        (Please note that there is a separate charge per delivery.)
Pick up in person.         Mail to above address.

Fax: (USA Only - Area Code & Fax Number) Certified copies cannot be faxed.
For all overnight/express service delivery, a prepaid airbill must be provided. 
METHOD OF PAYMENT:
Check/Money order is included. (Make payable to Corporation Division.)
MasterCard                 VISA              Discover

CREDIT CARD NUMBER:

American Express

CREDIT CARD NUMBER:

Expiration Date:

Cardholder Name:

Billing Address:

City, State, Zip Code:

Phone Number:
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