Fill and Sign the Docketing Statementchanges Pa Department of State Form

PENNSYLVANIA DEPARTMENT OF STATE BUREAU OF CORPORATIONS AND CHARITABLE ORGANIZATIONS Read all instructions prior to completing. This form may be submitted online at https://www.corporations.pa.gov/. Fee: $125 Check only one: Business-stock (§ 1306) Management (§ 2703) Benefit (§ 3303) Business-nonstock (§ 2102) Professional (§ 29 03) Cooperative (§ 7102) Business-statutory close (§ 2303) Insurance (§ 3101) In compliance with the requirements of th e applicable provisions (relating to corporations and unincorporated associations), the undersigned, desiring to incorpor ate a corporation for profit, hereby states that: 1. The name of the corporation (corporate designator required, i.e., “corporation,” “incorporated,” “limited,” “company,” or any abbreviation thereof. “Professional corporation” or “P.C.” permitted for professional corporations) : 2. Complete part (a) or (b) – not both: (a) The address of this corporation’s proposed registered office in this Commonwealth is: (post office box alone is not acceptable) Number and Street City State Zip County (b) The name of this corporation’s commercial registered office provider and the county of venue is: c/o: Name of Commercial Registered Office Provider County 3. The corporation is incorporated under the pr ovisions of the Business Corporation Law of 1988. 4. Check and complete one: The corporation is organized on a nonstock basis. The corporation is organized on a stock share basis and the aggregate number of shares authorized is: ____________________________. Return document by mail to: Name Address City State Zip Code Return document by email to: _________________________________ Articles of Incorporation - For Profit DSCB:15-1306/2102/2303/2702/2903/3101/3303/7102 (rev. 7/2015) *01236* 01236 DSCB:15-1306/2102/2303/2702/2903/3101/3303/7102 – 2 5. The name and address, including number and street, if any, of each incorporator (all incorporators must sign below) : Name Address 6. The specified future effective date, if any: . month/day/year hour, if any 7. Additional provisions of the articles, if any, attach an 8½ by 11 sheet. 8. Statutory close corporation only : Neither the corporation nor any shareholder shall make an offering of any of its shares of any class that would constitute a “public offering” within the meaning of the Securities Act of 1933 (15 U.S.C. § 77a et seq.) IN TESTIMONY WHEREOF, the incorporator(s) has/have signed these Articles of Incorporation this day of , . Signature Signature Signature 9. For Cooperative Corporation Only. Check and complete one: ____ The corporation is a cooperative corpor ation and the common bond of membership among its members is: . ____ The corporation is a cooperative corpor ation and the common bond of membership among its shareholders is: . 10. Benefit corporations only: This corporation shall have the purpo se of creating general public benefit. Strike out if inapplicable: This corporation shall ha ve the purpose of creating the enumerated specific public benefit(s): ______________________________________________________________________________________ ________________________________________________________________________________________________ DSCB:15-15-1306/2102/2303/2702/2903/3101/3303/7102 - Instructions    Pennsylvania Department of State  Bureau of Corporations and Charitable Organizations   P.O. Box 8722  Harrisburg, PA 17105-8722  (717) 787-1057  web site: www.dos.pa.gov/corps    Instructions for Completion of Form (Articles of In corporation-For Profit):    A.   Typewritten is preferred.  If handwritten, the  form shall be legible and completed in black or blu e-black ink in order to  permit reproduction.  The nonrefundable filing fee  for this form is $125 made payable to the Departmen t of State.   Checks must contain a commercially pre-printed name  and address.      Enter the name and mailing address to which any co rrespondence regarding this filing should be sent.  This field must be  completed for the Bureau to return the filing. If t he filing is to be returned by email, an email addr ess must be provided. An  email will be sent to address provided, containing  a link and instructions on how a copy of the filed document or  correspondence may be downloaded. Any email or mail ing addresses provided on this form will become part of the filed  document and therefore public record.    B.  Under 15 Pa.C.S. § 135(c) (relating to addresses ) an actual street or rural route box number must be used as an address, and the  Department of State is required to refuse to receiv e or file any document that sets forth only a post office box address.    C. The following, in addition to the filing fee, sh all accompany this form:  (1)  One copy of a completed form DSCB:15-134A (Doc keting Statement).  (2)  Any necessary copies of form DSCB:19-17.2 (Consent  to Appropriation of Name).  (3)  Any necessary governmental approvals.    D.   For  general  instructions  relating  to  the  incorp oration  of  business  corporations  see  19  Pa.  Code  Ch .  23  (relating  to  business  corporations  generally).  These  instructions  relate  to  such  matters  as  corporate  name,  stated  purposes,   term  of  existence,  nonstock  status,  authorized  share  structure  and  rel ated  authority  of  the  board  of  directors,  par  values,  inclusion  of  names  of  first directors in the Articles of Incorporation, o ptional provisions on cumulative voting for electio n of directors, etc.     E.   For  required  provisions  in  the  Articles  of  a  no nstock  corporation,  see  15  Pa.C.S.  §§  2102-2103  (re lating  to  formation  of  nonstock corporations and contents of articles).    F.   For required provisions in the Articles of a st atutory close corporation, see 15 Pa.C.S. § 2304 (r elating to additional contents of  articles of statutory close corporations).     G.   For required provisions in the Articles of a ma nagement corporation, see 15 Pa.C.S. § 2703 (relati ng to additional contents of  articles of management corporations).     H.   For  restrictions  on  the  stated  purposes  of  prof essional  corporations,  see  15  Pa.C.S.  §  2903  (relat ing  to  formation  of  professional corporations).     I.   For required provisions on the stated purposes  of benefit corporations, see 15 Pa.C.S. § 3311 (relating to corporate purposes).    J.   Articles  for  a  nonprofit  cooperative  corporatio n  should  be  filed  on  Form  DSCB:15-5306/7102B  (Artic les  of  Incorporation  Nonprofit).     K.   One or more corporations or natural persons of  full age may incorporate a business corporation.     L.   15  Pa.C.S.  §  1307  (relating  to  advertisement)  r equires  that  the  incorporators  shall  advertise  their  intention  to  file  or  the  corporation  shall  advertise  the  filing  of  articles  of  incorporation.  Proofs  of  publication  of  such  adv ertising  should  not  be  submitted to, and will not be received by or filed  in, the Department, but should be filed with the mi nutes of the corporation.     M. This form and all accompanying documents shall b e mailed to the address stated above.