Fill and Sign the Free Form 40 Co Op Certificate of Authority State of New

Mailing Address - Corporation Division, NH Dept. of State, 107 N Main St, Rm 204, Concord, NH 03 301-4989 Physical Location - State House Annex, 3rd Floor, Rm 317, 25 Capitol St, Concord, N H Form 40 (Instruct.) State of New Hampshire APPLICATION FOR CERTIFICATE OF AUTHORITY - FOR PROFIT FOREIGN CORPORATION NOTES FOR COMPLETING F ORM 40 (RSA 293 -A:15.03) 1. The form must be legibly printed or typed on 8.5” x 11” paper and maintain 1” margins. Pencil or erasable ink is not acceptable. 2. Article First : The EXACT name of the corporation as registered with the state of incorporation’s s ecretary of state. The name must match exactly as on record including punctuation wherever it appears on the Form 40. 3. Article Second : If the name of the corporation does not contain the word "Corporation", "Incorporated" or "Li mited" or an abbreviation "Corp.", "Inc." or "Ltd.", insert the name of the corporation with t he word or abbreviation which it elects to add thereto for use in New Hampshire. OR If the corporate name is not available for use in New Hampshire, enter the name to be used in New Hampshire. I n this case a trade name application must be filed with an additional $50.00 fee and a copy of a board of di rectors' resoluti on to use the trade name in New Hampshire. The board of directors' resolution must be signed by the SECRETARY of the corporation. (A corporate designation cannot be used on the trade name.) 4. Article Third: The complete address of its principal office. This must be a street address, city, state and zip code; post office box, if any, may be included. All mail will be directed to this address unl ess otherwise specified. 5. Principal business information is optional and is not part of Article Third. 6. Artic le Fourth : The state of incorporation or country (if outside the U.S.) must be listed. ”. 7. Article Fifth : The exact date of incorporation with the corporation’s state of domicile’s Secretary of S tate. This must be a month/day/year date. The period of duration is to be listed. If there is none then it must be l isted as “perpetual” or “ongoing 8. Article Sixth : Per RSA 293 A:15.07 , a registered agent and registered office must be provided. The registered agent must reside in New Hampshire. The registered agent is the person who would receive servic e of process should the corporation be sued. The registered office is the registered agent’s business address where the regi stered agent can be found for in -hand service of process. A street/physical address must be provided. Your application will not be processed without an agent named or if an out of state addre ss is listed. 9. Article Seventh : A brief description of the type of business (e.g. real estate, hairdresser, etc.) may be li sted. This is not required by statute . 10. Article Eighth: Please list the names and addresses of all of the current officers and directors; use an additional sheet if necessary. If the laws in your state of incorporation do not require directors, please indicate in the space pro vided for the directors “none required by law”. 11. Application Signatures: The forms must be signed by the chairman of the board of directors, president or another officer; or see RSA 293 -A:1.20(f) for alternative signature s. 12. The total filing fee to register is $100.00, payable to the State of New Hampshire. PLEASE NOTE: The name will be searched for availability upon receipt of these documents. If the filing has been accepted, you will receive a filed -stamped copy within 30 days. If you do not receive an acknowledgement, please contact our office. Checks are deposited upon receipt. If the check has been cashed, it only indicat es we have received the document. A cashed check is not an indication that the document has been accepted and filed. Please call the Corporation Division (603 -271 -324 6) with any questions you may have regarding this application. Page 1 of 2 Form 40 State of New Hampshire Filing fee: $100.00 Form 40 Use black print or type. RSA 293-A:15.03 APPLICATION FOR CERTIFICATE OF AUTHORITY OF A FOR PROFIT FOREIGN CORPORATION PURSUANT TO THE PROVISIONS of the New Hampshire Business Corporation Act, the undersigned corporation hereby applies for a certificate of authority to transact business in New Hamps hire and for that purpose submits the following statement: FIRST: The name of the corporation is . SECOND: The name which it elects to use in New Hampshire is . THIRD: The complete address (including zip code and post office box, if any) of its principal off ice is: . (no. & street) (city/town) (state) (zip code) Principal Business Information: Principal Mailing Address : (no. & street) (city/town) (state) (zip code) Business Phone: Business Email: ____ Please check if you would prefer to receive the Annual Report Reminder Notice by email . FOURTH : It is incorporated under the laws of . FIFTH: The date of its incorporation is and the period of its duration is . SIX TH: The name of its registered agent IN NEW HAMPSHIRE is : . The complete address of its registered office IN NEW HAMPSHIRE (agent's business address) is : . (no. & street) (city/town) (state) (zip code) SEVENTH : Describe the principal purpose or purposes which it proposes to pursue in the transaction of business in New Hampshire (and if known , list the NAICS Code and Sub Code) . DISCLAIMER: All documents filed with the Corporation Division become public records and will be available for public inspection in eit her tangible or electronic form. Mailing Address - Corporation Division, NH Dept of State, 107 N Main St, Rm 204, Concord, NH 03301 -4989 Physical Location - State House Annex, 3rd Floor , Rm 317, 25 Capitol St, Concord, NH Page 2 of 2 Form 40 (9/2015) APPLICATION FOR CERTIFICATE OF AUTHORITY Form 40 OF A FOR PROFIT FOREIGN CORPORATION (Cont.) EIGHTH : The names and usual business addresses of its current officers and directors are: (If there are addition al officers or directors, attach additional sheet OR if the laws of the state of inc orporation do not require directors, indicate below.) Name Title Address OFFICERS DIRECTORS (Corporate Name) (Signature) (Print or type name) (Title) Date signed: Note: The sale or offer for sale of capital stock of the corporation will comply with the r equirements of the New Hampshire Uniform Securities Act (RSA 421 -B). The capital stock of the corporation: 1) has been registered or when offered will be registered under RSA 421 -B; 2) is exempted or when offered will be exempted under RSA 421 -B; 3) is or will be offered in a transaction exempted from registration under RSA 421 -B; 4) is not a security under RSA 421 -B; OR 5) is a federal covered securities under RSA 421 - B. The statement above shall not by itself constitute a registration or a notice of exem ption from registration of securities within the meaning o f sections 448 and 461(i)(3) of the United States Internal Revenue Code and the regulation promulgated thereunder. Mailing Address - Corporation Division, NH Dept. of State, 107 N Main St, Rm 204, Concord, NH 03 301-4989 Physical Location - State House Annex, 3rd Fl oor, Rm 317, 25 Capitol St, Concord, NH Form FLLC -1 Instruct . State of New Hampshire APPLICATION FOR REGISTRATION AS A FOREIGN LIMITED LIABILITY COMPANY INSTRUCTIONS FOR COM PLETING FORM FLLC -1 (RSA 304-C: 175 ) 1. The form must be legibly printed or typed on 8.5” x 11” paper and maintain 1” margins. Pencil or erasabl e ink is not acceptable. 2. Article First : The EXACT name of the limited liability company as registered by the Secretary of State from the state or country of formation. The name must match exactly as on record including punctuation wherever it appears on the Form FLLC -1 application. 3. Article Second: If the name of the limited liability company does not contain the words “Limited Liability Company”, the abbreviation “L.L.C.” or similar abbreviation, insert the na me of the limited liability company with th e words “Limited Liability Company”, the abbreviation “L.L.C.” or similar abbreviation. OR If the limited liability company name is not available for use in New Hampshire, enter the nam e to be used in New Hampshire. In this case , a trade name application must be filed with an additional $50.00 fee. 4. Principal business information is optional and is not part of article second. The registered agent address will be used as the principal office address if no principal office address is listed. 5. Article s Thi rd & Fourth: State or country of formation and date formed in that state or country. 6. Article Fifth: A br ief des cription of the typ e of bus iness (e.g. real estate, hairdresser, etc.) m ust be listed. Refer to RSA 304 -C:2 1 f or nat ure of business permitted . 7. Article Sixth: Per RSA 304 -C:177 IV , a registered agent and registered office must be provided. The registered agent must reside in New Hampshire. The registered agent is the person who would receive service of process should the corporation be sued. The registered office is the registered agent’s business address where the registered agent can be found for in -hand service of process. A street/physical address must be provided. Your application will not be processed without an agent named or if an out of state address is listed. 8. Shall be executed on behalf of the foreign limited liability company by a person with authorit y to do so under the laws of the state or other jurisdiction of its formation, or, if the foreign limi ted liability company is in the hands of a receiver, executor, or other court appointed fiduciary, trustee, or other fiduciary, it must be signed by that fiduciary. 9. The total filing fee to register is $100.00, payable to the State of New Hampshire. PLEASE NOTE: The name will be searched for availability upon receipt of these documents. If the filing has been accepted, you will receive a filed -stamped copy within 30 days. If you do not receive an acknowledgement, please contact our office. Checks are deposited upon receipt. If the check has been cashed, it only indicates we have received the document. A cashed check is not an indication t hat the document has been accepted and filed. Please call the Corporation Division (603 -271 -324 6) with any questions you may have regarding t his application. Page 1 of 2 Form FLLC-1 State o f New Hampshire Filing fee: $100.00 Form FLLC -1 Use black print or type. RSA 304-C: 175 APPLICATION FOR REGISTRATION AS A FOREIGN LIMITED LIABILITY COMPANY PURSUANT TO THE PROVISIONS of the New Hampshire Limited Liability Company laws, the undersigned hereby applies for registration to transact business in New Hampshire and for that purpos e submits the following statement: FIRST: The name of the limited liability company is . SECOND: The name which it proposes to regist er and do business in New Hampshire is . Principal Business Information: Principal Office Address: (no. & street) (city/town) (state) (zip code) Principal Mailing Address (if different): (no. & street) (city/town) (state) (zip code) Busi ness Phone: Business Email: ____ Please check if you would prefer to receive the Annual Report Reminder Notice by email. THIRD: It is formed under the laws of . FOURTH: The date of its formation is . FIFTH: Describe the nature of the business or purpose s to be conducted or promoted in New Hampshire (and if known , list the NAICS Code and Sub Code) : . SIXTH: The name of its registered agent in New Hampshire is : . The complete address of its registered office IN NEW HAMPSHIRE (agent' s business address) is: . (no. & street) (city/town) (state) (zip code) * Shall be executed on behalf of the foreign limited liability company by a person with authority t o do so under the laws of the state or other jurisdiction of its formation, or, if the foreign limited liability company is in the hands of a receiver, executor, or other court appointed fiduciary, trustee, or other fiduciary, it must be signed by that fiduciary. DISCLAIMER: All documents filed with the Corporation Division become public records and will be available for public inspection in either tangible or electronic form. Mailing Address - Corporation Division, NH Dept. of State, 107 N Main St, Rm 204, Concord, NH 03 301-4989 Physical Location - State House Ann ex, 3rd Floor, Rm 317, 25 Capitol St, Concord, NH Page 2 of 2 Form FLLC-1 (9 /201 5) APPLICATION FOR REGISTRATION AS A Form FLLC-1 FOREIGN LIMITED LIABILITY COMPANY (Cont.) *Signature: Print or type name: Title: Date signed: Complete address of person signing: Note: The sale or offer for sale of membership interests of the limited liability company will c omply with the requirements of the New Hampshire Uniform Securities Act (RSA 421 -B). The membership interests of the limited liability company: 1) have been registered or when offered will be registered under RSA 421 -B; 2) are exempted or when offered will be exempted under RSA 421 -B; 3) are or will be offered in a transaction exempted from registration under RSA 421 -B; 4) a re not securities under RSA 421 -B; OR 5) are federal covered securities under RSA 421 -B. The statement above shall not by itself constitute a registration or a notice of exemption from registration of securities within the meaning of sections 448 and 461( i)(3) of the United States Internal Revenue Code and the regulation promulgated thereunder.