Application For Certificate Of Authority For A Foreign Cooperative Association {CA 42}

JAMES C. KIRKPATRICK STATE INFORMATION CENTER (573) 751-4936 JOHN R. ASHCROFT SECRETARY OF STATE STATE OF MISSOURI CORPORATIONS (573) 751-4153 A foreign cooperative association may not transact business in Missouri until it obtains a certificate of authority. Before applying for a certificate to do business in Missouri, you may wish to review Section 351.1213. RSMo, available online at www.sos.mo.gov/business/corporations/statutes.asp. Enclosed are forms to be used to apply for a certificate of authority. In completing the form, the following will assist you: 1. The application must be accompanied by a current (dated within 60 days) "Certificate of Good Standing/Existence" from the parent state. This must be an original with original seals and signatures. This certificate can be obtained from the parent state's Secretary of State or authority which issues corporate charters; normally a fee is charged by the parent state for issuing this certificate. 2. The filing fee for a certificate of authority is $105. (Checks should be made payable to Director of Revenue.) 3. By law, the cooperative must list a registered agent and the agent's address in Missouri. The registered agent may be an individual or a corporation registered in Missouri. A cooperative association may not serve as its own registered agent. 4. The necessary documents should be sent to Secretary of State, Corporations Division, PO Box 778, Jefferson City, MO 65102. For express mailings which require a street address, use 600 West Main, Jefferson City, MO 65101. If you have any questions, please contact us toll-free at (866) 223-6535. Best Regards, John R. Ashcroft Secretary of State INSTRUCTIONS FOR APPLICATION FOR CERTIFICATE OF AUTHORITY TO DO BUSINESS IN MISSOURI FOR A COOPERATIVE ASSOCIATION CA Ltr. 6A 01/2017 James C. Kirkpatrick State Information Center 600 W. Main Street · Jefferson City 65101 Administrative Rules · Business Services · Elections · Publications · Securities · State Archives · State Library · Wolfner Library American LegalNet, Inc. www.FormsWorkFlow.com State of Missouri Corporations Division PO Box 778 / 600 W. Main St., Rm. 322 Jefferson City, MO 65102 John R. Ashcroft, Secretary of State 1. The association name is Application for Certificate of Authority For a Foreign Cooperative Association (Submit with filing fee of $105.00) 2. The name it will use in Missouri is (The name shall contain the designation "Cooperative Association," "Co-op," "Association," or "C.A.") 3. The date of its association was 4. The address of its principal place of business is month/day/year and it is organized and existing under the laws of , and the period of its duration is 5. The name and physical address of its registered agent and office in the State of Missouri is Name Address Address City/State/Zip The Secretary of State is appointed as the agent of the foreign cooperative association for service of process if the association fails to maintain a registered agent in Missouri or if the agent cannot be found or served in the exercise of due diligence. 6. The cooperative association's purpose complies with Section 351.1006 RSMo. In Affirmation thereof, the facts stated above are true and correct: (The undersigned understands that false statements made in this filing are subject to the penalties provided under Section 575.040, RSMo) Authorized Person Printed Name Title Date City/State/Zip Note: A current (not more than 60 days old) original certificate of good standing or certificate of existence must be submitted with this application. This may be obtained from the Secretary of State or other authority that issues corporate charters in the state of domicile. Name and address to return filed document: Name: Address: City, State, and Zip Code: CA 42 (01/2017) American LegalNet, Inc. www.FormsWorkFlow.com