Notice Of Sale Transfer Conversion Or Merger (Domestic Nonprofit Corp)

Page 1 of 2 Secretary of State Office 500 E Capitol Ave Pierre, SD 57501 (605)773-4845 At least ten days prior to the sale, transfer, conversion, or merger of at least thirty percent of the assets of a nonprofit corporation, the corporation shall give written notice to the Attorney General AND the following information shall be submitted to the Secretary of State within sixty days of such sale, transfer, conversion or merger. 1.The Name and Business ID of the corporation is: Name (Note: This must be the exact corporate name as registered.) Business ID 2.The name and address of the parties involved in the sale, transfer, conversion or merger (You may add additionalpages if necessary): Name of party: Actual Street Address City State ZIP+4 Mailing Address in this State, if Different from Street Address City State ZIP+4 Name of party: Actual Street Address City State ZIP+4 Mailing Address in this State, if Different from Street Address City State ZIP+4 3.Terms and conditions of the sale, transfer, conversion or merger: NOTICE OF SALE, TRANSFER, CONVERSION or MERGER DOMESTIC NONPROFIT CORPORATION SDCL 47-24-17 FILING FEE: $15 ayable to SECRETARY OF STATE American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 2 nonprofitsaletransferconversionmerger 4.The dollar value of the assets being sold, transferred, converted or merged, including an account of how thevalue was determined. 5.An explanation of how the sale, transfer, conversion or merger furthers the purpose of the nonprofit corporation. The application must be signed by an authorized officer of the corporation. No person may execute this report knowing it is false in any material respect. Any violation may be subject to a civil and/or criminal penalty (SDCL 22-39-36). Dated Signature of an authorized person Email (Optional) Printed Name Title American LegalNet, Inc. www.FormsWorkFlow.com