Free $25.00 - Alaska

Department of Commerce, Community, and Economic Development Division of Corporations, Business, and Professional Licensing Corporations Section PO Box 110808 Juneau AK 99811-0808

FOREIGN CORPORATE NAME REGISTRATION OR RENEWAL APPLICATION
Check if this is a renewal application FULL LEGAL NAME OF ENTITY:

STATE OR TERRITORY OF DOMICLE:

DATE OF INCORPORATION:

PRINCIPAL OFFICE ADDRESS: Mailing Address City, State, Zip

The signer acknowledges that the business is in operation. The nature of the business is:

ATTACH A CERTIFICATE OF GOOD STANDING FROM THE STATE OR TERRITORY OF DOMICILE OF THIS CORPORATION. THE CERTIFICATE MUST HAVE BEEN ISSUED WITHIN THE LAST 60 DAYS. The signer must be an owner of the business; president or vice-president of the corporation; general partner of the limited partnership; member of the limited liability company; or general partner of the limited liability partnership. Signature of Applicant Date Printed Name of Applicant Contact Name and Phone Number (To resolve questions with this filing)

If you have specific legal questions or concerns about this filing, you are strongly advised to consult an attorney or other professional to assist you. Mail the filing and the non-refundable application fee of $25.00 (in U.S. dollars) to: State of Alaska Corporations Section PO Box 110808 Juneau, AK 99811 For additional information or forms please visit our web site at: www.corporations.alaska.gov

08-585 (Rev. 09/05) alh