State or country of incorporation/formation, if known:



If more than one certification is requested, please indicate the number:



The name and mailing address of the party to receive this order:

 

NOTE: If the service of an "overnight" courier is to be utilized, a complete airbill (including the account number to which the charges for service should be made) must accompany your request.


This request must be accompanied by the statutory fee of $20.00 per certification per business. No credit will be extended. Make checks payable to: Vermont Secretary of State.