Certificate of Authority
Form
Foreign (non-vermont) corporation
Vermont Secretary of State,
128 State Street, Montpelier, VT 05633-1101 -
802-828-2386
Created and existing under the laws of: :
Date of Incorporation: Profit corporation Non-profit corporation
Business description:
Principal
Office Address:
City State Zip Code
NAME OF
REGISTERED AGENT:
Registered office address:
City VERMONT Zip Code
The Fiscal month: Note: December will be designated unless stated
differently.
FOREIGN BANK AUTHORITY. Name
of deceased individual:
NAME and ADDRESS of current officers and directors:
Pres
V.P.
Sec.
Trea
Dir.
Dir.
Dir.
The person submitting this
form should enter his or her name and title and sign:
Printed Name Title
Signature ________________________________________________________Date:
NOTE: $100. fee and a certificate of good standing,
dated within 30 days of filing, must be attached to application.
email or phone where you may be
reached: