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Get CA SI-550 2017

Date Type or Print Name of Person Completing the Form Title Signature 2017 California Secretary of State SI-550 REV 01/2017 Clear Form Print Form www. Secretary 5. Director s Suffix c. Chief Financial Officer/ Corporation has additional directors enter the name s and addresses on Form SI-550A see instructions. Secretary of State Statement of Information SI-550 California Stock Agricultural Cooperative and Foreign Corporations IMPORTANT Read instructions before completing this form. Fees Filing plus Disclosure 25. 00 Copy Fees First page 1. 00 each attachment page 0. 50 Certification Fee - 5. 00 plus copy fees 1. Corporation Name Enter the exact name of the corporation as it is recorded with the California This Space For Office Use Only 2. 7-Digit Secretary of State File Number 3. Business Addresses a* Street Address of Principal Executive Office - Do not list a P. O. Box City no abbreviations State Zip Code b. Mailing Address of Corporation if different than item 3a CA 4. Officers a* Chief Executive Officer/ The Corporation is required to list all three of the officers set forth below. An additional title for the Chief Executive Officer and Chief Financial Officer may be added however the preprinted titles on this form must not be altered* First Name Middle Name Last Name Address b. b. Number of Vacancies on the Board of Directors if any 6. Service of Process Must provide either Individual OR Corporation* INDIVIDUAL Complete Items 6a and 6b only. Must include agent s full name and California street address. a* California Agent s First Name if agent is not a corporation CORPORATION Complete Item 6c only. Only include the name of the registered agent Corporation* c* California Registered Corporate Agent s Name if agent is a corporation Do not complete Item 6a or 6b 7. Type of Business Describe the type of business or services of the Corporation 8. The Information contained herein including in any attachments is true and correct. 00 Copy Fees First page 1. 00 each attachment page 0. 50 Certification Fee - 5. 00 plus copy fees 1. Corporation Name Enter the exact name of the corporation as it is recorded with the California This Space For Office Use Only 2. Corporation Name Enter the exact name of the corporation as it is recorded with the California This Space For Office Use Only 2. 7-Digit Secretary of State File Number 3. Business Addresses a* Street Address of Principal Executive Office - Do not list a P. 7-Digit Secretary of State File Number 3. Business Addresses a* Street Address of Principal Executive Office - Do not list a P. O. Box City no abbreviations State Zip Code b. Mailing Address of Corporation if different than item 3a CA 4. O. Box City no abbreviations State Zip Code b. Mailing Address of Corporation if different than item 3a CA 4. Officers a* Chief Executive Officer/ The Corporation is required to list all three of the officers set forth below. Officers a* Chief Executive Officer/ The Corporation is required to list all three of the officers set forth below. An additional title for the Chief Executive Officer and Chief Financial Officer may be added however the preprinted titles on this form must not be altered* First Name Middle Name Last Name Address b. .

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