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Get PA Annual Statement-Nonprofit Corporation

PENNSYLVANIA DEPARTMENT OF STATE CORPORATION BUREAU Annual Statement-Nonprofit Corporation 15 Pa.C. S. 5110 Document will be returned to the name and address you enter to the left. Name Address City State Zip Code Fee None In compliance with the requirements of 15 Pa.C. S. 5110 relating to annual report the undersigned domestic or qualified foreign nonprofit corporation hereby states that 1. The names and title of the persons who are its principal officers are Titles IN TESTIMONY WHEREOF the undersigned corporation has caused this Annual Statement to be signed by a day of. duly authorized officer thereof this Name of Corporation Signature Department of State Corporation Bureau P. O. Box 8722 Harrisburg PA 17105-8722 717 787-1057 web site www. dos. state. pa.us/corps Instructions for Completion of Form A. S. 5110 relating to annual report the undersigned domestic or qualified foreign nonprofit corporation hereby states that 1. The name of the corporation is 2. The address of its principal office is Number and street Zip County 3. The names and title of the persons who are its principal officers are Titles IN TESTIMONY WHEREOF the undersigned corporation has caused this Annual Statement to be signed by a day of. S* 5110 Document will be returned to the name and address you enter to the left. Name Address City State Zip Code Fee None In compliance with the requirements of 15 Pa*C. S* 5110 relating to annual report the undersigned domestic or qualified foreign nonprofit corporation hereby states that 1. The name of the corporation is 2. The address of its principal office is Number and street Zip County 3. The names and title of the persons who are its principal officers are Titles IN TESTIMONY WHEREOF the undersigned corporation has caused this Annual Statement to be signed by a day of. duly authorized officer thereof this Name of Corporation Signature Department of State Corporation Bureau P. O. Box 8722 Harrisburg PA 17105-8722 717 787-1057 web site www. dos. state. pa*us/corps Instructions for Completion of Form A. Typewritten is preferred* If not the form shall be completed in black or blue-black ink in order to permit reproduction* There is no filing fee with respect to this form* B. On or before April 30 of each year where there has been a change in corporate officers during the preceding calendar year this form shall be filed by each domestic nonprofit corporation which effected any filing in the Department of State after December 31 1972 and by each qualified nonprofit corporation* C. This form is not a substitute for form DSCB 15-1507/4144/5507/6144/8506 Statement of Change of Registered Office and the appropriate form shall be filed to reflect a change in Pennsylvania registered office address. S* 5110 relating to annual report the undersigned domestic or qualified foreign nonprofit corporation hereby states that 1. The name of the corporation is 2. The address of its principal office is Number and street Zip County 3. The name of the corporation is 2. The address of its principal office is Number and street Zip County 3. The names and title of the persons who are its principal officers are Titles IN TESTIMONY WHEREOF the undersigned corporation has caused this Annual Statement to be signed by a day of. .

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