Form SI-100: Statement of Information

In 1. Corporation Name, enter the exact name of the corporation as it is recorded with the California Secretary of State.

In 2. Secretary of State Entity Number, enter the number.

In 3. Business Addresses, 3a, enter the Street Address of California Principal Office, if any. Do not enter a P.O.

In 3a, enter the City (no abbreviations), State and Zip Code.

In 3b, enter the Mailing Address of Corporation, if different than item 3a, with City (no abbreviations), State and Zip Code.

In 4. Officers, 4a, enter the Chief Executive Officer First Name, Middle Name, Last Name and Suffix.

In 4a, enter the Address, City (no abbreviations), State and Zip Code.

In 4b, enter the Secretary First Name, Middle Name, Last Name and Suffix.

In 4b, enter the Address, City (no abbreviations), State and Zip Code.

In 4c, enter the Chief Financial Officer First Name, Middle Name, Last Name and Suffix.

In 4c, enter the Address, City (no abbreviations), State and Zip Code.

An additional title for Chief Executive Officer or Chief Financial Officer may be added; however, the preprinted titles on this form must not be altered.

In 5. Service of Process, you must provide either Individual OR Corporation.

INDIVIDUAL - Complete Items 5a and 5b only. Must include agent's full name and California street address.

In 5a, enter the California Agent's First Name (if agent is not a corporation), Middle Name, Last Name and Suffix.

In 5b, enter the Street Address (if agent is not a corporation) - Do not enter a P.O., with City (no abbreviations), State and Zip Code.

CORPORATION - Complete Item 5c only. Only include the name of the registered agent Corporation.

In 5c, enter the California Registered Corporate Agent's Name (if agent is a corporation) - Do not complete Item 5a or 5b.

In 6. Common Interest Developments, check here if the corporation is an association formed to manage a common interest development under the Davis-Stirling Common Interest Development Act (California Civil Code section 4000, et seq.) or under the Commercial and Industrial Common Interest Development Act (California Civil Code section 6500, et seq.).

The corporation must file a Statement by Common Interest Development Association (Form SI-CID) as required by California Civil Code sections 5405(a) and 6760(a).

In 7. Email Notifications, provide an email address to opt-in to receive entity related notifications, including Statement of Information reminders, by email rather than USPS mail.

Yes, I opt-in to receive entity notifications via email. Email Address:

Note: If no email address is provided, you will continue to receive notices and reminders by USPS mail.

To change your option after filing, you must submit a new complete Statement of Information.

The Information contained herein, including in any attachments, is true and correct.

Enter the Date, Title, Signature and Type or Print Name.

Complete and include this Business Entities Submission Cover Sheet with your paper submission. This form will not be made part of the filed document.

Make all checks or money orders payable to the Secretary of State.

In-person submissions (excluding Statements of Information): $15 special handling fee. Do not include a $15 special handling fee when submitting documents by mail (checked October 19, 2026).

To obtain a certified copy, include certification fees with your submission.

All correspondence related to your submission will be sent to the name and address on your check or money order.

SI-100 is the Secretary of State Statement of Information (California Nonprofit, Credit Union and General Cooperative Corporations). The Corporation is required to enter the names and addresses of all three of the officers.

This form is due within 90 days of initial registration and every two years thereafter.

For fastest service, file online at bizfileOnline.sos.ca.gov.

The filing fee is $20.00 (checked October 19, 2026). The optional certification fee is $5.00 (checked October 19, 2026).