Secretary of State
Business Programs Division
Statement of Information, P.O. Box 944230, Sacramento, CA 94244-2300
Free Electronic Copy for Statements of Information Filed Online
Effective October 14, 2013
The Secretary of State's office is excited to announce that Monday, October 14th, 2013, corporations who use our online E-file service for submitting the required Statement of Information will be able to request a FREE PDF copy of the filed statement at the time of submission.
By simply providing an email address as part of the submission process, an image of the filed statement in PDF format is emailed automatically once the statement is successfully processed. The email address provided for purposes of receiving a free filed copy is not public information, and is deleted from our system once the image of the filed statement is sent.
The required Statement of Information for most corporations can be filed online and is processed generally in one business day. A free PDF copy of the submitted Statement of Information will be returned electronically following confirmation of payment, if an email address is provided. Additional plain copies and certified copies may be requested at a later time in person or by mail. Refer to Information Requests for information about obtaining additional copies.
Online Copies: Annual/Biennial Statements of Information (Rev. 10/31/2013) |
www.sos.ca.gov/business/be |
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(916) 657-5448 |
Completed forms along with the applicable fees can be mailed to Secretary of State, Statement of Information Unit, P.O. Box 944230, Sacramento, CA 94244-2300 or delivered in person (drop off) to the Sacramento office, 1500 11th Street, Sacramento, CA 95814. If you are not completing this form online, please type or legibly print in black or blue ink. This form must not be altered. This form is filed only in the Sacramento office.
Briefly describe the general type of business that constitutes the principal business activity of the corporation.
Type or print the name and title of the person completing this form and enter the date this form was completed. By submitting this Statement of Information to the California Secretary of State, the corporation certifies the information contained herein, including any attachments, is true and correct.
Item 16. Item 17.
If an individual is designated as agent for service of process, enter a business or residential street address in California (a P.O. Box address is not acceptable). Please do not enter “in care of” (c/o) or abbreviate the name of the city. If another corporation is designated as agent, leave Item 15 blank and proceed to Item 16.
Item 15.
Enter the name and complete business or residential address of each incumbent director. If there are more than three directors, please attach additional pages. Please do not abbreviate the name of the city. The corporation must have at least one director. (Section 212(a).)
Enter the number of vacancies on the board of directors, if any.
Enter the name of the agent for service of process in California. An agent is an individual (director, officer or any other person, whether or not affiliated with the corporation) who resides in California or another corporation designated to accept service of process if the corporation is sued. The agent must agree to accept service of process on behalf of the corporation prior to designation.
If an individual is designated as agent, complete Items 14 and 15. If another corporation is designated as agent, complete Item 14 and proceed to Item 16 (do not complete Item 15).
Note: Before another corporation may be designated as agent, that corporation must have previously filed with the California Secretary of State, a certificate pursuant to Section 1505. A corporation cannot act as its own agent and no domestic or foreign corporation may file pursuant to Section 1505 unless the corporation is currently authorized to engage in business in California and is in good standing in the records of the California Secretary of State.
Items 10-12.
Item 13. Item 14.
Enter the mailing address of the corporation, if different from the street address of the principal executive office.
Enter the name and complete business or residential address of the corporation's chief executive officer (i.e., president), secretary and chief financial officer (i.e., treasurer). Please do not abbreviate the name of the city. The corporation must have these three officers (Section 312(a).) Any number of offices may be held by the same person unless the articles or bylaws provide otherwise, except, in the case of an agricultural cooperative, neither the president nor the secretary may be the same person. (California Food and Agricultural Code section 54149.) Please note, unless the articles or bylaws provide otherwise, the president, or if there is no president, the chairman of the board, is the chief executive officer of the corporation. A comparable title for the specific officer may be added; however, the preprinted titles on this form must not be altered.
Item 6.
Items 7-9.
Enter the complete street address, city and zip code of the corporation's principal office in California, if any. Please do not enter a P.O. Box or abbreviate the name of the city. Complete this item only if the address in Item 4 is outside of California.
Item 5.
Enter the complete street address, city, state and zip code of the principal executive office. Please do not enter a P.O. Box or abbreviate the name of the city.
Item 4.
If there has been any change to the last Statement of Information filed with the California Secretary of State, including a change to any address, or no statement has ever been filed, complete this form in its entirety.
If there has been no change to the information contained in the last Statement of Information filed with the California Secretary of State, check the box and proceed to Item 17. Note: A P.O. Box address is not an acceptable address for the agent for service of process. Therefore, if the last listed address for the agent for service of process is a P.O. Box address, this form must be completed in its entirety.
Enter the corporation number issued by the California Secretary of State.
Complete the Statement of Information (Form SI-200) as follows:
Item 1. Enter the name of the corporation exactly as it is of record with the California Secretary of State.
Item 2.
Item 3.
Instructions For Completing Form SI-200
For faster processing, the required statement for most corporations can be filed online at https://businessfilings.sos.ca.gov.
Every domestic stock and agricultural cooperative corporation must file a Statement of Information with the California Secretary of State, within 90 days after the filing of its initial Articles of Incorporation, and annually thereafter during the applicable filing period. The applicable filing period for a domestic corporation is the calendar month during which the initial Articles of Incorporation were filed and the immediately preceding five calendar months. A corporation is required to file this statement even though it may not be actively engaged in business at the time this statement is due. Changes to information contained in a previously filed statement can be made by filing a new form, completed in its entirety.
Legal Authority: Statutory filing provisions are found in California Corporations Code section 1502 or California Food and Agricultural Code section 54040, unless otherwise indicated. All subsequent statutory references are to the California Corporations Code, unless otherwise stated. Failure to file this Statement of Information by the due date will result in the assessment of a $250.00 penalty. (Section 2204; California Revenue and Taxation Code section 19141.)
Fees: The Statement of Information must be accompanied by a $20.00 filing fee and $5.00 disclosure fee. The filing fee and the disclosure fee may be included in a single check made payable to the Secretary of State. All domestic stock and agricultural cooperative corporations must pay a total of $25.00 at the time of filing the statement. If this statement is being filed to amend any information on a previously filed statement and is being filed outside the applicable filing period, as defined above, no fee is required.
Copies: To get a copy of the filed statement, include a separate request and payment for copy fees when the statement is submitted. Copy fees are $1.00 for the first page and $.50 for each additional page. For certified copies, there is an additional $5.00 certification fee, per copy.
Publicly Traded Corporations: Every publicly traded corporation also must file a Corporate Disclosure Statement (Form SI-PT) annually, within 150 days after the end of its fiscal year. A “publicly traded corporation” is a corporation, as defined in Section 162, that is an issuer as defined in Section 3 of the Securities Exchange Act of 1934, as amended (United States Code, Title 15, section 78c), and has at least one class of securities listed or admitted for trading on a national securities exchange, on the OTC-Bulletin Board, or on the electronic service operated by Pink OTC Markets Inc. Form SI-PT may be obtained from the Secretary of State’s website at www.sos.ca.gov/business/be/statements.htm or by calling the Statement of Information Unit at (916) 657-5448.
State of California |
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Secretary of State |
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Statement of Information
(Domestic Stock and Agricultural Cooperative Corporations)
FEES (Filing and Disclosure): $25.00.
If this is an amendment, see instructions.
IMPORTANT – READ INSTRUCTIONS BEFORE COMPLETING THIS FORM
1.CORPORATE NAME
2.CALIFORNIA CORPORATE NUMBER
This Space for Filing Use Only
No Change Statement (Not applicable if agent address of record is a P.O. Box address. See instructions.)
3. If there have been any changes to the information contained in the last Statement of Information filed with the California Secretary of State, or no statement of information has been previously filed, this form must be completed in its entirety.
If there has been no change in any of the information contained in the last Statement of Information filed with the California Secretary of State, check the box and proceed to Item 17.
Complete Addresses for the Following (Do not abbreviate the name of the city. Items 4 and 5 cannot be P.O. Boxes.)
4. |
STREET ADDRESS OF PRINCIPAL EXECUTIVE OFFICE |
CITY |
STATE |
ZIP CODE |
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5. |
STREET ADDRESS OF PRINCIPAL BUSINESS OFFICE IN CALIFORNIA, IF ANY |
CITY |
STATE |
ZIP CODE |
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CA |
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6. |
MAILING ADDRESS OF CORPORATION, IF DIFFERENT THAN ITEM 4 |
CITY |
STATE |
ZIP CODE |
7.EMAIL ADDRESS FOR RECEIVING STATUTORY NOTIFICATIONS
Names and Complete Addresses of the Following Officers (The corporation must list these three officers. A comparable title for the specific officer may be added; however, the preprinted titles on this form must not be altered.)
7. |
CHIEF EXECUTIVE OFFICER/ |
ADDRESS |
CITY |
STATE |
ZIP CODE |
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8. |
SECRETARY |
ADDRESS |
CITY |
STATE |
ZIP CODE |
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9. |
CHIEF FINANCIAL OFFICER/ |
ADDRESS |
CITY |
STATE |
ZIP CODE |
Names and Complete Addresses of All Directors, Including Directors Who are Also Officers (The corporation must have at least one director. Attach additional pages, if necessary.)
10. |
NAME |
ADDRESS |
CITY |
STATE |
ZIP CODE |
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11. |
NAME |
ADDRESS |
CITY |
STATE |
ZIP CODE |
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12. |
NAME |
ADDRESS |
CITY |
STATE |
ZIP CODE |
13. NUMBER OF VACANCIES ON THE BOARD OF DIRECTORS, IF ANY:
Agent for Service of Process If the agent is an individual, the agent must reside in California and Item 15 must be completed with a California street address, a P.O. Box address is not acceptable. If the agent is another corporation, the agent must have on file with the California Secretary of State a certificate pursuant to California Corporations Code section 1505 and Item 15 must be left blank.
14.NAME OF AGENT FOR SERVICE OF PROCESS [Note: The person designated as the corporation's agent MUST have agreed to act in that capacity prior to the designation.]
15. STREET ADDRESS OF AGENT FOR SERVICE OF PROCESS IN CALIFORNIA, IF AN INDIVIDUAL CITY |
STATE |
ZIP CODE |
CA
Type of Business
16.DESCRIBE THE TYPE OF BUSINESS OF THE CORPORATION
17.BY SUBMITTING THIS STATEMENT OF INFORMATION TO THE CALIFORNIA SECRETARY OF STATE, THE CORPORATION CERTIFIES THE INFORMATION CONTAINED HEREIN, INCLUDING ANY ATTACHMENTS, IS TRUE AND CORRECT.
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DATE |
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TYPE/PRINT NAME OF PERSON COMPLETING FORM |
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TITLE |
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SIGNATURE |
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SI-200 (REV 01/2013) |
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APPROVED BY SECRETARY OF STATE |
