these instructions when completing a Statement Appointing an Agent for an
unincorporated nonprofit association pursuant to §7-30-110 and part 3 of
Article 90 of Title 7 of the Colorado Revised Statutes (C.R.S.). Provide only information required or permitted
to be included in the document by Colorado law.
Information included in the document must be typewritten, in English and
must state the name(s) and address(es) of at least one individual causing the
document to be delivered for filing. The
required form/coversheet must be used when filing the document. For legal authority, refer to §7-90-301 and
§7-90-302, C.R.S. You may include
additional information in an attachment to the form/coversheet. Any attachment becomes part of the
document. If there is a conflict between
information in the attachment and the form/coversheet, the information in the
form/coversheet controls. Information
provided in a case-sensitive format will be retrieved and displayed in the same
format. Visit our Web site at www.sos.state.co.us and click on
“Business Center” for a copy of a document after filing, Certificates of Good
Standing, other electronic services, and other information. For answers to general filing questions
consult the Frequently Asked Questions (FAQs), also on our Web site.
True Name of the Nonprofit Association. True Name is the name under which the organization
transacts business or conducts activities in Colorado.
Office Street Address. List the complete street
address of the entity’s principal office.
Office Mailing Address. If mail cannot be delivered to
the street address, provide an address where mail may be delivered.
List the name of the registered agent.
A registered agent must be an individual age 18 years or older whose
primary residence or usual place of business is in Colorado, a domestic entity
having a usual place of business in Colorado or a foreign entity authorized to
transact business or conduct activities in Colorado that has a usual place of
business in Colorado. If the entity has
a usual place of business in Colorado, it may serve as its own registered agent. For legal authority, refer to §7-90-701,
Regarding Registered Agent Consent. A statement
is required that the person appointed as the registered agent in the document
has consented to being so appointed.
Agent Street Address. Please list the complete
street address (physical location) of the entity’s registered agent, including
zip code. This may be the address of the
registered agent’s primary residence in Colorado or usual place of business in
Colorado if the registered agent is an individual, or of the usual place of
business in Colorado if the registered agent is an entity.
Agent Mailing Address. If mail cannot be delivered to
the street address, please provide an address where mail may be delivered.
Delayed Effective Date. The effective date of this document may be
delayed up to 90 days after filing with the Colorado Secretary of State. The delayed effective date may also specify a
particular time of day Mountain Time. If
no time of day is specified, it defaults to close of business on that
date. Close of business is 11:59:59 PM
Mountain Time. For legal authority,
refer to §7-90-304, C.R.S.
Notice. Causing this document to be delivered to the
secretary of state for filing shall constitute the affirmation or
acknowledgment of each individual causing such delivery, under penalties of
perjury, that the document is the individual's act and deed, or that the
individual in good faith believes the document is the act and deed of the
person on whose behalf the individual is causing the document to be delivered
for filing, taken in conformity with the requirements of part 3 of article 90
of title 7, C.R.S., the constituent documents, and the organic statutes, and
that the individual in good faith believes the facts stated in the document are
true and the document complies with the requirements of that Part, the
constituent documents, and the organic statutes.
This perjury notice applies
to each individual who causes this document to be delivered to the secretary of
state, whether or not such individual is named in the document as one who has
caused it to be delivered.
Filing Information. State the name(s) and address(es) of the
individual(s) causing this document to be delivered for filing. This information is required for the Colorado
Secretary of State to deliver notice if the filing of the document is refused
(§7-90-301, C.R.S.). The individual(s)
listed will be held responsible for complying with the above notice. The document
need not state the true name and address of more than one individual. However, if you wish to state the name and
address of any additional individuals causing the document to be delivered for
filing, mark this box ٱ and include an attachment stating the name and address of such
Disclaimer. These instructions, and the related form, are
not intended to provide legal, business or tax advice, and are offered as a
public service without representation or warranty. While the related form is believed to satisfy
minimum legal requirements as of its revision date, compliance with applicable
law, as the same may be amended from time to time, remains the responsibility
of the user of this form. Questions
should be addressed to the user’s attorney.