"Annual Report for Professional and Foreign Professional Corporations" - Massachusetts

Annual Report for Professional and Foreign Professional Corporations is a legal document that was released by the Secretary of the Commonwealth of Massachusetts - a government authority operating within Massachusetts.

Form Details:

  • Released on October 26, 2009;
  • The latest edition currently provided by the Secretary of the Commonwealth of Massachusetts;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Secretary of the Commonwealth of Massachusetts.

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Download "Annual Report for Professional and Foreign Professional Corporations" - Massachusetts

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PC
Filing Fee: $125.00
Late Fee: $25.00
The Commonwealth of Massachusetts
FPC
William Francis Galvin
Secretary of the Commonwealth
One Ashburton Place - Room 1717, Boston, Massachusetts 02108-1512
Annual Report for Professional and
FORM MUST BE TYPED
Foreign Professional Corporations
(General Laws Chapter 156A, Section 18 and Chapter 156D, Section 16.22)
(1) Exact name of the corporation: _______________________________________________________________________________________
(2) Jurisdiction of incorporation: _________________________________________________________________________________________
(3) Street address of the corporation’s registered office in the commonwealth:
_______________________________________________________________________________________________________________
(number, street, city or town, state, zip code)
(4) Name of the registered agent at the registered office: _______________________________________________________________________
(5) Street address of the corporation’s principal office:
_______________________________________________________________________________________________________________
(number, street, city or town, state, zip code)
(6) Provide the names and addresses of the corporation’s board of directors, shareholders, and its president, treasurer, secretary, and if different, its
chief executive officer and chief financial officer.
NAME
ADDRESS
President: ________________________________________________________________________________________________________
Treasurer: ________________________________________________________________________________________________________
Secretary: ________________________________________________________________________________________________________
Chief Executive Officer: _____________________________________________________________________________________________
Chief Financial Officer: _____________________________________________________________________________________________
Directors: _______________________________________________________________________________________________________
_______________________________________________________________________________________________________________
Shareholders (with residential address): _________________________________________________________________________________
(7) Briefly describe the business of the corporation:
_______________________________________________________________________________________________________________
(8-9) Capital stock of each class and series:
CLASS OF STOCK
TOTAL AUTHORIZED BY ARTICLES OF
TOTAL ISSUED AND OUTSTANDING
ORGANIZATION OR AMENDMENTS
Number of Shares
Number of Shares
COMMON
PREFERRED
(10) Check if the stock of the corporation is publicly traded.
(11) Report is filed for fiscal year ending: ________________________ / ________________________ /_______________________________
(month)
(day)
(year)
It is hereby certified, pursuant to G.L. Chapter 156A, Section 18, that the shareholders, and all the partners of a general partnership which is a share-
holder of the corporation are duly licensed to render one or more professional services for which the corporation was organized, or are professional
corporations authorized to render such professional services, and that a copy of this report is being sent to the appropriate regulatory board.
Signed by: __________________________________________________________________________________________________________
Chairman of the board of directors
President
Other officer
Court appointed fiduciary
on this ____________________________________ day of _______________________________________________ , _________________ .
c156as18c156ds1622 10/26/09
PC
Filing Fee: $125.00
Late Fee: $25.00
The Commonwealth of Massachusetts
FPC
William Francis Galvin
Secretary of the Commonwealth
One Ashburton Place - Room 1717, Boston, Massachusetts 02108-1512
Annual Report for Professional and
FORM MUST BE TYPED
Foreign Professional Corporations
(General Laws Chapter 156A, Section 18 and Chapter 156D, Section 16.22)
(1) Exact name of the corporation: _______________________________________________________________________________________
(2) Jurisdiction of incorporation: _________________________________________________________________________________________
(3) Street address of the corporation’s registered office in the commonwealth:
_______________________________________________________________________________________________________________
(number, street, city or town, state, zip code)
(4) Name of the registered agent at the registered office: _______________________________________________________________________
(5) Street address of the corporation’s principal office:
_______________________________________________________________________________________________________________
(number, street, city or town, state, zip code)
(6) Provide the names and addresses of the corporation’s board of directors, shareholders, and its president, treasurer, secretary, and if different, its
chief executive officer and chief financial officer.
NAME
ADDRESS
President: ________________________________________________________________________________________________________
Treasurer: ________________________________________________________________________________________________________
Secretary: ________________________________________________________________________________________________________
Chief Executive Officer: _____________________________________________________________________________________________
Chief Financial Officer: _____________________________________________________________________________________________
Directors: _______________________________________________________________________________________________________
_______________________________________________________________________________________________________________
Shareholders (with residential address): _________________________________________________________________________________
(7) Briefly describe the business of the corporation:
_______________________________________________________________________________________________________________
(8-9) Capital stock of each class and series:
CLASS OF STOCK
TOTAL AUTHORIZED BY ARTICLES OF
TOTAL ISSUED AND OUTSTANDING
ORGANIZATION OR AMENDMENTS
Number of Shares
Number of Shares
COMMON
PREFERRED
(10) Check if the stock of the corporation is publicly traded.
(11) Report is filed for fiscal year ending: ________________________ / ________________________ /_______________________________
(month)
(day)
(year)
It is hereby certified, pursuant to G.L. Chapter 156A, Section 18, that the shareholders, and all the partners of a general partnership which is a share-
holder of the corporation are duly licensed to render one or more professional services for which the corporation was organized, or are professional
corporations authorized to render such professional services, and that a copy of this report is being sent to the appropriate regulatory board.
Signed by: __________________________________________________________________________________________________________
Chairman of the board of directors
President
Other officer
Court appointed fiduciary
on this ____________________________________ day of _______________________________________________ , _________________ .
c156as18c156ds1622 10/26/09