Form 170701 Certificate of Revival for a Foreign Qualified Corporation (For Corporations Governed by Nrs Chapter 80) - Nevada

Form 170701 is a Nevada Secretary of State form also known as the "Certificate Of Revival For A Foreign Qualified Corporation (for Corporations Governed By Nrs Chapter 80)". The latest edition of the form was released in October 1, 2015 and is available for digital filing.

Download a PDF version of the Form 170701 down below or find it on Nevada Secretary of State Forms website.

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*170701*
*170701*
BARBARA K. CEGAVSKE
Secretary of State
202 North Carson Street
Carson City, Nevada 89701-4201
(775) 684-5708
Website: www.nvsos.gov
Certificate of Revival
(PURSUANT TO NRS CHAPTER 80)
Page 1
USE BLACK INK ONLY - DO NOT HIGHLIGHT
ABOVE SPACE IS FOR OFFICE USE ONLY
Certificate of Revival for a Foreign Qualified Corporation
(For Corporations Governed by NRS Chapter 80)
1. Name of corporation:
2. Registered Agent for service of process:
(check only one box)
Commercial Registered Agent:
Name
Noncommercial Registered Agent
Office or Position with Entity
(name and address below)
(name and address below)
Name of Noncommercial Registered Agent OR Name of Title of Office or Other Position with Entity
NEVADA
City
Street Address
Zip Code
NEVADA
City
Zip Code
Mailing Address (if different from street address)
3. Date when revival of qualification to do business is to commence or be effective, which may be
before the date of the certificate:
(month, day, year)
4. Indicate whether or not the revival is to be perpetual, and, if not perpetual, the time for which
the revival is to continue. The qualification's existence shall be:
PERPETUAL or
(Time for which the revival is to continue)
This form must be accompanied by appropriate fees.
Nevada Secretary of State 80 Profit Revival Page 1
Revised: 10-1-15
*170701*
*170701*
BARBARA K. CEGAVSKE
Secretary of State
202 North Carson Street
Carson City, Nevada 89701-4201
(775) 684-5708
Website: www.nvsos.gov
Certificate of Revival
(PURSUANT TO NRS CHAPTER 80)
Page 1
USE BLACK INK ONLY - DO NOT HIGHLIGHT
ABOVE SPACE IS FOR OFFICE USE ONLY
Certificate of Revival for a Foreign Qualified Corporation
(For Corporations Governed by NRS Chapter 80)
1. Name of corporation:
2. Registered Agent for service of process:
(check only one box)
Commercial Registered Agent:
Name
Noncommercial Registered Agent
Office or Position with Entity
(name and address below)
(name and address below)
Name of Noncommercial Registered Agent OR Name of Title of Office or Other Position with Entity
NEVADA
City
Street Address
Zip Code
NEVADA
City
Zip Code
Mailing Address (if different from street address)
3. Date when revival of qualification to do business is to commence or be effective, which may be
before the date of the certificate:
(month, day, year)
4. Indicate whether or not the revival is to be perpetual, and, if not perpetual, the time for which
the revival is to continue. The qualification's existence shall be:
PERPETUAL or
(Time for which the revival is to continue)
This form must be accompanied by appropriate fees.
Nevada Secretary of State 80 Profit Revival Page 1
Revised: 10-1-15
BARBARA K. CEGAVSKE
Secretary of State
202 North Carson Street
Carson City, Nevada 89701-4201
(775) 684-5708
Website: www.nvsos.gov
Certificate of Revival
(PURSUANT TO NRS CHAPTER 80)
Page 2
ABOVE SPACE IS FOR OFFICE USE ONLY
USE BLACK INK ONLY - DO NOT HIGHLIGHT
5. Names and addresses of President, Secretary, Treasurer and Directors:
(additional pages may
be attached as necessary)
Name of President or equivalent
Address
State
Zip Code
City
Name of Secretary or equivalent
Address
State
Zip Code
City
Name of Treasurer or equivalent
Zip Code
Address
City
State
Name of Director
Address
City
State
Zip Code
Name of Director
Zip Code
Address
City
State
This form must be accompanied by appropriate fees
Nevada Secretary of State 80 Profit Revival Page 2
Revised: 10-1-15
BARBARA K. CEGAVSKE
Secretary of State
202 North Carson Street
Carson City, Nevada 89701-4201
(775) 684-5708
Website: www.nvsos.gov
Certificate of Revival
(PURSUANT TO NRS CHAPTER 80)
Page 3
USE BLACK INK ONLY - DO NOT HIGHLIGHT
ABOVE SPACE IS FOR OFFICE USE ONLY
6. The undersigned declare that the corporation desires to revive its qualification to do business
and is, or has been, organized and carrying on the business authorized by its existing or original
qualification and amendments thereto, and desires to continue through revival its existence
pursuant to and subject to the provisions of Chapter 80.
7. Check one:
The undersigned declare that they have obtained written consent of the stockholders of the
corporation holding at least a majority of the voting power and that this consent was secured;
furthermore, that they are the person(s) designated or appointed by the stockholders of the
corporation to revive the qualification.
The undersigned declare that they are the person(s) who have been designated by a majority
of the directors in office to sign this certificate and that no stock has been issued.
I declare under the penalty of perjury that the revival has been authorized by a court of competent jurisdiction or by
the duly elected board of directors of the entity or if the entity has no board of directors, its equivalent of such board.
I declare, to the best of my knowledge under penalty of perjury, that the information contained herein is correct and
acknowledge that pursuant to NRS 239.330, it is a category C felony to knowingly offer any false or forged instrument
for filing in the Office of the Secretary of State.
X
Title
Signature
X
Title
Signature
A REGISTERED AGENT ACCEPTANCE MUST ACCOMPANY THIS CERTIFICATE
IMPORTANT:
Failure to include any of the above information and submit with the proper fees may cause this filing to be rejected.
PRINT
Nevada Secretary of State 80 Profit Revival Page 3
This form must be accompanied by appropriate fees.
Revised: 10-1-15
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