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(b) Property owned by the corporation situated in another State or country and subject to taxation therein:

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Other assets (giving items)

*(c) Securities:

This schedule should include all securities owned by the corporation, those which if owned by a natural person resident in this Commonwealth would be liable to taxation, as well as those which would not be liable to taxation.

NO. OF SHARES.

DEORIPTION OF SECURITIES.

AMOUNT INVESTED THEREIN.

The term "real estate, machinery and merchandise " is intended to cover all the tangible property of a business corporation, and the term "securities" all choses in action which would be taxable to a natural person resident in Massachusetts.

The following is a complete list of the stockholders in said. corporation, their residences and number of shares held by each on the first day of May, 190 :

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[The attention of treasurers is called to the necessity of giving the correct residence of each stockholder. Strictly, the law requires the name of the town or city (not the post office) to be written out in full against each name, and this is the only way to prevent mistakes.]

NAME.

NUMBER OF SHARES.

RESIDENCE.

Common or General.

Preferred,

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and made oath that the foregoing certificate by him subscribed is true to the best of his knowledge and belief.

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and established under the laws of said State, desiring to transact business in the Commonwealth of Massachusetts in conformity with the laws thereof, hereby constitutes and appoints the Commissioner of Corporations of said Commonwealth, or his successor in office, to be the true and lawful Attorney of said Corporation, in and for the said Commonwealth, upon whom all lawful processes in any action or proceeding against said Corporation in said Commonwealth may be served, in like manner and with the same effect as if said Corporation existed therein. And the said Corporation hereby stipulates and agrees, that any lawful process against said Corporation, which is served on its said Attorney, shall be of the same legal force and validity as if served on said Corporation.

14 See St. 1903, c. 437, § 58.

BUS. COR. LAW- - 29

This appointment and the authority of said Attorney shall continue in force so long as any liability remains outstanding against said Corporation in said Commonwealth.

IN WITNESS WHEREOF, the aforesaid Corporation, pursuant to a resolution of its Board of Directors, duly passed on the... .day of.... ..A. D. 190.. (a certified copy whereof is hereto annexed), hath caused these presents to be subscribed by its President and countersigned by its Clerk or Secretary, and the corporate seal of said Corporation to be hereunto affixed, this.

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[N. B. The seal of the corporation should be affixed.]

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appointed and qualified, personally appeared the beforenamed....

President, and..

...Clerk or Secretary, of the.....

(who are personally known to me), and severally acknowledged the execution of the foregoing instrument by them subscribed, and they severally made oath that they are respectively the afore-described officers of said Corporation; that the seal affixed to said instrument is its true and proper corporate seal; and that they subscribed said instrument, and said corporate seal was affixed, by virtue of authority duly conferred by said Corporation.

WITNESS my hand and official seal, at..

in the State and county aforesaid, the day and year above written.

[* If out of Massachusetts, before a commissioner for Massachusetts or notary public. If within Massachusetts, before a notary public or justice of the peace.]

[COPY.]

At a meeting of the Board of Directors of the.... a Corporation established under the laws of

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RESOLVED, that this Corporation hereby appoints the Commissioner of Corporations of the Commonwealth of Massachusetts, or his successor in office, to be its true and lawful attorney, in and for said Commonwealth, upon whom all lawful processes in any action or proceeding against this Corporation in said Commonwealth may be served, in like manner and with the same effect as if this Corporation existed therein. And this Corporation hereby stipulates and agrees that any lawful process against it, which is served on its said Attorney shall be of the same legal force and validity as if served on this Corporation. This appointment, and the authority of said Attorney, shall continue in force so long as any liability remains outstanding against this Corporation in said Commonwealth; and the President and Clerk or Secretary are hereby authorized to execute, in the name of the Corporation, and under its corporate seal, a certificate of authority or power of attorney to the said Commissioner of Corporations, in conformity with this Resolution and the laws of said Commonwealth."

I HEREBY CERTIFY, that the above is a true copy of the Resolution of the Directors of this Corporation, authorizing the appointment of an Attorney for the Commonwealth of Massachusetts, as recorded by me.

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a corporation organized under the laws of...

in compliance with the provisions of chapter 437 of the Acts of 1903, do hereby certify as follows concerning said corpora tion:

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2. That the location of its principal office is.

...

3. That the names and addresses of its officers are as

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4. That the date of its annual for the election of officers

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5. That the amount of its capital stock authorized is

..dollars.

The amount of capital stock issued is.... .. dollars.

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The amount of such payment made otherwise than in money is as follows:

Paid in property, viz.:- [State here the number of shares issued on each item.]

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