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Form 222.

[Section 150, p. 126, ante.]

REPORT TO STATE BOARD OF ASSESSORS.

This report must show existing conditions, January 1st, 190.

Report of the

President:

Treasurer:

Secretary:

I.

2.

Company

Date of incorporation

Principal Office in New Jersey

City or Town

Street and Number

Name of Agent in charge

OFFICE STATE BOARD OF ASSESSORS.

TRENTON, NEW JERSEY.

All of the following questions MUST be answered.
What is the amount of your capital stock authorized? $
Into how many shares is it divided?

3. How many shares are fully paid, either in cash or by property purchased?

4. How many shares are partially paid?

5. What is the amount of your capital stock issued?

6. What is the nature of the business of your corporation?

7. Is your corporation engaged in manufacturing or mining? 8. If so, state where,

A. In New Jersey.

City or town.

Street and number.

B. If in other places, state where.

City or town.

Street and number.

9. What is the amount of your capital stock invested in manufacturing or mining in New Jersey?

10.

What is the local assessed valuation for 190, of your corporation's real and personal estate used in manufacturing or mining in New Jersey?

Real estate,
Personal,

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The above certificate is made in conformity with Section 3 of the act of April 18th, 1884, which provides that if any officer of any company required by this act to make a return, shall in such return make a false statement, he shall be deemed guilty of perjury.

AMENDMENTS AND CHANGES.

Form 223.

[Sections 26a, 43a, pp. 44, 67, ante.]

AMENDED CERTIFICATE OF INCORPORATION BEFORE PAYMENT OF CAPITAL.

[Set out in full the body of the certificate of incorporation as desired to be amended, then add the following attestation clause]:

THE UNDERSIGNED, being all the incorporators of the

Company, a corporation organized under and in pursuance of an act of the legislature of the State of New Jersey entitled "An Act concerning corporations (Revision of 1896)," the certificate of incorporation of which was duly recorded in the office of the clerk of the County of New Jersey, on the day of

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190, no part of the

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190 and duly filed in the office of the secretary of state of New Jersey, on the day of capital stock of said corporation having been paid in, do hereby, pursuant to the provisions of Section 1 of an act of the legislature of the State of New Jersey, entitled "A supplement to an act entitled An Act concerning corporations (Revision of 1896)' approved April twenty-first, one thousand eight hundred and ninety-six," approved April 19, 1898, amend said certificate of incorporation so that the same shall read as herein before set forth, and accordingly do hereunto set our hands and seals.

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[Add acknowledgment (Form 7); then add an affidavit as follows]:

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severally duly sworn did severally depose and say they are all of the original incorporators of the

Company as set

forth in the foregoing certificate, and that no part of the capital stock of said Company has been paid in.

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[The amended certificate should be first recorded in the office of the clerk of the county where the original certificate of incorporation was recorded, and then filed in the office of the secretary of state. If the principal office is changed to another county, record also in the county where the new principal office is located.]

Form 224.

[Sections 27, 28, 43a, pp. 45, 46, 67, ante.]

CERTIFICATE OF AMENDMENT OF CHARTER, INCREASE OF CAPITAL, &c.

[This form may be used for changing the nature of the business, changing the name, increasing the capital stock, decreasing the capital stock, changing the par value of shares of the capital stock, changing the location of the principal office, extending the corporate existence, creating a class or classes of preferred stock, and for making such other amendment, change or alteration as may be desired." Section 27, pp. 45, 46, ante.]

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COMPANY, a corporation of the State of New Jersey, by its President and Secretary, DOES HEREBY CERTIFY:

I. That the principal office of the company is at No. street, New Jersey, and that the agent therein in charge thereof and upon whom process against the corporation may be served is

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day of

, 190

II. That the board of directors of said corporation at a meeting duly convened and held on the passed a resolution declaring that the changes and amendments in the certificate of incorporation [or increase of capital stock, etc., as the case may be], hereinafter set forth are advisable, and calling a meeting of the stockholders to take action thereon.

III. That a copy of said resolution of the board of directors is hereto appended.

day of

IV. That thereafter, on the , 190 pursuant to such call of the board of directors, and upon notice given to each stockholder as provided in the by-laws, a special meeting of the stockholders of the company was held, at which meeting more than twothirds in interest of each class of the stockholders having voting powers were present in person or represented by proxy, and that more than twothirds in interest of each class of the stockholders having voting powers voted in favor of such changes and amendments [or, increase of capital stock, etc.,] such changes and amendments being as follows: The amendment of article

tion to read as follows:

of said certificate of incorpora

[Here insert the article to be amended in full, as amended.]

V. That at said meeting of the stockholders the foregoing amendments were assented to in writing by more than two-thirds in interest of each class of the stockholders having voting powers, which said written assent is hereto appended.

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preferred stock of said corporation are issued and outstanding.

shares of

IN WITNESS WHEREOF, the said

Company

has caused this certificate to be signed by its president and its secretary, and its corporate seal to be hereto affixed this

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day of

COMPANY,

By

President.

Secretary.

RESOLUTION of the BOARD OF DIRECTORS.

"RESOLVED that it is advisable to amend article

tificate of incorporation to read as follows.

[Insert same.]

[or to increase the capital stock of the company from

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of the cer

dollars

Further RESOLVED that a meeting of the stockholders to take action upon the foregoing resolution be called to be held at the principal office of the Company, No. the

street,

day of

, 190

at

M."

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ASSENT OF STOCKHOLDERS.

N. J., on

THE UNDERSIGNED, being more than two-thirds in interest of each class of the stockholders of the

Company, having voting powers, having at a meeting regularly called for that purpose voted in favor of the changes and amendments [or increase of capital stock, etc.] set forth in the above certificate do now pursuant to law give our written assent to such changes and amend

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corporation mentioned in and which executed the foregoing certificate, who, being by me duly sworn on his oath says, that he is such secretary and that the seal affixed to the said certificate is the corporate seal of said corporation, the same being well known to him; that

is president and signed said certificate and affixed

said seal thereto and delivered said certificate by authority of the board of directors and with the assent of two-thirds in interest of each class of the stockholders having voting powers as and for his voluntary act and deed and the voluntary act and deed of said corporation in the presence of deponent who thereupon subscribed his name thereto as witness.

And he further says that the resolution of the board of directors referred to in the said certificate, a true copy of which is appended to said certificate, was adopted at a meeting of said board of directors duly convened and held on the

day of

190 .

And he further says that the written assent of stockholders appended to the foregoing certificate is signed by two-thirds in interest of each class of the stockholders having voting powers, either in person or by their severally duly constituted attorneys in fact thereunto duly authorized in writing.

Subscribed and sworn to before

me the day and year aforesaid.

[For full form of certificate of amendment of certificate of incorporation, see Form 187.]

Form 225.

[Section 28a, p. 47, ante.]

CERTIFICATE OF CHANGE OF LOCATION OF THE PRINCIPAL OFFICE.

RESOLUTION OF DIRECTORS.

'The board of directors of the

Company, a corporation of New Jersey, on this

day of

A. D. 190, do hereby resolve and order that the location of the principal office of this corporation within this state be, and the same hereby is, changed from

in the county of

in the

to No. county of

street,

The name of the agent therein and in charge thereof, upon whom process against the corporation may be served, is

The

CERTIFICATE OF CHANGE.

Company, a corpora

tion of New Jersey, doth hereby certify that the foregoing is a true copy

of a resolution adopted by the board of directors by a
vote of the members thereof at a meeting held as therein stated.

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