Incorporator's Statement
The undersigned, the incorporator of ___________, who signed and filed its Articles of
Incorporation or similar organizing document with the state, appoints the following
individuals to serve as the initial directors of the corporation, who will serve as directors
until the first meeting of shareholders for the election of directors and until their
successors are elected and agree to serve on the board:
____________________________
____________________________
____________________________
____________________________
Date: __________
Signature: ____________________________________, Incorporator
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Incorporator's Statement
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