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5610.0100 SWORN STATEMENT TO BOARD.

At the time a professional corporation files with the board the copy of its articles of incorporation as required by Minnesota Statutes, section 319A.08, and annually thereafter when such corporation files with the board its annual report as required by Minnesota Statutes, section 319A.21, it shall file with the board a statement under oath as to each and all of the following:

A.

the address of the registered office of the corporation and the name of its proposed registered agent, if any, for service and process;

B.

the name or names and respective office and residence addresses of the directors and officers of the corporation;

C.

in the case of a corporation organized under Minnesota Statutes, chapter 301, a statement of the aggregate number of issued shares, itemized by classes and the person or persons to whom issued;

D.

in the case of a corporation organized under Minnesota Statutes, chapter 317A, a statement of the names of the members of the corporation if no stock has been issued, or if stock has been issued, a statement of the aggregate number of issued shares, itemized by classes and the person or persons to whom issued;

E.

a description of the nature of the professional services and ancillary services, if any, to be provided by the corporation;

F.

the location or locations of the premises at which the applicant corporation proposes to provide professional services;

G.

a statement listing the name or names of employees, other than members or shareholders of the corporation, who are licensed under Minnesota Statutes, chapter 147, to practice medicine and surgery within the state of Minnesota; and

H.

a statement whether or not all shareholders, members, directors, officers, employees, and agents rendering professional service in Minnesota on behalf of the corporation are licensed to practice medicine and surgery in Minnesota or are otherwise authorized to render the professional service being rendered by the corporation.

Statutory Authority:

MS s 319A.18

History:

L 1989 c 304 s 137

Published Electronically:

June 11, 2008

Official Publication of the State of Minnesota
Revisor of Statutes