said corporation in the making of this affidavit. And I do further solemnly swear that the said is not now, a member of or a party to any pool, trust, agreement, combination, confederation or understanding with any other corporation, partnership, individual, or any other person or association of persons, to regulate or fix the price of any article of manufacture, mechanism, merchandise, commodity, convenience, repair, any product of mining, or any article or thing whatsoever, or the price or premium to be paid for insuring property against loss or damage by fire, lightning or storm, and that it has not entered into or become a member of or a party to any pool, trust, agreement, contract, combination or confederation to fix or limit the amount or quantity of any article of manufacture, mechanism, merchandise, commodity, convenience, repair, any product of mining, or any article or thing whatsoever, or the price or premium to be paid for insuring property against loss or damage by fire, lightning or storm, and that it has not issued and does not own any trust certificates, and for any corporation, agent, officer or employe, or for the directors or stockholders of any corporation, has not entered into and is not now in any combination, contract or agreement with any person or persons, corporation or corporations, or with any stockholder or director thereof, the purpose and effect of which said combination, contract or agreement would be to place the management or control of such combination, or combinations, or the manufactured product thereof, in the hands of any trustee or trustees with the intent to limit or fix the price or lessen the production and sale of any article of commerce, use or consumption, or to prevent, restrict or diminish the manufacture or output of any article; and that it has not made or entered into any arrangement, contract or agreement with any person, association of persons or corporation designed to lessen, or which tends to lessen, full and free competition in the importation, manufacture or sale of any article, product or commodity in this State, or under the terms of which it is proposed, stipulated, provided, agreed or understood that any particular or specified article, product or commodity shall be dealt in, sold or offered for sale in this State to the exclusion, in whole or in part, of any competing article, product or commodity. (President, Secretary, Treasurer or Director.) day of 19-. Notary Public. Subscribed and sworn to before me this (Seal) Fourth-And certified check payable to the order of State Treasurer, to cover the State tax and fees, estimated as follows: On a capital of $50,000, or less, invested in Missouri, $50.00; license, $10.00, and fee for issuing certificate, $1.50; total, $61.50. For each $10,000 capital so invested in excess of $50,000, $5.00 additional. FORM FOR INCORPORATING FARMERS' MUTUAL FIRE AND LIGHTNING INSURANCE COMPANIES. (Sec. 8079.) Know all men by these presents: State of That we, the undersigned citizens and residents of the county of Missouri, desirous of forming a Farmers' Mutual Fire and Lightning Insurance company under the laws of Missouri, and more particularly under the provisions of section 8079, R. S. 1899, have adopted the following constitution and by-laws: CONSTITUTION. First-The name of this company shall be the Lightning Insurance Company. Farmers' Mutual Fire and Second-The chief office and place of business of this company shall be at Third-The business of this company shall be managed by a board of directors consisting of members; and the names of those selected for the first year are (Here complete the constitution.) BY-LAWS. (Here insert the by-laws.) In testimony whereof, we have hereunto set our hands this NOTE.-Should be signed by all the members, and verified by the affidavit of the directors named. Tax, $10.00, and fees for certificates, $2.50. FORM FOR INCORPORATING FARMERS' MUTUAL TORNADO, WINDSTORM AND CYCLONE INSURANCE COMPANIES. Know all men by these presents: (Secs. 8080 and 8081.) That we, the undersigned citizens and residents of the county of - State of Missouri, desirous of forming a Farmers' Mutual Tornado, Windstorm and Cyclone Insurance Company under the laws of Missouri, and more particularly under the provisions of sections 8080 and 8081, R. S. 1899, have adopted the following constitution and by-laws. CONSTITUTION. First-The name of this company shall be the Windstorm and Cyclone Insurance Company. Farmers' Mutual Tornado, Second-The chief office and place of business of this company shall be at county of -, State of Missouri. Third-The business of this company shall be managed by a board of directors, consisting of members; and the names of those selected for the first year are (Here complete the constitution.) BY-LAWS. (Here insert the by-laws.) In testimony whereof, we have hereunto set our hands this NOTE.-Should be signed by all the members, and verified by the affidavit of the directors named. Tax, $10.00, and fess for certificates, $2.50. FORM FOR INCORPORATING FARMERS' MUTUAL HAIL INSURANCE COMPANIES. Know all men by these presents: (Secs. 8082 and 8083.) That we, the undersigned, citizens and residents of the county of -———————————, State of Missouri, desirous of forming a Farmers' Mutual Hail Insurance Company under the laws of Missouri, and more particularly under the provisions of sections 8082 and 8083, R. S. 1899, have adopted the following constitution and by-laws: CONSTITUTION. First-The name of this company shall be the Insurance Company. Farmers' Mutual Hail Second-The chief office and place of business of this company shall be at Third-The business of this company shall be managed by a board of directors, consisting of members; and the names of those selected for the first year are (Here complete the constitution.) BY-LAWS. (Here insert the by-laws.) In testimony whereof, we have hereunto set our hands this NOTE. Should be signed by all the members, and verified by the affidavit of the directors named. Tax, $10.00, and fees for certificates, $2.50. FORM FOR INCORPORATING TOWN MUTUAL FIRE, LIGHTHNING, TORNADO WINDSTORM OR CYCLONE INSURANCE COMPANIES. (Secs. 8085 and 8087.) Know all men by these presents: That we, the undersigned, citizens and residents of the county of ---, in the State of Missouri, desirous of forming a Town Mutual Fire, Lightning, Windstorm, Tornado or Cyclone Insurance Company under the laws of Missouri, and more particularly under article XI, chapter 119, R. S. 1899, have adopted the following constitution and by-laws. CONSTITUTION. First-The name of this company shall be the Town Mutual Fire, Lightning, Windstorm, Tornado, or Cyclone Insurance Company of 1 Second-The chief office and place of business of this company shall be at in the county of State of Missouri. Third-The business of this company shall be managed by a board of directors, consisting of members; and the names of those selected for the first year are (Here complete the constitution.) BY-LAWS. (Here insert the by-laws.) In testimony whereof, we have hereunto set our hands this State of Missouri, SS. (To be signed by all the members.> County of Before me, the undersigned Notary Public within and for the county of personally appeared who being by me severally sworn, on his oath each for himself, did say that he has been selected as a director of the Town Mutual that the foregoing is a true and complete copy of the constitution and by-laws. adopted by said company; and that, to his personal knowledge, said company has bona fide contracts for insurance to aggregate one thousand dollars in premiums. Subscribed and sworn to before me this My commission expires (To be signed by all the directors.) INSTRUCTIONS: Care should be taken in the preparation of the Constitution and by-laws that they do not conflict with other provisions of the insurance law. The instrument should be signed by all of its members; but the affidavit must be signed only by all of its directors. The certificate of incorporation must be recorded in the office of the recorder of deeds in the county where the company is located and a copy of such recorded certificate must be filed with the Insurance Department. The State tax and fee for certificate of incorporation will be $12.50, in check payable to the order of the State Treasurer, but should be inclosed with the papers to the Secretary of State. the State of (President or Secretary of the -, a corporation under the laws of duly authorized to do business in the State of Missouri, as evicertificate of authority issued by the Secretary of State on the 1-, being duly sworn, on his oath, says that the said from business in the State of Missouri on the denced by its day of Subscribed and sworn to before me this day of 19-. retired Notary Public. NOTE.-Affidavit must be filed in the office of the Secretary of State. Fee for -certified copy, $1.25, if one is desired. |