EX-3.70 51 g96520exv3w70.txt EX-3.70 PUBLIC RECORDS FILING FOR NEW BUSINESS ENTITY FOR PSI SUMMIT HOSPITAL, INC. EXHIBIT 3.70 Mail to: Po Box 308 STATE OF NEW JERSEY Overnight to: 225 Wear Tenon NJ 08625 DIVISION OF REVENUE State St. 3rd floor Tenon NJ 08606-1001 PUBLIC RECORDS FILING FOR NEW BUSINESS ENTITY Fill out all information below INCLUDING INFORMATION FOR ITEM 11, and sign in the space provided. Please note that once filed, this form constitutes your original certificate of incorporation/formation/registration/authority, and the information contained in the filed form is considered public. Refer to the instructions for delivery/return options, filing fees and [ILLEGIBLE] to remit the appropriate fee amount. Use attachments if more space is required for any field, or if you [ILLEGIBLE] 1. Business Name: PSI Summit Hospital, Inc 2. Type of Business Entity: DP 3. Business Purpose: (See Instructions For Codes, Page 21, Item 2) (See Instructions, Page 22, Item [ILLEGIBLE])
4. Stock (Domestic Corporations Only - Total Shares) 5. Duration (If Indefinite or Perpetual, One Thousand (1,000) Common Shares Leave Blank)
6. State of Formation/Incorporation (Foreign Entities Only): 7. Date of Formation/Incorporation (Foreign Entities only)
8. Contact Information: Registered Agent name: National Registered Agents, Inc. of NJ Registered Office Main Business or Principal Business Address (Must be a New Jersey address with street address) Street 51 Everell Drive, Suite 107B, P.O. Box 927 Street 113 Seaboard Lane, Suite C-100
City West Windsor, NJ Zip 08550-0927 City Franklin State TN Zip 37067
9. Management (Domestic Corporations and Limited Partnership Only) - For-Profit and Professional Corporations list initial Board of Directors, minimum of 1: - Domestic Non-Profit list Board of trustees, minimum of 3; - Limited Partnership list all General Partners
Name Street Address City State Zip Joey A. Jacobs 113 Seaboard Lane, Suite C-100 Franklin TN 37067-2858 Steven T. Davidson 113 Seaboard Lane, Suite C-100 Franklin TN 37067-2858
The signature below certify that the business entity has compiled with all applicable along requirements pursuant to the laws of the State of New Jersey 10. Incorporators (Domestic Corporations Only, minimum of 1)
Name Street Address City State Zip Greg Giffen 315 Deaderick, St. Suite 1800 Nashviie TN 37238-1800
**Signature(s) for the Public Record (See instructions for Information on Signature Requirements) Signature Name Title Date /s/ Greg Giffen Greg Giffen Incorporator March 30,2004