COVER LETTER
TO: Amendment Section Division of Corporations
SUBJECT:
Name of Corporation
DOCUMENT NUMBER: The enclosed Affidavit by Foreign Corporation to Change/Add Officer(s) and/or Director(s) and fee are submitted for filing. Please return all correspondence concerning this matter to the following:
Name of Contact Person
Firm/Company
Address
City/State and Zip Code
E-mail address: (to be used for future annual report notification)
For further information concerning this matter, please call: at (
Name of Contact Person
)
Area Code & Daytime Telephone Number
Enclosed is a check made payable to the Florida Department of State for the following amount:
$35.00 Filing Fee $43.75 Filing Fee & Certificate of Status $43.75 Filing Fee & Certified Copy (Additional copy is enclosed) $52.50 Filing Fee, Certificate of Status & Certified Copy (Additional copy is enclosed)
Mailing Address: Amendment Section Division of Corporations P.O. Box 6327 Tallahassee, FL 32314
Street Address: Amendment Section Division of Corporations Clifton Building 2661 Executive Center Circle Tallahassee, FL 32301
CR2E127 (8/08)
FLORIDA DEPARTMENT OF STATE DIVISION OF CORPORATIONS
AFFIDAVIT BY FOREIGN CORPORATION TO CHANGE/ADD OFFICER(S) AND/OR DIRECTOR(S)
(Note: Applicable only during the first calendar year of qualification) 1. The name of the foreign corporation as it appears on the records of the Florida Department of State is:
2. This entity was authorized to transact business in Florida on number is 3. This corporation was formed under the laws of 4. The name and address of each officer and/or director is as follows: Title: Name and Address
and its Florida document
(Attach additional pages if necessary)
Signature of an officer or director Typed or printed name of person signing
Title of person signing FILING FEE $35 Make checks payable to Florida Department of State and Mail to: Division of Corporations PO Box 6327 Tallahassee, FL 32314
CR2E127 (8/08)