Free L112 Restated and Amended Certificate of Formation - LLC - New Jersey

L-112 (4/94)

New Jersey Division of Revenue Restated and Amended Certificate of Formation
(For use by a Limited Liability Company)

This form may be used to restate and integrate, AND FURTHER AMEND, the Certificate of Formation of a Limited Liability Company on file with the Department of the Treasury, as supplemented and amended by any instrument that was executed and filed pursuant NJSA 42. 1. Name of Limited Liability Company: 2. Identification Number: (10 digit) 3. New LLC Name: (If applicable) 4. Other Provisions: 5. The Restated Certificate of Formation is amended as follows: (Use attachments if required)

6. Attachments:

The undersigned represent(s) that this filing complies with State law as detailed in NJSA 42 and that they are authorized to sign this form on behalf of the LLC. Signature Name Date

NJ Division of Revenue, PO Box 308, Trenton NJ 08646

Rev 2/15/06

Instructions for Form L-112 RESTATED CERTIFICATE - LIMITED LIABILITY COMPANY RESTATED AND AMENDED (Title 42:2B)
STATUTORY FEE: $100 The MANDATORY fields are: Field # 1 --Business Name List the name as it appears on the records of the State Treasurer. Field #2 -- Identification Number Provide the 10-digit corporation number as issued by the State of New Jersey. Field # 3 & 5 Amendments Use field #3 to state the new name if applicable. Use Field #5 to list any other amendatory language. If the amendment involves a name change, then name availability provisions apply.** **The name must be distinguishable from other names on the State's database. The Division of Revenue will check the proposed name for availability as part of the filing review process. If desired, you can reserve/register a name prior to submitting your filing by obtaining a reservation/registration. For information on name availability and reservation/registration services and fees, visit the Division's WEB site at http://www.state.nj.us/treasury/revenue/certcomm.htm or call (609) 292-9292 MondayFriday, 8:30 a.m. - 4:30 p.m. Field # 4 -- OTHER PROVISIONS (as needed) Specify other information such as the effective date if it is other than the filing date. The effective date cannot be before the filing date nor can it be more than 30 days after the filing date. The filing date is the date the document is received for processing. Field # 6 ­ Attachments (as needed) List discrepancies between existing and restated Certificates. ATTESTATIONS Add a statement that indicates that the signers are authorized to sign on behalf of the LLC. Form L-112 provides the statement. EXECUTION (Signature/Date) An authorized representative must sign. Also, list the date of execution (signature). ********** These documents should be filed in duplicate. Make checks payable to: TREASURER, STATE OF NEW JERSEY. (No cash, please) Mail to: NJ Division of Revenue, PO Box 308, Trenton, NJ 08646 FAX File: 609.984.6851 (Fax Filing is an optional expedited service subject to processing fees that are in addition to those stated above. For FAX Filing information , visit http://www.state.nj.us/treasury/revenue/dcr/programs/ffs.html. )