Free $25.00 - Alaska

State of Alaska Department of Commerce, Community and Economic Development Division of Corporations, Business and Professional Licensing CORPORATIONS SECTION Po Box 110808 Juneau, AK 99811-0808

APPLICATION FOR AMENDED CERTIFICATE OF REGISTRATION
For Foreign Limited Liability Company and Limited Partnership
Pursuant to the provisions of the Alaska Statutes, the undersigned applies for an amended certificate of registration to transact business in Alaska. 1. Name of the entity (as it is currently stated on the Certificate of Registration): Alaska Entity #:

2. Amended name of entity (if changing the name of the entity):

3. The assumed name elected to use in Alaska if the legal name is not available:

4. The purpose of the entity other than those set forth in its prior application: Purpose: NAICS Code:

5. Address of the principle office of the entity in the state or country of domicile: Name: Mailing Address: City: State: Zip:

6. Other amendments to the prior registrations are as follows:

The PRINTED name and SIGNATURE by a person who is authorized by the law of the state or other jurisdiction where the company was organized to sign the application: Signed this _______ day of __________________________, 20______. Signature of Authorized Person: Printed Name: Title

If the name of the entity is amended, an original Certificate of Compliance, sometimes referred to as a Certificate of Good Standing or Certificate of Existence, issued by the state of domicile of the entity must be filed with this application. The original certificate must not be older than 60 days. A certified copy of the articles of amendment from the state of domicile must be attached to the Application for Amended Certificate of Registration for any change other than a name change. CONTINUED ON NEXT PAGE
08-456 (Rev. 04/14/09)

If you have specific legal questions or concerns about this filing, you are strongly advised to consult an attorney or other professional to assist you. Mail the Application for Amended Certificate of Registration and the $25.00 filing fee (in U.S. dollars) to: State of Alaska Corporations Section PO Box 110808 Juneau, AK 99811 For additional information or forms please visit our website at: www. corporations.alaska.gov

08-456 (Rev. 04/14/09)