Free Fillable Certificate of Change Form - New York

New York State Department of State Division of Corporations, State Records and Uniform Commercial Code One Commerce Plaza, 99 Washington Avenue Albany, NY 12231 www.dos.state.ny.us

CERTIFICATE OF CHANGE OF
(Insert Name of Domestic Limited Liability Company)

Under Section 211-A of the Limited Liability Company Law

FIRST: The name of the limited liability company is:

If the name of the limited liability company has been changed, the name under which it was organized is:

SECOND: The date of filing of the articles of organization is: THIRD: The change(s) effected hereby are: [Check appropriate statement(s)]
The county location, within this state, in which the office of the limited liability company is located, is changed to: The address to which the Secretary of State shall forward copies of process accepted on behalf of the limited liability company is changed to read in its entirety as follows:

The limited liability company hereby: [check one] Designates as its registered agent upon whom process against the limited liability company may be served. The street address of the registered agent is: Changes the designation of its registered agent to: The street address of the registered agent is: Changes the address of its registered agent to: Revokes the authority of its registered agent. .

X

(Signature) (Type or print name)

DOS-1359 (Rev. 5/08)

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(Title of signer)

CERTIFICATE OF CHANGE OF
(Insert Name of Domestic Limited Liability Company)

Under Section 211-A of the Limited Liability Company Law

Filed by:

(Name)

(Mailing address)

(City, State and ZIP code)

NOTE: This form was prepared by the New York State Department of State for filing a certificate of change by a domestic limited liability company. You are not required to use this form. You may draft your own form or use forms available at legal supply stores. The Department of State recommends that legal documents be prepared under the guidance of an attorney. The certificate must be submitted with a $30 filing fee made payable to the Department of State.
(For office use only)

DOS-1359 (Rev. 5/08)

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