Free corp. 43 - Missouri

JAMES C. KIRKPATRICK STATE INFORMATION CENTER (573) 751-4936

ROBIN CARNAHAN
SECRETARY OF STATE STATE OF MISSOURI

CORPORATIONS (573) 751-4153

INSTRUCTIONS FOR APPLICATION FOR AMENDED CERTIFICATE OF AUTHORITY TO DO BUSINESS IN MISSOURI

If you are qualified under the GENERAL AND BUSINESS CORPORATION LAW of Missouri (Chapter 351, RSMo): 1. You need only amend in Missouri if the name is changed, the duration is changed, or you have changed your state of incorporation. 2. Forms must be accompanied by a one page "Certificate of Fact" from the parent state evidencing the date of amendment and filing, and the present good standing status of the corporation. We do not need copies of the amendment. 3. The forms must be signed. 4. Fee for filing the Amended Application for Certificate of Authority is $25.00. 5. Check should be made payable to the Director of Revenue and sent with the necessary documents to the Secretary of State, Corporations Division, PO Box 778, Jefferson City, MO 65102. If you have any questions, please contact us toll-free at (866) 223-6535 or at (573) 751-4153. Very truly yours, Robin Carnahan Secretary of State

Ltr. 7 (07/09)

PO BOX 778 · JEFFERSON CITY, MISSOURI · 65102 www.sos.mo.gov

State of Missouri
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This form is designed to be filled out online for your convenience. Please read the instructions carefully. Complete the necessary information, print, sign and mail.

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Robin Carnahan, Secretary of State
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The below corporation, relating to amending its certificate of authority of Foreign Corporation, does hereby state: 1. The corporation's name is and is incorporated in the State of was qualified in the State of Missouri on
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2. By appropriate corporate action on
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1. Changed its corporate name to: Name it will use in Missouri if new name not available: 2. Changed its period of duration to: 3. Changed the state or country of its incorporation to: 3. There is attached hereto a Certificate of the Secretary of State or other state authority of the State of relating to the amendment(s), set forth in item 2 above and showing that the Corporation is in existence and in good standing in said State. (Certificate must be less than 60 days old.) 4. The effective date of this document is the date it is filed by the Secretary of State of Missouri unless a future date is otherwise indicated:
(Date may not be more than 90 days after the filing date in this office)

In Affirmation thereof, the facts stated above are true and correct: (The undersigned understands that false statements made in this filing are subject to the penalties provided under Section 575.040, RSMo)

Authorized Signature

Attached is an original current certificate attesting to the change, duly authenticated by the secretary of state or other official having custody of corporate records in the state or country of incorporation.

Name and address to return filed document: Name: Address: City, State, and Zip Code:
Corp. 43 (11/2008)

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Corporations Division PO Box 778 / 600 W. Main St., Rm. 322 Jefferson City, MO 65102

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Application for an Amended Certificate of Authority for a Foreign Corporation
(Submit with filing fee of $25.00)

Missouri Charter #: ; and it . , the corporation

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