Fillable CERTIFICATE OF CHANGE OF (New York State)

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CERTIFICATE OF CHANGE OF (New York State)

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The CERTIFICATE OF CHANGE OF (New York State) form is 3 pages long and contains:

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File type: PDF

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New York State
Department of State
DIVISION OF CORPORATIONS,
STATE RECORDS AND
UNIFORM COMMERCIAL CODE
One Commerce Plaza
99 Washington Ave.
Albany, NY 12231-0001
www.dos.ny.gov
CERTIFICATE OF CHANGE
OF
(Insert Name of Foreign Limited Liability Company)
Under Section 804-A of the Limited Liability Company Law
FIRST: The name of the foreign limited liability company is:
.
If applicable, the fictitious name the foreign limited liability company has agreed to use in this state is:
.
SECOND: The application for authority was filed with the Department of State on:
.
THIRD: The change(s) effected hereby are: (Check appropriate statement(s))
The county location, within this state, in which the office of the foreign 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
foreign limited liability company is changed to read in its entirety as follows:
.
The foreign limited liability company hereby: (
check one)
Designates
as its registered agent upon whom process against the foreign limited liability company may be
served. The street address of the registered agent is:
.
DOS-1362-f (Rev. 03/17) Page 1 of 3
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-1362-f (Rev. 03/17)
Capacity of signer (Check appropriate box):
Member
Manager
Authorized Person
Page 2 of 3
CERTIFICATE OF CHANGE
OF
(Insert Name of Foreign Limited Liability Company)
Under Section 804-A of the Limited Liability Company Law
Filer’s Name and Mailing Address:
Name:
Company, if Applicable:
Mailing Address:
City, State and Zip Code:
NOTES:
1. The name of the foreign limited liability company and the date of filing of the application for authority must exactly match the
records of the Department of State. This information should be verified on the Department of State’s website at
www.dos.ny.gov.
2. This form was prepared by the New York State Department of State for filing a certificate of change by a foreign 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.
3. The Department of State recommends that legal documents be prepared under the guidance of an attorney.
4. The certificate must be submitted with a $30 filing fee made payable to the Department of State.
(For office use only)
DOS-1362-f (Rev. 03/17)
Page 3 of 3
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CERTIFICATE OF CHANGE OF (New York State)

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Completed 8 June 2022

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