DSCB:15-413–Instructions
Pennsylvania Department of State
Bureau of Corporations and Charitable Organizations
P.O. Box 8722
Harrisburg, PA 17105-8722
(717) 787-1057
Website: www.dos.pa.gov/corps
General Information
Typewritten is preferred. If handwritten, the form must be
legible and completed in black or blue-black ink in order to
permit reproduction.
The nonrefundable filing fee for this form is $250. Checks
should be made payable to the Department of State. Checks
must contain a commercially pre-printed name and address.
This form and all accompanying documents shall be mailed to
the address stated above.
Who should file this form?
A foreign association that is registered to do business in this
Commonwealth must deliver to the Department for filing an
amendment to its foreign registration statement if there is a
change in any of the following:
(1) The name of the association.
(2) The type of association, including, if it is a foreign
limited partnership, whether the association became or ceased
to be a foreign limited liability limited partnership.
(3) The association’s jurisdiction of formation.
(4) An address required by section 412(a)(4) (relating to
foreign registration statement).
(5) Its registered office.
(6) The authority of the association to have one or more
series.
Applicable Law
For foreign associations, in general, 15 Pa.C.S. §§ 102; 401-
419; for amendment, 15 Pa.C.S. § 413; for names, 15 Pa.C.S.
§ 414 and §§ 201-209. Statutes are available on the
Pennsylvania General Assembly website,
www.legis.state.pa.us
, by following the link for Statutes.
Attachments
The following, in addition to the filing fee, shall accompany
this form:
(1) One copy of a completed form DSCB: 15-134B
(Docketing Statement - Changes).
(2) Any necessary copies of form DSCB: 19-17.2 (Consent
to Appropriation of Name). If Consent cannot be obtained, the
association may adopt, for the purpose of doing business in
this Commonwealth, an alternate name that complies with 15
Pa.C.S. § 414 and §§ 201-209.
(3) Any necessary governmental approvals.
Form Instructions
Enter the name and mailing address to which any
correspondence regarding this filing should be sent. This field
must be completed for the Bureau to return the filing. If the
filing is to be returned by email, an email address must be
provided. An email will be sent to address provided,
containing a link and instructions on how a copy of the filed
document or correspondence may be downloaded. Any email
or mailing addresses provided on this form will become part
of the filed document and therefore public record.
1. Give the exact name of the association as registered to do
business in Pennsylvania and as on file with the Department of
State. If a foreign association has adopted an alternate name in
order to register to do business in Pennsylvania, the registered
foreign association must use the alternate name in response to
a requirement that a document delivered to the Department for
filing state the name of the association. This field is required.
2. Select the type of association. Only one option may be
selected. This field is required.
3. Give one of the following: the current registered office
address in the Commonwealth in (a) or the name of a
Commercial Registered Office Provider (b) and the county of
venue, as on file with the Department of State at the time the
amendment is submitted for filing.
Post office boxes are not acceptable for any address. Under 15
Pa.C.S. § 135(c) (relating to addresses), an actual street or
rural route box number must be used as an address, and the
Department of State is required to refuse to receive or file any
document that sets forth only a post office box address.
This field is required.
4. Any date specified as the effective date of the Amendment
of Foreign Registration must be a future effective date (after
the date and time of its delivery to the Department). A
specified effective date may not be retroactive (prior to the
date and time of the delivery of the Amendment of Foreign
Registration to the Department). If a delayed effective date is
specified, but no time is given, then the time used will be
12:01 a.m. on the date specified. If neither option for an
effective date is checked, it will be presumed that no specified
delayed effective date is intended and the document will be
effective upon filing. This field is required.
5. Supply the change(s) to the information previously supplied
in the association’s Foreign Registration Statement
(DSCB:15-412). If the amendment reflects a change in name
for the association which does not comply with 15 Pa.C.S. §
414 and 15 Pa.C.S. §§ 201-209, the foreign association must
have consent to use the name or adopt an alternate name that
complies 15 Pa.C.S. §§ 201-209 for use in Pennsylvania.
This field is required.
Signature and Verification
An authorized representative of the foreign association must
sign the Amendment of Foreign Registration. Signing a
document delivered to the Department for filing is an
affirmation under the penalties provided in 18 Pa.C.S. § 4904
(relating to unsworn falsification to authorities) that the facts
stated in the document are true in all material respects.
This field is required.
