Non-Refundable Processing Fee: $37.00
Pursuant to UCA § 48-3a-202, the individual named below causes this Amendment to the Certificate of
Organization to be delivered to the Utah Division of Corporations for filing, and states as follows:
Entity Number: ___________________
The name of the limited liability company is: ______________________________________________________
The Certificate of Organization shall be amended as set forth herein (complete all that apply):
There is a change in the name of the limited liability company to:
______________________________________________________________________________________
The Certificate of Organization is amended as follows:
Filing date of initial certificate ____________________________________
Future effective date (if not to be effective upon filing) __________________ (00''<<<<not to exceed 90 days)
Under penalties of perjury, I declare that this Amendment of Certificate of Organization has been
examined by me and is, to the best of my knowledge and belief, true, correct and complete.
Name: ____________________________________ Signed: _______________________________
Title: _____________________________________ Dated: ________________________________
Under GRAMA {63G-2-201}, all registration informa
tion maintained by the Division is classified as public record. For confidentiality purposes, you
may use the business entity physical address rather than the residential or private address of any individual affiliated with the entity.
State of Utah
Department of Commerce
Division of Corporations & Commercial Code
Amendment to Certificate of Organization
This form must be type written or computer generated.
Sign here after the form is printed
Mailing/Faxing Information:
www.corporations.utah.gov/contactus.html
www.corporations.utah.gov
