Fillable REQUEST FOR CHANGE OF REGISTRATION INFORMATION STATE OF (The State of New Jersey)

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REQUEST FOR CHANGE OF REGISTRATION INFORMATION STATE OF (The State of New Jersey)

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A. CURRENT INFORMATION (must be completed to process this form)
FEIN ____________________________________________
Name ______________________________________________________________________________________________________________
Address ____________________________________________________________________________________________________________
B. CHANGES TO IDENTIFICATION INFORMATION
FEIN - Reason for change of FEIN ________________________________________
Business Name
Trade Name
Business Location: (Do not use P. O. Box for location address)
Street ___________________________________________________
City ____________________________________ State
Zip Code
Mailing Name and Address:
Name ____________________________________________________
Street ____________________________________________________
City ______________________________________ State
Zip Code -
(Give 9-digit Zip)
STATE OF NEW JERSEY - DIVISION OF REVENUE
REQUEST FOR CHANGE OF REGISTRATION INFORMATION
REG-C-L
(8-05)
Use this form to report any change in filing status, business activity, or to change your identification information such as identification number,
business and/or trade name, business address, mailing address, etc. DO NOT use this form for a change in ownership or an incorporation of a busi-
ness. A NJ-REG must be completed for these changes.
Signature_______________________________________________________ Date________________________________________
Title ___________________________________________________________ Telephone ( ) ___________________________
C. Contact Information: Contact Person: __________________________________________ Title: __________________________________
Daytime Phone: ( ) __________ - _______________ E-mail address: _________________________________________
D. IF SEASONAL, CIRCLE MONTHS BUSINESS WILL BE OPEN:
JAN FEB MAR APR MAY JUN JUL AUG SEPT OCT NOV DEC
E. CHANGES IN OWNERSHIP OR CORPORATE OFFICERS
- Name (Last Name, First, MI)
- Indicate new or resigning officer/owner and effective date of change
- Social Security Number - Home address (Street, City, State, Zip) %
- Title Ownership
F. CHANGES IN FILING STATUS AND BUSINESS ACTIVITY
Proprietorship/Partnership Date Corporate Entities
Business Sold or Discontinued __________________________
Business Incorporated __________________________
Owner Deceased __________________________
Name and Address of New Owner or Survivor of Merger _____________________________________________________________________
Date Ceased Collecting Sales Tax _________________________ Date Ceased Renting Motor Vehicles ___________________
Date Ceased Paying Wages _________________________ Date Ceased Sale of New Tires/Motor Vehicles____________
List any new
State tax for which this business may be eligible: Tax: ____________________________ Effective Date: ___________________
MAIL TO: PO BOX 252
TRENTON, NJ
08646-0252
NO FEE REQUIRED
- 37 -
(Give 9-digit Zip)
-
(Corporations authorized by the NJ State Treasurer must file a corporate name change amendment, pg. 39)
Important: Corporate entities may not use this form to dis-
solve, cancel, withdraw
, merge, or consolidate. Forms and
Instructions for these changes may be obtained online at
www.state.nj.us/njbgs/ or by calling the Division of Revenue
at (609) 292-9292.
STATE OF NEW JERSEY
DIVISION OF REVENUE
BUSINESS ENTITY AMENDMENT FILING
Complete the following information and sign in the space provided. Please note that once filed, the information on this page is considered public.
Refer to the instructions for delivery/return options, filing fees and field-by-field requirements. Remember to remit the appropriate fee amount for this
filing. Use attachments if more space is required for any field, or if you wish to add articles for the public record.
A. Business Name:_________________________________________________________________________________________________________
Business Entity NJ 10-digit ID number: _____ _____ _____ _____ _____ _____ _____ _____ _____ _____
B. Statutory Authority for Amendment: _______________________________________________ (See Instructions for List of Statutory Authorities)
C. ARTICLE __________________ OF THE CERTIFICATE of the above referenced business is amended to read as follows. (If more space is
necessary, use attachment)
D. Other Provisions: (Optional)______________________________________________________________________________________________
E. Date Amendment was Adopted:____________________
F. CERTIFICATION OF CONSENT/VOTING: (If required by one of the following laws cited, certify consent/voting)
N.J.S.A. 14A:9-1 et seq. or N.J.S.A 15A:9-1 et seq., Profit and Non-Profit Corps. Amendment by the Incorporators
Amendment was adopted by unanimous consent of the Incorporators.
N.J.S.A 14A:9-2(4) and 14A:9-4(3), Profit Corps., Amendment by the Shareholders
Amendment was adopted by the Directors and thereafter adopted by the shareholders.
Number of shares outstanding at the time the amendment was adopted __________________, and total number of shares entitled to vote
thereon ______________. If applicable, list the designation and number of each class/series of shares entitled to vote:
List votes for and against amendment, and if applicable, show the vote by designation and number of each class/series of shares entitled to
vote:
Number of Shares Voting for Amendment Number of Shares
Voting Against
Amendment
** If the amendment provides for the exchange, reclassification, or cancellation of issued shares, attach a statement indicating the manner in
which same shall be effected.
N.J.S.A. 15A:9-4, Non-profit Corps., Amendment by Members or Trustees
The corporation has
does not have members.
If the corporation has members, indicate the number entitled to vote _______, and how voting was accomplished:
At a meeting of the corporation. Indicate the number VOTING FOR _____ and VOTING AGAINST _____. If any class(es) of members
may vote as a class, set forth the number of members in each class, the votes for and against by class, and the number present at the meeting:
Class Number of Members Voting for Amendment Voting Against Amendment
Adoption was by unanimous written consent without a meeting.
If the corporation does not have members, indicate the total number of Trustees ___________________, and how voting was accomplished:
At a meeting of the corporation. The number of Trustees VOTING FOR ______________ and VOTING AGAINST ______________.
Adoption was by unanimous written consent without a meeting.
G. AGENT/OFFICE CHANGE
New Registered Agent: ___________________________________________________________________________________________________
Registered Office: ( Must be a NJ street
address)
Street__________________________________________________________________ City _______________________ Zip ________________
H. SIGNATURE(S) FOR THE PUBLIC RECORD (See Instructions for Information on Signature Requirements)
Signature_________________________________________________Title ____________________________________________ Date _____________
Signature_________________________________________________Title ____________________________________________ Date _____________
The above-signed certifies that the business entity has complied with all applicable NJ statutory filing requirements
REG-C-EA
(08-05
)
- 39 -
Mail to: PO Box 308
Trenton, NJ 08646
FEE REQUIRED
INSTRUCTIONS
BUSINESS CHANGE AND AMENDMENT FORM (REG-C-L and REG-C-EA)
I. GENERAL INSTRUCTIONS
A. Use the appropriate form for filing:
1. Sole Pr
oprietorships and Partnerships should use Form REG-C-L, Sections A - F to report changes in
tax/wage registration, and mail changes to the Division of Revenue, Client Registration Bureau, PO Box
252, Trenton, NJ 08646-0252.
2. Business Entities
- i.e. Foreign or domestic corporations, limited partnerships, limited liability companies
and limited liability partnerships, should use Form REG-C-L, Section A -F (page 37) to report changes in
address, seasonal business cycles or tax/wage collection status only
. Amendments to articles recorded
in the original certificate of the business entity, including name changes, must be reported on page 39
(REG-C-EA). Business entities may submit Changes/Amendments through one of the service options
listed in these instructions (page 21) along with the correct FEE amount for filing an amendment. (See
FEE Schedule below.)
NJ authorized corporations may not use the Business Change/Amendment Form to DISSOLVE, CANCEL,
WITHDRAW, MERGE OR CONSOLIDATE. Contact the Division of Revenue at (609) 292-9292 to obtain
forms and instructions for these transactions. These forms may also be downloaded from the New Jersey
Business Gateway Service at www.state.nj.us/njbgs/.
REMEMBER TO TYPE OR MACHINE PRINT ALL AMENDMENT FILING SUBMISSIONS.
B. For Delivery/Return Options for Amended Business Filings, please see page 21, items 2a-2c.
C. Fee Schedule for Business Entity Amendment Filings
1. Basic Filing Fees
a. Filing fees for all corporate and limited partnership amendments is $75 per filing.
b. Filing fee for all limited liability company and limited liability partnership amendments is $100 per
filing.
c. Filing fee for corporate and limited partnership agent changes is $25 per filing.
d. Filing fee for limited liability company and limited liability partnership agent changes is $25 per filing.
2. Service Fees and Other Optional Fees (All added to basic fees above if selected, see page 21 Items
2a-2c for service options)
a. Expedited service per filing request for corporations, non-profits and LP transactions is $15.00.
Expedited service per filing for LLC and LLP transactions (8.5 business hour turnaround for over-the-
counter and FAX requests) is $25.00.
b. Same day service for FAX requests only, fee is $50.00 per filing.
c. Fax page transmission, fee is $1 per page for all filings that are FAXED back through the FAX filing
service.
d. Certified copy fee for accepted filings is $25 per copy.
- 35 -
II. LINE BY LINE REQUIREMENTS FOR BUSINESS AMENDMENT FILING (REG-C-EA)
A. Business Name and NJ 10-digit ID number - List the Business Entity name as currently reflected on the State’s
public records system and the NJ 10-digit ID number.
B. Statutory Authority for Amendment - In accordance with the following table, state the statutory authority for
the amendment. Business entities seeking only to change registered office/agent may leave this blank.
Statutory Authority (NJSA
Business Entity Type Amendment By:Title) to Enter in Field B
Domestic Profit Corps. Incorporators 14A:9-1 et seq.
Domestic Non-Profit Corps. 15A:9-1 et seq.
Domestic Profit Corps. Shareholders 14A:9-2(4) & 14A:9-4(3)
Domestic Non-Profit Corps. Members or Trustees 15A:9-4
Foreign Profit Corp s. The Business Entity 14A:13-6
Foreign Non-Profit Corps. 15A:13-6
All Limited Liability Comp anies The Business Entity 42:2B
All Limited Partnership s The Business Entity 42:2A
All Limited Liability Partnership s The Business Entity 42
C-E. Amendment Details - List the Article being amended and the type of certificate being amended. Recite the details
of the amendment, including a new name change if applicable. Provide other provisions and an adoption date. The
“Other Provisions” field may not be used to indicate the adoption of an Alternate name. Form C-150G is used for
Alternate name registration.
If you are changing the corporate name, provide a designator that indicates the type of business entity--for
example: Inc, Corp., Corporation, Ltd., Co., or Company for a corporation; Limited Liability Company or L.L.C.
for a Limited Liability Company; Limited Partnership or L.P. for a Limited Partnership, Limited Liability
Partnership or L.L.P. for Limited Liability Partnership.
The Division of Revenue will add an appropriate designator if none is provided.
** Remember that the name must be distinguishable from other names on the State’s data base. The Division of
Revenue will check the proposed name for availability as part of the filing process. If desired, you can
reserve/register a name prior to submitting your filing. To obtain information about reservation/registration
services and fees, visit the Division's Web site at www.state.nj.us/njbgs/ or call (609) 292-9292 Monday-
Friday, 8:30 a.m. - 4:30 p.m.
F. Certification of Consent/Voting - If applicable, pursuant to the statutes listed, provide the requested information
on consent/voting relative to the proposed amendment. MARK THE METHOD of consent or voting employed
to adopt the amendment, and where applicable, provide the requested details associated with the chosen method.
G. Change of Agent/Office - If you are changing the registered agent or office or both, provide the following
information as applicable:
1. New Registered Agent - Enter one agent only - the agent may be an individual or a corporation duly registered
and in good standing with the State Treasurer; and/or
2. New Registered Office - Provide a New Jersey street address. A Post Office Box may be used only if the street
address is listed as well.
H. Signatures for the Public Record - If a corporate amendment is being filed by the incorporators, then the
incorporators and only the incorporators may sign. For all other corporate amendments, the Chairman of the
Board, president or vice-president must sign. For Limited partnerships, at least one general partner must sign. For
all other entities, an authorized partner or representative must sign.
- 36 -
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REQUEST FOR CHANGE OF REGISTRATION INFORMATION STATE OF (The State of New Jersey)

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Completed 8 December 2020

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