Application For An Amended Certificate Of Authority To Transact Business In Virginia {SCC760-922}

COMMONWEALTH OF VIRGINIA SCC760/922 STATE CORPORATION COMMISSION (07/05) APPLICATION FOR AN AMENDED CERTIFICATE OF AUTHORITY TO TRANSACT BUSINESS IN VIRGINIA This application of a foreign corporation authorized to transact business in Virginia for an amended certificate of authority sets forth: The former name of the corporation was ____________________________ __________ ________________________________________________________________________ _. The present name of the corporation is _______________________________________ ________________________________________________________________________ _. If the corporation is a stock corporation and the present name of the corporation does not contain the word "corporation," "company," "incorporated" or "limited," or an abbreviation of one of such words, or if the corporations present name is not available for use in Virginia, the name of the corporation with the word or abbreviation which it has elected to add thereto for use in Virginia, or the name designated by the corporation for use in Virginia, is ________________________________________________________________________ _. The name of the state or country under whose law the corporation is presently incorporated is _________________________________. The name of the state or country under whose law the corporation was formerly incorporated (if changed by the enclosed amendment, merger or domestication) is ___ __________________. Executed in the name of the corporation by: __________________________________________ _________________________ (signature) (date) __________________________________________ _________________________ (printed name) (corporate title) __________________________________________ _________________________ (corporations SCC ID no.) (telephone number (optional))(The execution must be by the chairman or any vice-chairman of the board of directors, the president, or any other of its officers authorized to act on behalf of the corporation.) See instructions on the reverse. American LegalNet, Inc. www.USCourtForms.com<<<<<<<<<********>>>>>>>>>>>>> 2 NOTE A foreign corporation that files an amendment, merger or domestication in the jurisdiction of its incorporation must file a copy of same with the Clerk of the State Corporation Commission within 30 days of the documents effective date. The amendment, merger or domestication must be duly certified or otherwise authenticated by the Secretary of State or other official h aving custody of the corporate records in the state or country under whose law it is incorporated. If an amendment, merger or domestication changes the name of the corporation or the state or country of incorporation (redomestication), an authenticated copy of that document must accompany this form. If an amendment, merger or domestication increases the number of authorized shares, an additional entrance fee may be due. Contact the Clerks Office for a fee quote. See 13 .1-760 and 13.1-766.1 of the Code of Virginia for stock corporations and 13.1-922 and 13.1-928.1 of the Code of Virginia for nonstock corporations. INSTRUCTIONS The application must be in the English language, typewritten or printed in black, legible and reproducible. The document must be presented on uniformly white, opaque paper, free of visible watermarks and background logos. You can download this form from our website at www.scc.virginia.gov/division/clk/fee_bus.htm. The application must be signed in the present name of the corporation by the chairman or any vice- chairman of the board of directors, the president, or any other of its officers authorized to act on behalf of the corporation. A copy of the amendment, merger or domestication changing the corporate name or the state of incorporation (redomestication), duly authenticated on a recent date by the Secretary of State or other official having custody of corporate records in the state or country und er whose law the corporation is incorporated, must be submitted with the application. The Commission cannot file or issue with respect to any corporation any document or certificate referred to in the Virginia Stock Corporation Act and Virginia Nonstock Corporation Act until all fees, fines, penalties and interest assessed, imposed, charged or to be collected by the Commission under the Acts have been paid by or on behalf of such corporation. See 13.1- 615 B of the Code of Virginia for stock corporations and 13.1-815 B of the Code for nonstock corporations. It is a Class 1 misdemeanor for any person to sign a document he or she knows is false in any material respect with intent that the document be delivered to the Commi ssion for filing. Submit the original, signed application and the authenticated copy of the amendment, merger or domestication to the Clerk of the State Corporation Commission, P.O. Box 1197, Richmond, Virginia st 23218-1197, (Street address: 1300 East Main Street, Tyler Building, 1 Floor, Richmond, Virginia23219), along with a check for the filing fee(s) specified below, pay able to the State Corporation Commission. PLEASE DO NOT SEND CASH . If you have any questions, please call (804) 371-9733 or toll-free in Virginia, 1-866-722-2551. Filing fee: $25.00 ( 13.1-616, Code of Virginia). Additional entrance fee: If the the number of authorized shares of stock of the corporation have increased, payment of an additional entrance fee may be required. See 13.1-615.1 B of the Code of Virginia. Send payment of both fees in one check made payable to STATE CORPORATION COMMISSION. American LegalNet, Inc. www.USCourtForms.com