Application For Amended Certificate Of Authority

Page 1 of 2 Secretary of State Office 500 E Capitol Ave Pierre, SD 57501 (605)773-4845 corpinfo@state.sd.us FILING INSTRUCTIONS: A foreign corporation authorized to transact business in this state must obtain an amended certificate of authority if it changes 1) Its corporate name; 2) The period of its duration; or 3) The state or country of its incorporation, or any information concerning its registered agent. Application must be accompanied by a one page Original Certificate of Existence issued by the Secretary of State or other official having custody of the corporate records in the state or other jurisdiction under whose law it is incorporated. 1.The Name and Business ID of the corporation is: Name (Note: This must be the exact corporate name as registered.) Business ID 2.The amended corporate name is: Note: The name must include the term corporation, incorporated, company, limited or the applicable abbreviation. 3.The name of the state or other jurisdiction under whose laws it is incorporated: 4.The date of its incorporation: 5.The period of its duration: 6.The address of the principal executive office (business address). Actual Street Address City State ZIP+4 Mailing Address, if Different from Street Address City State ZIP+4 Email Address (Optional) The South Dakota Registered Agent222s nameSouth Dakota law permits the registered agent to be either: A) noncommercial registered agent (this may be anindividual), B) a commercial registered agent, or C) an office holder. Complete only one below, either (a) or (b) or (c).The South Dakota Noncommercial Registered Agent222s name Actual Street Address in this State City State ZIP+4 Mailing Address in this State, if Different from Street Address City State ZIP+4 Email APPLICATION FOR AMENDED CERTIFICATE OF AUTHORITY FOREIGN BUSINESS CORPORATION SDCL 47-1A-1504 FILING FEE: $250 ayable to SECRETARY OF STATE American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 2 Foreignamendmentcertificateofauthority (b)When listing a Commercial Registered Agent, please state their CRA#. This number can be obtained from theCommercial Registered Agent. Commercial Registered Agent Name CRA# (c)Title of the office or other position with the corporation Business Office222s Actual Street Address in this State City State ZIP+4 Mailing Address in this State, if Different from Street Address City State ZIP+4 Email Address (Optional) 8.The names and usual business addresses of its principal officers and directors. Place a check mark next to the name ifthe principal officer serves as a director. President Street Address City State ZIP+4 Vice President Street Address City State ZIP+4 Secretary Street Address City State ZIP+4 Treasurer Street Address City State ZIP+4 Director Street Address City State ZIP+4 Director Street Address City State ZIP+4 Director Street Address City State ZIP+4 The application must be signed by an authorized officer of the corporation. No person may execute this report knowing it is false in any material respect. Any violation may be subject to a civil and/or criminal penalty (SDCL 47-1A-129; 22-39-36). Dated Signature of an authorized person Email (Optional) Printed Name Title American LegalNet, Inc. www.FormsWorkFlow.com