This Box For Office Use Only Page 1 of 1 Limited Liability Company See attached detailed instructions Ƒ Filing Fee $30.00 Ƒ Filing Fee with Expedited Service $50.00 UBI Number: AMENDED CERTIFICATE OF FORMATION/REGISTRATION Chapter 25.15 RCW SECTION 1 Name of Limited Liability Company: (as currently recorded with the Office of the Secretary of State) SECTION 2 Amendments to Certificate of Formation: (if necessary, attach additional information) SECTION 3 Effective Date of Amendments to Certificate of Formation: (please check one of the following) Ƒ Upon filing by the Secretary of State Ƒ Specific Date: __________________ (Specified effective date must be within 90 days AFTER the Amended Certificate has been filed by the Office of the Secretary of State) SECTION 4 MEMBER OR MANAGER SIGNATURE (see instructions page) This document is hereby executed under penalties of perjury, and is, to the best of my knowledge, true and correct. X __________________________________________________________________________ Signature Printed Name & Title Date LLC - Amendment Washington Secretary of State Revised 10/08 American LegalNet, Inc. www.FormsWorkflow.com INSTRUCTIONS – AMENDED CERTIFICATE OF FORMATION/REGISTRATION Please complete all sections of the Amended Certificate of Formation/Registration. USE DARK INK ONLY Section 1 Indicate the Limited Liability Company (LLC) name as it currently is recorded with the Office of the Secretary of State. Section 2 Clearly list the changes you are making to the Certificate of Formation/Registration (if necessary, attach additional information). Do not use this form to update members, managers or the principal place of business. Please contact our office for the appropriate form. Section 3 Choose either upon filing by the Secretary of State or you may indicate an effective date. The effective date can be up to 90 days AFTER filing of the amendments to the Certificate of Formation by the Office of the Secretary of State. Section 4 The amendment(s) must be signed by a member or manager of the LLC or their authorized representative. Additional Information: UBI Number: Please enter your existing Unified Business Identifier (UBI Number) as currently recorded with the Office of the Secretary of State, in the shaded box in the upper right hand corner of page 1. FEES: The filing fee for Amended Certificate of Formation/Registration is $30.00 If expedited service is requested, include an additional $20.00 and write “EXPEDITE” on the outside of the envelope. Make the checks or money orders payable to “Secretary of State”. (Expedite fees are non-refundable) Mail completed forms and payment to: Secretary of State Corporation Division 801 Capitol Way S PO Box 40234 Olympia WA 98504-0234 If you have questions or need assistance, please visit the Corporation Division website at www.secstate.wa.gov/corps or call 360-725-0377. LLC - Amendment Washington Secretary of State Revised 10/08 American LegalNet, Inc. www.FormsWorkflow.com