Secretary of State Business Programs Division Business Entities, 1500 11th Street, 3rd Floor, Sacramento, CA 95814 Amended Statement and Designation by Foreign Associations To change any of the information contained within the Statement and Designation by Foreign Association form, the qualified foreign (out-of-state or out-of-country) association must file the enclosed Amended Statement and Designation by Foreign Association form with the California Secretary of State. (California Corporations Code section 2107(b).) If amending to change the name of the foreign association or an assumed named pursuant to California Corporations Code section 2106, upon the filing of the Amended Statement and Designation by Foreign Association form a new Certificate of Qualification will be issued to the association by the California Secretary of State. Note: The new Certificate of Qualification is issued only at the time of filing the Amended Statement and Designation by Foreign Association form and will not be reissued if lost or misplaced. Additional Requirement If amending to change the name of the foreign association, an officers' certificate, or if the foreign association has no officers, a trustees' certificate, stating the change of name of the association was made in accordance with its declaration of trust must be attached to the Amended Statement and Designation by Foreign Association form at the time of filing. A form for this purpose is included with the enclosed Amended Statement and Designation by Foreign Association form. Where to File The Amended Statement and Designation by Foreign Association can be mailed to Secretary of State, Document Filing Support Unit, 1500 11th Street, 3rd Floor, Sacramento, CA 95814 or delivered in person (drop off) to the Sacramento office between the hours of 8:00 a.m. and 4:30 p.m., Monday through Friday (excluding holidays). Amended Statement and Designation by Foreign Association forms are filed only in the Sacramento office. To facilitate the processing of documents mailed to the California Secretary of State, a letter referencing the association's name, a return address and the name and telephone number of the person submitting the document also should be submitted. Go to www.sos.ca.gov/business-programs/business-entities/processing-times to get the current processing times and determine which method of submission meets your needs. Fees The fee for filing an Amended Statement and Designation by Foreign Association is $30.00. In addition to the filing fee, there is a non-refundable $15.00 special handling fee for processing documents delivered in person (drop off) at the Sacramento office. The preclearance and/or expedited filing of a document within a guaranteed time frame can be requested for an additional non-refundable fee in lieu of the special handling fee. For detailed information about preclearance and expedited filing services, go to www.sos.ca.gov/business-programs/business-entities/service-options. The special handling fee or preclearance and expedited filing services are not applicable to documents submitted by mail. Check(s) should be made payable to the Secretary of State. Copies Upon filing, we will return one (1) uncertified copy of your filed document for free, and will certify the copy upon request and payment of a $5.00 certification fee. To get additional copies, include a separate request and payment for copy fees when the document is submitted. Copy fees are $1.00 for the first page and $.50 for each additional page. For certified copies, there is an additional $5.00 certification fee, per copy. ASDA-Information (Rev. 12/2014) Page 1 of 1 California Secretary of State www.sos.ca.gov/business/be (916) 657-5448 American LegalNet, Inc. www.FormsWorkFlow.com Amended Statement and Designation by Foreign Association Instructions: To change any of the information contained within the Statement and Designation by Foreign Association form, the qualified foreign association must file the enclosed Amended Statement and Designation by Foreign Association form with the California Secretary of State. (California Corporations Code section 2107(b).) The document should be typed with letters in dark contrast to the paper. Documents not suitable for reproduction will be returned unfiled. Note: The file date of the Statement and Designation by Foreign Association form is generally the date the document complying with applicable law is received in the California Secretary of State's office. Additional Requirements: If amending to change the name of the foreign association, an officers' certificate, or if the foreign association has no officers, a trustees' certificate stating the change of name of the association was made in accordance with its declaration of trust must be attached to the Amended Statement and Designation by Foreign Association form at the time of filing. The officers' certificate must be signed by the Chairman of the Board, President or any Vice-President and by the Secretary, Chief Financial Officer, Treasurer, assistant Secretary or Assistant Treasurer. The trustees' certificate must be signed by two of the trustees or, if there is only a single trustee, by the single trustee. Complete the Amended Statement and Designation by Foreign Association form as follows: Entity Name: Enter the name of the foreign association exactly as it is of record with the California Secretary of State, or if the name has changed, enter the new name. If the name of the foreign association has changed to a name that is not available for use in the State of California, the association must qualify under an assumed name (i.e., a name other than the true association name) as required by California Corporations Code section 2106(b). If an assumed name is required, complete the first line of the form with true association name, followed by the words ." "which will do business in California as [state the assumed name] Name requirements and restrictions apply to most business entities. For business entity name regulations and the most common name requirements and restrictions relating to the use or adoption of a business entity name in the State of California, go to www.sos.ca.gov/business-programs/business-entities/name-availability. Enter the jurisdiction (state or place of organization) of the foreign association. Jurisdiction: (Items 1 through 7: Complete ONLY the items that have been changed) Item 1: If the name of the foreign association has change