Amendment To A Joint Powers Agreement
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Amendment To A Joint Powers Agreement Form. This is a California form and can be use in Special Filings Secretary Of State.
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Tags: Amendment To A Joint Powers Agreement, NP SF 404B, California Secretary Of State, Special Filings
FILE NO._____________________________
State of California
Secretary of State
AMENDMENT OF A JOINT POWERS AGREEMENT
(Government Code section 6503.5)
Instructions:
1.
Complete and mail to: Secretary of State, P.O. Box 942877,
Sacramento, CA 94277-0001.
2.
Include filing fee of $1.00.
3.
Do not include attachments.
4.
A copy of the full text of the joint powers agreement and amendments, if any, must be submitted to the State
Controller’s office. For address information, contact the State Controller’s office at www.sco.ca.gov.
(Office Use Only)
Date of filing initial notice with the Secretary of State:_____________________________________________________
File number of initial notice: ________________________________________________________________________
Name of the agency or entity created under the agreement and responsible for the administration of the agreement:
Agency’s or Entity’s Mailing Address:
Title of the agreement:
Complete one or more boxes below. The agreement has been amended to:
[
] Change the parties to the agreement as follows:
[
] Change the name of the administering agency or entity as follows:
[
] Change the purpose of the agreement or the powers to be exercised as follows:
[
] Change the short title of the agreement as follows:
[
] Make other changes to the agreement as follows:
_________________________________________
Date
RETURN ACKNOWLEDGMENT TO: (Type or Print)
NAME
_________________________________________
Signature
ADDRESS
CITY/STATE/ZIP
_________________________________________________
Typed Name and Title
SEC/STATE NP/SF 404B (REV. 10/2010)
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