Instructions for completing Form CD 1 1 0 (Articles of Amendment) Important Please Read . A nonprofit name is changed by filing an amendment to the articles of incorporation . Form CD 1 1 0 may be u sed for this specific purpose. Use of this form is optional. Articles of amendment may also be drafted pursuant O.C.G.A. 247 14 - 3 - 100 5 . F orm CD 1 1 0 is not intended to re place competent legal counsel. Secretary of State staff is not authorized to provide legal counsel or explain the steps necessary to successfully change a name or to complete this form. F ilers are strongly urged to seek competent legal counsel in this matter. Article One Name of the corporation Provide the current name of the nonprofit corporation . Control number Provide the control number of the corporation. Article Two State the amendment Provide the proposed name of the corporation. Article Three Method of adoption O.C.G.A. 247 14 - 3 - 1002 through 14 - 3 - 100 5 requires specific disclosures about the details of the approval of the amendment. Choose only one of the methods identified on the form. Article Four Date of adoption Provide actual date the amendment was approved by one of the methods identified in article three. Article Fiv e Certification of publication Filer must provide a written statement, which may appear in the articles of amendment, certifying that notice of change of corporate name along with payment thereof has been or will be forward to the official organ of the county where the registered office is located. Filer may satisfy the statutory requirement for publication certification by signing this form. Do not forward the publication notice to the Secretary of State. Article Six Effective date/time Check the appropriate statement regarding the effective date and time of the articles of amendment. If the articles of amendment are to be effective on the date of filing, check the first statement. If the articles of amendment are to become effective later than the date of filing, check the second statement and enter the effective date and time in the space provided. Please be advised that the delayed effective date may not be later than 90 days afte r the filing date of the articles of amendment . Signature The form is properly executed w hen signed and dated by filer. Filer must indicate the capacity in which signing (i.e. chairperson of board of directors , officer , attorney in fact, etc.). Print the name of the signer. The entire form must be completed. Please mail or deliver the completed form along with a Corporations Division, 2 Martin Luther King Jr. Dr. SE, Suite 313 West Tower, Atlanta, Georgia 30334 . American LegalNet, Inc. www.FormsWorkFlow.com Secretary of State OFFICE OF SECRETARY OF STATE CORPOR A TIONS DIVISION 2 Martin Luther King Jr. Dr. SE Suite 313 West Tower Atlanta, Georgia 30334 (404) 656 - 2817 sos.georgia.gov/corporations Articles of Amendment o f Articles of Incorporation Article One The name of the nonprofit c is : . The control number is: . Article Two The c orporation hereby adopts the following amendment to change the name of the c orporation. The new name of the c orporation is: . Article Three The amendment was duly adopted b y the following method (choose one statement only) : The amendment was adopted by the incorporators pursuant to O.C.G.A. 247 14 - 3 - 1002 . The amendment was adopted by a sufficient vote of the members of the C orporation . The amendment was adopted by the board of directors (choose one additional box below) w ith member approval. w ithout member approval as member approval was not required. Article Four The date of the adoption of the amendment was: . Article Five The undersigned does hereby certify that a request for publication of a notice of the filing of articles of amendment to change the c forwarded to the legal organ of the county of the registered office as required by O.C.G.A. 24714 - 3 - 100 5 .1 . Article Six ( Check, and if applicable complete, one of the following ) The articles of amendment shall be effective upon the filing with the Secretary of State. The articles of amendment shall be effective on: at . (Date) (Time) IN WITNESS WHEREOF , the undersigned has executed these Articles of Amendment on . (Date) Signature Print Name Capacity (choose one option only): Incorporator Officer Attorney I n F act Court - Appointed Fiduciary Chairperson of Board of Directors Email Address: Form CD 110 (Rev. 6/2019) American LegalNet, Inc. www.FormsWorkFlow.com