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Certificate Of Amendment Form. This is a Massachusetts form and can be use in Corporations Division Secretary Of State.
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Tags: Certificate Of Amendment, Massachusetts Secretary Of State, Corporations Division
F
FPC
The Commonwealth of Massachusetts
William Francis Galvin
Secretary of the Commonwealth
One Ashburton Place, Boston, Massachusetts 02108-1512
FORM MUST BE TYPED
Certificate of Amendment
FORM MUST BE TYPED
(General Laws Chapter 156D, Section 15.04; 950 CMR 113.49)
(1) Exact name of corporation:_ ___________________________________________________________________________
(as contained in the Division’s records)
(2) Registered office address: ______________________________________________________________________________
(number, street, city or town, state, zip code)
(3) This amendment shall change:
(check appropriate box(es))
® the corporation’s name to *:________________________________________________________________________
® the period of the corporation’s duration to:_ ___________________________________________________________
® the state or country of its incorporation to*:_ __________________________________________________________
® the street address of its principal office to:_ ____________________________________________________________
® the fiscal year end to:_____________________________________________________________________________
® the activities conducted by the foreign corporation in the commonwealth:_ ___________________________________
_ ____________________________________________________________________________________________
® its officers and directors:__________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
® other_ ________________________________________________________________________________________
The name must satisfy the requirements of G.L. Chapter 156D, Section 15.06.
* If the amendment includes a change of its corporate name, or the state or country of its incorporation, attach a certificate evidencing the
changes duly authenticated by the secretary of state or other official having custody of the corporate records in the state or country under
whose law it is incorporated. If the certificate is in a foreign language, a translation thereof under oath of the translator shall be attached.
P.C.
c156ds1504950c11349 01/13/05
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This certificate is effective at the time and on the date approved by the Division, unless a later effective date not more than 90 days
from the date of filing is specified:_ _________________________________________________________________________
Signed by:_ ___________________________________________________________________________________________ ,
(signature of authorized individual)
® Chairman of the board of directors,
® President,
® Other officer,
® Court-appointed fiduciary,
on this__________________________ day of_________________________________________ , ______________________ .
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COMMONWEALTH OF MASSACHUSETTS
William Francis Galvin
Secretary of the Commonwealth
One Ashburton Place, Boston, Massachusetts 02108-1512
Certificate of Amendment
(General Laws Chapter 156D, Section 15.04; 950 CMR 113.49)
I hereby certify that upon examination of this foreign certificate of amendment, duly
submitted to me, it appears that the provisions of the General Laws relative thereto have
been complied with, and I hereby approve said certificate; and the filing fee in the amount
of $______ having been paid, said certificate is deemed to have been filed with me this
_____________ day of_ _____________, 20______ , at________a.m./p.m.
time
Effective date:______________________________________________________
(must be within 90 days of date submitted)
WILLIAM FRANCIS GALVIN
Secretary of the Commonwealth
Filing fee: $100
Examiner
TO BE FILLED IN BY CORPORATION
Contact Information:
Name approval
C
M
___________________________________________________________
___________________________________________________________
___________________________________________________________
Telephone:____________________________________________________
Email:_ ______________________________________________________
Upon filing, a copy of this filing will be available at www.sec.state.ma.us/cor.
If the document is rejected, a copy of the rejection sheet and rejected document will
be available in the rejected queue.
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