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Certificate Of Amendment Of Certificate Of Assumed Name Form. This is a New York form and can be use in Corporations And Business Entities Secretary Of State.
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Tags: Certificate Of Amendment Of Certificate Of Assumed Name, DOS-1626, New York Secretary Of State, Corporations And Business Entities
New York State
Department of State
Division of Corporations, State Records & Uniform Commercial Code
One Commerce Plaza, 99 Washington Avenue
Albany, NY 12231
www.dos.state.ny.us
CERTIFICATE OF AMENDMENT
OF
CERTIFICATE OF ASSUMED NAME
OF
(Insert Name of Entity)
Under Section 130 of the General Business Law
FIRST:
The name of the entity is:
SECOND: Foreign entities only. If applicable, the fictitious name the entity agreed to use in
New York State is:
THIRD:
If the name of the entity is different on the last Certificate of Assumed Name or
Certificate of Amendment of Certificate of Assumed Name, the previous name of the entity is:
FOURTH: The entity was formed or authorized under (indicate law):
Business Corporation Law
Education Law
Insurance Law
Limited Liability Company Law
FIFTH:
Not-for-Profit Corporation Law
Revised Limited Partnership Act
Other (specify law)
The present assumed name is
SIXTH: The date the original Certificate of Assumed Name was filed is:
SEVENTH:
The date, if applicable, the last Certificate of Amendment of Certificate of
Assumed Name was filed is:
EIGHTH: The following change(s) are being made (check the appropriate change(s)):
Entity Name:
The new name of the entity is:
Assumed Name:
The new assumed name is:
Principal Place of Business:
The principal place of business is changed to (include the number and street, city, state and zip
code) :
DOS-1626 (Rev. 4/08)
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County(ies), Added or Deleted, in Which Business Will be Conducted Under the
Assumed Name:
County(ies) Added:
County(ies) Deleted:
Address(es) of Specific Business Location(s), Added or Deleted:
Business Location(s) Added (include the
Business Location(s) Deleted (include the
number and street, city, state and zip code):
number and street, city, state and zip code):
INSTRUCTIONS FOR SIGNING: If a corporation, by an officer; if a limited partnership, by a general
partner; if a limited liability company, by a member or manager; or by an authorized person or attorney-infact for such corporation, limited partnership or limited liability company. If the certificate is signed by an
attorney-in-fact, include the name and title of the person for whom the attorney-in-fact is acting. (Example,
John Smith, attorney-in-fact for Robert Johnson, president.)
Name of Signer
Signature
Title of Signer
CERTIFICATE OF AMENDMENT
OF
CERTIFICATE OF ASSUMED NAME
OF
(Insert Name of Entity)
Under Section 130 of the General Business Law
Filer’s Name:
Address:
City, State and Zip Code:
Note:
This form was prepared by the New York State Department of State. You are not required to use this form. You may draft
your own form or use forms available at legal stationery stores. The Department of State recommends that all documents be
prepared under the guidance of an attorney. The certificate must be submitted with a $25 fee. The Department of State also
collects the following, additional, county clerk fees for each county affected by the amendment in which a corporation does
or transacts business: $100 for each county within New York City (Bronx, Kings, New York, Queens and Richmond) and $25
for each county outside New York City. All checks over $500 must be certified.
For Office Use Only
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