AMENDMENT OF ASSUMED BUSINESS NAME CERTIFICATE (NCGS 66-71.7) (Please print legibly.) 1.The assumed business name previously registered is: 2.The real name of the person or entity engaging in business under the assumed business nameis: (Corporations, LLC222s, limited partnerships must provide their NC www.sosnc.gov/br/search SOSID number with the exact name they registered with the Secretary of State222s office. Go to to look up this information.) 3.The book and page number of the initial filing that is being amended is: Book, Page . 4.The identification number assigned to the assumed business name by the Secretary of State (SOS ID) is: (Go to www.sosnc.gov/abn/search to look up this number.) 5.The current mailing address of the business: 6.The certificate of assumed business name should be amended by changing the following information:(Check all that apply and provide new information in the space provided below.):Change assumed business nameAdd real name of person engaging in business under assumed business nameDelete real name of person engaging in business under assumed business nameChange nature of businessChange street address of principal place of businessChange mailing addressAdd counties where assumed business name will be used to engage in businessDelete counties where assumed business name will be used to engage in business7.Provide new information here: Add/ Delete/ Change Add/ Delete/ Change (Attach additional pages if needed.)This certificate is signed by the owner/legal representative of the person named above, this day of , 20 . Signature: Title: (See instructions for who must sign for various business entity types.) Amendment of ABN Certificate 03.06.18 American LegalNet, Inc. www.FormsWorkFlow.com Instructions for Amending an Assumed Business Name Certificate You must file any amendment in the SAME COUNTY as the initial filing. Item 1: Enter the assumed business name to which this amendment applies, as stated on the initial or most recently amended assumed business name certificate. Item 2: Enter a real name of the person or entity engaging in business under the assumed business name as stated on the initial or most recently amended assumed business name certificate. Item 3: Enter the book and page number of the initial filing to which the amendment applies. The book and page will be stamped at the top of the original certificate returned to you after recording. Item 4: Enter the SOS ID number that was assigned by the NC Secretary of State. You may find this information on the Secretary of State222s website at www.sosnc.gov/abn/search . Item 5: Enter the current mailing address of the business. Item 6: Indicate the information that you are amending by checking the block next to each selection. Item 7: Enter the new information in the blank spaces provided, checking whether you are adding, deleting or changing each entry. You may attach additional pages if needed. Execution of Certificate: Enter the date that you signed the certificate. Certificates must be signed by a person with the capacity listed below on behalf of the person(s) named in Item 2: Sole proprietorship: must be signed by the individual; title as 223sole proprietor224 or 223owner224. General Partnership: must be signed by a general partner. Limited partnership: must be signed by a general partner. Corporation: must be signed by an officer of the corporation. Limited Liability Company: must be signed by a manager, director or officer of the LLC. Trust: must be signed by a trustee or other person authorized to act on behalf of the trust. In the case of any other legal entity, the certificate must be signed in the name of the entity by an individual authorized to act for the entity. Please note: 1. You must file a Certificate of Amendment within sixty (60) days of change of any information provided on this form. (See NCGS 247 66-71.7) 2. Knowingly signing a certificate that is false in any material respect is a Class 1 misdemeanor. (See NCGS 247 66-71.14) Instructions for Amendment of ABN Certificate 03.06.18 American LegalNet, Inc. www.FormsWorkFlow.com