Certificate Of Amendment To Foreign Corporation Application For License
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Certificate Of Amendment To Foreign Corporation Application For License Form. This is a Ohio form and can be use in Corporations Secretary Of State.
Tags: Certificate Of Amendment To Foreign Corporation Application For License, 565, Ohio Secretary Of State, Corporations
Expedite this Form: (Select One)
Prescribed by:
The Ohio Secretary of State
Central Ohio: (614) 466-3910
Toll Free: 1-877-SOS-FILE (1-877-767-3453)
Mail Form to one of the Following:
Yes
PO Box 1390
Columbus, OH 43216
*** Requires an additional fee of $100 ***
www.sos.state.oh.us
e-mail: busserv@sos.state.oh.us
No
PO Box 1028
Columbus, OH 43216
CERTIFICATE OF AMENDMENT TO
FOREIGN CORPORATION APPLICATION
FOR LICENSE
(For Foreign, Profit or Nonprofit )
Filing Fee $50.00
(1)
Foreign for Profit
License No.
(2)
Foreign Nonprofit
License No.
(179-FAM)
(179-FAM)
Complete the following information in this section if box (1) or (2) is checked.
(Name of Corporation - Including Assumed Name if Applicable)
, does hereby certify that the above named Foreign
(Authorized Officer and Title)
Corporation formed in the state of
has modified the information set forth in the original Application for License or any Amendment thereto with the
following:
The name of the corporation has been amended to
The corporation's principal office shall be located in
(street address)
NOTE: P.O. Box Addresses are NOT acceptable.
(state)
(city, township, or village)
The corporation's principal office within Ohio shall be located in
(zip code)
Check box if there is no Ohio Location
, Ohio
(city, township, or village)
(county)
(zip code)
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565
Page 1 of 2
Last Revised: May 2002
Complete the following information in this section if box (1) or (2) is checked Cont.
The corporation will exercise the following corporate purpose(s) in Ohio:
This certificate of amendment supersedes the information currently on file with the Secretary of State of Ohio.
This Certificate of Amendment to the Foreign Corporation Application for License has been adopted in accordance
with the laws of the state of domestication.
REQUIRED
Must be authenticated (signed)
by an authorized representative
Authorized Representative
Date
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565
Page 2 of 2
Last Revised: May 2002
Instructions
Use Tab key to move between entry fields
1. If some of the information contained in the original Application for License has not changed, you
may leave the corresponding information on this form blank.
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