RHODE ISLAND SUPREME COURT LIMITED LIABILITY ENTITY AMENDMENT CHANGE IN CIRCUMSTANCES AND LLP RENEWAL FORM Within thirty (30) days after filing any limited liability entity amendment with the Secretary of State, a copy of the amendment shall be filed with the Clerk. Within thirty (30) days of any change in the facts set forth in the application for limited liability entity license filed with the Clerk, a statement describing such change shall be filed with the Clerk, with a new insurance company certificate, if necessary. Art. II, Rule 10(e). Type of Filing: Amendment (Complete sections A, B & E only) Change in Circumstances (Complete sections A, C & E only) LLP Renewal (Complete sections A, D & E only) Section A. Entity Identification Entity Name: LLE No: Local Address or Principal Office: Date of Original Application: / / Entity Contact Person: Email Address: Telephone No.: Fax No.: Section B. Amendment Filing. Please attach documentation filed with the Rhode Island Secretary of State's Office as well as an updated insurance certificate, if applicable. Type of Amendment Filed Articles of Amendment to Articles of Incorporation Articles of Amendment to Articles of Organization Amendment to Application for Registration Section C. Change in Circumstance. Please set forth below a description of the changes to the information in the application; attach additional pages and other documentation, including updated insurance certificate, as necessary.____________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ Section D. LLP Renewal. Please attach documentation filed with the Rhode Island Secretary of State's Office as well as updated insurance certificate, if applicable. Domestic Limited Liability Partnership Domestic limited liability partnerships must renew their registration with the Rhode Island Secretary of State's Office every year. Within thirty (30) days of filing for renewal with the Secretary of State, this form with the required documentation must be filed with the Clerk's Office. with the Rhode Island Secretary of State's Office every two years. Within thirty (30) days of filing for renewal with the Secretary of State, this form with the required documentation must be filed with the Clerk's Office. Foreign Limited Liability Partnership Foreign limited liability partnerships must renew their registration Section E. Verification. I certify that the information contained in this Limited Liability Entity Amendment Form is correct as of this date. I agree to notify the Clerk of the Supreme Court within thirty (30) days of any further amendments to the limited liability entity or of any change of the facts set forth herein or in the application. / Authorized Representative Name Title American LegalNet, Inc. www.FormsWorkFlow.com / Date LLEA 5/14