State of Utah Department of Commerce Division of Corporations & Commercial Code Amendment to Certificate of Organization Non-Refundable Processing Fee: $37.00 Pursuant to UCA § 48-3a-202, the individual named below causes this Amendment to the Certificate of Organization to be delivered to the Utah Division of Corporations for filing, and states as follows: Entity Number: ___________________ The name of the limited liability company is: ______________________________________________________ The Certificate of Organization shall be amended as set forth herein (complete all that apply): There is a change in the name of the limited liability company to: ______________________________________________________________________________________ The Certificate of Organization is amended as follows: Filing date of initial certificate ____________________________________ Future effective date (if not to be effective upon filing) __________________ ( not to exceed 90 days) Under penalties of perjury, I declare that this Amendment of Certificate of Organization has been examined by me and is, to the best of my knowledge and belief, true, correct and complete. Name: ____________________________________ Title: _____________________________________ Signed: _______________________________ Dated: ________________________________ Under GRAMA {63-2-201}, all registration information maintained by the Division is classified as public record. For confidentiality purposes, you may use the business entity physical address rather than the residential or private address of any individual affiliated with the entity. American LegalNet, Inc. www.FormsWorkFlow.com