COMMONWEALTH OF VIRGINIA STATE CORPORATION COMMISSION SCC760/922 (07/07) APPLICATION FOR AN AMENDED CERTIFICATE OF AUTHORITY TO TRANSACT BUSINESS IN VIRGINIA The undersigned, on behalf of the foreign corporation set forth below, pursuant to § 13.1-760 or § 13.1-922 of the Code of Virginia, hereby makes this application for an amended certificate of authority to transact business in Virginia and states as follows: The former name of the corporation was _________________________________________________________________________ _________________________________________________________________________. The present name of the corporation is _________________________________________________________________________ _________________________________________________________________________. If the corporation’s present name is not available for use in Virginia or the corporation is a stock corporation and its present name does not contain the word "corporation," "company," "incorporated" or "limited," or an abbreviation of one of such words, the designated name adopted by the corporation for use in Virginia is ________________________________________________________________________. The name of the state or country under whose law the corporation is presently incorporated is _________________________________. The name of the state or country under whose law the corporation was formerly incorporated (if changed by the instrument submitted herewith) is ____________________________. Executed in the name of the corporation by: __________________________________________ (signature) _________________________ (date) __________________________________________ (printed name) _________________________ (corporate title) __________________________________________ (corporation’s SCC ID no.) _________________________ (telephone number (optional)) (The execution must be by the chairman or any vice-chairman of the board of directors, the president, or any other of its officers authorized to act on behalf of the corporation.) PRIVACY ADVISORY: Information such as social security number, date of birth, maiden name, or financial institution account numbers is NOT required to be included in business entity documents filed with the Office of the Clerk of the Commission. Any information provided on these documents is subject to public viewing. SEE INSTRUCTIONS ON THE REVERSE American LegalNet, Inc. www.FormsWorkflow.com INSTRUCTIONS TO FORM 760/922 This form must be used whenever a foreign corporation that is authorized to transact business in Virginia changes its name or jurisdiction of incorporation. The application must be in the English language, typewritten or printed in black, legible and reproducible. The document must be presented on uniformly white, opaque paper, free of visible watermarks and background logos. You can download this form from our website at www.scc.virginia.gov/division/clk/fee_bus.htm. If the present name of a foreign stock corporation does not contain the word "corporation," "company," "incorporated" or "limited," or an abbreviation of one of such words, the corporation must adopt a designated name for use in Virginia that adds one of such words or abbreviations to its present name. See § 13.1-762 of the Code of Virginia. The application must be signed in the present name of the corporation by the chairman or any vice-chairman of the board of directors, the president, or any other of its officers authorized to act on behalf of the corporation. IMPORTANT: The application must be submitted to the State Corporation Commission with a certified or otherwise authenticated copy of the amendment, merger or domestication changing the corporate name or the jurisdiction of incorporation (redomestication), authenticated within the past 12 months under the original signature and seal of the Secretary of State or other official having custody of corporate records in the state or other jurisdiction under whose law the corporation is incorporated. The certificate of the Secretary of State or other public official having custody of corporate records must indicate that the attached instrument is a “true and correct copy” of the official records, or words to that effect. A Certificate of Existence/Fact/Good Standing is not acceptable. See §§ 13.1-760 C and 13.1-922 C of the Code of Virginia. This application may not be filed with the Commission until all fees and penalties to be collected by the Commission under the Virginia Stock Corporation Act or the Virginia Nonstock Corporation Act have been paid by or on behalf of the corporation; provided, however, that an assessed annual registration fee does not have to be paid prior to filing if the application is filed on or before the due date of the annual registration fee payment. See §§ 13.1-615 and 13.1-815 of the Code of Virginia. It is a Class 1 misdemeanor for any person to sign a document he or she knows is false in any material respect with intent that the document be delivered to the Commission for filing. See §§ 13.1-612 and 13.1-811 of the Code of Virginia. Submit the original, signed application and the authenticated copy of the amendment, merger or domestication to the Clerk of the State Corporation Commission, P.O. Box 1197, Richmond, Virginia 23218-1197, (Street address: 1300 East Main Street, Tyler Building, 1st Floor, Richmond, Virginia 23219), along with a check for the filing fee(s) specified below, payable to the State Corporation Commission. PLEASE DO NOT SEND CASH. If you have any questions, please call (804) 371-9733 or toll-free in Virginia, (866) 722-2551. Stock Corporation: Filing fee: $25.00. See § 13.1-616 of the Code of Virginia. Additional entrance fee: If the number of authorized shares of stock of the corporation has increased, payment of an additional entrance fee may be required. See § 13.1-615.1 B of the Code of Virginia. Send payment of both fees in one check made payable to STATE CORPORATION COMMISSION. Nonstock Corporation: Filing fee: $25.00. See § 13.1-816 of the Code of Virginia. NOTE Whenever a foreign corporation that is authorized to transact business in Virginia files an amendment, merger or domestication in the jurisdiction of its incorporation, it must file with the Clerk of the State Corporation Commission within 30 days of the instrument’s effective date, a copy of the instrument duly certified or otherwise authenticated by the Secretary of State or other official having custody of the corporate records in the state or country under whose law it is incorporated. See §§ 13.1-760 and 13.1-766.1 of the Code of Virginia for stock corporations, and §§ 13.1-922 and 13.1-928.1 of the Code for nonstock corporations. This form should be used by a foreign corporation that wants to discontinue use of a previously adopted designated name because its present name has become available for use in Virginia. If an amendment, merger or domestication has increased the number of shares a corporation is authorized to issue, an additional entrance fee may be due. Contact the Clerk’s Office for a fee quote. See § 13.1-615.1 of the Code of Virginia. American LegalNet, Inc. www.FormsWorkflow.com