LLC1055 (08 /1 6 ) COMMONWEALTH OF VIRGINIA STATE CORPORATION COMMISSION AMENDED APPLICATION FOR REGISTRATION AS A FOREIGN LIMITED LIABILITY COMPANY FILING FEE: $25.00 The undersigned, on behalf of the foreign limited liability company named below, pursuant to 247 13.1-1055 of the Code of Virginia, states as follows: 1. According to the records of the Commission (prior to the filing of this application): A. The name of the limited liability company is . B. The limited liability company adopted the following designated name for use in Virginia (because its real name was not available): (Leave blank if no designated name was adopted.) . C. The name of the state or other jurisdiction under whose law the limited liability company is formed is . 2. This application is submitted for the purpose of amending the Commission222s records as follows: A. The name of the limited liability company has been changed to . B. The limited liability company desires to: (Mark appropriate box and complete, if appropriate.) Adopt the following designated name for use in Virginia (because its new name is not available): . Change its designated name for use in Virginia to . Abandon the use of its designated name in Virginia. C. The name of the state or other jurisdiction under whose law the limited liability company is formed has been changed to . D. Other statements or facts in the application for registration should be amended or corrected as follows: . Signed in the name of the limited liability company by: (signature) (date) (printed name) (title (e.g., manager or member)) (company222s SCC ID no.) (telephone number (optional)) See Instructions for acceptable titles and required notations. CHECK IF APPLICABLE (See Instructions): The person signing this application on behalf of the limited liability company has been delegated the right and power to manage the company222s business and affairs. REVIEW THE INSTRUCTIONS BEFORE SUBMITTING THIS FORM. Personal Information , such as a social security number, should NOT be included in a business entity document submitted to the Office of the Clerk for filing with the Commission. For more information, see Notice Regarding Personal Identifiable Information at www.scc.virginia.gov/clk . American LegalNet, Inc. www.FormsWorkFlow.com INSTRUCTIONS TO FORM LLC-1055 This amended application, which has been prescribed by the Commission, must be used by a foreign limited liability company that needs to amend or correct its application for a certificate of registration to transact business in Virginia, subject to the exceptions set forth in the second paragraph of the Notes, below. The amended application must be in the English language, typewritten or printed in black, legible and reproducible, and presented on uniformly white, opaque paper, free of visible watermarks and background logos. This form can be downloaded from our website in PDF-fillable format at www.scc.virginia.gov/clk/forllc.aspx . IMPORTANT: The amended application must be submitted with a certified or otherwise authenticated copy of any instrument of amendment, correction or merger filed by the limited liability company in its state or other jurisdiction of formation that effected the change(s) in said jurisdiction, authenticated within the past 12 months under the original signature and seal of the Secretary of State or official having custody of limited liability company records in the state or other jurisdiction of its formation. The certificate of the Secretary of State or other public official having custody of limited liability company records must indicate that each document is a 223true and correct copy224 of the official records, or words to that effect. See 247 13.1-1055 of the Code of Virginia. If the limited liability company has changed its name and its present name is not distinguishable upon the records of the Commission, the company will need to adopt a designated name for use in Virginia that is distinguishable upon the records of the Commission. See 247 13.1-1054 of the Code of Virginia. To check the availability of a company name, including a designated name, visit https://sccefile.scc.virginia.gov/NameAvailability or contact the Clerk222s Office at (804) 371-9733 or toll-free in Virginia, 1-866-722-2551. If the new name of the limited liability company does not contain the words limited company or limited liability company, or the abbreviation L.C., LC, L.L.C. or LLC, it must adopt a designated name for use in Virginia that adds one of the foregoing to its name. See 247 13.1-1054 of the Code of Virginia. This form is to be used by a limited liability company that wants to abandon a designated name that it previously adopted for use in Virginia because its real name is now distinguishable on the Commission222s records. This amended application must be signed (i) by a manager or other person who has been delegated the right and power to manage the business and affairs of the limited liability company, or (ii) if no managers or such other persons have been selected, by any member of the limited liability company, or (iii) by a person who is authorized to sign an amendment to the articles of organization or other constituent documents delivered for filing to the Secretary of State or other official having custody of limited liability company records in the state or other jurisdiction under whose law it is formed. The printed name and title of the person who signs the amended application must be set forth next to the signature. An individual signing on behalf of a business entity that is (i) a manager or member of the limited liability company, or (ii) authorized to sign post-formation documents on behalf of the limited liability company, must set forth the business entity222s name, the capacity in which the business entity is signing on behalf of the limited liability company, the individual222s printed name, and the capacity in which he or she is signing on behalf of the business entity. See 247 13.1-1003 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 247 13.1-1006 of the Code of Virginia. This amended application may not be filed with the Commission until all fees and penalties to be collected by the Commission under the Virginia Limited Liability Company Act have been paid by or on behalf of the limited liability company; provided, however, that an assessed annual registration fee does not have to be paid if this amended application is filed on or before the due date of the annual registration fee payment. See 247 13.1-1065 of the Code of Virginia. Submit the signed amended application and the original certified copy of the limited liability company222s instrument effecting the amendment or change to State Corporation Commission, Office of the Clerk, 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 in the amount of $25.00, payable to State Corporation Commission. DO NOT SEND CASH. If you have any questions, contact the Clerk222s Office at (804) 371-9733 or toll-free in Virginia, 1-866-722-2551. NOTES Whenever the articles of organization or other constituent document of a foreign limited liability company that is registered to transact business in the Commonwealth is amended or corrected, the foreign limited liability company must promptly file with the Commission a copy of the amendment or correction duly authenticated by the Secretary of State or other official having custody of the limited liability company records in the state or other jurisdiction of its organization. See 247 13.1-1055 of the Code of Va. To change the company222s registered agent and/or the registered office address in Virginia, or its principal office address on record with the Commission, in lieu of this form, the company must file a statement of change of registered agent/registered office on form LLC-1016, or a statement of change of principal office address on form LLC-1018.1.