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Certificate of Amendment (Connecticut)

This is a certificate of amendment for a non-stock corporation in Connecticut. The form provided here is simply a sample of what the actual Form NSC 201 looks like.

CERTIFICATE OF AMENDMENT
NON-STOCK CORPORATION

Office of the Secretary of the State
30 Trinity Street / P.O. Box 150470 / Hartford, CT 06115-0470 /Rev. 12/1999

Space For Office Use Only


1. NAME OF CORPORATION: __________________________

2. THE CERTIFICATE OF INCORPORATION IS (check A., B. or C.):

______ A. AMENDED

______ B. AMENDED AND RESTATED

______ C. RESTATED

3. TEXT OF EACH AMENDMENT / RESTATEMENT (include date on which each amendment was approved):

__________________________

(Please reference an 8 1/2 X 11 attachment if additional space is needed)

4. VOTE INFORMATION (check/complete A., B. or C.)

_____ A. The resolution was approved by the corporation's board of directors and by its members who voted as follows:

Complete if no members were entitled to vote as a class

Number of votes cast in favor of the amendment _______________

Number of votes cast against the amendment ________________

Complete if members were entitled to vote as a class

Designation of each class of members entitled to vote separately

__________________________

Number of votes cast in favor of the amendment _______________

Number of votes cast against the amendment ________________

(Member votes in favor of adopting the amendment(s) provided above were sufficient for approval.)

_____ B. The amendment was adopted by sufficient vote of the board of directors without member vote. No member vote was required for adoption.

_____C. The amendment was adopted by sufficient vote of the incorporators.

5. EXECUTION

Dated this _____________ day of _____________, 20______.

Print or type name of Signatory __________________________

Capacity of signatory __________________________

Signature __________________________


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INSTRUCTIONS FOR FILLING OUT THIS FORM
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Instructions correspond with numbered entries on the form

1. NAME OF CORPORATION: Please provide the complete name of the corporation as it currently appears on the records of the Secretary of the State. Note: If the corporation is adopting a new name, such new name must be set forth in item number 3 on the form.

2. THE CERTIFICATE OF INCORPORATION IS (check A., B., or C.): Please place a check next to the appropriate function. Note: If the Certificate of Incorporation is either Restated or Amended and Restated, each element of the corporation's Certificate of Incorporation must be set forth in item number 3 or on a referenced attachment.

3. TEXT OF EACH AMENDMENT / RESTATEMENT: Please provide the full text of each amendment and/or a complete expression of the certificate of incorporation being restated. If you intend to change the corporation's name by way of an amendment, you may wish to reserve the new corporation name to ensure its availability at the time of filing. The fee to reserve a corporate name for 120 days is $30.

A. Amended Only: Check this block only if the company's Certificate of Incorporation is being amended. Example: the company's name is being changed.

B. Restated Only: Check this block only if the provisions of the original Certificate of Incorporation as supplemented and amended, are merely being restated so that the effective provisions of the Certificate of Incorporation are integrated into one document. There cannot be any discrepancy between the above mentioned provisions and the provisions being restated.

C. Amended and Restated: Check this block only if the Certificate of Incorporation is being amended and every article of the original Certificate of Incorporation as supplemented and amended, are integrated into one document.

4. VOTE INFORMATION (complete A., B. or C.): Please choose and complete A if a member vote was required and taken. Note: membership classes must be designated along with voting information for each class if members were entitled to vote as a class. Select B if the amendment, amendment and restatement or restatement was approved without the need for member approval. Select C if incorporators amended the certificate of incorporation.

5. EXECUTION: The document must be executed by an authorized official of the corporation. That person must print or type their name, state the capacity under which they sign and provide a signature. The execution constitutes a legal statement under the penalties of false statement that the information provided in the document is true.

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