Certificate of Change (New York)
This is a certificate of change of a foreign limited liability company in New York. The form provided here is simply a sample of what the actual Form DOS-1362 looks like.
NYS Department of State
Division of Corporations, State Records and UCC
41 State Street, Albany, NY 12231-0001
www.dos.state.ny.us
CERTIFICATE OF CHANGE
OF
_____________________________________
(Insert name of Foreign Limited Liability Company)
Under Section 804-A of the Limited Liability Company Law
FIRST: The name of the foreign limited liability company is:
_______________________________
If applicable, the fictitious name the foreign limited liability company has agreed to use in this state
is: _____________________________________
SECOND: The application for authority was filed with the Department of State
on: _____________________________________
THIRD: The change(s) effected hereby are:[check appropriate box(es)]
____ The county location, within this state, in which the office of the foreign limited liability company is located,
is changed to: _____________________________________
____ The address to which the Secretary of State shall forward copies of process accepted on behalf of the foreign limited liability company
is changed to: _____________________________________
____ The foreign limited liability company hereby: [check one]
____ Designates as its registered agent upon whom process against the foreign limited liability company may be served.
____ Changes the designation of its registered agent to:
_____________________________________
____ Changes the address of its registered agent to:
_____________________________________
____ Revokes the authority of its registered agent.
____________________________________ (Signature)
____________________________________ (Type or print name)
____________________________________ (Title or capacity of signer)
CERTIFICATE OF CHANGE
OF
____________________________________
(Insert name of Foreign Limited Liability Company)
Under Section 804-A of the Limited Liability Company Law
Filed by: ____________________________________ (Name)
____________________________________ (Mailing address)
____________________________________ (City, State and ZIP code)