Form L-10 - Application For Amended Certificate Of Authority For Limited Liability Company

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State of North Carolina
Department of the Secretary of State
APPLICATION FOR AMENDED CERTIFICATE OF AUTHORITY
FOR LIMITED LIABILITY COMPANY
Pursuant to §57C-7-05 of the General Statutes of North Carolina, the undersigned limited liability company hereby applies for an
Amended Certificate of Authority to transact business in the State of North Carolina, and for that purpose submits the following
statement.
1. The name of the limited liability company is:_________________________________________________________________
2. The name the limited liability company is currently using in the State of North Carolina is:
________________________________________________________________________________________________________
3. The state or country of formation is:________________________________________________________________________
4. The date the limited liability company was authorized to transact business in the State of North Carolina is:
_________________________________________________________________________________________________________
5. The changes being made are as follows:
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
6. Attached is a certificate of existence (or document of similar import), duly authenticated by the Secretary of State or other official
having custody of limited liability company records in the state or country of formation. The certificate of existence must be less
than six months old. A photocopy of the certification cannot be accepted.
7. This application will be effective upon filing, unless a date and/or time is specified:_____________________________________
This the _______ day of _____________________ , 20 ____
____________________________________
Name of Limited Liability Company
____________________________________
Signature
____________________________________
Type or Print Name and Title
Notes:
1.
Filing fee is $50. This application must be filed with the Secretary of State.
CORPORATIONS DIVISION
P. O. BOX 29622
RALEIGH, NC 27626-0622
(Revised January 2002)
(Form L-10)

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