4a.
This statement should not be altered.
• This certificate must be approved by at least a majority of
the corporation’s directors.
4b.
Check the box next to the applicable
statement.
Only one box may be
checked.
5.
The name change amendment must
• Verification requires a statement under penalty of perjury
be
signed
and
verified
by
two
that the information is true and correct of the signor’s own
corporate officers as provided in
knowledge.
Section
5062
and
5076
or
12241
and
• If the name change amendment will be signed by officers
12251.
other than the President and Secretary, you may alter the
officer titles on the form.
Generally, the corporation’s president
and secretary sign.
• Pursuant to Section 5062 and 12241, the name change
amendment must be dated, signed and verified by the
corporation’s chairperson of the board, president or any
vice president and by the secretary, chief financial officer,
treasurer or any assistant secretary or assistant treasurer.
Mail Submission Cover Sheet (Optional):
To make it easier to receive communication related to this
document, including receipt of the copy of the filed document, complete the Mail Submission Cover Sheet. For
the Return Address: enter the name of a designated person and/or company and the corresponding mailing
address. Please note the Mail Submission Cover Sheet will be treated as correspondence and will not be made
part of the filed document.
Where to File: Completed forms along with the applicable fees, if any can be mailed to Secretary of State,
Business Entities Filings Unit, P.O. Box 944260, Sacramento, CA 94244-2600 or delivered in person (drop off)
to the Sacramento office, 1500 11th Street, 3rd Floor, Sacramento, CA 95814. This form is filed only in the
Sacramento office.
Legal Authority:
General statutory filing provisions are found in Sections
5810-5817, 7810-7817
or
12500-12508. All statutory references are to the California Corporations Code, unless otherwise stated.
2016 California Secretary of State
AMDT-NP-NA Instructions (EST 09/2016)