Application For Certificate Of Amended Authority For Foreign Non-Profit Corporation Form

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Version 2; 04-30-09
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District of Columbia Government
Corporations Division
PO Box 92300
Washington DC 20090
Application for Certificate of Amended Authority for Foreign Non-Profit Corporation
Use this form to amend certificate of authority for foreign non-profit corporation in the District of Columbia.
Foreign Non-Profit Corporation
$65, payable to DC Treasurer
Under the provisions of the Non-Profit Corporation Act, DC Official Code (DCOC) Title 29 Chapter 3, the corporation below
applies for a Certificate of Amended Authority to conduct its affairs in the District of Columbia.
1a. Entity name:
1b. Date of issuance of Certificate of Authority:
2. The corporate name has been changed to:
(Attach a certified copy of name change from the state of domicile, dated within the last 6 months. If name
was changed by merger, attach a certified copy of merger and additional fee of $70.)
3. The Corporation wishes to pursue these added transactions or purposes in the District (not now listed in the Application for a Certificate of
4. Select corporate officer executing this form:
5. Signature:
7. Signature:
6. Select corporate officer executing this form
Assistant Secretary
If you sign this application, you agree that you understand that anyone who makes a false statement anywhere on it can be
punished by criminal penalties of a fine up to $1000, imprisonment up to 180 days, or both, under DCOC § 22-2405.
Mail all forms and required payments to:
Department of Consumer and Regulatory Affairs
Corporations Division
P.O. Box 92300
Washington, DC 20090
Phone: (202) 442-4400
Please check to view organizations required to register, to search business names, to get step-by-step guidelines to register an
organization, to search registered organizations, and to download forms and documents. Just click on "Corporate Registrations."


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