Division Of Corporations & Commercial Code Application Amending Authority To Conduct Affairs Or Registration Form

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This form must be type written or computer
State of Utah
File Number ________________________
Check Here If:
Non-Refundable Processing Fee:
[ ] Foreign Profit Corporation
Division of Corporations & Commercial Code
Application Amending Authority to Conduct
[ ] Foreign Nonprofit Corporation
Affairs or Registration
[ ] Foreign Limited Partnership
[ ] Foreign Limited Liability Company
Print Form
Clear Form
If the business name has changed its name in the home state, a copy of the Certificate of Amendment or a certified
copy of the amendment must accompany this application.
1. Check either or both of the following which apply:
[ ] The name of the entity is changing it's name in Utah to the new name of the corporation in the home state.
[ ] The name of the entity is being changed in Utah to comply with Utah State Insurance Regulations.
2. Amending the business name:
Current Name in Utah: ______________________________________________________________________
Name of Home State: _______________________________________________________________________
Business entity name in home state:____________________________________________________________
*The entity shall use as its name in Utah:________________________________________________________
If the name is not available in Utah the corporation shall use ________________________________________
*The entity shall use its name as set forth, unless this name is not available.
3. Amending the duration of the business existance
The businesses period of duration is changed to:__________________________________________________
4. Purpose of the business_____________________________________________________________________
5. Amending the state or country of incorporation/registration
The entity's state or country of incorporation/registration is changed to:________________________________
Under penalties of perjury, I declare this Application to Amend the Certificate of Authority or Registration to be,
to the best of my knowledge and belief, true and correct.
Authorized Party must sign here after the form is printed
You may file with the Division of Corporations the completed application in person, by mail, or fax. Means of
payment are, cash, check, money order made payable to the "State of Utah". Please include one (1) self addressed
envelope with application. If you are faxing you must include, on a cover sheet, the number of a Visa,
MasterCard or American Express with the date of expiration.
Under GRAMA {63-2-201}, all registration information maintained by the Division is classified as public record. For confidentiality purposes, the business
entity physical address may be provided rather than the residential or private address of any individual affiliated with the entity.
Division's Website:
Mail In: PO Box 146705
Mailing/Faxing Information:
Salt Lake City, UT 84114-6705
Walk In: 160 East 300 South, Main Floor
Information Center: (801) 530-4849
Toll Free: (877) 526-3994 (within Utah)
Fax: (801) 530-6438


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