Form Llf-4 - Wv Application For Amended Certificate Of Authority Of A Limited Liability Company 2014
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1Natalie E. Tennant
Penney Barker, Manager
Secretary of State
Corporations Division
1900 Kanawha Blvd E
Tel: (304)558-8000
Bldg 1, Suite 157-K
Fax: (304)558-8381
Charleston, WV 25305
Website:
E-mail:
WV APPLICATION FOR AMENDED
FILE ONE ORIGINAL
Office Hrs: Monday – Friday
CERTIFICATE OF AUTHORITY OF A
(Two if you want a filed
8:30 a.m. – 5:00 p.m. ET
stamped copy returned to you)
LIMITED LIABILITY COMPANY
FEE: $25.00
**** In accordance with the provisions of the WV Code, the undersigned limited liability company ****
hereby applies for an Amended Certificate of Authority and submits the following statement:
1. Name under which the limited liability company
was authorized to transact business in WV:
___________________________________________________
2. Date Certificate of Authority was issued in West Virginia: _______________________________
†
3. Change of Name Information
or Text of Amendment
: (†If changing business name, you must attach one Certified
Copy of the Name Change as filed in the home State of original organization. )
Change of Name From: __________________________________________________________________
To: __________________________________________________________________
Name the organization elects to use in WV: _________________________________________________________
(Due to home State name not being available)
Other amendment
:
(Attach additional pages if necessary.)
_____________________________________________________________________________________________
_____________________________________________________________________________________________
4. Contact information.
(This is optional, however, if there is a problem with the filing, listing a contact person and phone
number may avoid having to return or reject the document.)
__________________________________________________
______________________________
Contact Name
Phone Number
Business e-mail address: ____________________________________________________________
5. Signature information (See below *Important Legal Notice Regarding Signature):
Print Name of Signer: _____________________________________ Title/Capacity: ______________________
Signature: _________________________________________
Date: ________________________
*Important Legal Notice Regarding Signature: Per West Virginia Code §31B-2-209. Liability for false statement in filed record. If a
record authorized or required to be filed under this chapter contains a false statement, one who suffers loss by reliance on the statement may
recover damages for the loss from a person who signed the record or caused another to sign it on the person's behalf and knew the statement
to be false at the time the record was signed.
Important Note: This form is a public document. Please DO NOT provide any personal identifiable information on this form such as
social security number, bank account numbers, credit card numbers, tax identification or driver’s license numbers.
Form LLF-4
Issued by the Office of the Secretary of State
Revised 11/14
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