Form 08-453 - Amended Certificate Of Authority Form - Division Of Corporations, Business And Professional Licensing

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State of Alaska
DO NOT STAMP ABOVE THIS BOX
Division of Corporations, Business and Professional Licensing
CORP
Office Use Only
CORPORATIONS SECTION
PO Box 110806
Juneau, AK 99811-0806
Phone: (907) 465-2550
Fax: (907) 465-2974
Website:
AMENDED CERTIFICATE OF AUTHORITY
Foreign Nonprofit Corporation
AS 10.20.555
$25.00 Filing Fee (non-refundable)
Pursuant to Alaska Statutes 10.20.555, the undersigned corporation applies for a Certificate of Authority.
NOTE: If the name is amended, attach a Certificate of Compliance from the state of domicile. If the purpose is
amended, attach a certified copy of the Articles of Incorporation form the state of domicile.
ITEM 1: Name of the Entity:
Alaska Entity #:
ITEM 2: Amended legal name:
ITEM 3: If amended name is not available for use in Alaska, elect an assumed name.
ITEM 4: Amended purpose and, separately, NAICS code.
Purpose:
NAICS
code:
ITEM 5: Principal office address of the corporation wherever located:
Name:
Mailing address:
City:
State/Province:
Country:
ITEM 6: The Amended Certificate of Authority must be signed by the corporate president or vice president and
by the secretary or assistant secretary.
Signature of President or Vice President
Printed name of President or Vice President
Date
Signature of Secretary or Assistant Secretary
Printed name of Secretary or Asst. Secretary
Date
08-453 (Rev. 02/01/2012)
Page 1 of 2

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