Form Pllc-03 - Application For Amended Certificate Of Authority (Professional Limited Liability Company) Page 2
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2Application for Amended Certificate of Authority (PLLC-03) – Page Two
9.
Attached is a certificate setting forth and attesting to the change, duly authenticated by the secretary of
state or other official having custody of limited liability company records in the state or country of
organization.
10.
If the limited liability company is required to use a fictitious name in order to transact business in this
State, a copy of the resolution of its managers adopting the fictitious name is attached.
11.
This application will be effective upon filing, unless a date and/or time not later than 90 days after the
date of filing is specified:_________________
This the _____ day of __________________, 20____
By executing this application on behalf of the applicant limited liability company, I certify under oath that
the undersigned limited liability company is a “foreign professional limited liability company” within the
scope of N.C.G.S. Sections 57C-2-01 and 55B-16(b).
__________________________________________
Name of Limited Liability Company
__________________________________________
Signature of Manager
__________________________________________
Type or Print Name and Title
___________________
(site of acknowledgment)
___________________
This ____ day of ____________, 20____, personally came before me, __________________________,
Notary Public, _______________________, who, being by me duly sworn, says that he/she is
_____________________ of __________________________________, a professional limited liability
company, and that this Application for Amended Certificate of Authority was signed by him/her on behalf of
the professional limited liability company by its authority duly given. And the said ______________________
acknowledged the said writing to be the act and deed of said professional limited liability company.
Witness my hand and official seal, this the ____ day of ________________, 20____.
(Official Seal)
____________________________________
Notary Public
My Commission Expires ______________, 20____
NOTES:
1.
Filing fee is $50. This application must be filed with the Secretary of State.
2. Only a “foreign professional limited liability company” may use this application. To determine whether a particular limited
liability company is such a “foreign professional limited liability company,” it is necessary to examine the requirements of
N.C.G.S. Sections 57C-2-01(c) and 55B-16(b). If the company does not meet those requirements, it must use the standard form
for a limited liability company.
(Revised January 2000)
(Form PLLC-03)
CORPORATIONS DIVISION
P. O. BOX 29622
RALEIGH, NC 27626-0622
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