Form 65 - Application For Amended Certificate Of Authority Of Foreign Nonprofit Corporation Page 2
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29. The name of the entity’s Commercial Registered Agent for service of process in Montana has changed to:
(A list of Commercial Registered Agents is available at: )
Name: ____________________________________________________________________________________________________
Or, the name and address of the entity’s Noncommercial Registered Agent for service of process in Montana has changed to:
Name: ____________________________________________________________________________________________________
Actual Street Address or Rural Route Box Number in Montana: (Must be an actual geographic location.)
__________________________________________________________________________________________________________
City: _______________________________________________________ Zip Code: _____________________________________
And, a mailing address in Montana, if different:
__________________________________________________________________________________________________________
City: _______________________________________________________ Zip Code: _____________________________________
Appointment of a Registered Agent is affirmation of the Registered Agent’s consent to serve as Registered Agent.
10. The designation has changed from: ____________________________________ to: _____________________________________
Note: Must be a Public Benefit Corporation, Mutual Benefit Corporation, or Religious Corporation.
11. I, HEREBY SWEAR AND/OR AFFIRM, under penalty of law, including criminal prosecution, that the facts contained in this
document are true and that this entity has complied with the organizational laws in the jurisdiction in which it is organized and
that it exists in that jurisdiction.
___________________________________________________________________________ _____________________________
Signature of Presiding Officer of the Board of Directors, President, or other Officer
Date
____________________________________________________________
___________________________________________
Printed Name
Title
12. Daytime Contact: Phone __________________________________________Email _____________________________________
65-Amended_Certificate_of_Authority_of_Foreign_Nonprofit_Corporation
sos.mt.gov/Business/Forms
Revised: 07/2015
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