Form Llf-4 - Wv Application For Amended Certificate Of Authority Of A Limited Liability Company

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Natalie 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
Hrs: 8:30 a.m. – 5:00 p.m. ET
WV APPLICATION FOR AMENDED
FILE ONE ORIGINAL
(Two if you want a filed
CERTIFICATE OF AUTHORITY OF A
stamped copy returned to you)
LIMITED LIABILITY COMPANY
FEE: $25.00
In accordance with the provisions of the West Virginia Code, the undersigned limited liability company
hereby applies for an Amended Certificate of Authority and submits the following statement:
1. Name under which the organization 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:
(Attach one certified copy of the name change as filed
in the home state)
Change of name from:
____________________________________________________________
To:
____________________________________________________________
Name the organization elects to use in WV: _____________________________________________
(Due to home state name not being available)
Other amendment (use additional pages if necessary)
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
4. Contact name and number to reach in case of a problem with filing: (optional, however, listing one
may help to avoid a return or rejection of filing if there is a problem with the document)
____________________________________________ ____________________________________
Contact Name
Phone Number
Business e-mail address, if any: _______________________________________________________
5. Signature of person executing document:
____________________________________________ ____________________________________
Signature
Title/Capacity
(Example: member, manager, etc.)
Form LLF-4
Issued by the Office of the Secretary of State
Revised 10/09

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