Form Dscb:15-4126/6126-2 - Application For Amended Certificate Of Authority Foreign Corporation - 2002

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PENNSYLVANIA DEPARTMENT OF STATE
CORPORATION BUREAU
Application for Amended Certificate of Authority
Foreign Corporation
Entity Number
(15 Pa.C.S.)
Foreign Business Corporation (§ 4126)
Foreign Nonprofit Corporation (§ 6126)
Document will be returned to the
Name
name and address you enter to
the left.
Address
⇐
City
State
Zip Code
Fee: $180
Filed in the Department of State on ________________________
Secretary of the Commonwealth
In compliance with the requirements of the applicable provisions of 15 Pa.C.S. (relating to corporations and unincorporated
associations), the undersigned foreign corporation, desiring to receive an amended certificate of authority, hereby states that:
The name under which the corporation currently holds a certificate of authority to do business within the
1.
Commonwealth of Pennsylvania is:
. The name of the jurisdiction under the laws of which the corporation is incorporated is:
2
3. The address of its principal office under the laws of the jurisdiction in which it is incorporated is:
Number and Street
City
State
Zip
.
4
The (a) address of this corporation's registered office in this Commonwealth or (b) name of its commercial
registered office provider and the county of venue is:
(a) Number and Street
City
State
Zip
County
(b) Name of Commercial Registered Office Provider
County
c/o:
Check if applicable:
The foregoing reflects a change in Pennsylvania registered office.

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