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STATE OF MONTANA

(This space for use by the Secretary of State only)

APPLICATION for AMENDED

CERTIFICATE of AUTHORITY

of FOREIGN CORPORATIONÿ

ÿÿ

MAIL:

BOB BROWN

Secretary of State

P.O. Box 202801

Helena, MT 59620-2801ÿ

PHONE ÿ

ÿ(406)444-3665ÿ

Form:FCM-6

FAX:

(406)444-3976

Filing Fee: $15.00

WEB SITE:

Priority Filing Add $20.00

For the purpose of amending its original application for certificate of authority with the State of Montana to transact business or conduct

affairs in Montana, according to 35-1-1029, MCA (profit) or 35-2-823, MCA (nonprofit), the undersigned submits the following statements

of fact to the Secretary of State and attaches a Certificate of Existence duly certified and issued under a current date by the

Secretary of State of the State of its jurisdiction with the Great Seal affixed:

A certificate of authority was issued to the corporation by the Secretary of State of Montana____________________________,

___________, authorizing it to transact business or conduct affairs in Montana under the current name of ________________

______________________________________________________________________________________________________

The corporate name has been changed to _______________________________________________________________________

(If a profit, the name must contain “corporation”, “company”, “incorporated”, “limited”, or abbreviation of such.)

Its period of duration has changed from ______________________________________ to ______________________________

Its state or country of jurisdiction has change from ___________________________ to_____________________________________

If the corporation was involved in a merger or consolidation, the name of the surviving corporation is:

______________________________________________________________________________________________________

(Both entities must be qualified)

If a nonprofit corporation, its designation has changed from ______________________ to _____________________________

(Either Public Benefit Corporation, Mutual Benefit Corporation or Religious Corporation)

WARNING

APENALTIES IMPOSED UPON OFFICERS AND DIRECTORS. The execution of any document required to be filed

with the Secretary of State constitutes an affirmation, under penalties of false swearing, by each person executing the

document that the facts stated therein are true.@ (Section 35-1-428, MCA)

_____________________________________________________________________________________________________________

Signature of Officer/Chairman of the Board

Title

Date

Please be advised that the Business Services Bureau of the Montana Secretary of State will process your business

documents within 10 working days of initial receipt. During this period if it is determined that your document does

not meet statutory requirements, a letter outlining the deficiencies will be returned to the original submitter. If the

document is complete and correct, the document will be filed and an acknowledgment copy showing completion

returned to the original submitter.

s:\forms\fcm-6

Revised: 08/08/2002

Form:fcm-6 - Application For Amended Certificate Of Authority Of Foreign Corporation

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