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State of Missouri
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Matt Blunt, Secretary of State
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Corporations Division
P.O. Box 778 / 600 W. Main Street, Rm 322
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Jefferson City, MO 65102
Statement of Correction for a
General Business or Nonprofit Corporation
(Submit with filing fee of $10)
(1)
The name of the corporation is: _________________________________________________________________
__________________________________________________________________________________________________
(2)
The state/country under whose laws it was organized is: ______________________________________________
__________________________________________________________________________________________________
(3)
Type of document being corrected (or filed copy attached): ___________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
(4)
The error is corrected as follows: ________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
(5)
The reason for such correction is: ________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
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(6)
Date the original document was filed with the Missouri Secretary of State: _______________________________
In Affirmation thereof, the facts stated above are true and correct:
(The undersigned understands that false statements made in this filing are subject to the penalties provided under Section 575.040, RSMo)
__________________________________________________________________________________________________
Authorized Signature
Printed Name
Title
month/day/year
Name and address to return filed document:
Name: __________________________________________
Address: _________________________________________
City, State, and Zip Code: __________________________
Corp. 60 (08/04)