Form Dos-1673-F-L - Certificate Of Change Of Application For Authority Of ___ - New York Division Of Corporations

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New York State Department of State
Division of Corporations, State Records and Uniform Commercial Code
One Commerce Plaza, 99 Washington Avenue
Albany, NY 12231
CERTIFICATE OF CHANGE
OF
APPLICATION FOR AUTHORITY
OF
(Name of Foreign Corporation)
Under Section 1309-A of the Business Corporation Law
(For Use By Agent)
FIRST:
The name of the foreign corporation, as it appears on the index of names of existing
domestic and authorized foreign corporations in the Department of State, Division of Corporations,
is :
Said corporation is hereinafter referred to as the “Foreign Corporation.”
If applicable: The fictitious name the Foreign Corporation has agreed to use in New York State is:
SECOND:
The jurisdiction of incorporation of the Foreign Corporation is:
THIRD:
The date on which the Foreign Corporation was authorized to do business in New York
State was:
FOURTH:
The only change effected hereby is: the post office address to which the Secretary of
State shall mail a copy of any process against the Foreign Corporation served upon the Secretary of
State is changed to:
FIFTH:
The undersigned person, partnership, or corporation (hereinafter referred to as the
“Agent”) is the agent of the Foreign Corporation to whose address the Secretary of State is required
to mail copies of process against the Foreign Corporation served upon the Secretary of State. The
post office address previously designated by the Foreign Corporation for that purpose was the
address of the undersigned Agent, and the address specified in paragraph Fourth above is the new
address of the undersigned Agent. The undersigned Agent mailed a notice of the proposed change
of address to the Foreign Corporation not less than thirty days prior to the date of delivery of this
(Continued)
DOS-1673-f-l (Rev. 05/10)
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