Form Corp.43 - Application For An Amended Certificate Of Authority For A Foreign Corporation


State of Missouri
Matt Blunt, Secretary of State
Corporations Division
James C. Kirkpatrick State Information Center
P.O. Box 778, Jefferson City, MO 65102
600 W. Main Street, Rm 322, Jefferson City, MO 65101
Application for an Amended Certificate of
Authority for a Foreign Corporation
(Submit in duplicate with filing fee of $25.00)
The below corporation, relating to amending its certificate of authority of Foreign Corporation, does hereby state:
Its name is: _________________________________________________________________________________
and is incorporated in the State of: _______________________________________________________; and it
was qualified in the State of Missouri on _________________________________________________________.
By appropriate corporate action on: ________________________________________________, the corporation:
Changed its corporate name to: ___________________________________________________________
Name it will use in Missouri if new name not available: ________________________________________
Changed its period of duration to: _________________________________________________________
Changed the state or country of its incorporation to: ___________________________________________
There is attached hereto a Certificate of the Secretary of State of the State of ______________________________
relating to the amendment(s), set forth in item 2 above and showing that the Corporation is in existence and in
good standing in said State.
The effective date of this document is the date it is filed by the Secretary of State of Missouri, unless you indicate
a future date, as follows: _______________________________________________________________________
(Date may not be more than 90 days after the filing date in this office)
In affirmation thereof, the facts stated above are true.
(Authorized Signature)
(Printed Name)
Attached is an original current certificate attesting to the change, duly authenticated by the secretary of state or
other official having custody of corporate records in the state or country of incorporation.
Corp. #43 (11/00)


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