Form Corp. 52a - Application For An Amended Certificate Of Authority For A Foreign Nonprofit Corporation
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1This form is designed to be filled out online for your
State of Missouri
convenience. Enter the data and press print when
Robin Carnahan, Secretary of State
ready. Use the reset button to reset the entire form.
Corporations Division
P.O. Box 778 / 600 W. Main Street, Rm 322
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Jefferson City, MO 65102
Application for an Amended Certificate of
Authority for a Foreign Nonprofit Corporation
(Submit with filing fee of $10.00)
The below-named corporation, relating to amending its Certificate of Authority of Foreign Corporation, does hereby state:
(1)
Its name is:
_______________________________________________________________________________________________________________;
it is incorporated in the State of: ____________________________________________________________________; and it was qualified
in the State of Missouri on _________________________________________________________________________________________.
(month/day/year)
(2)
By appropriate corporate action on: ______________________________________________________________ the corporation:
(month/day/year)
(1)
Changed its corporate name to: _______________________________________________________________________
Name it will use in Missouri if new name not available: ___________________________________________________
(2)
Changed its period of duration to: _____________________________________________________________________
(3)
Changed the state or country of its incorporation to: _______________________________________________________
(3)
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.
(4)
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 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 of officer or chairman of the board
Printed Name
Title
Date
Attached is a current certificate attesting to the change, duly authenticated and certified by the secretary of state or other official having
custody of corporate records in the state or country of incorporation.
Name and address to return filed document:
Name: __________________________________________
Address: _________________________________________
City, State, and Zip Code: __________________________
Corp. 52A (01/05)
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