Form Sfn 13107 - Amended Certificate Of Authority Foreign Corporation Application

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COMPLETE, PRINT, SIGN, AND FAX OR MAIL

(If paying with credit card complete authorization at bottom of page 3)

FOR OFFICE USE ONLY

AMENDED CERTIFICATE OF AUTHORITY

IDNumber:

FOREIGN CORPORATION

WO Number:

APPLICATION

SECRETARY OF STATE

Filed:

By:

SFN 13107 (07-2008)

SEE REVERSE SIDE FOR FEES, FILING AND MAILING INSTRUCTIONS

1.A. The application MUST be accompanied by ALL of the following:

B. The following MAY be required:

Filing fee of $40

Signed consent to use of name and fee of $10

If amending the name, a current Certificate of Fact verifying the

Trade Name Registration and fee of $25

name change certified by the government officer of the state or

country where Articles of Incorporation are filed.

TYPE OR PRINT LEGIBLY

For reference, see North Dakota Century Code, Section 10-19.1-137 or 10-33-130.

2. Type of corporation applying for amended certificate of authority (check one)

3. Reason for Amended Certificate of Authority

Foreign Nonprofit

Foreign Business

Foreign Professional

Name changed

Correction

4. Name of corporation EXACTLY as currently authorized by the North Dakota Secretary of State

5. Federal ID Number

6. Name of corporation as amended, EXACTLY as it appears on Certificate of Fact from state or country of origin

7. If applicable, provide the trade name and complete the Trade Name Registration form if the selected trade name is not already registered in North Dakota.

Only provide the trade name in this line if:

a) The "new" corporate name is not in the form as required of corporations in North Dakota.

b) The Secretary of State has notified the corporation that its "new" corporate name is the same as or deceptively similar to a name already

registered, and the corporation is unable to obtain consent to use of name from the previous filer or a certified copy of a final decree of a court of

competent jurisdiction establishing prior right of this corporation to use of the name in North Dakota.

c) The corporation does not wish to use or protect its "new" corporate name in North Dakota and chooses to use a name other than its corporate

name.

8. Physical and mailing address of principal executive office which may not only be a post office box: (Street/RR, PO Box, City, State, Zip+4)

9. STATE or country where

11. Duration of corporation

12. Telephone Number

10. EXACT date incorporated:

incorporated

(Month, day, AND year)

Perpetual

Other (Specify)

13. Toll-free telephone Number

14.A. Name of commercial registered agent in North Dakota

14.B.

Name of noncommercial registered agent in North Dakota

14.C. Address of noncommercial registered agent in North Dakota: (Street/RR, PO Box, City, State, Zip+4) May not be only a post office box.

15. Nature of business or activities the corporation conducts or intends to conduct in the State of North Dakota

Check box if

16.

OFFICERS AND DIRECTORS OF THE CORPORATION

officer also

serves as

NAME

COMPLETE MAILING ADDRESS

OFFICER

director

Street/RR

PO Box

City

State

Zip+4

PRESIDENT

VICE PRES.

SECRETARY

TREASURER

DIRECTOR

17. The undersigned, a person authorized by the corporation to sign this application, knows the contents thereof, and believes the statements to be true I

further authorize the Secretary of State to correct numbers 4, 6, 9, 10, 14A and 14B if not correctly reflected."

Signature

Date

E-mail address

Daytime telephone number

18. Name of person to contact if questions about this document