Form: Cf-4 - Wv Application For Amended Certificate Of Authority

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Joe Manchin, III
Penney Barker, Team Leader
Secretary of State
Corporations Division
State Capitol Bldg.
Tel.(304) 558-8000
1900 Kanawha Blvd. E.
Fax (304) 558-5758
Charleston, WV 25305
WV APPLICATION FOR
File One original application & one
FEE $25
AMENDED CERTIFICATE
certified copy of amendment from
OF AUTHORITY
incorporation state
In accordance with the provisions of the West Virginia Code, the undersigned corporation hereby applies for an
Amended Certificate of Authority and submits the following statement:
1.
Name under which corporation was
Authorized to transact business in
____________________________________
West Virginia:
____________________________________
2.
Date Certificate of Authority was
issued in West Virginia:
____________________________________
3.
Corporate name has been changed to:
____________________________________
attach one certified copy of name change from home state)
(
4.
Name the corporation elects to use in WV:
____________________________________
(due to home state name not being available in WV)
________________________________________________
5.
Date of signing:
____________________________________
6.
Print Name of Signer
____________________________________
7.
Print Title or Capacity of Signer:
____________________________________
8.
Signature of Signer:
____________________________________
9.
Contact name and number of
person to reach in case of problem
____________________________________
with filing: (optional)
____________________________________
PRINT THIS COPY, THEN CLICK HERE TO RESET.
Form: CF-4
Issued by the Secretary of State, State Capitol, Charleston, WV 25305
Rev.10/02

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