State Form 49462 - Application For Amended Certificate Of Authority For A Foreign Limited Liability Company - 2017 Page 2

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APPLICATION FOR AMENDED CERTIFICATE OF AUTHORITY
FOR A FOREIGN LIMITED LIABILITY COMPANY
State Form 49462 (R5 / 3-17)
Approved by State Board of Accounts, 2017
Indiana Code 23-18-11-5
23-18-12-3
FILING FEE: $30.00
APPLICATION FOR AMENDED CERTIFICATE OF AUTHORITY
OF:
______________________________________________________________________________________________________________________
(Name of Limited Liability Company)
A FOREIGN LIMITED LIABILITY COMPANY ADMITTED TO TRANSACT BUSINESS IN INDIANA
The undersigned manager or member of ______________________________________________________________________________________
(hereinafter referred to as the “LLC”), which exists pursuant to the provisions of the laws of _____________________________________ as
(State or county of organization)
amended, desire to obtain an Amended Certificate of Authority.
1.
The above LLC received a Certificate of Authority to transact business in the State of Indiana on the ______ day of _______________, 20____.
2.
The LLC desires to change its LLC name in Indiana as follows: ________________________________________________________________
__________________________________________________________________________________________________________________.
3.
The LLC has changed the period of its duration from _______________________________________________________________________
to _______________________________________________________________________.
4.
The LLC has changed the state or country of its organization from _____________________________________________________________
to _______________________________________________________________________.
5.
The LLC has changed its entity type to a Foreign Master LLC.
Name of Master LLC (Please note: The name must meet the requirements of Indiana Code 23-18.1-6-7.)
__________________________________________________________________________________________________________________.
The Foreign Master LLC is authorized to designate one (1) or more Series.
In witness whereof, the undersigned being the ___________________________________________________________ of said LLC executes
(manager or member)
this Application for Amended Certificate of Authority and verifies, subject to penalties of perjury, that the statements contained herein are true,
this ______ day of ________________________, 20______.
Signature
Printed name

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