Corporate Name __________________________________________________
(Corporate Seal)
By _______________________________________________
Its President or Vice President
Attest ____________________________________________
Its Secretary or Assistant Secretary
If changing the name you must attach a recent dated Certificate of Fact or if the name was changed by
Merger, a State Certified copy of the Merger must be attached and an additional $100.00 to also file the
Merger.
If changing the jurisdiction (redomesticating) a Good Standing Certificate from the new home state must
be attached.
Notes :
1. If no change, insert "NO CHANGE" and make check payable to the D.C. Treasurer.
2. This name must be the same as in SECOND, unless the name in SECOND does not include
"Corporation". "Incorporated", "Company" or "Limited", or an abbreviation thereof, in which case one of
the above words or abbreviations must be added.
Mail To:
DEPARTMENT OF CONSUMER AND REGULATORY AFFAIRS
ONE STOP BUSINESS CENTER
941 NORTH CAPITOL STREET, N.E., ROOM #1100
WASHINGTON, D.C. 20002
FEES DUE:
Filing Fee .......... $100.00