Form Dscb:15-8832 - Certificate Of Authority/amendment/cancellation Page 2
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2. The following named person (i.e., John Smith) __________________________________ has the authority to do
the following: Check all that apply. For additional persons, attach additional pages as needed.
Sign an instrument transferring real property held in the name of the company. Other specification or
limitation may be provided. Additional pages may be attached as needed.
__________________________________________________________________________________________
__________________________________________________________________________________________
Enter into other transactions on behalf of, or otherwise act for or bind, the company. Other specification
or limitation may be provided. Additional pages may be attached as needed.
__________________________________________________________________________________________
__________________________________________________________________________________________
III. Amendment to Certificate of Company Authority
If amending a Certificate of Authority previously filed in the Department of State, check the box below and complete
the following:
The Certificate of Company Authority that became effective on _______________________ is amended.
Date (MM/DD/YYYY)
The contents of the amendment are stated below. Additional pages may be attached as needed.
_________________________________________________________________________________________________
_________________________________________________________________________________________________
IV. Cancellation of Certificate of Company Authority
If cancelling a Certificate of Authority previously filed in the Department of State, check the box below and
complete the following.
The Certificate of Company Authority that became effective _________________________ is cancelled.
Date (MM/DD/YYYY)
IN TESTIMONY WHEREOF, the undersigned has caused this Certificate of Company Authority to be signed by a person
duly authorized by the company thereof this _______ day of ______________________, 20_______.
______________________________________________________________
Name of Limited Liability Company
______________________________________________________________
Signature
______________________________________________________________
Title
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