Form Dscb:15-413 - Amendment Of Foreign Registration
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3PENNSYLVANIA DEPARTMENT OF STATE
BUREAU OF CORPORATIONS AND CHARITABLE ORGANIZATIONS
Return document by mail to:
Name
Address
City
State
Zip Code
Return document by email to:
_________________________________
Read all instructions prior to completing. This form may be submitted online at https://
Fee: $250
In compliance with the requirements of the applicable provisions of 15 Pa.C.S. § 413 (relating to amendment of
foreign registration statement), the undersigned registered foreign association hereby states that:
1. The name of the association under which it is registered to do business in this Commonwealth is:
2. The type of association is (check only one):
Business Corporation
Limited Partnership
Business Trust
Nonprofit Corporation
Limited Liability (General) Partnership
Professional Association
Limited Liability Company
Limited Liability Limited Partnership
3. The (a) address of the association’s registered office in this Commonwealth or (b) name of its Commercial Registered
Office Provider and the county of venue is:
Complete part (a) OR (b) – not both:
(a) ________________________________________________________________________________________________________
Number and street
City
State
Zip
County
OR
(b) c/o: _____________________________________________________________________________________________________
Name of Commercial Registered Office Provider
County
4. Effective date of amendment of foreign registration (check, and if appropriate complete, one of the following):
The Amendment of Foreign Registration shall be effective upon filing in the Department of State.
The Amendment of Foreign Registration shall be effective on: ________________________ at _______________.
Date (MM/DD/YYYY)
Hour (if any)
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