D
The Commonwealth of Massachusetts
PC
William Francis Galvin
Secretary of the Commonwealth
One Ashburton Place, Boston, Massachusetts 02108-1512
Statement of Change of Supplemental
FORM MUST BE TYPED
FORM MUST BE TYPED
Information Contained in Article
VIII of Articles of Organization
(General Laws Chapter 156D, Section 2.02 and Section 8.45; 950 CMR 113.17)
(1) Exact name of the corporation: ________________________________________________________________________
(2) Current registered offi ce address: _______________________________________________________________________
(number, street, city or town, state, zip code)
(3) Th e following supplemental information has changed:
(
check appropriate box)
® Names and addresses of the directors, president, treasurer and secretary (an address need not be specifi ed if the business
address of the offi cer or director is the same as the principal offi ce location):
President:
Treasurer:
Secretary:
Director(s):
® Fiscal year end: ________________________________________________________________________________
(month, day)
® Principal offi ce address: __________________________________________________________________________
(number, street. city or town, state, zip code)
® Type of business in which the corporation intends to engage:
____________________________________________________________________________________________
® Other:
____________________________________________________________________________________________
Th is certifi cate is eff ective at the time and on the date approved by the Division, unless a later eff ective date not more than 90 days
from the date of fi ling is specifi ed: _________________________________________________________________________
P.C.
c156ds202s845950c11317 01/13/05