Application For Amended Certificate Of Authority (Foreign Corporation) Form - 2009
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1APPLICATION FOR AMENDED CERTIFICATE OF
AUTHORITY
FOREIGN CORPORATION
MAILING ADDRESS:
COURIER ADDRESS:
Commercial Recording Division
Office of the Secretary of the State
Commercial Recording Division
Connecticut Secretary of the State
Connecticut Secretary of the State
P.O. Box 150470
30 Trinity Street
Hartford, CT 06115-0470
Hartford, CT 06106
860-509-6003
860-509-6003
FEE: Stock $100.00
Non-Stock $40.00
Make Checks Payable To “Secretary of the State”
Space For Office Use Only
1. NAME OF CORPORATION IN ITS STATE OR COUNTRY OF FORMATION:
2. IF DIFFERENT FROM THE ABOVE, THE NAME UNDER WHICH CORPORATION TRANSACTS BUSINESS IN
CONNECTICUT:
3. CHECK EITHER A. OR B.
_____A. The corporation is organized for profit.
_____B. The corporation is nonprofit.
4. STATE/COUNTRY OF INCORPORATION:
________________________________________
5. DURATION: (CHECK ONE) ____PERPETUAL
_____OTHER
(SPECIFY)__________________
6. THE CORPORATION HEREBY APPLIES FOR AN AMENDED CERTIFICATE OF
AUTHORITY FOR THE FOLLOWING REASON(S):
_____A. The name of the corporation in its state or country of incorporation has been changed to:
_______________________________________________________
_____B. The name stated in item A above is unavailable for use in Connecticut. The name under
which the corporation shall transact business is:
_______________________________________________________
_____C. The state or country of the corporation's incorporation has been changed to:
___________________________________________________________________
_____D. The corporation's duration has been changed to:
___________________________________________________________________
7. EXECUTION
Dated this _____ day of _________, 20_________.
__________________________
__________________________
__________________________
Print or type name of signatory
Capacity of signatory
Signature
Revised 12/07/09
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