State of Alaska
Department of Commerce, Community and Economic Development
Division of Corporations, Business and Professional Licensing
CORPORATIONS SECTION
Po Box 110808
Juneau, AK 99811-0808
APPLICATION FOR AMENDED CERTIFICATE OF REGISTRATION
For Foreign Limited Liability Company and Limited Partnership
Pursuant to the provisions of the Alaska Statutes, the undersigned applies for an amended certificate of registration to
transact business in Alaska.
1. Name of the entity (as it is currently stated on the Certificate of Registration):
Alaska Entity #:
2. Amended name of entity (if changing the name of the entity):
3. The assumed name elected to use in Alaska if the legal name is not available:
4. The purpose of the entity other than those set forth in its prior application:
Purpose:
NAICS Code:
5. Address of the principle office of the entity in the state or country of domicile:
Name:
Mailing Address:
City:
State:
Zip:
6. Other amendments to the prior registrations are as follows:
The PRINTED name and SIGNATURE by a person who is authorized by the law of the state or other jurisdiction where the
company was organized to sign the application:
Signed this _______ day of __________________________, 20______.
Signature of Authorized Person:
Printed Name:
Title
If the name of the entity is amended, an original Certificate of Compliance, sometimes referred to as a Certificate of Good
Standing or Certificate of Existence, issued by the state of domicile of the entity must be filed with this application. The
original certificate must not be older than 60 days.
A certified copy of the articles of amendment from the state of domicile must be attached to the Application for Amended
Certificate of Registration for any change other than a name change.
CONTINUED ON NEXT PAGE
08-456 (Rev. 04/14/09)