State of Missouri
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Robin Carnahan, Secretary of State
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Corporations Division
P.O. Box 778 / 600 W. Main Street, Rm 322
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Jefferson City, MO 65102
Statement of Correction for
Limited Liability Company
(Submit with filing fee of $10)
1.
The name of the limited liability company is:
________________________________________________________________________________________________________________
2.
The jurisdiction under whose laws it was organized is:
________________________________________________________________________________________________________________
3.
Type of document being corrected (or filed copy thereof attached):
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
4.
Describe the incorrect statement and the reason for the correction:
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
5.
If the correction is for a foreign limited liability company with regard to an incorect name, provide a certificate of existence or
document of similar import duly authenticated by the appropriate official of the state or country where the foreign llc is regis-
tered.
6.
Date the original document was filed with the Missouri Secretary of State: ____________________________________________
Month/Day/Year
Please see next page
Name and address to return filed document:
Name: __________________________________________
Address: _________________________________________
City, State, and Zip Code: __________________________
LLC- 7 (01/05)