Form Dscb:15-8433 - Certificate Of Partnership Authority/amendment/cancellation Page 4

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Partnership Authority which is already on file with the
Department of State.
Check the box. List the date that the Certificate of Partnership
Authority that is being amended became effective. List
verbatim, the content of the amendment. Additional pages
may be attached as needed.
Section IV. This field is required in addition to Section I
only if the general partnership is canceling a Certificate of
Partnership Authority which is already on file with the
Department of State.
Check the box. List the date that the Certificate of Partnership
Authority that is being canceled became effective.
Signature and Verification
An authorized representative of the partnership must sign
the Certificate of Partnership Authority (or amendment or
cancellation thereto).
Signing a document delivered to the
Department for filing is an affirmation under the penalties
provided in 18 Pa.C.S. § 4904 (relating to unsworn
falsification to authorities) that the facts stated in the
document are true in all material respects.
This field is
required.

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