Company Name Change Form

COMPANY NAME CHANGE FORM

This Company Name Change Form is entered into as of Month Day Year by and between Company Name: a Corporation Limited Liability Company Limited Partnership Other Jurisdiction of formation: with principal office located at (the "Company"), and Authorized Agent Name: with address (the "Agent").

RECITALS

WHEREAS, the Company has adopted a resolution in accordance with its governing documents and applicable law authorizing a change of its legal business name from to ;

WHEREAS, the Company desires to effect the change of its name by amending its articles of incorporation or articles of organization (as applicable) and to make all necessary filings and notifications required by law and contractual counterparties; and

WHEREAS, the Company desires to appoint the Agent to prepare, execute and deliver all documents and take such actions as are necessary or advisable to effect and evidence the name change.

NOW, THEREFORE, in consideration of the mutual covenants and agreements herein contained, the parties agree as follows:

1. NAME CHANGE

1.1 Effective Name. The Company hereby amends its legal name to: (the "New Name"), and the Company shall cause its governing documents to be amended accordingly.

1.2 Effective Date. The parties intend for the New Name to become effective on or after or such other date as reflected in the filed amendment accepted by the appropriate filing authority.

2. AUTHORIZATION AND AGENT POWERS

2.1 Appointment. The Company appoints the Agent as its true and lawful agent and attorney-in-fact, with full power and authority to prepare, execute, deliver and file the Certificate/Articles of Amendment or similar instrument, to pay filing fees, to execute supporting affidavits, and to take all actions reasonably necessary to obtain and evidence the acceptance of such filings by the appropriate authorities.

2.2 Execution of Instruments. The Agent is authorized to execute and deliver any instrument on behalf of the Company that the Agent reasonably determines is necessary to consummate the name change and to effect any ministerial changes to the Company's internal records, contracts or registrations to reflect the New Name.

3. REPRESENTATIONS AND WARRANTIES

3.1 Company Representations. The Company represents and warrants that (a) it is duly organized, validly existing and in good standing under the laws of ; (b) the execution, delivery and performance of this Form and the actions contemplated herein have been duly authorized by all necessary corporate action; and (c) when executed and filed, the amendment will not violate any material agreement or law to which the Company is subject.

3.2 Agent Representations. The Agent represents that it has the authority to accept appointment, will act in good faith, and will use commercially reasonable efforts to effect the filings and notifications required to implement the name change.

4. FILING, NOTICE AND RECORDS

4.1 Filing. The Agent shall file the necessary documents with the appropriate filing office in and shall use reasonable efforts to secure confirmation of acceptance.

4.2 Notice of Acceptance. The Agent shall deliver to the Company, at the address for notices set forth below, a copy of any filed instrument and a written statement certifying the date of filing and the effective date of the change within of receipt of such confirmation.

5. AMENDMENT TO GOVERNING DOCUMENTS

5.1 The Company shall cause its Articles of Incorporation/Organization, bylaws or operating agreement and other internal and external records to be amended as necessary to reflect the New Name. The Company shall be responsible for any substantive amendments requiring board or shareholder approval in accordance with its governing documents.

6. INDEMNIFICATION

6.1 Indemnity by Company. The Company shall indemnify, defend and hold harmless the Agent and its affiliates, officers, directors and employees from and against any third-party claims, liabilities, losses, costs and expenses (including reasonable attorneys' fees) arising out of or resulting from the Agent's good faith performance of its duties under this Form, except to the extent such liability results from the Agent's willful misconduct or gross negligence.

7. NOTICES

Company Notice Address:

Company Contact Email/Phone:

Agent Notice Address:

Agent Contact Email/Phone:

8. FEES AND EXPENSES

8.1 Payment. The Company shall be responsible for all filing fees, taxes, assessments and reasonable out-of-pocket expenses incurred by the Agent in connection with the name change. If an amount is to be prepaid, the Company shall remit such sum in the amount of .

9. GOVERNING LAW

This Form shall be governed by and construed in accordance with the laws of the jurisdiction of without regard to its conflicts of law principles.

10. ENTIRE AGREEMENT; SEVERABILITY

10.1 Entire Agreement. This Form constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, whether written or oral.

10.2 Severability. If any provision of this Form is determined to be invalid, illegal or unenforceable in any respect, the validity, legality and enforceability of the remaining provisions shall not be affected or impaired.

11. AMENDMENTS; WAIVER; COUNTERPARTS

11.1 Amendments and Waiver. Any amendment to this Form must be in writing and executed by both parties. No waiver of any provision shall be effective unless in writing and signed by the party against whom enforcement is sought.

11.2 Counterparts. This Form may be executed in counterparts, each of which shall be deemed an original and all of which together shall constitute one and the same instrument. Signatures transmitted by electronic means shall be deemed originals for all purposes.

12. ADDITIONAL INFORMATION

Reason for Name Change (optional):

Additional Instructions to Agent (optional):

Sign Now