Fill and Sign the Corporations New York State Department of State Form

Docketing Statement DSCB:15-134A (Rev 2012) Departments of State and Revenue One (1) required Check proper box: Pennsylvania Entities Foreign Entities State/Country Date______ Other BUREAU USE ONLY: Dept. of State Entity # _______________________ Dept. of Rev. Box # _________________________ Filing Period ____________Date 3 4 5 __________ SIC/NAICS _____________Report Code ________ business stock business non-stock professional nonprofit stock nonprofit non-stock statutory close management cooperative insurance ____ benefit limited liability company restricted professional limited liability company business trust business ____ benefit nonprofit limited liability company restricted professional limited liability company business trust domestication division consolidation 1. Entity Name: 2. Individual name and mailing address responsible for initial tax reports: Name Number and street City State Zip 3. Description of business activity: 4. Specified effective date, if any: month/day/year hour, if any 5. EIN (Employer Identification Number), if any: 6. Fiscal Year End: 7. Fictitious Name (only if foreign corporation is transacting business in PA under a fictitious name): d Print Form Fee: $70 In compliance with the requirements of the applicable provisions (relating to articles of amendment), the undersigned, desiring to amend its articles, hereby states that: PENNSYLVANIA DEPARTMENT OF STATE BUREAU OF CORPORATIONS AND CHARITABLE ORGANIZATIONS Articles of Amendment-Domestic Corporation (15 Pa.C.S.) Business Corporation (§ 1915) Nonprofit Corporation (§ 5915) Document will be returned to the name and address you enter to the left. Name Address City State \ Zip Code 1. The name of the corporation is: 2. The (a) address of this corporation's current registered office in\ this Commonwealth or (b) name of its commercial registered office provider and the county of venue is (the D\ epartment is hereby authorized to correct the following information to conform to the records of the Depar\ tment):(a) Number and Street City \ State Zip County (b) Name of Commercial Registered Office Provider County c/o 3. The statute by or under which it was incorporated: 4. The date of its incorporation: 5. Check, and if appropriate complete, one of the following : The amendment shall be effective upon filing these Articles of Amendment in the Department of State. The amendment shall be effective on: at ____________ Date Hour Print Form DSCB:15-1915/5915–2 6. Check one of the following: The amendment was adopted by the shareholders or members pursuant to 15 \ Pa.C.S. § 1914(a) and (b) or § 5914(a). The amendment was adopted by the board of directors pursuant to 15 Pa. C.S. § 1914(c) or § 5914(b). 7. Check, and if appropriate, complete one of the following: The amendment adopted by the corporation, set forth in full, is as follo\ ws The amendment adopted by the corporation is set forth in full in Exhibit A attached hereto and made a part hereof. 8. Check if the amendment restates the Articles: The restated Articles of Incorporation supersede the original articles a\ nd all amendments thereto. IN TESTIMONY WHEREOF, the undersigned corporation has caused these Articles of Amendment to be signed by a duly authorized officer thereof this day of , . Name of Corporation Signature Title Department of State Bureau of Corporations and Charitable Organizations P.O. Box 8722 Harrisburg, PA 17105-8722 (717) 787-1057 web site: www.dos.state.pa.us/corps Instructions for Completion of Form: A. Typewritten is preferred. If not, the form shall be completed in bl\ ack or blue-black ink in order to permit reproduction. The filing fee for this form is $70 made payable to the Commonwealth of Pennsylvania. Checks must contain a commercially pre-printed name and address. B. Under 15 Pa.C.S. § 135(c) (relating to addresses) an actual s\ treet or rural route box number must be used as an address, and the Department of State is required to refuse to rece\ ive or file any document that sets forth only a post office box address. C. The following, in addition to the filing fee, shall accompany this f\ orm: (1) Two copies of a completed form DSCB:15-134B (Docketing Statement\ -Changes). (2) Any necessary copies of form DSCB:17.2.3 (Consent to Appropriation of N\ ame) shall accompany Articles of Amendment effecting a change of name and th\ e change in name shall contain a statement of the complete new name. (3) Any necessary governmental approvals. D. Nonprofit Corporations: If the action was authorized by a body other than the board of directo\ rs Paragraph 6 should be modified accordingly. E. This form and all accompanying documents shall be mailed to the abov\ e stated address. Fee: $70 In compliance with the requirements of the applicable provisions (relat\ ing to certificate of amendment), the undersigned, desiring to amend its Certificate of Limited Partner\ ship/Organization, hereby certifies that: PENNSYLVANIA DEPARTMENT OF STATE BUREAU OF CORPORATIONS AND CHARITABLE ORGANIZATIONS Certificate of Amendment-Domestic (15 Pa.C.S.) Limited Partnership (§ 8512) Limited Liability Company (§ 8951) Document will be returned to the name and address you enter tothe left. Name Address City State \ Zip Code 1. The name of the limited partnership/limited liability company is: 2. The date of filing of the original Certificate of Limited Partnershi\ p/Organization: 4. Check, and if appropriate complete, one of the following: The amendment shall be effective upon filing this Certificate of Amendment in the Depa\ rtment of State. The amendment shall be effective on: at . Date Hour 3. Check, and if appropriate complete, one of the following: The amendment adopted by the limited partnership/limited liability compa\ ny, set forth in full, is as follows: The amendment adopted by the limited partnership/limited liability company is set forth in full in Exhibit A attached hereto and made a part hereof. Print Form DSCB:15-8512/8951–2 5. Check if the amendment restates the Certificate of Limited Partnership/O\ rganization: The restated Certificate of Limited Partnership/Organization supersedes \ the original Certificate of LimitedPartnership/Organization and all previous amendments thereto. IN TESTIMONY WHEREOF, the undersigned limited partnership/limited liability company has caused this Certificate of Amendment to be executed this day of , . Name of Limited Partnership/Limited Liability Company Signature Title le Department of State Bureau of Corporations and Charitable Organizations P.O. Box 8722 Harrisburg, PA 17105-8722 (717) 787-1057 web site: www.dos.state.pa.us/corps General Instructions for Completion of Form: A. Typewritten is preferred. If not, the form shall be completed in bl\ ack or blue-black ink in order to permit reproduction. The filing fee for this form is $70 made payable to the C\ ommonwealth of Pennsylvania. Checks must contain a commercially pre-printed name and address. B. The following, in addition to the filing fee, shall accompany this f\ orm: (1) If the amendment effects a change of name, two copies of a completed fo\ rm DSCB:15-134B Docketing Statement-Changes). (2) If the amendment effects a change of name, any necessary copies o\ f form DSCB:17.2.3 (Consent toAppropriation of Name). (3) Any necessary governmental approvals. C. This form and all accompanying documents shall be mailed to the abov\ e stated address. Instruction for Amendment for Domestic Limited Liability Company Only: E. A Certificate of Organization may be amended for any other proper pu\ rpose, including a restatement of the certificate in its entirety, omitting any matter that is obsolete or no longer\ required. Form DSCB:15-8906 (Certificate of Change of Registered Office) may be used if the only change in the certi\ ficate is a change of registered office. Instruction for Amendment for Domestic Limited Partnership Only: F. This form shall be executed by any general partner and each other entity\ designated in the form as a new general partner. If this form is executed by an individual or by multiple p\ arties, the execution portion of the form should be modified accordingly. G. This form shall be filed upon the occurrence of any of the following\ events: (1) A change in the name of the limited partnership. (2) The admission of a new general partner. (3) The withdrawal of a general partner not reflected by the filing of form \ DSCB:15-8524/8532 (Certificate of Withdrawal by General Partner-Limited Partnership/From Limited Partnersh\ ip). This form should be used where the withdrawal is accompanied by another chang\ e in the Certificate of Limited Partnership, e.g., the addition of a new general partner. H. A Certificate of Limited Partnership may be amended for any other pro\ per purpose, including a restatement of the certificate in its entirety, omitting any matter that is obsolete or no longer required. Form DSCB:15-1507/ 4144/5507/6144/8506 (Statement of Change of Registered Office) \ shall be used if the only change in the certificate is a change of registered office.