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Certificate Of Amendment (Other) - Nevada

Certificate Of Amendment (Other) Form. This is a Nevada form and can be used in State Business License (Non Title 7) Secretary Of State .
 Fillable pdf Last Modified 11/4/2010
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ROSS MILLER Secretary of State 202 North Carson Street Carson City, Nevada 89701-4201 (775) 684-5708 Website: Nevada State Business License *021101* *021101* Certificate of Amendment "Other" ABOVE SPACE IS FOR OFFICE USE ONLY USE BLACK INK ONLY - DO NOT HIGHLIGHT Completing this form does not relieve you of any statutory or regulatory requirements relating to your business. This form is for the use of a business that is not a sole proprietor or partnership or that is not required to organize pursuant to Title 7 of NRS. It MAY NOT be used by those entities organized and on file with the Secretary of State that file an annual list. * Asterisks indicate required information. Incomplete forms will be rejected. INSTRUCTIONS: 1. Print legibly or type all information on this form. 2. Enter the name and NV Business ID # exactly as shown on State Business License certificate and as on file with the Secretary of State. 3. File online at, or, 4. Return the completed form to: Secretary of State, 202 North Carson Street, Carson City, Nevada, 89701-4201, (775) 684-5708. 5. This form must be signed by a responsible party. FORM WILL BE RETURNED IF UNSIGNED. 1* Name as it appears on Business License 2* NV Business ID # (NV Secretary of State - issued, may be found on State Business License) (Check the box of the information you are changing) 3 The State Business License is hereby amended as follows: Entity Name IMPORTANT: Name change requires document certifying a legal name change. If this is not provided, amendment will be rejected. Phone # ( Physical Address Mailing Address Email Address ) Physical Street Address City State Zip Code PO Box or Street Address City State Zip Code 4* Signature must be that of a responsible party of the entity amending the State Business License. I declare under penalty of perjury that the information provided is true, correct and complete to the best of my knowledge and belief and acknowledge that pursuant to NRS 239.330, it is a category C felony to knowingly offer any false or forged instrument for filing in the Office of the Secretary of State. First Name Middle (Optional) Last Name Suffix Title X Signature Date Nevada Secretary of State Busn License Amend Other Revised: 8-3-10 American LegalNet, Inc.
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