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Application For Amended Certificate Of Authority (Nonprofit) SS-4434 - Tennessee
| Application For Amended Certificate Of Authority (Nonprofit) Form. This is a Tennessee form and can be used in Corporation Secretary Of State . |
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For Office Use Only APPLICATION FOR AMENDED CERTIFICATE OF AUTHORITY Corporate Filings (NONPROFIT) 312 Eighth Avenue North 6th Floor, William R. Snodgrass Tower Nashville, TN 37243 Pursuant to the provisions of Section 48-65-104 of the Tennessee Nonprofit Corporation Act, the undersigned corporation hereby applies foran amended certificate of authority to transact business or conduct affairs in the State of Tennessee, and for that purpose sets forth: 1. The name of the corporation is If different, the name under which the certificate of authority is to be obtained is 2. The state or country under whose law it is incorporated is 3. The date of its incorporation is (must be month, day, and year), and the period of duration, ifother than perpetual, is 4. The complete street address (including zip code) of its principal office is Street City State/Country Zip Code 5. The complete street address (including the county and the zip code) of its registered office in Tennessee is Street City State/Country Zip Code Registered agent 6. The names and complete business addresses (including zip code) of its current officers are: (Attach separate sheet if necessary.) 7. The names and complete business addresses (including zip code) of its current board of directors are: (Attach separate sheet if necessary.) 8. The corporation has members. NOTE: Please mark the applicable box in #8.] 9. The corporation is a nonprofit corporation. 10. If the corporation had been incorporated in Tennessee, it would be a public benefit corporation, or a mutual benefit NOTE: Please mark the applicable box in #10.] 11. If the document is not to be effective upon filing by the Secretary of State, the delayed effective date/time is , (date) (time). [NOTE: A delayed effective date shall not be later than the 90th day after the date this document is filed by the Secretary of S]tate.[NOTE: This application must be accompanied by a certificate of existence (or a document of similar import) duly authenticated by the Secretary ofState or other official having custody of corporate records in the state or country under whose law it is incorporated. tificate shall not bear a dateThe cerof more than two (2) months prior to the date the application is successfully filed in Tennessee.] Signature Date Name of Corporation Signers Capacity Signature SS-4434 (Rev. 7/00) Name (typed or printed) RDA 1678
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