Application For Amended Certificate Of Authority For Foreign Master LLC {56266}

APPLICATION FOR AMENDED CERTIFICATE OF AUTHORITY FOR A FOREIGN MASTER LIMITED LIABILITY COMPANY State Form 56266 (3-17) Approved by State Board of Accounts, 2017 SECRETARY OF STATE BUSINESS SERVICES DIVISION 302 West Washington Street, Room E018 Indianapolis, IN 46204 Telephone: (317) 232-6576 www.sos.in.gov INSTRUCTIONS: 1. Use 8 ½" x 11" white paper for attachments. 2. Please TYPE or PRINT in INK. 3. Please visit our office on the web at www.sos.IN.gov 4. Make check or money order payable to the Secretary of State. 5. Submit original completed paperwork and payment to: 302 West Washington Street, Room E-018, Indianapolis, IN 46204. NOTE: This application must be accompanied by an original certificate of existence duly authenticated by the proper authority from the Master LLC's domiciliary state, within the last sixty (60) days. INFORMATION CONTAINED ON THIS PAGE IS NOT PART OF THE PUBLIC RECORD. Name of business E-mail address of business (SOS use only) RETURN DOCUMENTS TO: Name Street address, line 1 Street address, line 2 City State ZIP code Telephone number E-mail address (If different from above ­ SOS use only) ( ) American LegalNet, Inc. www.FormsWorkFlow.com APPLICATION FOR AMENDED CERTIFICATE OF AUTHORITY FOR A FOREIGN MASTER LIMITED LIABILITY COMPANY State Form 56266 (3-17) Approved by State Board of Accounts, 2017 Indiana Code 23-18-11-5 23-18-12-3 FILING FEE: $30.00 APPLICATION FOR AMENDED CERTIFICATE OF AUTHORITY OF: _______________________________________________________________________________________________________________________ (Name of Master Limited Liability Company) A FOREIGN MASTER LIMITED LIABILITY COMPANY ADMITTED TO TRANSACT BUSINESS IN INDIANA The undersigned manager or member of _______________________________________________________________________________________ (hereinafter referred to as the "Master LLC"), which exists pursuant to the provisions of the laws of ________________________________ as amended, (State or county of organization) desire to obtain an Amended Certificate of Authority. 1. The above Master LLC received a Certificate of Authority to transact business in the State of Indiana on the ______ day of ___________________, ________. 2. The Master LLC desires to change its name in Indiana as follows: ________________________________________________________________. (Please note that in order to amend the name of the Master LLC, you must also amend the name of each associated Series. The Articles of Amendment changing the name of the Master LLC and the Articles of Designation amending the name of every Series must be submitted to the Secretary of State's office together.) 3. The Master LLC has changed the period of its duration from __________________________________________________________________ to _______________________________________________________________________. 4. The Master LLC has changed the state or country of its organization from _______________________________________________________ to _______________________________________________________________________. 5. The Master LLC has converted the entity type to a ____________________________________________________________________________. In witness whereof, the undersigned being the ___________________________________________________________ of said Master LLC executes (manager or member) this Application for Amended Certificate of Authority and verifies, subject to penalties of perjury, that the statements contained herein are true, this ______ day of ________________________, 20______. Signature Printed name American LegalNet, Inc. www.FormsWorkFlow.com