Application For Amended Certificate Of Authority (LLC) {LLF-4}

FILE ONE ORIGINAL (Two if you want a filed stamped copy returned to you)FEE: $25.00 **** In accordance with the provisions of the WV Code, the undersigned limited liability company **** hereby applies for an Amended Certificate of Authority and submits the following statement:1.Name under which the limited liability companywas authorized to transact business in WV: 2.Date Certificate of Authority was issued in West Virginia:3.Change of Name Information206 or Text of Amendment: (206If changing business name, you must attach one Certified Copy of the Name Change as filed in the home State of original organization.) Change of Name From: To: Name the organization elects to use in WV: (Due to home State name not being available)Other amendment (Attach additional pages if necessary.):4.Contact information.(This is optional, however, if there is a problem with the filing, listing a contact person and phonenumber may avoid having to return or reject the document.) Contact Name Phone Number Business e-mail address: 5.Signature information (See below*Important Legal Notice Regarding Signature): Print Name of Signer: Title/Capacity:Signature: Date: *Important Legal Notice Regarding Signature: PerWest Virginia Code24731B-2-209. Liability for false statement in filed record. If a record authorized or required to be filed under this chapter contains a false statement, one who suffers loss by reliance on the statement may recover damages for the loss from a person who signed the record or caused another to sign it on the person's behalf and knew the statement to be false at the time the record was signed. Important Note: This form is a public document. Please DO NOT provide any personal identifiable information on this form such as social security number, bank account numbers, credit card numbers, tax identification or driver222s license numbers. Form LLF-4 Rev. 11/2017WEST VIRGINIA APPLICATION FOR AMENDED CERTIFICATE OF AUTHORITY OF A LIMITED LIABILITY COMPANYWest Virginia Secretary of State Business & Licensing Division Tel: (304)558-8000 Fax: (304)558-8381 Website: www.wvsos.gov CHOOSE ONE OF THE FOLLOWING PROCESSING SERVICES: 1 EXPEDITED SERVICE (24-hour, 2-hour and 1-hour; *Requires standard filing fee plus additional expedite fee, see below) West Virginia Secretary of State Business & Licensing Division Tel: (304) 558-8000 Fax: (304) 558-8381 Website: www.wvsos.gov Filing Submission Instructions - Business DivisionSUBMIT THE COMPLETED APPLICATION WITH THE CUSTOMER ORDER REQUEST FORM TO ONE OF THE OFFICES BELOW. CHOOSE EXPEDITED OR STANDARD PROCESSING SERVICE. IF NOT USING THE CUSTOMER ORDER REQUEST FORM AND YOU ARE REQUESTING EXPEDITED SERVICE, YOU MUST INCLUDE THE WORD "EXPEDITE" AND THE LEVEL OF EXPEDITED SERVICE BEING REQUESTED (24-HOUR, 2-HOUR OR 1-HOUR) IN YOUR CORRESPONDENCE. BE SURE TO INCLUDE THE CORRECT ADDITIONAL EXPEDITED FEE. THIS FEE IS IN ADDITION TO THE REGULAR FILING FEE (SEE FEES BELOW).BUSINESS SERVICE CENTERS Standard and Expedited Filings Charleston Office One-Stop Business Center 1615 Washington Street East Charleston, WV 25311 Phone: (304) 558-8000 Fax: (304) 558-8381 Hours: Mon. - Fri. 8:30a - 5:00p EST Clarksburg Office North Central WV Business Center 200 West Main Street Clarksburg, WV 26301 Phone: (304) 367-2775 Fax: (304) 627-2243 Hours: Mon. -Fri. 9:00a - 5:00p EST Martinsburg Office Eastern Panhandle Business Center 229 E. Martin Street Martinsburg, WV 25401 Phone: TBA Fax: TBA Hours: Mon. - Fri. 9:00a - 5:00p ESTIMPORTANT: READ ALL INSTRUCTIONS CAREFULLY BEFORE COMPLETING FORMS. Please follow the instructions included with the application. Failure to include any of the required information on the form may cause the filing to be rejected.All forms may be downloaded from our web site www.wvsos.gov . Rev. 11/2017 *Fee$ 25.00 $250.00 $500.00 Expedite Service 24-Hour 2-Hour 1-HourEXPEDITED SERVICE requests may be submitted by: - E-mail to efilings@wvsos.gov - Fax - Walk in delivery 2 STANDARD PROCESSING (5-10 business days) SUBMIT COMPLETED FILING TO ONE OF THE BUSINESS CENTERS BELOW: INCLUDE PAYMENT: Be sure to enclose the correct filing fee with your filing. If paying by credit card, be sure to include the e-Payment Authorization form with your filing. Your filing will be rejected if the payment is not included or if the e-Payment Authorization form is not included if paying by credit card. Standard filing fees apply.STANDARD PROCESSING requests may be submitted by: - E-mail to CorpFilings@wvsos.gov - Fax - Walk in delivery (drop off service only filed within 5-10 business days) READ CAREFULLY BEFORE SUBMITTING - Expedite service is NOT AVAILABLE for the following filings: West Virginia Secretary of State Business & Licensing Division Tel: (304)558-8000 Fax: (304)558-8381 Website: www.wvsos.gov Customer Order RequestSUBMIT THIS COMPLETED FORM WITH YOUR FILING. Order Processing Requested*: * * * Expedite Processing Requires Additional Fees * * * Standard Processing** 24-HOUR Expedite*** 2-HOUR Expedite 1-HOUR Expedite Name of Entity: Return filing to: (Return Address) Contact Name: Phone: Return Delivery Options: Email or Fax options do not receive a copy via mail; must be ordered separately. Email to: Fax to: Hold for Pick Up UPS: Acct # Other (explain below): (additional $500.00 fee included)(additional $25.00 fee included)(additional $250.00 fee included) FedEx: Acct # Mail to Return Address above Order Description (include items being ordered and fee breakdown): *PLEASE NOTE: Original paperwork is kept by this office. Include a copy of the original filing ifyou want a file stamped copy returned to you at no extra charge. Certified copy requests are an additional $15 per certified copy being requested. Total Amount: Payment Method: Cash (Do Not mail cash) Pre-paid Acct #: Credit Card (Must attach e-Payment Authorization request form including payment information.) Check/Money Order *"Processing" indicates the filing will be completed and registered in the Secretary of State registration database. **Standard Processing applications received by E-MAIL or FAX must include the e-Payment Authorization form with credit card information. ***NOTE: Orders filed in person through any Secretary of State office location requesting the filing be processed will be assessed a 24-HOUR Expedite fee of $25.00 per order.(Avg. processing turnaround 5-10 business days)Rev. 6/2018Attach signed pre-paid slip. >> Tax Department filings including Sole Proprietorships, General Partnerships, and Associations >> Dissolution or Withdrawal of Corporation, Voluntary Association or Business Trust Email to: CorpFilings@wvsos.govEmail to: eFilings@wvsos.gov 24-hour, 2-hour and 1-hour Expedite Service GuidelinesMAC WARNER Secretary of State State Capitol Building Charleston, WV 25305 Phone: (304) 558-6000 Website: www.sos.wv.gov IMPORTANT: To ensure expedited service, please mark 223EXPEDITE224 in a conspicuous place at the top of the service request. Please indicate method of delivery. 24-HOUR EXPEDITE SERVICE The Secretary of State offers a 24-hour expedite service on most business organization filings processed by this office. If you choose to utilize this service, please enclose with your filing the additional expedite fee. Please note that this expedite fee is in addition to the standard fee charged on each filing and/or order. You must mark the document with your 22324-HOUR EXPEDITE224 request. If using a cover letter, note that you are requesting 24-hour expedited service, and include your telephone number and return information. Each filing will be returned by U.S.P.S. regular mail unless other arrangements are made. This office does not fax confirmation of a 24-hour expedite. The fee for 24-hour handling is $25.00 in addition to the usual fee for service. Please consult our fee schedules for the appropriate fee. If you require assistance, please contact this office. Time Constraints: Under most circumstances, each filing submitted receives same day filing date and may be picked up in the office by the end of the same business day. Filings to be mailed the next business day if received by 2:00 pm of receipt date and no later than the 2nd busi