Wyoming Secretary of State 
                                     Herschler Building East, Suite 101
                                          122 W 25th Street
                                           Cheyenne, WY 82002-0020                                  For Office Use Only 
                                          Ph. 307.777.7311 
                                          Email: Business@wyo.gov   

                                          Foreign Nonprofit Corporation 
                           Application for Amended Certificate of Authority 

Pursuant to W.S. 17-19-1504 the undersigned corporation hereby applies for an Amended Certificate of Authority. 

Current Information on File: 
1. Name of the corporation:

2. Organized under the laws of:

                                          (State or country) 

3. Period of duration:
 (This is referring to the length of time nonprofit corporation intends to exist and not the length of time it has been in existence. The most 
common term used is “perpetual.”) 

Amended Information: 
(Check all that apply and enter the changes in the appropriate fields.) 

4.          New Company Name :

5.          New State of Country of Incorporation:

6.          New Period of Duration:

Signature: ___________________________________________                                       Date: 
(May be executed by Chairman of Board, President or another of its officers.)                          (mm/dd/yyyy) 

Print Name:                                                     Contact Person: 

Title:                                                          Daytime Phone Number: 

                                                                Email:  

                                                                (An email address is required. Email(s) provided will receive important 
                                                                reminders, notices and filing evidence.)

FNP-AmendedCertificateAuthority - Revised June 2021

Checklist 
Filing Fee: $25.00 Make check or money order payable to Wyoming Secretary of State.

Processing time is up to 15 business days following the date of receipt in our office. 

Please mail with payment to the address at the top of this form. This form cannot be accepted via email.

Please review the form prior to submission. The Secretary of State’s Office is unable to process incomplete forms.

REQUIRED ATTACHMENTS TO INCLUDE WITH THE FILING: 
The completed application must be accompanied by an original certificate of existence/good standing, dated not 
more than sixty (60) days prior to filing in Wyoming, authenticated by the Secretary of State or official having 
custody of corporate records in the state or country of formation.          

The completed application must be accompanied by an original Certificate of Evidence of the  
Amendment, or a certified copy of the amendment, dated not more than sixty (60) days prior to filing in            
Wyoming. If the amendment involves a name change, the certificate must state the previous name and the 
new name along with the date of the amendment. 

FNP-AmendedCertificateAuthority - Revised June 2021