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

                               Foreign Limited Liability Company 
                      Application for Amended Certificate of Authority 

Pursuant to W.S. 17-16-1504 the undersigned limited liability company hereby applies for an Amended Certificate of 
Authority: 

Current Information on File: 
1. Name of the limited liability company:

2. Organized under the laws of:

                               (State or country) 

3. Period of duration:
(This is referring to the length of time the limited liability company 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 or Country of Organization: 

6.          New Period of Duration: 

Signature: ___________________________________________                     Date: 
(Shall be executed by a person authorized by the company.)                       (mm/dd/yyyy) 

Print Name:                                                Contact Person: 

Title:                                                     Daytime Phone Number: 

                                                           Email:  

                                                           (Email provided will receive annual report reminders and filing evidence) 
                                                                        *May list multiple email addresses

FLLC-AmendedCertificateAuthority - Revised August 2019 

Checklist 
         Filing Fee: $50.00   Make check or money order payable to Wyoming Secretary of State. 

          Please submit one originally signed document. 

          Typical processing time is 3-5 business days following the date of receipt in our office. 

          Please review form prior to submitting to the Secretary of State to ensure all areas have been 
          completed to avoid a delay in the processing of your documents. 

          REQUIRED ATTACHMENTS TO INCLUDE WITH THE FILING: 
          The 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 anoriginal Certificate of Evidenceof 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. 

FLLC-AmendedCertificateAuthority – August 201 9