State of Alaska 
                          Division of Corporations, Business and Professional Licensing 
                          CORPORATIONS SECTION 
                          PO Box 110806 
                          Juneau, AK  99811-0806 
                          Phone: (907) 465-2550 
                          Fax: (907) 465-2974 
                          Website: www.commerce.alaska.gov/occ 
                                                            
              AMENDED CERTIFICATE OF AUTHORITY 
                            Foreign Nonprofit Corporation 
                                              AS 10.20.555 
 Filing Fee: $25.00 (non-refundable)    
  
 INSTRUCTIONS (Please retain for your records): 
  
 NOTICE: The Amended Certificate of Authority will not be filed if a biennial report is due or the signatures do 
 not match what the Corporations Section has on record. To verify this information please search for the entity 
 by going to Search Corporations Database in the Corporations Section of our website at 
 www.commerce.alaska.gov/occ. If there is a biennial report due, the report may be filed online by selecting 
 Biennial Reports on the Corporations Section page. If the officers/directors have changed, but no biennial 
 report is due, please submit a Notice of Change located in the Forms and Fees section.  
  
 Refer to Alaska Statutes 10.20.555. It is not necessary for the corporation to obtain a new or amended 
 certificate of authority to transact business in this state unless the name of the corporation is changed or 
 unless the corporation’s purpose has changed.  If the name is amended, attach a Certificate of Compliance 
 from the state of domicile. If the purpose is amended, attach a certified copy of the Articles of 
 Incorporation form the state of domicile. 
  
 ITEM 1: Provide the name of the entity currently on record and the Alaska Entity Number. 
  
 ITEM 2: Provide the amended legal name of the corporation; this must contain the word “corporation,” 
 “company,” “incorporated,” “limited,” or an abbreviation of one of these words.  
  
 ITEM 3: Provide the assumed name if the legal name is not available for use in Alaska. 
  
 ITEM 4: State the amended purpose and the NAICS code.  
  
 ITEM 5: Address of the corporation in the state or country of domicile. 
  
 ITEM 6: The Amended Certificate of Authority must be signed by the corporation’s president or vice president 
 and by the secretary or assistant secretary on record.  
  
 NOTE: Persons who sign documents filed with the commissioner that are known to the person to be false in 
 material respects, is guilty of a class A misdemeanor.  
  
 Mail the Amended Certificate of Authority and the non-refundable $25.00 filing fee in U.S. dollars to: 
 State of Alaska, Corporations Section, PO Box 110806, Juneau, AK  99811-0806 
  
 STANDARD PROCESSING TIME for complete and correct applications submitted to this office is 
 approximately 10-15 business days. All applications are reviewed in the date order they are received.  

 08-453 (Rev. 02/01/2012)   Amended Certificate of Authority Instructions          
  

                 State of Alaska 
                                                                                    DO NOT STAMP ABOVE THIS BOX 
                 Division of Corporations, Business and Professional Licensing 
                                                                                    Office Use Only       CORP 
                 CORPORATIONS SECTION 
                 PO Box 110806 
                 Juneau, AK  99811-0806 
                 Phone: (907) 465-2550 
                 Fax: (907) 465-2974 
                 Website: www.commerce.alaska.gov/occ
                                                         
                          AMENDED CERTIFICATE OF AUTHORITY 
                                 Foreign Nonprofit Corporation 
                                         AS 10.20.555 

  $25.00 Filing Fee (non-refundable) 

Pursuant to Alaska Statutes 10.20.555, the undersigned corporation applies for a Certificate of Authority. 

NOTE: If the name is amended, attach a Certificate of Compliance from the state of domicile. If the purpose is 
amended, attach a certified copy of the Articles of Incorporation form the state of domicile. 

ITEM 1 :Name of the Entity:                                           Alaska Entity #: 

ITEM 2 : Amended legal name: 

ITEM 3 : If amended name is not available for use in Alaska, elect an assumed name. 

ITEM 4 : Amended purpose and, separately, NAICS code. 
Purpose:                                                              NAICS 
                                                                      code: 

ITEM 5 :Principal office address of the corporation wherever located: 
Name: 

Mailing address: 

City:                            State/Province:                      Country: 

ITEM 6: The Amended Certificate of Authority must be signed by the corporate president or vice president and 
by the secretary or assistant secretary. If the same person holds two of these positions, two different people 
must sign the application, unless that person holds all positions. 

Signature of President or Vice President      Printed name of President or Vice President        Date 

Signature of Secretary or Assistant Secretary Printed name of Secretary or Asst. Secretary       Date 

08-453 (Rev. 06/07/201 )8                     Page  1of 2 

NOTE: Persons who sign documents filed with the commissioner that are known to the person to be false in 
material respects are guilty of a class A misdemeanor.  
 
Mail the Amended Certificate of Authority and the non-refundable $25.00 filing fee in U.S. dollars to: 
State of Alaska, Corporations Section, PO Box 110806, Juneau, AK  99811-0806 
 
STANDARD PROCESSING TIME for complete and correct applications submitted to this office is 
approximately 10-15 business days. All applications are reviewed in the date order they are received.  

08-453 (Rev. 02/01/2012) Page  2of                      2                     

               State of Alaska 
                                                                              DO NOT STAMP ABOVE THIS BOX 
               Division of Corporations, Business and Professional Licensing 
                                                                              Office Use Only       CORP 
               CORPORATIONS SECTION 
               PO Box 110806 
               Juneau, AK  99811-0806 
               Phone: (907) 465-2550 
               Fax: (907) 465-2974 
               Website: www.commerce.alaska.gov/occ                                                                      
                                                                                                                         
                            CONTACT INFORMATION SHEET  

 Please return this document with your filing. This information will only be used to resolve questions with the filings 
 attached. NOTE: this form will not be filed for record or appear online. 
  
 Name of entity as it appears on filing: 
   
 To resolve questions with this filing, contact: 
  Name: 

  Email: Phone: 

  Mailing address: 

 Return documents to: 
  Name: 

  Company: 

  Mailing address: 
  
 Attach this form to your filings. Send all documents to: 
 State of Alaska, Corporations Section, PO Box 110806, Juneau, AK  99811-0806 
  
 STANDARD PROCESSING TIME for complete and correct applications submitted to this office is 
 approximately 10-15 business days. All applications are reviewed in the date order they are received.  

  08-561 (Rev. 02/01/2012)                       Page  1of 1                  
  

                         THE  TATE S                                                                                                          FOR DIVISION USE ONLY 
                         of 
                                                                                                                                                              
                           ALASKA 
                         Department of Commerce, Community, and Economic Development 
                         Division of Corporations, Business and Professional Licensing 
 
          State of Alaska  
          Department of Commerce, Community, and Economic Development 
          Division of      Corporations, Business and Professional Licensing 
          PO Box 110806, Juneau, AK 99811 
          Phone: (907)     465-2550 
 
Credit Card Payment Form                                                                                        

All major credit cards are accepted. For security purposes, do not email credit card information. 
Include this credit card payment form with your application.  

Name of Applicant or Licensee:      _________________________________________________________________________________________________________________________ 

Program Type:   ________________________________________________________       License Number (if applicable):                                    ________________________________ 

 I wish to make          payment by credit card for the following(check all that apply):                                                                        AMOUNT           

          Application Fee:  _________________________________________________________________________________________________                           __________________________         

          License or Renewal Fee:        _________________________________________________________________________________                              __________________________         

          Other (name change, wall certificate, fine, duplicate license, exam, etc.):         

            1.           _____________________________________________________________________________________________________________________               __________________________ 

            2.          _____________________________________________________________________________________________________________________                __________________________         

                                                                                                       TOTAL:            ___________________________ 

Name (as shown on credit card):   ________________________________________________________________________________________________________________________ 

Mailing Address:            ___________________________________________________________________________________________________________________________________________________ 

Phone Number:   ________________________________________________________      Email (optional):               _______________________________________________________ 

Signature of Credit Card Holder:                     _____________________________________________________________________________________________________________________ 

  08-4438                   Rev 12/26/18                   Credit Card Payment Form (all major cards accepted) 
  
   CREDIT CARD INFO:  Your payment cannot be processed unless all fields are completed! 
   
       1. Account Number:                                                                                       All four fields MUST 

                                                                                                                                                 be completed! 
       2. Expiration Date:                                                                                                                                    

                                                                                                                This section will be 
       3. Billing ZIP Code: 
                                                                                                                destroyed after the 
       4. Security Code:                                                                                       payment is processed.