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DSCB:15-413–Instructions
Pennsylvania Department of State
Bureau of Corporations and Charitable Organizations
P.O. Box 8722
Harrisburg, PA 17105-8722
(717) 787-1057
Website: www.dos.pa.gov/corps
General Information 1. Give the exact name of the association as registered to do
Typewritten is preferred. If handwritten, the form must be business in Pennsylvania and as on file with the Department of
legible and completed in black or blue-black ink in order to State.If a foreign association has adopted an alternate name in
permit reproduction. order to register to do business in Pennsylvania, the registered
The nonrefundable filing fee for this form is $250. Checks foreign association must use the alternate name in response to
should be made payable to the Department of State. Checks a requirement that a document delivered to the Department for
must contain a commercially pre-printed name and address. filing state the name of the association. This field is required.
This form and all accompanying documents shall be mailed to 2. Select the type of association. Only one option may be
the address stated above. selected. This field is required.
Who should file this form? 3. Give one of the following: the current registered office
A foreign association that is registered to do business in this address in the Commonwealth in (a) or the name of a
Commonwealth must deliver to the Department for filing an Commercial Registered Office Provider (b) and the county of
amendment to its foreign registration statement if there is a venue, as on file with the Department of State at the time the
change in any of the following: amendment is submitted for filing.
(1) The name of the association. Post office boxes are not acceptable for any address. Under 15
(2) The type of association, including, if it is a foreign Pa.C.S. § 135(c) (relating to addresses), an actual street or
limited partnership, whether the association became or ceased rural route box number must be used as an address, and the
to be a foreign limited liability limited partnership. Department of State is required to refuse to receive or file any
(3) The association’s jurisdiction of formation. document that sets forth only a post office box address.
(4) An address required by section 412(a)(4) (relating to This field is required.
foreign registration statement).
(5) Its registered office. 4. Any date specified as the effective date of the Amendment
(6) The authority of the association to have one or more of Foreign Registration must be a future effective date (after
series. the date and time of its delivery to the Department). A
Applicable Law specified effective date may not be retroactive (prior to the
For foreign associations, in general, 15 Pa.C.S. §§ 102; 401- date and time of the delivery of the Amendment of Foreign
419; for amendment, 15 Pa.C.S. § 413; for names, 15 Pa.C.S. Registration to the Department). If a delayed effective date is
§ 414 and §§ 201-209. Statutes are available on the specified, but no time is given, then the time used will be
Pennsylvania General Assembly website, 12:01 a.m. on the date specified. If neither option for an
www.legis.state.pa.us, by following the link for Statutes. effective date is checked, it will be presumed that no specified
delayed effective date is intended and the document will be
Attachments effective upon filing. This field is required.
The following, in addition to the filing fee, shall accompany
this form: 5. Supply the change(s) to the information previously supplied
(1)One copy of a completed form DSCB: 15-134B in the association’s Foreign Registration Statement
(Docketing Statement - Changes). (DSCB:15-412). If the amendment reflects a change in name
(2)Any necessary copies of form DSCB: 19-17.2 (Consent for the association which does not comply with 15 Pa.C.S. §
to Appropriation of Name). If Consent cannot be obtained, the 414 and 15 Pa.C.S. §§ 201-209, the foreign association must
association may adopt, for the purpose of doing business in have consent to use the name or adopt an alternate name that
this Commonwealth, an alternate name that complies with 15 complies 15 Pa.C.S. §§ 201-209 for use in Pennsylvania.
Pa.C.S. § 414 and §§ 201-209. This field is required.
(3)Any necessary governmental approvals. Signature and Verification
An authorized representative of the foreign association must
Form Instructions sign the Amendment of Foreign Registration. Signing a
Enter the name and mailing address to which any document delivered to the Department for filing is an
correspondence regarding this filing should be sent. This field affirmation under the penalties provided in 18 Pa.C.S. § 4904
must be completed for the Bureau to return the filing. If the (relating to unsworn falsification to authorities) that the facts
filing is to be returned by email, an email address must be stated in the document are true in all material respects.
provided. An email will be sent to address provided, This field is required.
containing a link and instructions on how a copy of the filed
document or correspondence may be downloaded. Any email
or mailing addresses provided on this form will become part
of the filed document and therefore public record.
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