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                                                                                                           New York State 
                                                                                         Department of State 
                                                                                         DIVISION OF CORPORATIONS, 
                                                                                         STATE RECORDS AND  
                                                                                         UNIFORM COMMERCIAL CODE 
                                                                                         One Commerce Plaza 
                                                                                         99 Washington Ave. 
                                                                                         Albany, NY 12231-0001 
                                                                                                                                                                            www.dos.ny.gov 
 
                         CERTIFICATE OF CHANGE 

                                                 OF 
 
                         (Insert Name of Domestic Limited Liability Company) 

                         Under Section 211-A of the Limited Liability Company Law 
 
 FIRST: The name of the limited liability company is: 
  
                                                                                                                                                                                                        . 
 If the name of the limited liability company has been changed, the name under which it was organized  

 is:                                                                                                                                                                             . 

 SECOND: The date of filing of the articles of organization is:                                                              . 

 THIRD: The change(s) effected hereby are: [check appropriate statement(s)] 
 
 1.        The county location, within this state, in which the office of the limited liability company is 

           located, is changed to:                                                                                                                       . 
    
 2.        The address to which the Secretary of State shall forward copies of process accepted on behalf of  
            the limited liability company is changed to read in its entirety as follows: 
  
                                                                                                                                                                       . 
 3.        The limited liability company hereby: [check one] 

           Designates                                                                                       as  
           its registered agent upon whom process against the limited liability company may be served. 
           The street address of the registered agent is: 
            
                                                                                                                                                                   . 
           Changes the designation of its registered agent to:                                                                  . 
           The street address of the registered agent is: 
            
                                                                                                                                                                               . 
           Changes the address of its registered agent to: 
                                                                                                                                                                            
                                                                                                                                                                               . 
           Revokes the authority of its registered agent. 
 
 DOS-1359-f (Rev. 03/17)                                                                                                                                                       Page 1 of 2



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           X                                        Capacity of Signer (Check appropriate box): 
  (Signature)                                          
                                                       Member 
 
 (Type or print name)                                  Manager 
  
                                                       Authorized Person
               
                                         CERTIFICATE OF CHANGE 

                                                 OF 
 
                                         (Insert Name of Domestic Limited Liability Company) 
 
                                         Under Section 211-A of the Limited Liability Company Law 
 
            Filer’s Name and Mailing Address: 

               Name: 

               Company, if Applicable: 

               Mailing Address:

               City, State and Zip Code: 

 NOTES:  
 1. The name of the limited liability company and the date of filing of the articles of organization must exactly match the 
     records of the Department of State.  This information should be verified on the Department of State’s website at 
     www.dos.ny.gov. 
 2. This form was prepared by the New York State Department of State for filing a certificate of change by a domestic limited  
     liability company.  You are not required to use this form.  You may draft your own form or use forms available at legal  
     supply stores.   
 3. The Department of State recommends that legal documents be prepared under the guidance of an attorney.   
 4. The certificate must be submitted with a $30 filing fee made payable to the Department of State. 
   
 (For office use only) 

 DOS-1359-f (Rev. 03/17)                                                                                                       Page 2 of 2
 






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