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CSCL/CD-762 (Rev. 07/19)

       MICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS
            CORPORATIONS, SECURITIES & COMMERCIAL LICENSING BUREAU
Date Received                                          (FOR BUREAU USE ONLY)
                        AC1

                        This document is effective on the date filed, unless a
                        subsequent effective date within 90 days after received
                        date is stated in the document.
Name

Address

City                                State                                     ZIP Code
                                                                                      EFFECTIVE DATE:
       Document will be returned to the name and address you enter above.
            If left blank, document will be returned to the registered office.

                        CERTIFICATE AMENDING APPLICATION FOR CERTIFICATE OF
                        AUTHORITY TO TRANSACT BUSINESS IN MICHIGAN
                        For use by Foreign Limited Liability Companies
                           (Please read information and instructions on the last page)
Pursuant to the provisions of Act 23, Public Acts of 1993, the undersigned limited liability company executes the following
Certificate:

1. The present name of the limited liability company is:

2. If the name in Item 1 was not available for use in Michigan, the assumed name adopted when obtaining the Certificate
     of Authority is:

3. The identification number assigned by the Bureau is:

4. It is organized under the laws of

5. The limited liability company was authorized to transact business in Michigan on the                day of

                                                        ,

6. The duration of the limited liability if other than perpetual is:

7. If the name of the limited liability company has changed, its new name is:

     The effective date of the name change was the                            day of                 , and the
     name change was made in compliance with the laws of the jurisdiction of its organization.

8. Complete this item only if the new name in Item 7 is not available for use in Michigan.  The assumed name of the limited
     liability company to be used in all its dealings with the Bureau and in the transaction of its business in Michigan is:

9. If the assumed name in Item 2 has changed, the new name is:



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10. The address of the office required to be maintained in the jurisdiction of its organization or, if not so required, the principal
office of the limited liability company is:

(Street Address)                                                       (City)                        (State)   (ZIP Code)

11. a.  The address of its registered office in Michigan is:
                                                                                                     , Michigan
(Street Address)                                                       (City)                                  (ZIP Code)

b. The mailing address of the registered office in Michigan if different than above:

                                                                                                     , Michigan
(Street Address or PO Box)                                             (City)                                  (ZIP Code)

c. The name of the resident agent at the registered office is:

12. The Department is appointed the agent of the foreign limited liability company for service of process if no agent has been
appointed, or if appointed, the agent's authority has been revoked, the agent has resigned, or the agent cannot be found
or served through the exercise of reasonable diligence.

The name and address of a member or manager or other person to whom the administrator is to send copies of any
process served on the administrator is:  (Must be different than agent shown in Item 11c)

(Name)

(Street Address)                                                       (City)                        (State)   (ZIP Code)

13. If the business the foreign limited liability company proposes to do in this State is to be enlarged, limited, or otherwise
changed, the specific business which the limited liability company is to transact in Michigan is as follows:

The limited liability company is authorized to transact such business or conduct such affairs in the jurisdiction of its
organization.

                      Signed this          day of                                   ,

                      By
                                                            (Signature)

                      (Type or Print Name)                                      (Type or Print Title)



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CSCL/CD-762 (Rev. 07/19) 

Preparer's Name

Business telephone number (            )

                                        INFORMATION AND INSTRUCTIONS

1. The certificate amending the application for certificate of authority to transact business cannot be filed until this form, or a
   comparable document, is submitted.

2. Submit one original of this document.  Upon filing, the document will be added to the records of the Corporations,
   Securities & Commercial Licensing Bureau.  The original will be returned to your registered office address, unless you
   enter a different address in the box on the front of this document.

   Since this document will be maintained on electronic format, it is important that the filing be legible.  Documents with poor
   black and white contrast, or otherwise illegible, will be rejected.

3. This Certificate is to be used pursuant to section 1005 of Act 23, P.A. of 1993 by a foreign limited liability company having
   a Certificate of Authority to Transact Business in this State where the information contained in its original or last amended
   Application has changed.  This amended Application must be filed promptly after the time the change becomes effective in
   the jurisdiction of its organization.

4. Item 3 - Enter the identification number previously assigned by the Bureau.  If this number is unknown, leave it blank.
5. Item 12 - The person must be different than agent shown in Item 11c.

6. Item 13 - This item should state only the specific activities to be conducted in Michigan.  An all purpose activities statement
   is not permitted.

7. This Certificate must be signed by a person with authority to sign as provided in the laws of jurisdiction of its
   organization.

8. NONREFUNDABLE FEE:  Make remittance payable to the State of Michigan.  Include limited liability company name and
     identification number on check or money order............................................................................................................$25.00
   Veterans: Pursuant to MCL 450.5101(9)(10), if a majority of the membership interests in the foreign limited liability 
   company responsible for paying the fee are held by 1 or more veterans who served in the United States Armed Forces, 
   (including the reserve components) who were discharged or released under conditions other than dishonorable, you 
   may obtain further information regarding a fee waiver at www.michigan.gov/corpveteranfeewaivers.

Submit with check or money order by mail:                              To submit in person:

     Michigan Department of Licensing and Regulatory Affairs                   2501 Woodlake Circle
     Corporations, Securities & Commercial Licensing Bureau                    Okemos, MI
     Corporation sDivision                                                     Telephone:  (517) 241-6470
     P.O. Box 30054
     Lansing, MI  48909                                               Fees may be paid by check, money order, VISA,MasterCard                                       , 
                                                                       or Discover when delivered in person to our office.

Documents that are endorsed filed are available at www.michigan.gov/corpentitysearch.  If the submitted document 
is not fileable, the notice of refusal to file and document will be available at the Rejected Filings Search website at 
www.michigan.gov/corprejectedsearch. 

LARA is an equal opportunity employer/program.  Auxiliary aids, services and other reasonable accommodations are available
upon request to individuals with disabilities.



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Optional expedited service.
Expedited review and filing, if fileable, is available for all documents for profit corporations, limited
liability companies, limited partnerships and nonprofit corporations.

The nonrefundable expedited service fee is in addition to the regular fees applicable to the specific
document.

Please complete a separate CSCL/CD-272 form for expedited service for each document submitted 
in person or by mail. 

24-hour service - $50 for formation documents and applications for certificate of authority.

24-hour service - $100 for any document concerning an existing entity.

Same day service
          Same day - $100 for formation documents and applications for certificate of
          authority.
          Same day - $200 for any document concerning an existing entity.
     Review completed on day of receipt.  Document and request for same day expedited
     service must be received by 1 p.m. EST OR EDT.

          Two hour - $500
     Review completed within two hours on day of receipt.  Document and request for two hour
     expedited service must be received by 3 p.m. EST OR EDT.

          One hour - $1000
     Review completed within one hour on day of receipt.  Document and request for 1 hour
     expedited service must be received by 4 p.m. EST OR EDT.

Documents submitted by mail are delivered to a remote location for receipts processing and are
then forwarded to the Corporation sDivision for review.  Day of receipt for mailed expedited service
requests is the day the Corporation sDivision receives the request.

Rev. 07/19






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