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                     State of Missouri John R. Ashcroft, Secretary of State 
                     Corporations Division
                     PO Box 778 / 600 W. Main St., Rm. 322
                     Jefferson City, MO 65102 

                                                                                                                                                        Application for an Amended Certificate of
                                                                                                                                                        Authority for a Foreign Nonprofit                   Corporation
                                                                                                                                                                         (Submit with filing fee of $10.00)

The below-named corporation, relating to amending its Certificate of Authority of Foreign Corporation, does hereby state: 

1.  Its name                                                                                                                                         is                                                                          Missouri Charter #:       ;

    it is incorporated in the State of:                                                                                                                           ; and it was qualified

    in the State of Missouri on                                                                                                                                                                                                                              . 
                                                                                                                                                                                           month/day/year

2.  By appropriate corporate action on:                                                                                                                               the corporation: 
                                                                                                                                                                                           month/day/year

         1.  Changed its corporate name to:                                                                                                               

              Name it will use in Missouri if  new name not available: 

         2.Changed its period of duration to:                                                                                                              

         3.Changed the state or country of its incorporation to: 

3.There is attached hereto a Certificate of the Secretary of State of the State of 
    relating to the amendment(s) set forth in item 2 above and showing that the Corporation is in existence and in good standing in said
State. 

The effective date of this document is the date it is filed by the Secretary of State of Missouri unless a future date is otherwise indicated: 

                                                                                                                                                        (Date may not be more than 90 days after the filing date in this office) 

In Affirmation thereof, the facts stated above are true and correct:
(The undersigned understands that false statements made in this filing are subject to the penalites provided under Section 575.040, RSMo) 

Authorized signature of officer or chairman of the board                                            Printed Name                                              Title                                                                     Date

Attached is a current (not more than 60 days old) certificate attesting to the change, duly authenticated and certified by the secretary
of state or other official having custody of corporate records in the state or country of incorporation. 

Name and address to return filed document: 

Name: 

Address: 

City, State, and Zip Code: 
                                                                                                                                                                                                                                 Corp. 52A (01/2017)