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        State of Missouri                                                                                  Print                                                                                           Reset
        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)