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 APPLICATION FOR AMENDED                                                                     West Virginia Secretary of State 
 CERTIFICATE OF AUTHORITY                                                                    Business & Licensing Division 
                                                                                             Tel: (304)558-8000 
 Form CF-4  
                                                                                             Fax: (304)558-8381 
 Rev. 11/2017
                                                                                             Website: www.wvsos.gov

FILE ONE ORIGINAL  
(Two if you want a filed
stamped copy returned to you)
FEE: $25.00 

**** In accordance with the provisions of the West Virginia Code, the undersigned corporation hereby **** 
         applies for an Amended Certificate of Authority and submits the following statement: 

1.   Name under which the corporation was 
    authorized to transact business in WV:            __________________________________________ 

2.   Date Certificate of Authority was issued 
    in West Virginia:                                 __________________________________________ 

3.   Corporate name has been changed to:              __________________________________________ 
    (Attach one Certified Copy of Name Change  
     as filed in home State of incorporation.) 

4.   Name the corporation elects to use in WV
    due to home State name not being available:       __________________________________________ 
    (If name is not available for use in West Virginia, you must attach to this application a Letter of 
    Resolution signed by the officers or directors of the corporation approving use of a "forced DBA 
    Name." Download a sample Letter of Resolution.)

5.   Other amendments:                                __________________________________________ 
    (attach additional pages if necessary) 
                                                      __________________________________________ 

                                                      __________________________________________ 

6.  Name and phone number of contact person.  (This is optional, however, if there is a problem with 
    the filing, listing a contact person and phone number may avoid having to return or reject the 
    document.) 

    __________________________________________________  ______________________________ 
    Contact Name                                                    Phone Number 

7.   Signature information (See below *Important Legal Notice Regarding Signature): 

    Print Name of Signer: ________________________________          Title/Capacity: __________________ 

    Signature:  _________________________________________           Date:                    ________________________ 

*Important Legal Notice Regarding Signature: Per West Virginia Code §31D-1-129. Penalty for signing false document. 
Any person who signs a document he or she knows is false in any material respect and knows that the document is to be delivered 
to the secretary of state for filing is guilty of a misdemeanor and, upon conviction thereof, shall be fined not more than one 
thousand dollars or confined in the county or regional jail not more than one year, or both. 

Important Note: This form is a public document. Please do NOT provide any personal identifiable information on this form 
such as social security number, bank account numbers, credit card numbers, tax identification or driver’s license numbers.

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West Virginia Secretary of State
Business & Licensing Division
Tel: (304) 558-8000
Fax: (304) 558-8381
Website: www.wvsos.gov
Rev. 9/2018

Filing Submission Instructions - Business Division

IMPORTANT: READ ALL INSTRUCTIONS CAREFULLY BEFORE COMPLETING FORMS.
Failure to include any of the required information on the form may cause the filing to be rejected.

All forms may be downloaded from our web site www.wvsos.gov.

SUBMIT THE COMPLETED APPLICATION WITH THE CUSTOMER ORDER REQUEST FORM TO ONE OF THE
OFFICES BELOW. CHOOSE EXPEDITED OR STANDARD PROCESSING SERVICE. IF NOT USING THE CUSTOMER
ORDER REQUEST FORM AND YOU ARE REQUESTING EXPEDITED SERVICE, YOU MUST INCLUDE THE WORD
"EXPEDITE" AND THE LEVEL OF EXPEDITED SERVICE BEING REQUESTED (24-HOUR, 2-HOUR OR 1-HOUR) IN
YOUR CORRESPONDENCE. BE SURE TO INCLUDE THE CORRECT ADDITIONAL EXPEDITED FEE. THIS FEE IS IN
ADDITION TO THE REGULAR FILING FEE (SEE FEES BELOW).

CHOOSE ONE OF THE FOLLOWING PROCESSING SERVICES:
1 EXPEDITED SERVICE (24-hour,2-hour and 1-hour; *Requires standard filing fee plus additional expedite fee, see below)

Expedite Service *Fee EXPEDITED SERVICE requests may be submitted by:
24-Hour $ 25.00 - E-mail to efilings@wvsos.gov
2-Hour $250.00 - Fax
1-Hour $500.00 - Walk in delivery

2 STANDARD PROCESSING (5-10 business days)
Standard filing fees apply. STANDARD PROCESSING requests may be submitted by:
- E-mail to CorpFilings@wvsos.gov
- Fax
- Walk in delivery (drop off service only filed within 5-10 business days)
INCLUDE PAYMENT:
Be sure to enclose the correct filing fee with your filing. If paying by credit card, be sure to include the e-Payment Authorization
form with your filing. Your filing will be rejected if the payment is not included or if the e-Payment Authorization form is not
included if paying by credit card.

SUBMIT COMPLETED FILING TO ONE OF THE BUSINESS CENTERS BELOW:

BUSINESS SERVICE CENTERS
Standard and Expedited Filings

Charleston Office Clarksburg Office Martinsburg Office
One-Stop Business Center North Central WV Business Center Eastern Panhandle Business Center
1615 Washington Street East 200 West Main Street 229 E. Martin Street
Charleston, WV 25311 Clarksburg, WV 26301 Martinsburg, WV 25401
Phone: (304) 558-8000 Phone: (304) 367-2775 Phone: (304) 356-2654
Fax: (304) 558-8381 Fax: (304) 627-2243 Fax: (304) 260-4360
Hours: Mon. - Fri. 8:30a - 5:00p EST Hours: Mon. -Fri. 9:00a - 5:00p EST Hours: Mon. - Fri. 9:00a - 5:00p EST

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                                                                                                                     West Virginia Secretary of State 
                                                                                                                      Business & Licensing Division 
                                                                                                                      Tel: (304)558-8000 
                                                                                                                      Fax: (304)558-8381 
                                                                                                                      Website: www.wvsos.gov
Rev. 9/2018

 Customer Order Request                              SUBMIT THIS COMPLETED FORM WITH YOUR FILING.

           READ CAREFULLY BEFORE SUBMITTING - Expedite service is NOT AVAILABLE for the following filings:
             >> Tax Department filings including Sole Proprietorships, General Partnerships, and Associations 
             >> Dissolution or Withdrawal of Corporation, Voluntary Association or Business Trust

 Order Processing Requested*:          * * *  Expedite Processing Requires Additional Fees  * * *                   
     Standard Processing**                         24-HOUR Expedite***          2-HOUR Expedite                        1-HOUR Expedite
    (Avg. processing turnaround     (additional $25.00 fee included)       (additional $250.00 fee included)          (additional $500.00 fee included)
     5-10 business days)
 Email to: CorpFilings@wvsos.gov                                 Email to: eFilings@wvsos.gov

 *"Processing" indicates the filing will be completed and registered in the Secretary of State registration database. 
 **Standard Processing applications received byE-MAIL or FAXmust   include the e-Payment Authorization form with credit card information.     
 ***NOTE: Orders filed in person through any Secretary of State office location requesting the filing be processed will be assessed a 24-HOUR 
 Expedite fee of $25.00 per order.

Name of Entity:

Return filing to: 
(Return Address)

Contact Name:                                                              Phone: 

Return Delivery Options: Email or Fax options do not receive a copy via mail; must be ordered separately.
   Email to:                                                           Fax to: 

   Hold for Pick Up               Mail to Return Address above         FedEx:  Acct #

   Other (explain below):                                              UPS:  Acct #

Order Description (include items being ordered and fee breakdown):

* PLEASE NOTE: Original paperwork is kept by this office. Include a copy of the original filing if  
you want a file stamped copy returned to you at no extra charge. Certified copy requests are an     Total Amount:
additional $15 per certified copy being requested.
Payment Method:
   Check/Money Order                Credit Card    (Must attach e-Payment Authorization request form including payment information.)
   Cash (Do Not mail cash)           Pre-paid Acct #:                      Attach signed pre-paid slip.

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MAC WARNER
Secretary of State 24-hour, 2-hour and 1-hour
State Capitol Building
Charleston, WV 25305
Phone: (304) 558-6000 Expedite Service Guidelines
Website: www.sos.wv.gov

IMPORTANT: To ensure expedited service, please mark “EXPEDITE” in a conspicuous place at
the top of the service request. Please indicate method of delivery.

24-HOUR EXPEDITE SERVICE

The Secretary of State offers a 24-hour expedite service on most business organization filings processed by this office. If
you choose to utilize this service, please enclose with your filing the additional expedite fee. Please note that this expedite
fee is in addition to the standard fee charged on each filing and/or order. You must mark the document with your “24-HOUR
EXPEDITE” request. If using a cover letter, note that you are requesting 24-hour expedited service, and include your
telephone number and return information. Each filing will be returned by U.S.P.S. regular mail unless other arrangements
are made. This office does not fax confirmation of a 24-hour expedite.

The fee for 24-hour handling is $25.00 in addition to the usual fee for service. Please consult our fee schedules for the
appropriate fee. If you require assistance, please contact this office.

Time Constraints: Under most circumstances, each filing submitted receives same day filing date and may be picked up in
the office by the end of the same business day. Filings to be mailed the next business day if received by 2:00 pm of receipt
date and no later than the 2nd business day if received after 2:00 pm. Expedite period begins when filing or service request
is received in this office in acceptable fileable form.

2-HOUR EXPEDITE SERVICE

The Secretary of State offers a 2-hour expedite service on most filings processed by this office. If you choose to utilize the
2-hour expedite service, please enclose with your filing an additional $250.00 per filing and/or order. Please note that this
expedite fee is in addition to the standard fee charged on each filing and/or order. Complete and submit the 2-hour
customer order instruction form. If not using our order form, state clearly in your cover letter that you are requesting 2-hour
expedited service and include your telephone number and return information. Attach the order form or cover sheet to the
top of your filing and submit to this office. Each filing will be returned by U.S.P.S. regular mail unless other arrangements
are made.

1-HOUR EXPEDITE SERVICE

The Secretary of State offers a 1-hour expedite service on most filings processed by this office. If you choose to utilize the
1-hour expedite service, please enclose with your filing an additional $500.00 per filing and/or order. Please note that this
expedite fee is in addition to the standard fee charged on each filing and/or order. Complete and submit the 1-hour
customer order instruction form. If not using our order form, state clearly in your cover letter that you are requesting 1-hour
expedited service and include your telephone number and return information. Attach the order form or cover sheet to the
top of your filing and submit to this office. Each filing will be returned by U.S.P.S. regular mail unless other arrangements
are made.

1-Hour and 2-Hour Time Constraints: Each filing submitted for either 1-hour or 2-hour expedite receives same day filing
date and will be acknowledged by fax or e-mail within expedite service time. Failure to indicate method of acknowledgement
(fax or e-mail) or to provide a correct fax number or e-mail address may prevent the Secretary of State from acknowledging
the filing of such documents. Filings may be picked up within the expedite service period. Filings to be mailed will be mailed
out no later than the next business day following receipt. Expedite period begins when filing or service request is received in
this office in fileable form.

The Secretary of State reserves the right to extend the expedite period in times of extreme
volume, staff shortages or equipment malfunction. These extensions are few and will rarely
extend more than a few hours.
WV Secretary of State Expedite Guidelines
Effective: 8-31-17

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                                                                                         West Virginia Secretary of State 
                                                                                              Business & Licensing Division 
                                                                                                                        Tel: (304)558-8000 
                                                                                                                        Fax: (304)558-8381 
                                                                                               Website: www.wvsos.gov
                                                                                                                              Rev. 11/2017
                                                                                         USE BLACK INK ONLY - DO NOT HIGHLIGHT 
e-Payment Authorization                 This document contains confidential financial information and will be properly shredded after payment 
                                        has been processed by this office. Electronic storage of payment information is only permitted by signed 
                                        authorization below which may be retracted at any time by written request by the authorized party.
Service Type:       Fax      E-mail        Mail

Payment by Card     (card holder name and billing address required below)

Card Type:           Visa               Mastercard                 Discover              American Express

Credit Card Number:                                                                           V Code*

  * 3-digit number on back of VISA, MasterCard and Discover cards. 
     4-digit number on front right side of American Express card.
NOTICE: For security and verification purposes, all credit card payments must include the 3- or 4-digit CVV2 code (V Code) number 
located on the credit card. Failure to include this code will result in the rejection of your filing or service request.

Credit Card Expiration Date: Month:                                Year:

                                                                   Amount to Charge Card: USD $
Order Information    (required) 

Entity Name: 

Card Holder Information: 
  Name as it appears on the account
                    Billing Address

                             City                                           State             Zip Code

                        Telephone                                    Ext.

Payment Information Storage Authorization          (optional) 
I authorize the Secretary of State to store this payment information for future payment transactions processed by Secretary of State:
X                                                                Date
Authorized Signature 

Payment Authorization        (required) 
I authorize the Secretary of State to bill an amount not to exceed the following to be charged to the above listed account(s):

X                                                                Date
Authorized Signature 
                                Reset Form                         Not to Exceed Amount: USD $

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