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Secretary of State Office   APPLICATION FOR AMENDED 
500 E Capitol Ave 
                                       CERTIFICATE OF AUTHORITY 
Pierre, SD 57501 
                                       FOREIGN BUSINESS  ORPORATIONC             
(605)773-4845                                        SDCL 47-1A-1504 
corpinfo@state.sd.us
                                                     FILING FEE: $250 
                                       Make check payable to SECRETARY OF STATE

FILING INSTRUCTIONS: A foreign corporation authorized to transact business in this state must obtain an amended 
certificate of authority if it changes 1) Its corporate name; 2) The period of its duration; or 3) The state or country of its 
incorporation, or any information concerning its registered agent.  
Application must be accompanied by a one page Original Certificate of Existence issued by the Secretary of State or 
other official having custody of the corporate records in the state or other jurisdiction under whose law it is incorporated. 

1. The Name and Business ID of the corporation is:

   Name (Note: This must be the exact corporate name as registered.)               Business ID 

2. The amended corporate name is:

   Note: The name must include the term corporation, incorporated, company, limited or the applicable abbreviation. 

3. The name of the state or other jurisdiction under whose laws it is incorporated:

4. The date of its incorporation:  ______________________________________________________________________

5. The period of its duration:  _________________________________________________________________________

6. The address of the principal executive office (business address).

   Actual Street Address                                                   City                                     State ZIP+4 

   Mailing Address, if Different from Street Address                       City                                     State ZIP+4 

   Email Address (Optional) 

7. The South Dakota Registered Agent’s name

   South Dakota law permits the registered agentto be either: A)  anoncommercial registered agent (this may be an
   individual), B) a commercial registered agent, or C) an office holder.  Complete only one below, either (a) or (b) or (c).

   (a) The South Dakota Noncommercial Registered Agent’s name

   Actual Street Address in this State                                     City                                     State ZIP+4 

   Mailing Address in this State, if Different from Street Address         City                                     State ZIP+4 

   Email Address (Optional)

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(b)   When listing a Commercial Registered Agent, please state their CRA#. This number can be obtained from the
      Commercial Registered Agent.

Commercial Registered Agent Name                                                                          CRA# 

(c)   Title of the office or other position with the corporation

Business Office’s Actual Street Address in this State                   City                              State ZIP+4 

Mailing Address in this State, if Different from Street Address         City                              State ZIP+4 

Email Address (Optional) 

8. The names and usual business addresses of its principal officers and directors. Place a check mark next to the name if
the principal officer serves as a director.

President                         Street Address                                     City                 State ZIP+4 

Vice President                    Street Address                                     City                 State ZIP+4 

Secretary                         Street Address                                     City                 State ZIP+4 

Treasurer                         Street Address                                     City                 State ZIP+4 

Director                          Street Address                                     City                 State ZIP+4 

Director                          Street Address                                     City                 State ZIP+4 

Director                          Street Address                                     City                 State ZIP+4 

The application must be signed by an authorized officer of the corporation. 

No person may execute this report knowing it is false in any material respect.  Any violation may be subject to a civil and/or 
criminal penalty (SDCL 47-1A-129; 22-39-36). 

Dated 
                                                                        Signature of an authorized person 

Email 
      (Optional)                                                        Printed Name 

                                                                        Title 

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                                                                                           Foreignamendmentcertificateofauthority Feb 2018






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