FILING FEE: $200.00
PRINT CLEARLY
AMENDED CERTIFICATE OF QUALIFICATION
TO: OKLAHOMA SECRETARY OF STATE 2300 N. Lincoln Blvd., Room 101, State Capitol Building Oklahoma City, Oklahoma 73105-4897 (405) 521-3912
IF this certificate SOLELY reflects a change of mailing address the fee is $10.00. The undersigned corporation, for the purpose of amending its Certificate of Qualification pursuant to Title 18, Section 1131, hereby certifies: 1. A. AS FILED: The name of the corporation is:
B. In the event the corporation was registered in the State of Oklahoma under a fictitious name, the fictitious name is: C. AS AMENDED: The new name of the corporation is: D. The change of name has been effected pursuant to the laws of the jurisdiction of its incorporation and the effective date of the change was the day of , . 2. 3. The jurisdiction of incorporation is: The corporation was duly authorized to do business in the State of Oklahoma on the day of , . This corporation is organized as: Profit or Not for Profit (Check one)
4. 5.
A. The mailing address of the principal office is:
Number
Street
City
County
State
Zip Code
B. AS AMENDED: The mailing address of the principal office is now:
Number
Street
City
County
State
Zip Code
6. If the name and/or address of the additional agent in the State of Oklahoma has changed, the new name and/or address in Oklahoma is:
Name
Street Address City (P.O. BOXES ARE NOT ACCEPTABLE)
County
Zip Code
7. A. AS AMENDED: The restatement of its amended capitalization which includes the aggregate number of its authorized shares, itemized by class, par value of shares, shares without par value, and series, if any, within a class is: CLASS SERIES NUMBER OF SHARES PAR VALUE - NPV
B. The change of capitalization has been effected pursuant to the laws of the jurisdiction of its incorporation and the effective date of the change was the day of , . 8. A. AS AMENDED: The business the corporation proposes to do in this state is:
B. The business which the corporation proposes to do in the State of Oklahoma is a business the corporation is authorized to do in the jurisdiction of its incorporation. IN WITNESS WHEREOF, said corporation has caused this certificate to be executed in its name by its President or Vice President, and attested by its Secretary or Assistant Secretary, this day of , .
By its
President
(PLEASE PRINT NAME) Attest:
By its
Secretary
(PLEASE PRINT NAME)
(SOS FORM 0014-12/01)