New York State 
                                                                                                                Department of State 
                                                                                              DIVISION OF CORPORATIONS, 
                                                                                                                STATE RECORDS AND 
                                                                                              UNIFORM COMMERCIAL CODE 
                                                                                                                One Commerce Plaza 
                                                                                                                99 Washington Ave.
                                                                                                                Albany, NY 12231-0001 
                                                                                                                www.dos.ny.gov 

                                  CERTIFICATE OF CHANGE 

                                                        OF 

                                             (Insert Name of Foreign Corporation) 
                                  Under Section 1309-A of the Business Corporation Law 

FIRST: The name of the corporation as it appears on the index of names in the Department of 
State is:                                                                                                       . 
(Complete the following section only if the corporation has agreed to use a fictitious name in New York State.) 
The fictitious name the corporation has agreed to use in New York State is: 

                                                                                                                . 

SECOND: The jurisdiction of incorporation of the corporation is: 

                                                                                       . 

THIRD: The date on which the corporation was authorized to do business in New York State is: 

                                                                              . 

FOURTH: The change(s) effected hereby are: (Check appropriate statement(s))

                     The county location, within this state, in which the office of the corporation is located, is 
                     changed to:                                                                                   . 
            The address to which the Secretary of State shall forward copies of process accepted on 
                     behalf of the corporation is changed to read in its entirety as follows: 

                                                                                                                . 

                     The corporation hereby: (Check one)

                           Designates    
                               as its registered agent upon whom process against the corporation may be served. 

                               The street address of the registered agent is: 

                                                                                                                   . 

DOS-1557-f-a  (Rev. 09/20)                                                                                           Page 1 of 2 

                         Changes the designation of its registered agent to: 
                                                                                                               . 
                         The street address of the registered agent is: 

                                                                                                               . 

                         Changes the address of its registered agent to: 

                                                                                                               . 

                         Revokes the authority of its registered agent. 

                                                           Capacity of Signer (Check appropriate box): 
   X                                                                              
                             (Signature) 
                                                                        Officer 
                                                                        Director 
                           (Name of Signer) 
                                                                        Authorized Person 

                                            CERTIFICATE OF CHANGE 
                                               OF 

                                            (Insert Name of Foreign Corporation) 

                               Under Section 1309-A of the Business Corporation Law 

Filer’s Name and Mailing Address: 

     Name: 

     Company, if Applicable: 

     Mailing Address: 

     City, State and Zip Code: 

NOTES: 
1. The name of the corporation and the date it was authorized to conduct business in New York State provided on
this certificate must exactly match the records of the Department of State.  The information should be verified
on the Department of State’ s website at    www.dos.ny.gov.
2. This form was prepared by the New York State Department of State. You are not required to use this form. You may
draft your own form or use forms available at legal stationery stores.
3. The Department of State recommends that all documents be prepared under the guidance of an attorney.
4. The certificate must be submitted with a $30 filing fee.

For Office Use Only 

DOS-1557-f-a  (Rev. 09/20)                                                                                       Page 2 of 2