Request for Amendment

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Statutory Purpose
Are there any outstanding dues with the CoC
These should be paid before the registration of the amendment.

The applicant(s), on behalf of the Company, declare(s):

- to understand that the notary does not perform name searches with the exception of a business name search at the CoC and to indemnify the notary for any and all liabilities or claims related directly or indirectly thereto;

- they are not acting on behalf of third parties and are acting in their own name and for their own risk;

- to have completed this form truthfully and to have read and understood the guidelines of the DEACI regarding changes to licenses.

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Name Applicant
Name Applicant

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