Wyoming Foreign LLC Application For Certificate of Authority Form

In case there were details that need to be changed in an application for a Foreign Limited Liability Company (LLC) in Wyoming, you are required to fill the following form.

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For Office Use Only  	
 	Wyoming Secretary of State 	
  State Capitol Building, Room 110 
   200 West 24	th Street  
  Cheyenne, W Y 82002-0020 
  Ph.  307.777. 7311 
  Fax 307.777. 5339 
  Email:  [email protected]   	
 	
    
 	
Foreign Limited Liability Company  
Application  for  Amended Certificate  of Authority  	
 
Pursuant to W.S. 17- 16-1504 of the Wyoming Business Corporation Act, the undersigned limited  liability company 
hereby applies for an Amended Certificate of Authority to tr ansact business in the state of Wyoming, and for that 
purpose submits the following statement:  
 
1. A Certificate of Authority was issued to the company by the Wyoming Secretary of State on                                    	,              	                 	                                                    	                   	 	
(Date  – mm/dd/yyyy)  	
authorizing it to transact business in Wyoming  and is presently registered under the name of: 
 
 
2. N ame of the limited liability company has been changed to:  
 
 
3. S tate or country of organization has been changed to:  
 
4. O rganized under the laws of:  	
  (State or country of organization)  	
 
5. Date of organization:  
 	
(Date  – mm/dd/yyyy)  	
 
6. Period of duration:  
 
7. P rincipal office  address : 
 
 
 
 
8. M ailing address of the li mited liability company : 
 
 
 
 
9. N ame and physical address of its registered agent: 
(The registered agent may be an individual resident in  Wyoming, a domestic corporation, or foreign corporation authorized to transact 
business in  Wyoming, having a business office identical with such registered office. The registered agent must have a physical address in 
Wyoming.   A Post Office Box or Drop Box is not acceptable. If the registered office includes a suite number, it must be included in the  
registered office add ress.)

FLLC-AmendedCertif icateAuthority - Revised  11/2012 
10. If the company is managed by a manager or managers, the names and addresses of such  managers: 
 
 
 
 
     If the management of the company is reserved to the members, the names and addresses of  its members: 
 
 
 
 
11.  An estimate, expressed in dol lars, of the value of the property of the limited liability  company located and  
employed in the state of Wyoming: $  
 
 
Date:         Signature: ___________________________________________ 
(mm/dd/yyyy)        (May  be executed by  a member, manager, or other authorized individual as set  
forth in the operating agreement.)  
 
        Print Name: 
  Title: 
 
Contact Person:      Email: 
 
Daytime Phone Number:  
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Checklist	 	
          Filing Fee:  $50.00   Make check or money order payable to Wyoming Secretary of State.   
          The completed application must be accompanied by an original	 CERTIFICATE OF EVIDENCE of the   	
          Amendment , or a document of similar import, dated not more than six ty (60) days prior to filing in  
          Wyoming. If the amendme nt involves a  name change, the c ertificate must state the previous name and the   
          new name along  with the date of the amendment.  
          Please submit one originally signed  document and one exact photocopy of the filing.  
          For consistenc y the Secretary of State’s Office will only keep one version of the agent’s name on file. 
          Please review form prior to submitting to the Secretary of State to ensure all areas have been  
          completed to avoid a delay in the processing of you r documents.