Certificate of Amendment

Certificate of Amendment

Contact Information

First Name

Last Name

Address

Suite/Apt

City, State, Zip

Phone

Fax

Email

Company Information

Name of Entity

Type of Entity
Corporation
S Corporation
Partnership
Single Member LLC
Multi Member LLC
Sole Proprietor

State of Formation

EIN Number

Date of Formation (mm/dd/yyyy)

Company Address

Suite/Apt

City, State, Zip

Old Company Name

New Company Name

Shareholder/Officers/Members Information

Shareholder 1 Full Name

Residence Address

City, State, Zip

Phone

Fax

Credit Card Authorization

Name on the Credit Card

Credit Card Number

CC Expiration Date

Security (CSV) Code

CC Billing Address

City, State, Zip

I authorize ITAXEXPERTS.COM to apply for Certificate of Amendment and agree to the terms.

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