Know all men by these presents:

That the undersigned do hereby certify the following:

1. The undersigned are the partners of a ___________ (general or limited) partnership that is transacting business in the State of _________________ under the fictitious name of_____________________________________.

2. The principal place of said business is located at _______________________________________.

3. The full names and places of residence of the undersigned are:

________________________, whose place of residence is ___________________________________________. .

This certificate is executed to reflect a change of ________________________ (membership or fictitious name).

Dated: _______________ Sign ________________________