Laserfiche WebLink
8. Other change(s) not provided for above: <br />If other information contained in the filed document is being changed, mark this box ❑ and <br />include an attachment stating the information to be changed and each such change. <br />If other information is being added or deleted, mark this box ❑ and include an attachment <br />stating each addition or deletion. <br />9. (Optional) Delayed effective date: <br />(nut✓ddl"559 <br />Notice: <br />Causing this document to be delivered to the Secretary of State for filing shall constitute the affirmation or <br />acknowledgment of each individual causing such delivery, under penalties of perjury, that such document is <br />such individual's act and deed, or that such individual in good faith believes such document is the act and deed <br />of the person on whose behalf such individual is causing such document to be delivered for filing, taken in <br />conformity with the requirements of part 3 of article 90 of title 7, C.R.S. and, if applicable, the constituent <br />documents and the organic statutes, and that such individual in good faith believes the facts stated in such <br />document are true and such document complies with the requirements of that Part, the constituent documents, <br />and the organic statutes. <br />This perjury notice applies to each individual who causes this document to be delivered to the Secretary of <br />State, whether or not such individual is identified in this document as one who has caused it to be delivered. <br />10. The true name and mailing address of the individual causing this document to be delivered for filing are <br />Murray ® Ann _ <br />(Last) (first) (Aliddle) (Suffivr� <br />701 Market Street _ <br />(Street number and name or Post Office Box information) <br />St. Louis ® MO 63101 <br />(Cin) US (State) (7IP /Postal Code) <br />(Province — ifapplicable) (CountnJ <br />(lfapplicable, adopt the following statement by marking the box and include an attachment) <br />❑ This document contains the true name and mailing address of one or more additional individuals <br />causing the document to be delivered for filing. <br />Disclaimer: <br />This fornVcover sheet, and any related instructions, are not intended to provide legal, business or tax advice, <br />and are furnished without representation or warranty. While this form/cover sheet is believed to satisfy <br />minimum legal requirements as of its revision date, compliance with applicable law, as the same may be <br />amended from time to time, remains the responsibility of the user of this form /cover sheet. Questions should <br />be addressed to the user's legal, business or tax advisor(s). <br />CHANGE OTHER Page 2 of 2 <br />Rev. 12/01/2009 <br />