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Check and complete at least one: The inaccuracy or defect to be corrected is (include Department of State form name and date filed):. If handwritten, the form must be legible and completed in black or blueblack ink in order to permit reproduction.Statement of Correction for a. General Business or Nonprofit Corporation. Provide the last name and first name of at least one individual causing the document to be delivered for filing. Complete and include this form with your paper submission. General Instructions: Use dark ink only. The enclosed Statement of Correction and fee(s) are submitted for filing. Check statement that applies: ❏ 1. General Instructions: Use dark ink only.