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Complete and include this form with your paper submission. This information only will be used to communicate in writing about the submission, if needed.2) INITIAL REGISTRATION DATE OF APPLICATION: 4) STATE OR COUNTRY OF ORGANIZATION: 3) AMENDMENT: (The amendment to the application for registration of foreign. Complete and submit the 2-hour customer order instruction form. Section 2 can be completed to effect a change to the registered agent or registered office address. LLC NAME CHANGE – NAME IN STATE OR COUNTRY OF FORMATION (Foreign Name). Please consider this when providing information on our forms. Kansas secretary of state. Identification Number: 3. Insert full name of the Limited Liability Company (LLC).