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Statement Form Of Change Of Commercial Registered Agent And/or Registered Office 35-7-110, Mca - State Of Montana 2011

STATE OF MONTANA

Prepare, sign, submit with an original signature and filing fee

This is the minimum information required.

(This space for use by the Secretary of State only)

STATEMENT of CHANGE

of COMMERCIAL REGISTERED AGENT

and/or REGISTERED OFFICE

35-7-110, MCA

LINDA McCULLOCH

MAIL

Secretary of State

P.O. Box 202801

Helena, MT 59620-2801

(406) 444-3665

HONE

(406) 444-3976

sos.mt.gov

ITE

No filing fee required for regular processing



24 Hour Priority Filing Add $ 20.00



1 Hour Expedite Filing Add $100.00

For the purpose of modifying their commercial registered agent information on file with the Montana Secretary of

State, the undersigned submits the following statements in accordance with

35-7-110,

MCA:

1. All entities associated with Commercial Agent ID # ________________________:

Registered Agent Information

2. The name of the current registered agent on file with the Montana Secretary of State’s office

(required):

___________________________________________________________________________________

3. The new type or jurisdiction of organization: ______________________________________________

4. The new name of the registered agent: ___________________________________________________

5. The street and mailing address of the new registered office (must be in Montana):

____________________________________________________________________________________

(

Include street name and number or physical location in addition to box number with the city, state & zip)

6. A commercial registered agent shall promptly furnish each entity represented by it with notice of record of the

filing of a statement of change relating to the name or address of the agent and the changes made by the filing.

7. By my signature, I, as commercial registered agent, do state that I signed this statement and that the statements

contained therein are true, under penalty of false swearing.

_____________________________________________

___________________________

Signature of Registered Agent or Authorized Person

Date

(Mo/Day/Yr)

_____________________________________________

Printed Name and Title of above Authorized Person

sos.mt.gov/Business/Forms

83-Commercial_Statement_of_Change_of_Agent_and_Office.doc

Revised: 02/15/2011

Statement Form Of Change Of Commercial Registered Agent And/or Registered Office 35-7-110, Mca - State Of Montana 2011

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