Form Ll: 0011 - Limited Liability Company Statement Of Resignation Of Statutory Agent

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LIMITED LIABILITY COMPANY
STATEMENT OF RESIGNATION OF
STATUTORY AGENT
OF
_____________________________________________________________
__________________
(Name of limited liability company resigning from)
(ACC file number)
NO FILING FEE REQUIRED
NOTE: It is critical that the Corporation Commission receive the exact name and file number of the limited liability
company (LLC) resigning from. Please check with our Records section, (602) 542-3026 or our web site,
to obtain the correct information.
IMPORTANT! You must evaluate both items. Check only those that apply.
1) The undersigned statutory agent of ____________________________________________,.
An Arizona LLC, or
a Foreign LLC qualified to do business Arizona, herby resign my
appointment as agent.
2)
The known place of business, currently the street address of the undersigned, is also discontinued.
The undersigned has given notice of this resignation to the LLC by mailing one copy to the Limited
Liability Company at the following address:
________________________________________________________________
________________________________________________________________
This resignation shall be effective on the thirty-first day after the date on which this statement is
delivered to the Arizona Corporation Commission for filing.
DATED this ______ day of _________________________, _________
Signature:_____________________________________________
Printed Name:__________________________________________
This form must be delivered to:
ARIZONA CORPORATION COMMISSION
Corporations Division
1300 West Washington
or
400 West Congress
Phoenix, Arizona 85007-2929
Tucson, Arizona 85701-1347
LL: 0011
Rev: 10/2007

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