Form Rac/poc - Statement Of Change Principal Office Address, Registered Agent And/or Registered Office Address

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Filing Fee:
Section 1: $10.00
Section 2: $10.00
Sections 1 and 2: $20.00
C
K
OMMONWEALTH OF
ENTUCKY
E
N. W
, S
S
LAINE
ALKER
ECRETARY OF
TATE
_________________________________________________________________________________________________________________________
Division of Corporations
Statement of Change
RAC
Business Filings
PO Box 718
Principal Office Address, Registered Agent
POC
Frankfort, KY 40602
and/or Registered Office Address
(502) 564-3490
__________________________________________________________________________________________
Pursuant to the provisions of KRS 14A and KRS 271B, 273, 274, 275, 362 or 386 the undersigned hereby applies to
change one or all of the following: the principal office address, the registered agent and/or registered office address on
behalf of
______________________________________________________________ and for that purpose submits the following:
(The name must be identical to the name on record with the Secretary of State.)
1. Principal office address currently on file:
Principal office is hereby changed to:
__________________________________________
__________________________________________
__________________________________________
__________________________________________
__________________________________________
__________________________________________
2. Registered agent currently on file:
Registered agent is hereby changed to:
___________________________________________
Name: _____________________________________
I consent to serve as the registered agent on behalf of
the business entity.
X
Signature:_________________________________
Registered office address currently on file:
Registered office address is hereby changed to
(must be a Kentucky street address):
___________________________________________
___________________________________________
___________________________________________
__________________________________________
___________________________________________
__________________________________________
Fee: The fees for changing 1 or all of the following: Section 1 is $10. Section 2 is $10. Section 1 and 2 is $20.
I declare under penalty of perjury under the laws of the state of Kentucky that the foregoing is true and correct.
X
______________________________________________________________________________________________
Signature of Authorized Agent
Printed Name
Date
(01/11)

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