Certificate Of Revival For A Nevada Limited-Liability Company Page 7
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12ROSS MILLER
Secretary of State
202 North Carson Street
Carson City, Nevada 89701-4201
(775) 684 5708
Website: secretaryofstate.biz
Certificate of Change
of Resident Agent and/or
Location of Registered Office
USE BLACK INK ONLY - DO NO HIGHLIGHT
ABOVE SPACE IS FOR OFFICE USE ONLY
General instructions for this form:
1. Complete all fields.
2. The physical Nevada address of the resident agent must be set forth. PMB's are not acceptable.
3. Ensure that document is signed in signature fields.
4. Include the filing fee of $60.00.
5. The change below is effective upon the filing of this document with the Secretary of State.
Name of Entity
File Number
Reason for change:
Change of Resident Agent
Change of Location of Registered Office
(check one)
The former resident agent and/or location of the registered office was:
Name
Nevada
Physical Street Address
Zip Code
City
City
State Zip Code
Mailing Address
The resident agent and/or location of the registered office is changed to:
Name
Nevada
(MANDATORY) Physical Street Address
Zip Code
City
(OPTIONAL) Mailing Address
City
State Zip Code
Signature of Officer
For an entity to file this certificate, the signature of one officer is required.
X
Signature of Officer
Title of Officer
Certificate of Acceptance of Appointment by Resident Agent
I hereby accept the appointment as Resident Agent for the above-named business entity.
X
Authorized Signature of R.A. or On Behalf of R.A. Company
Date
Nevada Secretary of State RA Change 2007
This form must be accompanied by appropriate fees.
Revised on 01/01/07
Reset
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