Consent To Appointment By Registered Agent - Wyoming Secretary Of State
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1Wyoming Secretary of State
State Capitol Building, Room 110
th
200 West 24
Street
Cheyenne, WY 82002-0020
Ph. 307.777.7311
Fax 307.777.5339
Email: business@state.wy.us
Consent to Appointment
By Registered Agent
I,
, registered office located at
(name of registered agent)
(registered office address, city, state & zip)
voluntarily consent to serve as the registered agent for
(name of business entity)
on the date shown below.
I hereby certify that I am in compliance with the requirements of W.S. 17-28-101 through W.S. 17-28-111.
Signature:__________________________________________
Date:
(Shall be executed by the registered agent.)
(mm/dd/yyyy)
Print Name:
Contact Person:
Title:
Daytime Phone:
Email:
Checklist
Submit one originally signed consent to appointment and one exact photocopy.
RAConsent – Revised 06/16/2009
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