Change Of Registered Agent'S Address Form - Connecticut Secretary Of The State

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CHANGE OF REGISTERED AGENT'S ADDRESS
DOMESTIC STOCK OR NON-STOCK CORPORATIONS
Office of the Secretary of the State
MAILING ADDRESS:
DELIVERY ADDRESS:
Commercial Recording Division
Commercial Recording Division
Connecticut Secretary of the State
Connecticut Secretary of the State
P.O. Box 150470
30 Trinity Street
Hartford, CT 06115-0470
Hartford, CT 06106
860-509-6003
860-509-6003
Space For Office Use Only
Filing Fee: $25.00 Stock
Make Checks Payable To “Secretary of the State”
$10.00 Nonstock
1. NAME OF CORPORATION:
2. CURRENT AGENT NAME AND ADDRESS INFORMATION:
Name of agent:
Business/registered office address:
Residence address:
I have notified the corporation of the above stated address changes.
3. EXECUTION:
Dated this _________________day of ____________________, 20_____.
Print or type name of agent
Signature of agent
Revised 11/2007

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