Change Of Registered Agent'S Address Form - Connecticut Secretary Of The State (Page 2 of 2) in pdf

Change Of Registered Agent'S Address Form - Connecticut Secretary Of The State Page 2

INSTRUCTIONS FOR COMPLETION OF THE CHANGE OF

REGISTERED AGENT'S ADDRESS FORM

Instructions correspond with numbered entries on the form

NAME OF CORPORATION: Please provide the full name of the corporation as it

appears on the records of The Secretary of the State.

CURRENT AGENT NAME AND ADDRESS INFORMATION: This form may not be

used to appoint a NEW agent. Provide the full name of the corporation’s agent, as it

appears on the record of the Office of the Secretary of the State. If the agent is a natural

person, provide the complete street address of his/her business and residence. If the

agent is a corporation; limited liability company; registered limited liability partnership

or statutory trust it must provide the address of its principal office in the block designated

for “Business address” and any person signing on its behalf must include his/her title on

signature line.

Information regarding the agent’s new address will replace the

information on the current indexes of this office.

Note: All addresses must include a street number, street name, city, state, and

postal code. P.O. Boxes are only acceptable as additional information.

EXECUTION: The agent must print or type their name and provide a signature. The

execution constitutes a legal statement under the penalties of false statement that the

information provided in the document is true.

Revised 11/2007

Change Of Registered Agent'S Address Form - Connecticut Secretary Of The State Page 2