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

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COMPLETING THE CHANGE OF REGISTERED
AGENT'S ADDRESS FORM
Instructions correspond with numbered entries on the form
1.
NAME OF CORPORATION: Please provide the complete current name of the corporation as it
appears in the records of its state or country of formation.
2.
NAME OF CORPORATION IN CONNECTICUT: If different from above, please
provide the complete name under which the corporation transacts business in
Connecticut.
3.
CURRENT AGENT NAME AND NEW ADDRESS INFORMATION: Please provide the name
of the corporation's agent as it currently appears on the records of the Office of the Secretary of
the State and the new address information pertaining to that agent. Information provided in the
address blocks on this form will replace like information on the indexes of this office. Please
note that all addresses must include a street number, street name, city, state, and postal code.
P.O. Boxes are only acceptable as additional information.
4.
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.
REV. 08/24/2007

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