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Change Of Agent Foreign Limited Liability Company Form - Connecticut Secretary Of The State

CHANGE OF AGENT

FOREIGN LIMITED LIABILITY COMPANY

Office of the Secretary of the State

MAILING ADDRESS:

DELIVERY ADDRESS:

Commercial Recording Division

Connecticut Secretary of the State

P.O. Box 150470

30 Trinity Street

Hartford, CT 06115-0470

Hartford, CT 06106

860-509-6003

Filing Fee: $25.00

Make Checks Payable To “Secretary of the State”

Space For Office Use Only

1. NAME OF LIMITED LIABILITY COMPANY IN STATE OR COUNTRY OF FORMATION:

2. THE NAME UNDER WHICH THE LIMITED LIABILITY COMPANY TRANSACTS BUSINESS IN

CONNECTICUT, IF DIFFERENT FROM NAME STATED IN NUMBER 1 ABOVE:

3. STATE/COUNTRY OF FORMATION:

4. APPOINTMENT OF NEW REGISTERED AGENT FOR SERVICE OF PROCESS:

(Check A or complete B.)

A. ________

The limited liability company appoints the Secretary of the State of Connecticut and his

successors in office to be its agent upon whom any process, in any action or proceeding against it,

may be served.

B. Print or type name of agent

Business address:

(P.O. Box is unacceptable)

______________________________________

Residence address:

(P.O. Box is unacceptable)

Acceptance of Appointment

______________________________________________________________________

Signature of Agent

5. EXECUTION:

Dated this _____ day of _________, 20_____.

Print or type name of signatory

Capacity of signatory

Signature

REV. 08/24/2007

Change Of Agent Foreign Limited Liability Company Form - Connecticut Secretary Of The State