Form Rac - Statement Of Change Of Registered Office Or Registered Agent Or Both

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Kentucky Secretary of State
T
G
REY
RAYSON
_________________________________________________________________________________________________________
Division of Corporations
Statement of Change of Registered Office
RAC
B
F
USINESS
ILINGS
or Registered Agent or Both
P.O. Box 718
Frankfort, KY 40602
(502) 564-2848
______________________________________________________________________________
Pursuant to the provisions of Chapter 271B,273,275, or 362 of the Kentucky Revised Statutes, the
undersigned hereby applies to change the registered office of registered agent, or both on behalf of
_____________________________________________________________________________
(Exact name of entity)
which is organized in the state of ______________, and for that purpose submits the following statements:
1. Name of current registered agent
2. Registered agent is hereby changed to
__________________________________
___________________________________
3. Address of current registered office
4. Registered office is hereby changed to
_________________________________
_________________________________
_________________________________
_________________________________
_________________________________
_________________________________
_________________________________
_________________________________
The Street address of the registered office and the business office of the registered agent, as changed, will be identical.
5. Signature of officer or chairman of the board
6. Consent of Registered Agent
member, manager, or partner
_________________________________
I consent to serve as the registered agent on behalf of
Signature and title
this entity
_________________________________
_________________________________
Type or print name and title
Signature of registered agent
_________________________________
_________________________________
Date
Date
RAC (06/07)
(See attached sheet for instructions)

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