Statement Of Resignation Of Registered Agent Form - Kentucky Secretary Of State
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1Kentucky Secretary of State
T
G
REY
RAYSON
_____________________________________________________________________________________________________________
Division of Corporations
Statement of Resignation of
SRA
B
F
USINESS
ILINGS
Registered Agent
P.O. Box 718
Frankfort, KY 40602
(502) 564-2848
_____________________________________________________________________________________________________________
I, _______________________________________________________________________
do hereby
_________________resign as registered agent, and
_________________discontinue the registered office address
on behalf of _____________________________________________________________________
Exact name of entity
_________________a corporation (KRS 271B, KRS 273)
_________________a limited liability company (KRS 275)
_________________a limited partnership (KRS 362)
_________________a limited liability partnership (KRS 362)
_________________a business trust (KRS 386)
organized and existing in the state or country of ________________________________________.
The agency appointment shall be terminated and the registered office discontinued, if so provided,
st
on the 31
day after the date on which the statement if filed.
_________________________________________
Signature of Resigning Agent
_________________________________________
Print or Type Name
_________________________________________
Street Address
_________________________________________
City
State
Zip Code
Submit one originally signed and two exact or conformed copies. One filed stamped copy will be returned to the resigning agent and one
copy will be mailed to the business entity at its principal office address.
Mailing Address:
Trey Grayson – Secretary of State – P. O. Box 718 -Frankfort, KY 40602
SRA (06/2007)
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