Consent For Service Charitable Organization Form - Attorney General, State Of Arkansas

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DUSTIN McDANIEL
ATTORNEY GENERAL
OFFICE OF THE ATTORNEY GENERAL
323 CENTER STREET, Suite 200
LITTLE ROCK, AR 72201-2610 (501) 682-2007
CONSENT FOR SERVICE
CHARITABLE ORGANIZATION
_____________________________________________, a Charitable Organization, hereby appoint(s) the
Attorney General of the State of Arkansas as agent for service in case of any and all lawsuits, proceedings and
actions growing out of the violation of any provisions of Ark. Code Ann. § 4-28-401 et seq., or as a result of any
activities conducted in the State of Arkansas giving rise to a cause of action.
It is hereby agreed that consent for service is irrevocable, and service on the Attorney General of the State
of Arkansas shall be binding on this organization as if due service has been made on its agents in person.
_______________________
___________________________________________
Date Signed
Legal Name of Charitable Organization
___________________________________________
Signature
___________________________________________
Printed Name
___________________________________________
Title/Official Position
NOTARY
STATE OF_______________
)
) SS.
COUNTY OF _____________
)
Subscribed and sworn to, before me, a Notary Public in, and for, said County and State, this _______ day
of ________________, 20____.
My Commission Expires:
________________________________________
______/______/_______
Signature of Notary Public
County of Residence
_________________________________________
____________________
Printed Name
STAMP or SEAL:

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