Notice Of Change Of Registered Agent Information Form - Arkansas Secretary Of State
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1Arkansas Secretary of State
M
M
ark
artin
State Capitol • Little Rock, Arkansas 72201-1094
501-682-3409 •
Business & Commercial Services, 250 Victory Building, 1401 W. Capitol, Little Rock
NOTICE OF CHANGE OF REGISTERED AGENT INFORMATION
(PLEASE TYPE OR PRINT CLEARLY IN INK)
MARK ENTITY TYPE
Corporation-Profit
General Partnership
Limited Liability Limited Partnership
Corporation-Nonprofit
Limited Partnership
Nonfiling/ Nonqualifying Entity
Limited Liability Company
Limited Liability Partnership
Other _________________________
Pursuant to the Laws of the State of Arkansas, the undersigned submits the following statement for the purpose of
changing its registered agent in the State of Arkansas. If this statement reflects a change in registered agent for any
entity or entities other than listed, this form must be accompanied by notice of such change to any and all applicable
entities.
1. Name of corporation: _____________________________________________________________________________________
2. Is the entity:
Domestic
Foreign
3. Street address of registered agent for service of process changing from: ________________________________________
Street Address
________________________________________________________________________________________________________
Street Address Line 2
City, State Zip
4. Street address for service of process, which registered agent is changing to:_____________________________________
Street Address
________________________________________________________________________________________________________
Street Address Line 2
City, State Zip
5. Name of registered agent changing from: ____________________________________________________________
To: __________________________________________________________________________________________
I understand that knowingly signing a false document with the intent to file with the Arkansas Secretary of State is a Class
C misdemeanor and is punishable by a fine up to $100.00 and /or imprisonment up to 30 days.
Executed this ____________________ day of ________________________, ___________________.
___________________________________________________
__________________________________________________
Signature and Title of Governor (Authorized Director or Officer)
Printed Name of Governor (Authorized Director or Officer)
DO-3/DN-04/FN-06/”ALL” Rev.08/07
NO FEE
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