Form 80 - Statement Of Change Of Registered Agent By Entity 35-7-108, Mca
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1Prepare, sign, and submit with an original signature and filing fee.
This is the minimum information required.
STATE OF MONTANA
(This space for Secretary of State use only)
STATEMENT of CHANGE of REGISTERED AGENT by ENTITY
35-7-108, MCA
:
MAIL
Secretary of State
P.O. Box 202801
Helena, MT 59620-2801
PHONE:
(406)444-3665
FAX:
(406)444-3976
WEBSITE:
sos.mt.gov
Required Filing Fees:
Standard
None
Folder ID Number: _____________
24 Hour Priority $ 20.00
The folder number begins with a “D, F, C, E” or “L” and
1 Hour Expedite $100.00
may be referenced at https://
Make checks payable to Secretary of State.
If the document is hand written, please print legibly or the application may be denied.
1. The exact name of the entity: _________________________________________________________________________________
2. The name and address of the registered agent as currently in effect:
Name:____________________________________________________________________________________________________
Address:__________________________________________________________________________________________________
3. The new name of the registered agent, if applicable:_______________________________________________________________
4. The new address of the registered agent, if applicable:
Actual Street Address or Rural Route Box Number in Montana: (Must be a geographic location.)
__________________________________________________________________________________________________________
City: ____________________________________________________ State: MT Zip Code: ________________________________
And, a mailing address in Montana, if different:
__________________________________________________________________________________________________________
City: ____________________________________________________ State: MT Zip Code: ________________________________
Appointment of a Registered Agent is affirmation of the Registered Agent’s consent to serve as Registered Agent.
5. I HEREBY SWEAR AND/OR AFFIRM, under penalty of law, including criminal prosecution, that the facts contained in this
document are true.
___________________________________________________________________________
____________________________
Signature of Authorized Agent for Entity
Date
____________________________________________________________
___________________________________________
Printed Name
Title
6. Daytime Contact: Phone_________________________________ Email _____________________________________________
sos.mt.gov/Business/Forms
80-Statement_of_Change_of_Registered_Agent_by_Entity
Revised: 3/2017
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