Form Ss-4512 Agent Appointment By Nonresident Fiduciary printable pdf download

Form Ss-4512 Agent Appointment By Nonresident Fiduciary

For Office Use Only

AGENT APPOINTMENT BY

NONRESIDENT FIDUCIARY

312 Eighth Avenue North

Floor, William R. Snodgrass Building

Nashville, TN 37243-0306

APPOINTMENT OF TENNESSEE SECRETARY OF STATE AS AGENT FOR

SERVICE OF PROCESS FOR NONRESIDENT FIDUCIARY

PURSUANT TO TCA §35-50-107

The undersigned, _______________________________________________, a nonresident per-

son, bank or trust company, wishing to act as a fiduciary in the State of Tennessee in confor-

mity with the laws thereof, hereby appoints the Secretary of State of the State of Tennessee

as the undersigned’s agent for service of process.

All process in any suit or proceeding against the undersigned may be served upon the Ten-

nessee Secretary of State in any action or proceeding relating to any trust, estate or matter

within this State in respect of which the undersigned is acting in a fiduciary capacity.

The undersigned agrees that any process against the undersigned, which is served upon the

Tennessee Secretary of State, shall be of the same legal force and validity as if served on the

undersigned.

It is understood that this appointment shall continue for as long as any liability shall remain

outstanding against the undersigned pertaining to any such matters.

The specific trust, estate or person for which the undersigned has been appointed as fidu-

ciary is:

________________________________________

The street address (including zip code) of the undersigned (to which all copies of legal pro-

cess should be addressed) is:

_________________________________________

Executed this ______ day of _______________________, ______.

_____________________________________

(signature)

Filing Fee $10.00

SS-4512 (Rev. 9-01)

RDA 1764

Form Ss-4512 Agent Appointment By Nonresident Fiduciary