REGISTERED AGENT OR REGISTERED AGENT ADDRESS STATEMENT OF CHANGE
Pursuant to the provisions of Alaska Statutes, Titles 10 and 32, the undersigned entity, organized under
the laws of the State of ________________________, submits the following statement for the purpose
of changing its registered agent or registered agent address in the State of Alaska.
Provide all information. Please type or print, except for the signature.
Domestic
Entity Information
Alaska file number:
Foreign
Complete legal name of entity:
Corporation
Limited Partnership
Type of entity
Limited Liability Company
Limited Liability Partnership
Registered Agent Information
The registered agent must be an individual or corporation authorized to transact business in Alaska. A corporation
may not act as its own agent. The registered agent address must be in Alaska.
Old information
Name:
Mailing address:
Physical address:
New information
Name:
Mailing address:
Physical address:
This is also the principal office address for the corporate entity shown above.
Authorization
by (check one)
This change was authorized on (date)
resolution of the board of directors (Corporation)
Signed:
a member (Limited Liability Company)
Printed name:
the general partner (Limited Partnership)
Title:
a general partner (Limited Liability Partnership)
Signer must be: President or vice-president of the corporation; the general
partner of the limited partnership; a member of the limited liability company;
a general partner of the limited liability partnership.
Return form and $25.00 payment to
STATE USE ONLY
Dept. of Community and Economic Development
Date received
Corporations Section
Check #
PO Box 110808
Juneau AK 99811-0808
Dollar amount
Cash
The change will not be accepted unless:
the proper individual has signed AND
Card type
the fee is enclosed, payable to the State of Alaska.
Authorization #
08-615
Revised 2/2001