Form Ar: 0011 - Corporation Statement Of Resignation Of Statutory Agent

Form Ar: 0011 - Corporation Statement Of Resignation Of Statutory Agent - 2002

CORPORATION

STATEMENT OF RESIGNATION OF

STATUTORY AGENT

(Name of corporation one is resigning from)

(ACC file number)

FILING FEE $10.00 (pursuant to A.R.S. §10-122.A)

NOTE: It is critical that the Corporation Commission receive the exact name and file number of the corporation one is resigning

from. Please check with our Records section, (602) 542-3026 or our web site,

to obtain the correct

information.

IMPORTANT! You must evaluate both items. Check those that apply.

The undersigned statutory agent of ______________________________________________,

an Arizona corporation, or

a foreign corporation qualified to do business in Arizona, hereby resign

my appointment as agent.

The known place of business, currently the street address of the undersigned, is also discontinued.

The undersigned has given notice of this resignation (required by A.R.S. §10-503.A) to the

Corporation by mailing one copy to the Corporation at the following address:

________________________________________________________________

This resignation shall be effective on the thirty-first day after the date on which this statement is

delivered to the Arizona Corporation Commission for filing.

DATED this ____ day of ________________________, _________

Signature:________________________________________________

Printed Name:_____________________________________________

This form must be accompanied by a filing fee of $10.00 (A.R.S. §10-122.A) U.S. funds made payable and

delivered to:

ARIZONA CORPORATION COMMISSION

Corporations Division

1300 West Washington

400 West Congress

Phoenix, Arizona 85007-2929

Tucson, Arizona 85701-1347

AR: 0011

Rev: 4/2002

Form Ar: 0011 - Corporation Statement Of Resignation Of Statutory Agent - 2002