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Statement Of Change Form Of Commercial Registered Agent And/or Registered Office 35-7-110, Mca - State Of Montana 2011

Prepare, sign, submit with an original signature and filing fee

STATE OF MONTANA

This is the minimum information required.

(This space for use by the Secretary of State only)

STATEMENT of CHANGE

of COMMERCIAL REGISTERED AGENT

and/or REGISTERED OFFICE

35-7-110, MCA

LINDA McCULLOCH

MAIL

Secretary of State

P.O. Box 202801

Helena, MT 59620-2801

(406) 444-3665

HONE

(406) 444-3976

sos.mt.gov

ITE

Required Filing Fee: No Fee



24 Hour Priority Handling check box and Add $ 20.00



1 Hour Expedite Handling check box and Add $100.00

For the purpose of modifying their commercial registered agent information on file with the Montana Secretary of

State, the undersigned submits the following statements in accordance with

35-7-110,

MCA:

1. Commercial Agent ID Number: ________________________________________________________________

Registered Agent Information

2. The name of the current registered agent: _______________________________________________

3. The new name of the registered agent: __________________________________________________

4. The new state of jurisdiction is: _________________________________________________________

5. The new type of organization is: ________________________________________________________

6. The street or rural route box number and mailing address of the new registered office:

____________________________________________________________________________________________________

Street or Rural Route Box Number

___________________________________________________________________________________

Mailing Address

City: _________________________________________State: MT Zip Code: _____________________

7. A commercial registered agent shall promptly furnish each entity represented by it with notice of record of the

filing of a statement of change relating to the name or address of the agent and the changes made by the filing.

8. I, HEREBY SWEAR AND AFFIRM, under penalty of law, that the facts contained in this document are true.

_____________________________________________

________________________

Signature of Registered Agent or Authorized Person

Date

_____________________________________________

Printed Name and Title of above Authorized Person

Daytime Contact: Phone__________________________Email_________________________________________

THIS FORM IS ONLY TO BE USED BY AGENTS THAT ARE CURRENTLY REGISTERED WITH THE

SECRETARY OF STATE AS A “COMMERCIAL REGISTERED AGENT”.

sos.mt.gov/Business/Forms

83-Commercial_Statement_of_Change_of_Agent_and_Office.doc

Revised: 11/14/2011

Statement Of Change Form Of Commercial Registered Agent And/or Registered Office 35-7-110, Mca - State Of Montana 2011

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