Statement Of Resignation Of Registered Agent - Montana Secretary Of State
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1
2Prepare, sign & submit with the proper fee
STATE OF MONTANA
This is the minimum information required
(This space for use by the Secretary of State only)
STATEMENT of RESIGNATION
of REGISTERED AGENT
:
LINDA McCULLOCH
MAIL
Secretary of State
P.O. Box 202801
Helena, MT 59620-2801
P
:
(406) 444-3665
HONE
F
:
(406) 444-3976
AX
W
S
:
sos.mt.gov
EB
ITE
No Filing Fee Required
24 Hour Priority Handling check box & Add $ 20.00
1 Hour Expedite Handling check box & Add $100.00
For the purpose of resigning as registered agent with the Montana Secretary of State’s Office, the undersigned
submits the following statements of fact to the Secretary of State in accordance with
35-7-111,
MCA:
1. The exact name of the entity:
___________________________________________________________________________________________
Resignation of Appointed Registered Agent Information
2. The name of current registered agent: __________________________________________________
3. The person representing the entity where agent will send notification of their resignation:
Person’s Name: ________________________________________________________________________
Mailing Address: ________________________________________________________________________
______________________________________________________________________________________
4. The registered agent resigns from serving as agent for service of process for the above listed entity.
st
5. A statement of resignation takes effect on the earlier of the 31
day after the day on which it is filed or the
appointment of a new registered agent for the represented entity.
6. When a statement of resignation takes effect, the registered agent ceases to have responsibility for any
matter tendered to it as agent for the represented entity.
7. By my signature, I, resign as registered agent for the above named entity and do state that the statements
contained therein are true, under penalty of false swearing.
___________________________________________________________
________________________
Signature of Registered Agent
(Date)
___________________________________________________________
Printed Name and Title of above Authorized Person
Daytime Contact: Phone _____________________ Email_____________________________________________
sos.mt.gov/Business/Forms
81-Resignation_of_Agent.doc
Revised: 11/14/2011
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