Form L-123 - Certification Of Resignation Of Registered Agent Without Successor
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2L-123 (4/94)
New Jersey Division of Revenue
Certification of Resignation of Registered Agent Without Successor
(For Use by a Limited Liability Company)
To: New Jersey Department of the Treasury, Division of Revenue
RE: _______________________________________________________
(Limited Liability Company)
1. In accordance with provisions of NJSA 42, I _____________________________________ at
(Agent Name)
_______________________________________ ___________________________ _____________
(No. and Street)
(City and State)
(Zip)
the address of the registered office of the above-named Limited Liability Company formed under the
laws of _________________________
(State)
DO HEREBY DECLARE THAT:
I sent a copy of said resignation by certified mail No. _________________________recorded at the Post
Office of _________________________ with return receipt requested to _________________________
(City and State)
being the last-known manager/member of said LLC known to me, at the address known to me at
__________________________________________ ___________________________ ___________
(No. and Street)
(City and State)
(Zip)
Certified mail was ___ accepted by ____________________________
__ was not accepted.
2. Attached is a copy of my resignation, mailed on ____________________
(Date)
3. Service of notice of my resignation has not been made as required because: (Leave blank if not
applicable)
4. It is understood that my resignation shall become effective upon 30 days after filing of the certificate
with the Treasurer or upon designation by the LLC of a new registered agent, whichever is earlier.
______________________________________
______________
Signature of Resigning Agent
Date
NJ Division of Revenue, PO Box 308, Trenton, NJ 08646
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