Form Sfn 16812w - North Dakota Business Or Farming Corporation Articles Of Incorporation Page 2

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COMPLETE, PRINT, SIGN AND FAX OR MAIL
FOR OFFICE USE ONLY
REGISTERED AGENT
ID#:
CONSENT TO SERVE
WO#:
SECRETARY OF STATE
SFN 7974 (06-2006)
Filed:
By:
SEE REVERSE SIDE FOR FILING AND MAILING INSTRUCTIONS
1. FILING FEE: $10.00
TYPE OR PRINT LEGIBLY
2. Name of the organization for which the registered agent is to serve (corporation, limited liability company, limited liability partnership, limited partnership,
limited liability limited partnership or real estate investment trust):
3. Name of the registered agent:
4. Registered agent is (Check one)
5. Federal ID # or social security # of registered agent:
An individual North Dakota resident
A corporation
A limited liability company
A limited liability partnership
6. According to state law, the newly appointed registered agent must sign a statement of consent to serve in that capacity (see instruction number 6 for
authorized signers).
"The undersigned, as the newly appointed registered agent for the organization named in number 2, consents to act as the registered agent for this
organization until a change or resignation is submitted to the Secretary of State according to the provisions of North Dakota state law."
Signature of Registered Agent:
Date:

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