Corporation Statement Of Change Form
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DO NOT WRITE ABOVE THIS LINE; RESERVED FOR ACC USE ONLY.
CORPORATION STATEMENT OF CHANGE
OF KNOWN PLACE OF BUSINESS ADDRESS, PRINCIPAL OFFICE ADDRESS,
OR STATUTORY AGENT
Read the Instructions
C016i
NOTE –
no matter what is being changed, numbers 1, 2, 3.1, 5.1, and 5.2 must be completed.
The form will be rejected if those sections are not completed.
1.
ENTITY NAME – give the exact name of the corporation as currently shown in A.C.C. records:
_________________________________________________________________________________________________
2.
A.C.C. FILE NUMBER: ___________________________________________________________
Find A.C.C. file number on the upper corner of filed documents OR on our website at:
3.
ARIZONA KNOWN PLACE OF BUSINESS ADDRESS:
3.1 REQUIRED – list the known place of
3.2 Optional - List the NEW known place of
business address currently shown in A.C.C.
business address in Arizona (must be a
records (before any changes):
street or physical address):
Attention (optional)
Attention (optional)
Address 1
Address 1
Address 2 (optional)
Address 2 (optional)
City
State
Zip
City
State
Zip
3.3 If you completed 3.2, is the NEW known place of business address in Arizona the same as
the street address of the statutory agent?
Yes
No
4.
PRINCIPAL OFFICE ADDRESS:
4.1 Required if changing – list the principal
4.2 Optional - List the NEW principal office
office address currently shown in
address (must be a street or physical
A.C.C. records (before any changes):
address):
Attention (optional)
Attention (optional)
Address 1
Address 1
Address 2 (optional)
Address 2 (optional)
City
State
Zip
City
State
Zip
Country
Country
C016.001
Arizona Corporation Commission – Corporations Division
Rev: 2010
Page 1 of 3
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Parent category: Legal