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Form Ll:0006 - Limited Liability Company Statement Of Address Change And Statement Of Statutory Agent Change

LIMITED LIABILITY COMPANY

STATEMENT OF ADDRESS CHANGE AND

STATEMENT OF STATUTORY AGENT CHANGE

Pursuant to A.R.S. §§ 29-605 and 29-605.01

FILING FEE $5.00 (A.R.S. § 29-851)

THIS FORM IS NOT TO BE USED FOR ADDING MEMBERS – IF ADDING

MEMBERS PLEASE USE THE AMENDMENT FORM

It is important that the information you provide on this form be correct. To obtain the correct information

about the Limited Liability Company’s current known place of business and statutory agent, consult the

Customer Phone Bank at (602) 542-3026 or the Division’s website at

1. The exact name of the Limited Liability Company (LLC) currently on file with the Arizona Corporation

Commission (ACC) is:

_______________________________________________________________________________

2. The ACC file number is: ______________________________________

3. The current address of the LLC’s known place of business on file with the ACC is:

______________________________________

4. The name and street address* of the current statutory agent on file with the ACC are:

______________________________________

5. If the LLC was not organized in Arizona, the address of the office required to be maintained in the state of

its organization or, if not so required, of the principal office of the foreign LLC is:

______________________________________

6. Is the known place of business in Arizona to be changed?

Yes and the address of the new place of business is:

______________________________________

* street address must be a physical address. P.O. Box addresses and personal mail boxes (PMB) will not be accepted.

LL:0006

Arizona Corporation Commission

Rev. 10/2007

Corporations Division

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Form Ll:0006 - Limited Liability Company Statement Of Address Change And Statement Of Statutory Agent Change