Form Ll:0006 - Limited Liability Company Statement Of Address Change And Statement Of Statutory Agent Change Page 3
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3LLC Name ______________________________________
ACC File Number __________________
Name: ____________________________________,
Member or
Manager
(circle one)
Current
New
Address: ________________________________ Address: _______________________________
________________________________
_______________________________
________________________________
_______________________________
Name: ____________________________________,
Member or
Manager
(circle one)
Current
New
Address: ________________________________ Address: _______________________________
________________________________
_______________________________
________________________________
_______________________________
Name: ____________________________________,
Member or
Manager
(circle one)
Current
New
Address: ________________________________ Address: _______________________________
________________________________
_______________________________
________________________________
_______________________________
* street address must be a physical address. P.O. Box addresses and personal mail boxes (PMB) will not be accepted.
Changes to the statutory agent address must be
A.R.S §§29-605 and 29-605.01 requires that changes
executed by the statutory agent.
to limited liability companies (except for changes to
the statutory agent’s address) be executed by a
member/manager of the LLC.
Dated this ______ day of ____________, _________
Dated this ______ day of ____________, _________
Signature: __________________________________
Signature: __________________________________
Printed Name: _______________________________
Printed Name: _______________________________
__________________________________________
Title: _______________________________________
If signing on behalf of a company, please print the company name here.
LL:0006
Arizona Corporation Commission
Rev. 10/2007
Corporations Division
Page 3 of 3
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