B
R
FORM LLC-7
WWW.
USINESS
1/2001
Nonrefundable Filing Fee: $50.00
STATE OF HAWAII
DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS
Business Registration Division
1010 Richards Street
Clear Form
Mailing Address: P.O. Box 40, Honolulu, Hawaii 96810
STATEMENT OF CHANGE OF AGENT FOR SERVICE OF PROCESS
(Section 428-108, Hawaii Revised Statutes)
PLEASE TYPE OR PRINT LEGIBLY IN BLACK INK
The undersigned, submitting this Statement certify as follows:
1.
The limited liability company is (check one):
Domestic
Foreign
2.
The name of the limited liability company is:
_______________________________________________________________________________________________________________
3.
Name and street address of its current agent for service of process in Hawaii.
Name:
___________________________________________________________________________________________________
Address:
_________________________________________________________________________________________________
4.
Name of the limited liability company’s new agent for service of process in Hawaii is:
______________________________________________________________________________________________________________
5.
Complete street address (including number, street, city, state, and zip code) of its new agent for service of process is:
______________________________________________________________________________________________________________
We certify, under the penalties set forth in the Hawaii Uniform Limited Liability Company Act, that we have read the above
statements and that the same are true and correct.
Signed this ____________day of ___________________________________, __________
_______________________________________________________
_________________________________________________________
(Type/Print Name & Title)
(Type/Print Name & Title)
_______________________________________________________
_________________________________________________________
(Signature)
(Signature)
SEE INSTRUCTIONS ON REVERSE SIDE. Statement must be signed and certified by at least one manager of a manager-
managed company or by at least one member of a member-managed company.