Form Dfi/corp/13 - Registered Agent And/or Registered Office Change Form - Department Of Financial Institutions - 2015

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FILING FEE
No Fee or $10.00
See Below
RESET
OPTIONAL EXPEDITED
+ $25.00
SERVICE
DO NOT STAPLE
Ss. 178.43(4), 179.046,
State of Wisconsin
180.0502, 180.1508,
DEPARTMENT OF FINANCIAL INSTITUTIONS
181.0502, 181.1508,
Division of Corporate & Consumer Services
183.0105(3) & 183.1008,
Wis. Stats
REGISTERED AGENT and/or
REGISTERED OFFICE CHANGE
1.
(Name of the corporation, limited liability company, limited liability partnership or limited partnership,
including its registered or fictitious name, if so licensed)
2. The corporation, limited liability company, limited liability partnership or limited partnership submitting this
statement is organized under the laws of
Wisconsin
OR
(name the foreign state or country)
3. A
This statement is submitted for the purpose of changing the entity’s REGISTERED
AGENT in Wisconsin to be:
NO FEE
New (or continuing) registered AGENT in Wisconsin:
__________________________________________________________________
3. B
This statement is submitted for the purpose of changing the entity’s REGISTERED
OFFICE in Wisconsin to be:
New registered OFFICE in Wisconsin:
$10.00
FILING FEE
(complete street address of registered office)
, Wisconsin _______________________
(City)
(ZIP code)
4. The street address of the registered office and the business office of the registered agent, as changed or
continued, are identical.
5. Executed on _______________________________
______________________________________________
(Date)
(Signature)
Select and mark (X) below the appropriate title
______________________________________________
of the person executing the document.
(Printed name)
For a corporation
For a limited liability company
Title:
President OR
Secretary
Title:
Member OR
Manager
or other officer title ___________________________
For a limited liability partnership
For a limited partnership
Title:
Partner
Title:
General Partner
Change by registered agent
Title:
Registered Agent (continuing registered agent or registered agent in effect prior to any change of agent
indicated above) The corporation, limited liability company, limited liability partnership or limited
partnership has been notified of the change.
DFI/CORP/13(R03/15)
1

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