Form For Change Of Registered Agent'S Address - Domestic Stock/non-Stock Corporations
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1CHANGE OF REGISTERED
AGENT’S ADDRESS
DOMESTIC
STOCK OR NON-STOCK
CORPORATIONS
Office of the Secretary of the State
30 Trinity Street / P.O. Box 150470 / Hartford, CT 06115-0470 / Rev. 12/1999
Please see reverse for instructions.
Space For Office Use Only
NAME OF CORPORATION:
Business/registered
office address:
Name of agent:
CURRENT AGENT NAME AND NEW ADDRESS INFORMATION:
Residence address:
I have notified the corporation
of the above stated address changes.
3. EXECUTION:
Dated this
day of
920
*
Print or type name of agent
Signature of agent
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