Form Poc - Statement Of Change Principal Office Address

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C
K
OMMONWEALTH OF
ENTUCKY
T
G
, S
S
REY
RAYSON
ECRETARY OF
TATE
_________________________________________________________________________________________________________
Division of Corporations
Statement of Change
POC
Business Filings
PO Box 718
Principal Office Address
Frankfort, KY 40602
(502) 564-3490
______________________________________________________________________________
Pursuant to the provisions of KRS 271B, 273, 275, or 362, the undersigned hereby applies to change the
principal office address on behalf of:
________________________________________________________________________________
(The name must be identical to the name on record with the Secretary of State.)
1. Address of current principal office
2. Principal office is hereby changed to
_________________________________
_________________________________
_________________________________
_________________________________
_________________________________
_________________________________
_________________________________
_________________________________
3. Signature of officer or chairman of the board
member, manager or partner
_________________________________
Signature and title
_________________________________
Type or print name and title
_________________________________
Date

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