Statement Of Change - Changing The Registered Agent Information
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1
2Document must be filed electronically.
Paper documents will not be accepted.
This copy is furnished as a sample
and may not be submitted for filing.
Submitting this form on paper
will result in rejection of the form.
Forms can be found online at the
File a Document page.
Statement of Change
Changing the Registered Agent Information
filed pursuant to § 7-90-305.5 and § 7-90-702 of the Colorado Revised Statutes (C.R.S.)
1. The entity ID number and the entity name, or, if the entity does not have an entity name, the true name are
Entity ID number
__________________________
(Colorado Secretary of State ID number)
Entity name or True name
______________________________________________________.
2.
(If applicable, adopt the following statement by marking the box and enter all changes.)
The registered agent name has changed.
Such name, as changed, is
Name
(if an individual)
____________________ ______________ ______________ ____.
(Last)
(First)
(Middle)
(Suffix)
OR
(if an entity)
______________________________________________________.
(Caution: Do not provide both an individual and an entity name.)
(The following statement is adopted by marking the box.)
The person appointed as registered agent has consented to being so appointed.
3.
(If applicable, adopt the following statement by marking the box and enter all changes.)
The registered agent address of the registered agent has changed.
Such address, as changed, is
Street
address
______________________________________________________
(Street number and name)
______________________________________________________
__________________________
CO
____________________.
(City)
(State)
(ZIP Code)
Mailing
address
______________________________________________________
(leave blank if same as street address)
(Street number and name or Post Office Box information)
______________________________________________________
__________________________
CO
____________________.
(City)
(State)
(ZIP Code)
EXAMPLE_CHANGE_ RA
Page 1 of 2
Rev. 4/10/2009
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