Commercial Registered Agent Statement Of Termination Form - 2012
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1COMMERCIAL REGISTERED AGENT
Secretary of State Office
500 E Capitol Ave
RECEIPT NO ___________________
STATEMENT OF TERMINATION
Pierre, SD 57501
(605)773-4845
Please Type or Print Clearly in Ink
Original
Photocopy
Please submit one
and one
Clear Form
FILING FEE: $10
SECRETARY OF STATE
Payable to
HELP
The indicated Commercial Registered Agent (CRA) submits to the Secretary of State the following statement for the
purpose of terminating its status as a commercial agent in the State of South Dakota.
1. The Commercial Registered Agent CRA# _____________________________________________________________
2. The CRA Name _________________________________________________________________________________
3. The agent is no longer in the business of serving as a commercial registered agent in South Dakota. The termination
will take effect on the thirty-first day after the day on which this statement is filed by the Secretary of State office.
4. The Commercial Registered Agent shall promptly furnish each entity represented by it with notice in a record of the
filing of the Commercial Registered Agent Statement of Termination.
The statement of termination shall be signed by or on behalf of the agent.
Dated ____________________________
______________________________________________
(Signature of an authorized officer)
______________________________________________
(Printed Name)
______________________________________________
(Title)
Commercialagttermination April 2012
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