Form Cxm-1-1.0 - Appointment Of Attorney For Service Of Process Amusements/circuses, Fireworks And Vendors (Cigarettes)

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SECRETARY OF THE STATE OF CONNECTICUT
MAILING ADDRESS: COMMERCIAL RECORDING DIVISION, CONNECTICUT SECRETARY OF THE STATE, P.O. BOX 150470, HARTFORD, CT 06115-0470
DELIVERY ADDRESS: COMMERCIAL RECORDING DIVISION, CONNECTICUT SECRETARY OF THE STATE, 30 TRINITY STREET, HARTFORD, CT 06106
860-509-6003
PHONE:
WEBSITE:
APPOINTMENT OF ATTORNEY FOR
SERVICE OF PROCESS
AMUSEMENTS/CIRCUSES,
FIREWORKS AND VENDORS (CIGARETTES)
USE INK. COMPLETE ALL SECTIONS. PRINT OR TYPE. ATTACH 81/2 X 11 SHEETS IF NECESSARY.
FILING FEE: $50
FILING PARTY
:
(CONFIRMATION WILL BE SENT TO THIS ADDRESS)
MAKE CHECKS PAYABLE TO "SECRETARY
OF THE STATE"
NAME:
ADDRESS:
CITY:
STATE:
ZIP:
COMPLETE EITHER SECTION 1 OR SECTION 2
SECTION 1: (BUSINESS ENTITY)
NAME OF BUSINESS ENTITY
STATE OF FORMATION
PRINCIPAL PLACE OF BUSINESS
THE CORPORATION APPOINTS THE SECRETARY OF THE STATE OF CONNECTICUT AND HIS SUCCESSORS IN OFFICE, TO BE ITS AGENT
UPON WHOM ALL PROCESS, IN ANY ACTION OR PROCEEDING AGAINST IT, MAY BE SERVED. THE CORPORATION AGREES THAT ANY
PROCESS AGAINST IT WHICH IS SERVED ON THE SECRETARY OF THE STATE SHALL BE OF THE SAME LEGAL FORCE AND VALIDITY AS
IF SERVED ON THE CORPORATION, AND THAT THIS APPOINTMENT SHALL CONTINUE IN FORCE AS LONG AS ANY LIABILITY REMAINS
OUTSTANDING AGAINST THE CORPORATION IN CONNECTICUT.
SECTION 2: UNINCORPORATED ASSOCIATIONS AND INDIVIDUALS
NAME UNDER WHICH BUSINESS WILL BE TRANSACTED
STATE OF FORMATION (IF APPLICABLE)
NAME OF PRINCIPAL OFFICER
ADDRESS OF PRINCIPAL OFFICER
ADDRESS:
CITY:
STATE:
ZIP:
FORM CXM-1-1.0
PAGE 1 OF 2
Rev. 7/2010

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