Statement Of Change Of Registered Office By Agent Form - Corporation Bureau Pennsylvania Department Of State

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PENNSYLVANIA DEPARTMENT OF STATE
CORPORATION BUREAU
Statement of Change of Registered Office by Agent
(15 Pa.C.S. § 108)
Document will be returned to the
Name
name and address you enter to
the left.
Address
City
State
Zip Code
Fee: $5
In compliance with the requirements of 15 Pa.C.S. § 108 (relating to change in location or status of
registered office provided by agent), the undersigned person who maintains the registered office of an association and
who desires to change the following with respect to such agency hereby states that:
The name of the association represented by the undersigned person is:
1.
2. The current name of the person in care of the foregoing office: ______________________________________
The person named immediately above in this paragraph has been designated in fact as the agent in care of the
registered office in the Commonwealth of Pennsylvania of the association named in paragraph 1 of this statement.
For change in the name of the Agent
3. The name to which the person in care of the foregoing office shall be changed to is:
____________________________________________________________________________________________
For change in the registered office of the association
4. The address of the present registered office in this Commonwealth of the above-named association is:
Number and Street
City
State
Zip
County

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