Form Sra - Statement Of Resignation Of Registered Agent - 2009 Page 2

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FILING INSTRUCTIONS

STATEMENT OF RESIGNATION OF REGISTERED AGENT

NAME

Use the exact name of the business entity as registered on file with the Office of the Secretary of State.

DOCUMENT DELIVERY

All documents will be sent to the return address on the outer envelope. If no address is found, the documents will be sent to the principal office. If the

applicant wishes for correspondence from the Office of the Secretary of State to be sent to someone other than those above, a request must be

submitted in writing affirming that request. All other communication and notification shall follow the process prescribed in Kentucky Revised Statute.

WHO MAY SIGN

The document must be signed by the registered agent.

NUMBER OF COPIES

When filing online with the FastTrack system, no copies are required. If filing via mail or in person, one exact or conformed copy of the documents with

the filing fee must be submitted to the address below. To make a copy of the filing for delivery to the local county clerk’s office, visit and

print a copy from the organization search tool.

FILING FEE

There is no filing fee for filing this document.

MAILING ADDRESS

OFFICE LOCATION

Trey Grayson

Room 154, Capitol Building

Office of the Secretary of State

700 Capital Avenue

P.O. Box 718

Frankfort, KY 40601