Form Acm-1-1.0 - Appointment Of Attorney For Service Of Process Real Estate - 2010
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1SECRETARY 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 REAL ESTATE
C.G.S. §§ 20-329c
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:
1. NAME OF PERSON OR BROKER:
2. STATE OF RESIDENCE OR FORMATION OF THE PERSON OR BROKER:
3. BUSINESS ADDRESS OF THE PERSON OR BROKER
(P.O. BOX NOT ACCEPTABLE):
ADDRESS:
CITY:
STATE:
ZIP:
THE ABOVE NAMED PERSON OR BROKER DOES HEREBY APPOINT THE SECRETARY OF THE STATE OF CONNECTICUT AND HIS
SUCCESSORS IN OFFICE TO BE ITS ATTORNEY UPON WHOM ALL PROCESS IN ANY ACTION OR PROCEEDING AGAINST SUCH PERSON
OR BROKER MAY BE SERVED. THE ABOVE NAMED PERSON OR BROKER FURTHER AGREES THAT ANY PROCESS AGAINST HIM OR IT
WHICH IS SERVED UPON THE SECRETARY OF THE STATE SHALL BE OF THE SAME LEGAL FORCE AND VALIDITY AS IF SERVED UPON
SUCH PERSON OR BROKER AND THAT THE APPOINTMENT MADE HEREBY SHALL CONTINUE IN FORCE AS LONG AS ANY LIABILITY
REMAINS OUTSTANDING AGAINST SUCH PERSON OR BROKER IN CONNECTICUT.
4. EXECUTION:
DATED THIS
DAY OF
, 20
NAME OF SIGNATORY
CAPACITY/TITLE OF SIGNATORY
SIGNATURE
5. AUTHENTICATION:
DATE
STATE OF
COUNTY OF
PERSONALLY APPEARED
AND ACKNOWLEDGED THE SAME TO BE HIS/HER FREE ACT AND DEED BEFORE ME.
NOTARY PUBLIC
FORM ACM-1-1.0
PAGE 1 OF 1
Rev. 7/2010
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