Form Dos-1373 - Certificate Of Registration For Receipt Of Process Page 2
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1
2FIFTH:
The designating limited liability company is required to deliver to the Department of
State a certificate of amendment or change providing for the designation by the limited liability
company of a new address and that upon its failure to file such certificate, its authority to do
business in this state shall be suspended.
X
(Signature)
(Name of signer)
(Title of signer)
CERTIFICATE OF RESIGNATION
FOR RECEIPT OF PROCESS
OF
(Insert Name of Limited Liability Company)
Under Section 301-A of the Limited Liability Company Law
Filed by:
(Name)
(Mailing address)
(City, State and ZIP code)
NOTE: This form was prepared by the New York State Department of State for a certificate of resignation for
receipt of process by a domestic or foreign limited liability company. You are not required to use this form. You
may draft your own form or use forms available at legal supply stores. The Department of State recommends that
legal documents be prepared under the guidance of an attorney. The certificate must be submitted with a $10 filing
fee made payable to the Department of State.
(For office use only)
DOS-1373 (Rev. 5/08)
-2-
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