Form Corp. 59a - Statement Of Change Of Business Office Address By A Registered Agent Of A Foreign Or Domestic For Profit Or Nonprofit Corporation

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This form is designed to be filled out online for your
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State of Missouri
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Matt Blunt, Secretary of State
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Corporations Division
P.O. Box 778 / 600 W. Main Street, Rm 322
Jefferson City, MO 65102
Statement of Change of Business Office Address
by a Registered Agent of a
Foreign or Domestic For Profit or Nonprofit Corporation
Instructions
1.
This form is to be used by a registered agent of a for profit or nonprofit corporation to change the
address of the business office of the registered agent.
2.
The filing fee for this change is $10.00. Change must be filed in DUPLICATE.
3.
P.O. Box may only be used in conjunction with a physical street address.
4.
Agent and address must be in the State of Missouri.
5.
The corporation cannot act as its own registered agent. The registered agent should sign his/her
individual name, unless the registered agent is a corporation, in which case the execution should be by
proper officers.
Charter No.__________________________
The undersigned registered agent, for the purpose of changing its business office in Missouri, represents that:
1. The name of the corporation is: ________________________________________________________________
2. The name of the registered agent is: ___________________________________________________________
3. The address, including street number, of the present business office of the registered agent is:
_________________________________________________________________________________________
Address
City/State/Zip
4. The address, including street number, of the business office of the registered agent is hereby changed to:
_________________________________________________________________________________________
Address
(P.O. Box may only be used in conjunction with a physical street address)
City/State/Zip
5. Notice in writing of the change has been mailed by the registered agent to the corporation named above.
6. The address of the registered office of the corporation named above and the business office of the registered agent,
as changed, is identical.
In affirmation of the facts stated above,
____________________________________________________________________________________________
(Authorized Signature of Registered Agent)
(Printed Name)
(month/day/year)
Corp. #59A (12/02)

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