Form X-9 - Statement Of Resignation Of Registered Agent
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1
2FORM X-9
7/2012
Nonrefundable Filing Fee: $25.00
STATE OF HAWAII
*X9*
DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS
Business Registration Division
Clear Info
335 Merchant Street
Mailing Address: P.O. Box 40, Honolulu, Hawaii 96810
Phone No. (808) 586-2727
STATEMENT OF RESIGNATION OF REGISTERED AGENT
(Section 414-63, 414-439, 414D-73, 414D-279, 425-20, 425E-116, 428-109, Hawaii Revised Statutes)
PLEASE TYPE OR PRINT LEGIBLY IN BLACK INK
The undersigned registered agent certifies as follows:
1.
The entity represented by the registered agent is: (please check one)
Profit Corporation
Nonprofit Corporation
General Partnership
Limited Liability Partnership
Limited Partnership
Limited Liability Limited Partnership
Limited Liability Company
Other:
2.
The name and state/country of incorporation/formation or organization of the represented entity is:
(State or County)
(Type/Print Entity Name)
3.
I am the resigning registered agent of the entity.
Name of Agent:
Under HRS 425R-10, the resigning registered agent must furnish written notice of the filing to the resignation statement.
4.
The name and address of the person to which the agent will send the required notice of resignation to is:
a. Name:
b. Address:
5.
Notice is hereby given that I am resigning as the registered agent for service of process for the entity. The statement of
resignation takes effect on the earlier of the thirty-first day after the filing of this statement in the office of the
Director of Department of Commerce and Consumer Affairs or the appointment of a new registered agent for the
represented entity.
I certify under the penalties of Section 414-20, 414D-12, 425-13, 425-172, 425E-208 and 428-1302, Hawaii Revised Statutes, as
applicable, that I have read the above statements, I am authorized to make this change, and that the above statements are true
and correct.
day of
Signed this
,
(Signature)
(Type/Print Name of Agent)
Office Held:
(if applicable)
SEE INSTRUCTIONS ON REVERSE SIDE. The statement must be signed by the registered agent.
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