Statement Of Change Of Registered Agent, Registered Office, Or Both - Idaho Secretary Of State

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STATEMENT OF CHANGE OF
REGISTERED AGENT,
REGISTERED OFFICE,
OR BOTH
(See reverse for instructions)
File #: ______________________________
The undersigned entity submits the following statement for the purpose of changing its registered
agent, its registered office, or both, in the State of Idaho.
1.
The name of the entity is:
______________________________________________________________________
2.
The name and street address of its old registered agent and office is:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
3.
The name and street address of its new registered agent and office in Idaho is:
______________________________________________________________________
______________________________________________________________________
(not a PO box or PMB)
______________________________________________________________________
I consent to serve as registered agent for the above-named entity.
(Signature of new registered agent)
(Date)
Dated: ____________________________________
Signature: _________________________________
Printed: ___________________________________
Capacity: _________________________________
NO FEE REQUIRED
FILE ONE COPY
change_ra_ro.pmd
Rev. 07/2010

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