Corporation Registration Information Change Form
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1State of Utah
This form may not be handwritten.
Link to Corporation Registration Information Change Form Addendum
Department of Commerce
Instructions
Clear Form
Print Form
Division of Corporations & Commercial Code
Corporation Registration Information Change Form
Entity File Number:
Non-Refundable Processing Fee: $15.00
_________________________
Entity Name:
___________________________________________________________________________________________
For each Yes button that you mark the question will appear below for you to fill out.
1). Do you want to Change the Business Purpose?
Yes
No
1). If Yes, what is the new Business Purpose? ___________________________________________________________________________
2). Do you want to Change the Registered Agent or the Address of the Registered Agent?
Yes
No
2). If Yes, who is the new Registered Agent, or the new Address of the Registered Agent?
______________________________________________________________________________________________
The address must be listed if you have a non-commercial registered agent. See instructions for further details.
__________________________________________________________________
Address of the Registered Agent:
Utah Street Address Required, PO Boxes can be listed after the Street Address
City _____________________________________________________________________________ State UT Zip __________
3). Do you want to Change the Principal Address of the Business Entity?
Yes
No
3). If Yes, what is the new Principal Address?
Street Address Required. PO Box can be listed after Street Address
_________________________________________________________________________________
Address:
4). Do you want to Add individuals to the Business Entity?
Yes
No
4). If Yes, who do you want to Add to the Business Entity and what Position will they hold?
Name: ____________________________________________
Position: ___________________________________________
________________________________________________ City ___________________ State ______ Zip __________
Address:
Name: ____________________________________________
Position: ___________________________________________
________________________________________________ City ___________________ State ______ Zip __________
Address:
5). Do you want to Remove individuals from the Business Entity?
Yes
No
5). If Yes, who do you want to Remove from the Business Entity and what Position do they hold?
Name: _________________________________________
Position: ___________________________________________
Name: _________________________________________
Position: ___________________________________________
Name: _________________________________________
Position: ___________________________________________
6). Do you want to Change the Address of the Business Entity’s Principal(s)?
Yes
No
6). If Yes, who is the Principal(s) whose Address you wish to Change?
Name: ____________________________________________
Position: ___________________________________________
________________________________________________ City ___________________ State ______ Zip __________
Address:
Name: ____________________________________________
Position: ___________________________________________
________________________________________________ City ___________________ State ______ Zip __________
Address:
Optional Inclusion of Ownership Information: This information is not required.
Is this a female owned business?
Yes
No
Select/Type the race of the owner here
Is this a minority owned business?
Yes
No
If yes, please specify: _____________________________________
Under GRAMA {63-2-201}, all registration information maintained by the Division is classified as public record. For confidentiality purposes, you may use
the business entity physical address rather than the residential or private address of any individual affiliated with the entity.
Under penalties of perjury and as an authorized authority, I declare that this statement of change(s), has been examined by me and is, to the best of
my knowledge and belief, true, correct and complete.
Sign here after printing form
Name/Title: ___________________________________ Signature: _________________________________ Date: _____________________
Mailing/Faxing Information:
Division's Website:
01/17
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