Statement Of Resignation Of Registered Agent
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1ROSS MILLER
Secretary of State
202 North Carson Street
Carson City, Nevada 89701-4201
(775) 684 5708
Website:
Statement of Resignation of
Registered Agent
(PURSUANT TO NRS 77.370)
This form may be submitted by: a Commercial Registered Agent,
Noncommercial Registered Agent or Represented Entity. For more
information please visit
USE BLACK INK ONLY - DO NOT HIGHLIGHT
ABOVE SPACE IS FOR OFFICE USE ONLY
1. Name of Registered Agent:
2. The above named registered agent resigns from serving as agent for service of process for the following entity(ies) and will
send notice required by NRS 77.370 subsection 3 to the name and address stated for each. List entities in alphabetical
order. Resigning agent may write "see attached list" in area below and attach a spreadsheet listing the entities in
alphabetical order with required information provided.
Entity Name
Entity Number
Name and Address Where Notice Sent
EFFECTIVE DATE: This statement of resignation takes
effect on the earlier of the 31st day after the day on which it
X
is filed or the appointment of a new registered agent for the
represented entity.
Authorized Signature of Registered Agent or On Behalf of Registered Agent Entity
Nevada Secretary of State Form RA Resignation
FEE: $100.00 for the first entity and $1.00 for each additional entity.
(NRS 77.280)
Effective: 5-15-09
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