Statement Of Change By Noncommercial Registered Agent

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ROSS MILLER
Secretary of State
202 North Carson Street
Carson City, Nevada 89701-4201
(775) 684 5708
Website:
Statement of Change by
Noncommercial
Registered Agent
(PURSUANT TO NRS 77.350)
This form may be submitted by: a Noncommercial Registered Agent
to update their name or address for service of process. For more
information please visit
USE BLACK INK ONLY - DO NOT HIGHLIGHT
ABOVE SPACE IS FOR OFFICE USE ONLY
1. Name of Entity Represented:
2. Entity File Number:
3. Name and Address of Noncommercial Registered Agent of record before change:
Name
Nevada
Street Address
City
Zip Code
Nevada
Mailing Address (if different from street address)
City
Zip Code
4. Name and Address of Noncommercial Registered Agent upon the filing of this document:
Name
Nevada
Street Address
City
Zip Code
Nevada
Mailing Address (if different from street address)
City
Zip Code
5. Signature of Noncommercial Registered Agent:
X
Date
Authorized Signature of Registered Agent or On Behalf of Registered Agent Entity
FEE: $60.00
Nevada Secretary of State Form Change by NonCRA
This form must be accompanied by appropriate fees.
Reset
Effective 12-8-08

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