Form 521 - Filing Form Cover Letter Page 4
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7Complete the information in this section if box (1) is checked and business is an Ohio entity
ACCEPTANCE OF APPOINTMENT FOR DOMESTIC ENTITY'S AGENT
The Undersigned,
, named herein as the
Name of Agent
statutory agent for
, hereby acknowledges
Name of Business Entity
and accepts the appointment of statutory agent for said entity.
Signature:
Individual Agent's Signature/Signature on behalf of Business Serving as Agent
Complete the information in this section if box (2) is checked
New Address of Agent
Mailing Address
State
City
ZIP Code
Complete the information in this section if box (3) is checked
The agent of record for the entity identified on page 1 resigns as statutory agent.
Current or last known address of the entity's principal office where a copy of this Resignation of Agent was sent as of the
date of filing or prior to the date filed.
Mailing Address
City
State
Zip Code
Form 521
Last Revised: 05/14/2014
Page 4 of 7
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Parent category: Legal