Form Ofr-S-5-91 - Uniform Consent To Service Of Process/corporate Acknowledgement/individual Or Partnership Acknowledgement

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STATE OF FLORIDA
OFFICE OF FINANCIAL REGULATION
UNIFORM CONSENT TO SERVICE OF PROCESS
KNOW ALL MEN BY THESE PRESENTS:
That the undersigned
(a corporation organized by the laws of the
State of
) (a partnership) (an individual) (other
), for the
purposes of complying with the laws of the State of Florida relating to either the
registration or sale of securities, as required by Chapter 517, Florida Statutes, hereby
irrevocably appoints the Office of Financial Regulation and its successors, its attorney in
the State of Florida upon whom may be served any notice, process or pleading in any
action or proceeding against it arising out of or in connection with the sale of securities
or out of violation of the aforesaid laws of said State; and the undersigned does hereby
consent that any such action or proceeding against it may be commenced in any court
of competent jurisdiction and proper venue within said State by service of process upon
said officer with the same effect as if the undersigned was organized or created under
the laws of said State and has lawfully been served with process in said State.
It is requested that a copy of any notice, process or pleading served hereunder be
mailed to:
_____________________________
(Name and Address)
Dated:
___
(Seal)
By:
By: ______________________
Title:
Title: _____________________
OFR-S-5-91, Uniform Consent to Service of Process, Effective 11/22/10, Incorporated by Reference in
Rule 69W-301.002, F.A.C.
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