Statement Of Change Regarding Resignation Or Other Termination Of Registered Agent printable pdf download

Statement Of Change Regarding Resignation Or Other Termination Of Registered Agent

Form must be filed electronically.

Paper forms are not accepted.

This copy is a sample and cannot be submitted for filing.

Statement of Change

Regarding Resignation or Other Termination of Registered Agent

filed pursuant to § 7-90-305.5 and § 7-90-702 of the Colorado Revised Statutes (C.R.S.)

1. The entity ID number and the entity name, or, if the entity does not have an entity name, the true name are

Entity ID number

__________________________

(Colorado Secretary of State ID number)

Entity name or True name

______________________________________________________.

2. The date on which such registered agent resigned or otherwise ceased to be the registered agent is

___________________________.

(mm/dd/yyyy)

3. The registered agent has resigned or otherwise is no longer the registered agent.

The name and address of such registered agent are

Name

(if an individual)

____________________ ______________ ______________ _____

(Last)

(First)

(Middle)

(Suffix)

(if an entity)

______________________________________________________

(Caution: Do not provide both an individual and an entity name.)

Street address

______________________________________________________

(Street number and name)

______________________________________________________

__________________________

____________________

(City)

(State)

(Zip Code)

Mailing address

______________________________________________________

(leave blank if same as street address)

(Street number and name or Post Office Box information)

______________________________________________________

__________________________

____________________.

(City)

(State)

(Zip Code)

(If applicable, adopt the following statement by marking the box.)

Such registered agent has delivered notice of the change to the entity.

(If applicable, adopt the following statement by marking the box and include an attachment.)

This document contains additional information as provided by law.

CHANGE_RA_RESIGN

Page 1 of 2

Rev. 10/06/2008

Statement Of Change Regarding Resignation Or Other Termination Of Registered Agent

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