Form Ditch_ext_term - Statement Of Extension Of Term - 2009
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If document is filed on paper
$125.00
If document is filed electronically
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Paper documents must be typewritten or machine printed.
ABOVE SPACE FOR OFFICE USE ONLY
Statement of Extension of Term
filed pursuant to
§7-42-112
of the Colorado Revised Statutes (C.R.S)
1. The entity ID number and the entity name of the ditch company are
Entity ID number
___________________________
(Colorado Secretary of State ID number)
Entity name
______________________________________________________.
2. The principal office address of the ditch company’s principal office is
Street
address
______________________________________________________
(Street number and name)
______________________________________________________
__________________________ ____ ____________________
(City)
(State)
(ZIP/Postal Code)
_______________________ _____________________________
(Province – if applicable)
(Country)
Mailing
address
______________________________________________________
(leave blank if same as street address)
(Street number and name or Post Office Box information)
______________________________________________________
__________________________ _____ ____________________
(City)
(State)
(ZIP/Postal Code)
_______________________ _____________________________
(Province – if applicable)
(Country)
3. The registered agent name and registered agent address of the ditch company’s registered agent are
Name
(if an individual)
____________________ ______________ ______________ _____
(Last)
(First)
(Middle)
(Suffix)
OR
(if an entity)
______________________________________________________
(Caution: Do not provide both an individual and an entity name.)
Street
address
______________________________________________________
(Street number and name)
______________________________________________________
__________________________
CO
____________________
(City)
(State)
(ZIP Code)
DITCH_EXT_TERM
Page 1 of 2
Rev. 12/01/2009
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