Certificate Of Resignation Of Resident Agent Form - The Commonwealth Of Massachusetts Page 2

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THE COMMONWEALTH OF MASSACHUSETTS
CERTIFICATE OF RESIGNATION OF RESIDENT AGENT
(General Laws, Chapter 180, Section 10C)
I hereby approve the within Certificate of Resignation of Resident Agent and,
the filing fee in the amount of $ ________________ having been paid, said
certificate is deemed to have been filed with me this ________________ d a y
of ___________________, 20_______ .
WILLIAM FRANCIS GALVIN
Secretary of the Commonwealth
TO BE FILLED IN BY CORPORATION
Contact information:
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________
Telephone:
Email: __________________________________________________________
A copy this filing will be available on-line at once the
document is filed.

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