Certificate Of Appointment Of Resident Agent Form - The Commonwealth Of Massachusetts
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1
2IDENTIFICATION
____________________
no.
Filing Fee: $10.00
The Commonwealth of Massachusetts
William Francis Galvin
Secretary of the Commonwealth
One Ashburton Place, Room 1717, Boston, Massachusetts 02108-1512
CERTIFICATE OF APPOINTMENT OF RESIDENT AGENT
(General Laws, Chapter 180, Section 10C)
I, _____________________________________________________________________________________ , *Clerk / *Assistant Clerk
of _________________________________________________________________________________________________________ ,
(Exact name of corporation)
having a principal office at ______________________________________________________________________________________ ,
(Street address of corporation in Massachusetts)
certify that pursuant to General Laws, Chapter 180, Section 10C, said corporation has appointed the following *individual /*corporation as
its resident agent, to be its true and lawful attorney upon whom all lawful processes in any action or proceeding against it may be served:
____________________________________________________________________________________________________________
(Exact name of *individual / *corporation)
of _________________________________________________________________________________________________________
(Business and residential address if individual / business address if corporation)
___________________________________________________________________________________________________________ .
**I further certify that the following is a true copy of the vote of the directors, duly adopted appointing said resident agent:
and that to the best of my knowledge and belief, the residential and business addresses stated above are those of the resident agent.
SIGNED UNDER THE PENALTIES OF PERJURY, this __________ day of________________________________ , 20 ___________,
_______________________________________________________________________________________ , *Clerk / *Assistant Clerk.
*Delete the inapplicable words.
**Indicate the complete tally of the vote of the directors, duly adopted, appointing said resident agent.
180cara 11/7/13
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