Articles Of Organization For A Domestic Limited Liability Company Page 3

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ORIGINAL APPOINTMENT OF AGENT
The undersigned authorized member(s), manager(s) or representative(s) of
Name of Limited Liability Company
hereby appoint the following to be Statutory Agent upon whom any process, notice or demand required
or permitted by statute to be served upon the limited liability company may be served. The name and
address of the agent is
Name of Agent
Mailing Address
City
State
ZIP Code
ACCEPTANCE OF APPOINTMENT
The undersigned,
named herein as the statutory agent
Statutory Agent Name
for
Name of Limited Liability Company
hereby acknowledges and accepts the appointment of agent for said limited liability company
Statutory Agent Signature
Individual Agent's Signature / Signature on Behalf of Corporate Agent
If the agent is an individual and using a P.O. Box, check this box to confirm that the agent is an
Ohio resident.
Form 533A
Page 2 of 3
Last Revised: 11/29/12

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