Wyoming > Secretary Of State > Corporations > Limited Liability Company > Domestic
Statement Of Change By Registered Agent - Wyoming
| Statement Of Change By Registered Agent Form. This is a Wyoming form and can be used in Domestic Limited Liability Company Corporations Secretary Of State . |
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Wyoming Secretary of State State Capitol Building, Room 110 th 200 West 24 Street Cheyenne, WY 82002-0020 Ph. 307.777.7311 Fax 307.777.5339 Email: Business@wyo.gov For Office Use Only Statement of Change by Registered Agent 1. This change affects every entity that I represent. (If not, please contact our office.) 2. Name of current registered agent and physical address of current registered office: Current Registered Agent: Current Registered Office: 3. New name of registered agent (if applicable) and physical address of new registered office (if applicable): New Name of Registered Agent: For consistency the Secretary of State's Office will only keep one version of the agent's name on file. New Registered Office: 4. I hereby certify that I am in compliance with all requirements of W.S. 17-28-101 through W.S. 17-28-111. 5. After the changes are made, the physical address of my registered office and business office will be identical. 6. I hereby certify that every entity I represent has been notified of my name/office change. Signature: _______________________________________________ (shall be executed by the registered agent) Date: (mm/dd/yyyy) Print Name: Title: Contact Person: Daytime Phone: Email: Checklist If you are a Commercial Registered Agent, changes noted on this form shall also be reflected on your Commercial Registered Agent form. Filing Fee: Nonprofit Corporation - $3.00 (by statute); All other business entities - No Fee Please submit one originally signed document and one exact photocopy of the filing. Please review form prior to submitting to the Secretary of State to ensure all areas have been completed to avoid a delay in the processing of your documents. RA-RO ChangeByRA 11/2012
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