Mississippi > Secretary Of State > Corporations > Corporation > Nonprofit
Registered Agent Or Office Statement Of Change F0021 - Mississippi
| Registered Agent Or Office Statement Of Change Form. This is a Mississippi form and can be used in Nonprofit Corporation Corporations Secretary Of State . |
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F0021 - Page 1 of 2 OFFICE OF THE MISSISSIPPI SECRETARY OF STATE P.O. BOX 136, JACKSON, MS 39205-0136 (601) 359-1333 Registered Agent/Office Statement of Change *0021-1-2* Nonprofit Corporation 1. Corporate ID 2. Corporate Name 3. Federal Tax ID 4. Name and Street Address of the Registered Agent and Registered Office are Name Physical Address P.O. Box City, State, ZIP5, ZIP4 - 5. New Registered Agent Name and Registered Office Address Physical Address P.O. Box City, State, ZIP5, ZIP4 - 6. If agent has changed, mark appropriate box 6A: The undersigned hereby accepts designation as registered agent for service of process Rev. 02/96 <<<<<<<<<********>>>>>>>>>>>>> 2 F0021 - Page 2 of 2 OFFICE OF THE MISSISSIPPI SECRETARY OF STATE P.O. BOX 136, JACKSON, MS 39205-0136 (601) 359-1333 Registered Agent/Office Statement of Change *0021-2-2* Nonprofit Corporation Signature of Registered Agent (Please keep writing within block) OR 6B: Statement of written consent is attached, signed by the new registered agent 7. The Corporation has been notified of the change of registered office. Yes No (Please keep writing within bloc)ks By: Signature Printed Name TitleFiling Fee: $10.00 Rev. 02/96
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