Missouri > Local Circuit Courts > 7th Circuit (Clay County) > Probate > Adults
Designation Of Resident Agent (Can Be Used For Minor) 375-A - Missouri
| Designation Of Resident Agent (Can Be Used For Minor) Form. This is a Missouri form and can be used in Adults Probate 7th Circuit (Clay County) Local Circuit Courts . |
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CIRCUIT COURT OF CLAY COUNTY, MISSOURI PROBATE DIVISION No. Matter of , incapacitated/disabled/minor. DESIGNATION OF RESIDENT AGENT I, residing at , State of , desiring to serve as Guardian-Conservator of the above named incapacitated/disabled person/minor pursuant to Section 475.055 RSMo., hereby appoint , as my agent for service of process upon me and for the receipt of all notices to me within the State of Missouri concerning said estate. THE STATEMENTS AND REPRESENTATIONS IN THIS DOCUMENT ARE MADE UNDER OATH AND ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF. I UNDERSTAND THEY ARE MADE SUBJECT TO THE PENALTIES OF MAKING A FALSE AFFIDAVIT OR DECLARATION. Date:___________________ Signature ACCEPTANCE OF APPOINTMENT AS RESIDENT AGENT I, , residing at , Missouri, telephone number , having been appointed pursuant to Section 475.055 RSMo., to act as agent for service of process on and receipt of notice to within the State of Missouri, concerning the above estate, hereby acknowledge such appointment and consent to act as such agent. THE STATEMENTS AND REPRESENTATIONS IN THIS DOCUMENT ARE MADE UNDER OATH AND ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF. I UNDERSTAND THEY ARE MADE SUBJECT TO THE PENALTIES OF MAKING A FALSE AFFIDAVIT OR DECLARATION. Date: Resident Agent Form 375-A Page 1 of 1 Revised 3/14/2003
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