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Consent To Service Of Process CT-4 - Connecticut
| Consent To Service Of Process Form. This is a Connecticut form and can be used in Securities Blue Sky Secretary Of State . |
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Form CT-4 CONSENT TO SERVICE OF PROCESS1. Pursuant to The Connecticut Uniform Securities Act, both foreign and domestic applicants must complete this form.2. Corporations must complete Parts I and II. 3. Individuals must complete Parts I and III. ________________________________________________________________________ _________________________PART I KNOWALL MEN BY THESE PRESENTS: That the undersigned,__________________________________________________ ____________ (a corporationorganized under the laws of the State of _______________________________ ________ (a partnership) (an individual)(other,_______________________________________) for the purpose of com plying with the laws and regulations of theState of Connecticut, hereby irrevocably appoints The Banking Commission er of the State of Connecticut, andthesuccessors in such office, its attorney in the State of Connecticut u pon whom may be served any notice, process orpleading in any action or other proceeding against it arising out of or in connection with the issuance, offer to sell, or sale ofsecurities or out of violation of the aforesaid laws or regulations of s aid State; and the undersigned does hereby consent thatany such action or proceeding against it may be commenced in any court o f competent jurisdiction and proper venue withinsaid State or in any administrative agency by service or process upon sa id officer with the same effect as if the undersignedhad lawfully been served with process or notice in said State. It is requested that a copy of any notice, process or pleading served he reunder be mailed to: _________________________________________________________ (Name and Address) _________________________________________________________ Dated:_____________________________________________, 20____ (Seal) By_________________________________________________ Title:_______________________________________________ By_________________________________________________ Title:_______________________________________________________________________________________________________________________ _________________________ PART II - CORPORATE ACKNOWLEDGMENTSTATE OF____________________________________) ) ss.COUNTY OF __________________________________) On this ________________ day of _____________________, 20____ , before me, the undersigned officer,personally appeared ____________________________________and ____________ ______________________, knownpersonally to me to be the ________________President and _____________Se cretary, respectively, of the above namedcorporation, and that they, as such officers, being authorized so to do, executed the foregoing instrument for the purposestherein contained, be signing the name of the corporation by themselves as such officers. IN WITNESS WHEREOF I have hereunto set my hand and official seal. (Notarial Seal) Notary Public__________________________________________ My Commission expires:_________________________________________________________________________________________________________ _________________________ PART III - INDIVIDUAL OR PARTNERSHIP ACKNOWLEDGMENTSTATE OF____________________________________) ) ss.COUNTY OF __________________________________) On this ________________ day of _____________________, 20____ , before me, the undersigned officer,personally appeared ____________________________________, to me personal ly known and known to be the sameperson(s) whose name(s) is (are) signed to the foregoing instrumen t, and acknowledged the execution thereof for the usesand purposes therein set forth. IN WITNESS WHEREOF I have hereunto set my hand and official seal. (Notarial Seal) Notary Public__________________________________________ My Commission expires:_________________________________
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