Idaho > Statewide > Office Of Attorney General > Consumer Protection Division
NPM Appointment Of Registered Agent - Idaho
| NPM Appointment Of Registered Agent Form. This is a Idaho form and can be used in Consumer Protection Division Office Of Attorney General Statewide . |
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OFFICE OF THE ATTORNEY GENERAL Lawrence G. Wasden Consumer Protection Division 650 W. State Street, Lower Level P.O. Box 83720 Boise, ID 83720-0010 Phone: (208) 334-2424 NON-PARTICIPATING MANUFACTURER'S (NPM) APPOINTMENT OF REGISTERED AGENT FOR STATE OF IDAHO AND REGISTERED AGENT'S STATEMENT STERED NON-PARTICIPATING TOBACCO MANUFACTURERS: hereby The undersigned Non-Participating Manufacturer ("NPM") as its registered agent to receive service of appoints process on its behalf. NPM agrees to do the following: (1) provide notice to the Office of the Attorney General for the State of Idaho ("Attorney General") at least 30 calendar days prior to termination of the authority of the registered agent; and (2) provide proof to the satisfaction of the Attorney General of the appointment of a new agent at least five calendar days prior to the termination of an existing agent appointment. NPM further agrees that if the agent terminates its agency appointment, NPM shall provide notice to the Attorney General of the termination within five calendar days and shall include proof to the Attorney General of the appointment of a new agent. Under penalty of perjury, I certify and declare that all of the statements and information contained in this Certification, including attachments, if any, are true, correct, accurate and complete in every particular, and that I am a person authorized, either under the laws of the State of Idaho or of the jurisdiction where the manufacturer resides or is organized, to bind the NPM making this Certification. Any violation of the requirements of Idaho Code § 39-8404 is a basis for removal of the NPM and its Brand Families from the Directory of Compliant Tobacco Product Manufacturers and Brand Families. ** This Certification must be signed and dated before an authorized notary public ** Signature of Designee for NPM: Designee (Print Name): Principle Place of Business (physical address): STATE OF COUNTY OF COUNTRY OF On } } } Title: before me, , personally appeared , personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. Signature: My Commission expires: Non-Participating Manufacturer Certification Statement of Registered Agent Page 1 of 2 American LegalNet, Inc. www.FormsWorkflow.com NAME AND ADDRESS OF IDAHO STATE REGISTERED AGENT: Name: _______________________________________________________________________________________ Street Address (Required Must be within Idaho): P. O. Box (Optional Must be in same city as street address): City & State: Telephone: FAX: Zip Code: Email: I consent to serve as Registered Agent in the State of Idaho for the NPM named herein, pursuant to Idaho Code § 39-8404. I understand it will be my responsibility to receive Service of Process on behalf of the NPM; to forward mail to the NPM; and to immediately notify the Office of the Attorney General if I resign or change the office address of the Registered Agent. ** This Certification must be signed and dated before an authorized notary public ** Registered Agent Signature: Registered Agent Printed Name: STATE OF COUNTY OF COUNTRY OF On } } } Title: Date: before me, , personally appeared , personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. Signature: My Commission expires: Non-Participating Manufacturer Certification Statement of Registered Agent Page 2 of 2 American LegalNet, Inc. www.FormsWorkflow.com
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