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Statement Of Change Of Registered Agent By Represented Entity - Nevada

Statement Of Change Of Registered Agent By Represented Entity Form. This is a Nevada form and can be used in Corporation Secretary Of State .
 Fillable pdf Last Modified 4/22/2014
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ROSS MILLER Secretary of State 202 North Carson Street Carson City, Nevada 89701-4201 (775) 684-5708 Website: www.nvsos.gov *181003* *181003* Statement of Change of Registered Agent by Represented Entity (PURSUANT TO NRS 77.340) This form may be submitted by: the Represented Entity to appoint a new Registered Agent or amend own service of process info. For more information please visit http://www.nvsos.gov/index.aspx?page=141 USE BLACK INK ONLY - DO NOT HIGHLIGHT ABOVE SPACE IS FOR OFFICE USE ONLY 1. Name of Represented Entity: 2. Entity File Number: 3. This statement of change will have the following effect: (check only one) Appoints a new agent for service of process (complete 4a or 4b) Updates contact information of the Represented Entity acting as own agent (complete 4c) 4. Information in effect upon the filing of this statement: (complete only one section) a) Commercial Registered Agent: Name b) Noncommercial Registered Agent: Name Nevada Street Address City Zip Code Nevada Mailing Address (if different from street address) City Zip Code c) Title of Office or Other Position within Represented Entity: Name of Title or Position Nevada Street Address City Zip Code Nevada Mailing Address (if different from street address) City Zip Code 5. Signature of Represented Entity: (required) X Authorized Signature Date 6. Registered Agent Acceptance: (required) I hereby accept appointment as Registered Agent for the above named Entity. X Authorized Signature of Registered Agent or On Behalf of Registered Agent Entity Date FEE: $60.00 This form must be accompanied by appropriate fees. Nevada Secretary of State Form RA Change by Entity Effective 5-7-13 American LegalNet, Inc. www.FormsWorkFlow.com
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