Resignation Of Statutory Agent {AR0011}

CORPORATION STATEMENT OF RESIGNATION OF STATUTORY AGENT OF (Name of corporation one is resigningfrom) (ACC file number)FILING FEE $10.00 (pursuant to A.R.S. 10-122.A) NOTE: It is critical that the Corporation Commission receive the exact name and file number of the corporation one is resigningfrom. Please check with our Records section, (602) 542-3026 or our web site, www.cc.state.az.us/cor to obtain the correctpinformation. IMPORTANT! You must evaluate both items. Check those that apply. 1) The undersigned statutory agent of ______________________________________________, an Arizona corporation, or foreig a n corporation qualified to do business in Arizona, hereby resign my appointment as agent. 2) The known place of business, currently the street address of the undersigd, is also discontinued.ne The undersigned has given notice of this resignation (required by A.R.S. 10-503.A) to the Corporation by mailing one copy to the Corporation at the following address: ________________________________________________________________ ________________________________________________________________ This resignation shall be effective on the thirty-first day after the date on which this statement is delivered to the Arizona Corporation Commission for filing. DATED this ____ day of ________________________, _________ Signature:________________________________________________ Printed Name:_____________________________________________This form must be accompanied by a filing fee of $10.00 (A.R.S. 10-122.A) U.S. funds made payable anddelivered to: ARIZONA CORPORATION COMMISSION Corporations Division 1300 West Washington or 400 West Congress Phoenix, Arizona 85007-2929 Tucson, Arizona 85701-1347AR: 0011 Rev: 4/2002