STATE OF SOUTH CAROLINA SECRETARY OF STATE RESIGNATION OF REGISTERED AGENT AND DISCONTINUANCE OF REGISTERED OFFICE OF A SOUTH CAROLINA OR FOREIGN NONPROFIT CORPORATION
PLEASE TYPE OR PRINT IN BLACK INK
Pursuant to Sections 33-31-503 of the South Carolina Code of Laws, as amended, the undersigned hereby submits the following: 1. The name of the Corporation that is affected by this document is The date of Incorporation is_____________________________ 2. [ ] That the undersigned resigns as the registered agent of the above named corporation effective st the 31 day after the date on which this document is filed in the Office of the Secretary of State. That the above named corporation's registered office, which is the business office of the st registered agent, is discontinued, effective the 31 day after the date on which this document is filed in the Office of the Secretary of State.
3. [ ]
Date: _____________________
______________________________________
Signature
______________________________________
Type or Print Name
FILING INSTRUCTIONS
1. 2. Three copies of this document, the original and either two duplicate originals or two conformed copies, must be filed. Filing fee (payable to the Secretary of State at the time of filing this document): Agent's Statement of Resignation Discontinuance of Registered Office Total Return to: Secretary of State P.O. Box 11350 Columbia, SC 29211 $ 3.00 2.00 $ 5.00
FRN-RESIGNATION OF REGISTERED AGENT.doc
Form Revised by South Carolina Secretary of State, January 2000