Free Microsoft Word - RAResignation-Successor - Wyoming

Wyoming Secretary of State
State Capitol Building, Room 110 200 West 24th Street Cheyenne, WY 82002-0020 Ph. 307.777.7311 Fax 307.777.5339 Email: [email protected]

For Office Use Only

Statement of Resignation of Registered Agent Successor Appointed
1. This change affects all entities listed on the attached list. 2. Attached is a Statement of Change of Registered Agent/Office by Entity form ratifying and approving the appointment of the new registered agent for each entity. 3. The new registered agent is: 4. The new registered office is:

5. The resignation is effective immediately upon filing of this statement with the Wyoming Secretary of State. I hereby resign my appointment as the Registered Agent for entities listed on the attached list.

Signature: _____________________________________________
Resigning Registered Agent Printed Name:

Date: __________________

I hereby accept my appointment as Registered Agent for the entities listed on the attached list. I hereby certify that the new registered office and the registered agent comply with the requirements of W.S. 17-28-101 through W.S. 17-28-111.

Signature: _____________________________________________
New Registered Agent Printed Name:

Date: __________________

Contact Person: Daytime Phone Number:
Checklist Filing Fee: Nonprofit Corporation - $3.00 (by statute); All other business entities - No Fee Please submit one originally signed document and one exact photocopy of the filing. Please review form prior to submitting to the Secretary of State to ensure all areas have been completed to avoid a delay in the processing of your documents.

Email:

RAResignation-Successor ­ 5/27/2009

Wyoming Secretary of State
State Capitol Building, Room 110 200 West 24th Street Cheyenne, WY 82002-0020 Ph. 307.777.7311 Fax 307.777.5339 Email: [email protected]

Consent to Appointment By Registered Agent
I,
(name of registered agent)

, registered office located at

(registered office address, city, state & zip)

voluntarily consent to serve as the registered agent for

(name of business entity)

on the date shown below.

I hereby certify that I am in compliance with the requirements of W.S. 17-28-101 through W.S. 17-28-111.

Signature:__________________________________________
(Shall be executed by the registered agent.)

Date:
(mm/dd/yyyy)

Print Name: Title:

Contact Person: Daytime Phone: Email:

Checklist Submit one originally signed consent to appointment and one exact photocopy.

RAConsent ­ Revised 06/16/2009