Free RRA-1 - West Virginia

Natalie E. Tennant Secretary of State State Capitol Bldg. 1900 Kanawha Blvd. East Charleston, WV 25305 File one original application along with two copies of the application

Penney Barker, Manager Process Section Tel. 304-558-6000 Fax 304-558-8381 Hrs. 8:30am ­ 5:00pm ET www.wvsos.com

STATEMENT OF RESIGNATION OF A REGISTERED AGENT

1.

The name of business entity is:

2.

The registered office will continue to be: ____________________________________________________________________
address city, state, zip

or The current registered office will be discontinued.

3.

I, ________________________________ hereby resign as registered agent of the
entity

above named business

4.

Signature of Agent Resigning: ____________________________________________

5.

Date:

Note:

The agency appointment is terminated on the thirty-first day after the date on which the statement was filed.

Revised 1/09