Free Corp. 59B - Missouri

State of Missouri
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This form is designed to be filled out online for your convenience. Please read the instructions carefully. Complete the necessary information, print, sign and mail.

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Robin Carnahan, Secretary of State
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1. The name of the business is

2. The street address of the registered office is

3. The name of the registered agent is

In Affirmation thereof, the facts stated above are true and correct: (The undersigned understands that false statements made in this filing are subject to the penalties provided under Section 575.040, RSMo)

Resigning Agent Signature

Name and address to return filed document: Name: Address: City, State, and Zip Code:
Corp. 59B (11/2008)

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Corporations Division PO Box 778 / 600 W. Main St., Rm. 322 Jefferson City, MO 65102

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Statement of Resignation of Registered Agent By a Foreign or Domestic For Profit / Non Profit Corporation or a Limited Partnership / Limited Liability Limited Partnership
(Submit with filing fee of $10.00)

Charter #:

Printed Name

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