Form RA-1 "Statement of Resignation of Registered Agent" - Georgia (United States)

What Is Form RA-1?

This is a legal form that was released by the Georgia Secretary of State - a government authority operating within Georgia (United States). As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on October 1, 2019;
  • The latest edition provided by the Georgia Secretary of State;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form RA-1 by clicking the link below or browse more documents and templates provided by the Georgia Secretary of State.

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Download Form RA-1 "Statement of Resignation of Registered Agent" - Georgia (United States)

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OFFICE OF SECRETARY OF STATE
CORPORATIONS DIVISION
2 Martin Luther King Jr. Dr. SE
Suite 313 West Tower
Atlanta, Georgia 30334
(404) 656-2817
Secretary of State
STATEMENT OF RESIGNATION
OF REGISTERED AGENT
1. Resigning Registered Agent:
Name: _________________________________________________________________________________
Current Street Address and County of Registered Office on File with the Secretary of State:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
City: _____________________________County: ________________________ State: GA
Zip Code:_____________
Email Address
: ___________________________________________________________________________________
2. Entity Name: _______________________________________________________________________________
Entity Control Number: ______________________________________
Entity Type (check one only):
Corporation
Limited Partnership/Limited Liability Limited Partnership
Limited Liability Company
Limited Liability Partnership
3. Statement of resignation: The undersigned hereby resigns as registered agent for the above-named entity.
4. Statement of discontinuance of registered office: (Choose one of the following statements.)
The registered office is also discontinued.
The registered office will remain the same.
5. Statement of notification: The undersigned certifies that written notice of the registered agent’s intention to
resign as registered agent was delivered or mailed to the above-named entity in accordance with the applicable
provisions of the Official Code of Georgia Annotated.
6. The registered agent’s appointment is terminated, and the registered office discontinued if so provided, on the
31st day after the date on which this statement is filed with the Secretary of State, or on the date the entity files an
st
annual registration designating a new registered agent if filed prior to the 31
day.
7. I hereby certify, under penalty of law, that the above information is true and correct.
__________________________________________________
_________________________________
Signature of Resigning Registered Agent
Date
__________________________________________________
_________________________________
Print Name*
Title (if signing for an entity)
8. Notice: Mail or deliver the following items to the Secretary of State at the above address:
(1) This application; and
(2) Payment of $10 paper filing service charge by check or money order payable to “Secretary of State”. Fees
are non-refundable.
* Enter individual’s legal name, i.e. first and last name without use of initials or nicknames. Middle names or initials may be included.
Form RA-1
(Rev. 10/2019)
OFFICE OF SECRETARY OF STATE
CORPORATIONS DIVISION
2 Martin Luther King Jr. Dr. SE
Suite 313 West Tower
Atlanta, Georgia 30334
(404) 656-2817
Secretary of State
STATEMENT OF RESIGNATION
OF REGISTERED AGENT
1. Resigning Registered Agent:
Name: _________________________________________________________________________________
Current Street Address and County of Registered Office on File with the Secretary of State:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
City: _____________________________County: ________________________ State: GA
Zip Code:_____________
Email Address
: ___________________________________________________________________________________
2. Entity Name: _______________________________________________________________________________
Entity Control Number: ______________________________________
Entity Type (check one only):
Corporation
Limited Partnership/Limited Liability Limited Partnership
Limited Liability Company
Limited Liability Partnership
3. Statement of resignation: The undersigned hereby resigns as registered agent for the above-named entity.
4. Statement of discontinuance of registered office: (Choose one of the following statements.)
The registered office is also discontinued.
The registered office will remain the same.
5. Statement of notification: The undersigned certifies that written notice of the registered agent’s intention to
resign as registered agent was delivered or mailed to the above-named entity in accordance with the applicable
provisions of the Official Code of Georgia Annotated.
6. The registered agent’s appointment is terminated, and the registered office discontinued if so provided, on the
31st day after the date on which this statement is filed with the Secretary of State, or on the date the entity files an
st
annual registration designating a new registered agent if filed prior to the 31
day.
7. I hereby certify, under penalty of law, that the above information is true and correct.
__________________________________________________
_________________________________
Signature of Resigning Registered Agent
Date
__________________________________________________
_________________________________
Print Name*
Title (if signing for an entity)
8. Notice: Mail or deliver the following items to the Secretary of State at the above address:
(1) This application; and
(2) Payment of $10 paper filing service charge by check or money order payable to “Secretary of State”. Fees
are non-refundable.
* Enter individual’s legal name, i.e. first and last name without use of initials or nicknames. Middle names or initials may be included.
Form RA-1
(Rev. 10/2019)