"Statement of Change Regarding Resignation or Other Termination of Registered Agent - Sample" - Colorado

Statement of Change Regarding Resignation or Other Termination of Registered Agent - Sample is a legal document that was released by the Colorado Secretary of State - a government authority operating within Colorado.

Form Details:

  • Released on October 6, 2008;
  • The latest edition currently provided by the Colorado Secretary of State;
  • Ready to use and print;
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  • Compatible with most PDF-viewing applications;

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Colorado Secretary of State.

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Download "Statement of Change Regarding Resignation or Other Termination of Registered Agent - Sample" - Colorado

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Form must be filed electronically.
Paper forms are not accepted.
This copy is a sample and cannot be submitted for filing.
Statement of Change
Regarding Resignation or Other Termination of Registered Agent
filed pursuant to § 7-90-305.5 and § 7-90-702 of the Colorado Revised Statutes (C.R.S.)
1. The entity ID number and the entity name, or, if the entity does not have an entity name, the true name are
Entity ID number
__________________________
(Colorado Secretary of State ID number)
Entity name or True name
______________________________________________________.
2. The date on which such registered agent resigned or otherwise ceased to be the registered agent is
___________________________.
(mm/dd/yyyy)
3. The registered agent has resigned or otherwise is no longer the registered agent.
The name and address of such registered agent are
Name
(if an individual)
____________________ ______________ ______________ _____
(Last)
(First)
(Middle)
(Suffix)
OR
(if an entity)
______________________________________________________
(Caution: Do not provide both an individual and an entity name.)
Street address
______________________________________________________
(Street number and name)
______________________________________________________
__________________________
CO
____________________
(City)
(State)
(Zip Code)
Mailing address
______________________________________________________
(leave blank if same as street address)
(Street number and name or Post Office Box information)
______________________________________________________
__________________________
CO
____________________.
(City)
(State)
(Zip Code)
4.
(If applicable, adopt the following statement by marking the box.)
Such registered agent has delivered notice of the change to the entity.
5.
(If applicable, adopt the following statement by marking the box and include an attachment.)
This document contains additional information as provided by law.
CHANGE_RA_RESIGN
Page 1 of 2
Rev. 10/06/2008
Form must be filed electronically.
Paper forms are not accepted.
This copy is a sample and cannot be submitted for filing.
Statement of Change
Regarding Resignation or Other Termination of Registered Agent
filed pursuant to § 7-90-305.5 and § 7-90-702 of the Colorado Revised Statutes (C.R.S.)
1. The entity ID number and the entity name, or, if the entity does not have an entity name, the true name are
Entity ID number
__________________________
(Colorado Secretary of State ID number)
Entity name or True name
______________________________________________________.
2. The date on which such registered agent resigned or otherwise ceased to be the registered agent is
___________________________.
(mm/dd/yyyy)
3. The registered agent has resigned or otherwise is no longer the registered agent.
The name and address of such registered agent are
Name
(if an individual)
____________________ ______________ ______________ _____
(Last)
(First)
(Middle)
(Suffix)
OR
(if an entity)
______________________________________________________
(Caution: Do not provide both an individual and an entity name.)
Street address
______________________________________________________
(Street number and name)
______________________________________________________
__________________________
CO
____________________
(City)
(State)
(Zip Code)
Mailing address
______________________________________________________
(leave blank if same as street address)
(Street number and name or Post Office Box information)
______________________________________________________
__________________________
CO
____________________.
(City)
(State)
(Zip Code)
4.
(If applicable, adopt the following statement by marking the box.)
Such registered agent has delivered notice of the change to the entity.
5.
(If applicable, adopt the following statement by marking the box and include an attachment.)
This document contains additional information as provided by law.
CHANGE_RA_RESIGN
Page 1 of 2
Rev. 10/06/2008
6.
(Caution: Leave blank if the document does not have a delayed effective date. Stating a delayed effective date has significant
legal consequences. Read instructions before entering a date.)
(If the following statement applies, adopt the statement by entering a date and, if applicable, time using the required format.)
The delayed effective date and, if applicable, time of this document are ___________________________.
(mm/dd/yyyy hour:minute am/pm)
Notice:
Causing this document to be delivered to the Secretary of State for filing shall constitute the affirmation or
acknowledgment of each individual causing such delivery, under penalties of perjury, that such document is
such individual's act and deed, or that such individual in good faith believes such document is the act and deed
of the person on whose behalf such individual is causing such document to be delivered for filing, taken in
conformity with the requirements of part 3 of article 90 of title 7, C.R.S. and, if applicable, the constituent
documents and the organic statutes, and that such individual in good faith believes the facts stated in such
document are true and such document complies with the requirements of that Part, the constituent documents,
and the organic statutes.
This perjury notice applies to each individual who causes this document to be delivered to the Secretary of
State, whether or not such individual is identified in this document as one who has caused it to be delivered.
7. The true name and mailing address of the individual causing this document to be delivered for filing are
____________________ ______________ ______________ _____
(Last)
(First)
(Middle)
(Suffix)
______________________________________________________
(Street number and name or Post Office Box information)
______________________________________________________
_
_
__________________________
__
____________________
(City)
(State)
(ZIP/Postal Code)
_______________________ ______________.
(Province – if applicable)
(Country)
(If applicable, adopt the following statement by marking the box and include an attachment.)
This document contains the true name and mailing address of one or more additional individuals
causing the document to be delivered for filing.
Disclaimer:
This form/cover sheet, and any related instructions, are not intended to provide legal, business or tax advice,
and are furnished without representation or warranty. While this form/cover sheet is believed to satisfy
minimum legal requirements as of its revision date, compliance with applicable law, as the same may be
amended from time to time, remains the responsibility of the user of this form/cover sheet. Questions should
be addressed to the user’s legal, business or tax advisor(s).
CHANGE_RA_RESIGN
Page 2 of 2
Rev. 10/06/2008
Page of 2