"Change of Agent's Address - Domestic or Foreign - All Entities" - Connecticut

The Connecticut Secretary of the State has released this version of the "Change of Agent's Address - Domestic or Foreign - All Entities" on October 1, 2017.

This form may be used by all Connecticut residents: download the printable PDF by clicking the link below and use it according to the applicable legal guidelines.

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Download "Change of Agent's Address - Domestic or Foreign - All Entities" - Connecticut

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SECRETARY OF THE STATE OF CONNECTICUT
MAILING ADDRESS: COMMERCIAL RECORDING DIVISION, CONNECTICUT SECRETARY OF THE STATE, P.O. BOX 150470, HARTFORD, CT 06115-0470
DELIVERY ADDRESS: COMMERCIAL RECORDING DIVISION, CONNECTICUT SECRETARY OF THE STATE, 30 TRINITY STREET, HARTFORD, CT 06106
860-509-6003
www.concord-sots.ct.gov
PHONE:
WEBSITE:
CHANGE OF AGENT'S ADDRESS
DOMESTIC OR FOREIGN - ALL ENTITIES
C.G.S. § 33-661; 33-927; 33-1051; 33-1217; 34-13b; 34-38p; 34-243o; 34-243q; 34-408; 34-429; 34-507; 34-532
USE INK. COMPLETE ALL SECTIONS. PRINT OR TYPE. ATTACH 8
1/2
X 11 SHEET(S) IF NECESSARY.
FILING PARTY
:
(CONFIRMATION WILL BE SENT TO THIS ADDRESS)
FILING FEE: $50
EXCEPTION: $20.00 FILING FEE FOR
NONSTOCK (NONPROFIT) CORPORATIONS
NAME:
& LIMITED PARTNERSHIPS.
MAILING ADDRESS:
MAKE CHECKS PAYABLE TO "SECRETARY
OF THE STATE"
CITY:
STATE:
ZIP:
1. NAME OF BUSINESS ENTITY - REQUIRED:
(INCLUDE BUSINESS DESIGNATION I.E., L.L.C., LLC, INC, ETC. MUST MATCH
OUR RECORDS EXACTLY)
2. STATE/COUNTRY OF FORMATION IF OTHER THAN CONNECTICUT - REQUIRED:
3. CURRENT AGENT NAME - REQUIRED:
(MUST MATCH OUR RECORDS EXACTLY)
CONNECTICUT RESIDENCE ADDRESS:
BUSINESS ADDRESS:
(P.O.BOX UNACCEPTABLE)
(P.O.BOX UNACCEPTABLE)
STREET:
STREET:
CITY:
CITY:
STATE:
ZIP:
STATE:
ZIP:
CONNECTICUT MAILING ADDRESS OF REGISTERED AGENT:
( REQUIRED FOR ALL LLC'S AND DOMESTIC STOCK
CORPORATIONS ): (P.O.BOX IS ACCEPTABLE)
STREET OR PO BOX :
CITY:
STATE:
ZIP:
4. EXECUTION:
(SUBJECT TO PENALTY OF FALSE STATEMENT)
DATE (MM/DD/YYYY)
SIGNATURE
NAME OF SIGNATORY
CAPACITY/TITLE OF SIGNATORY
(required)
(print/type)
PAGE 1 OF 1
Rev. 10/2017
SECRETARY OF THE STATE OF CONNECTICUT
MAILING ADDRESS: COMMERCIAL RECORDING DIVISION, CONNECTICUT SECRETARY OF THE STATE, P.O. BOX 150470, HARTFORD, CT 06115-0470
DELIVERY ADDRESS: COMMERCIAL RECORDING DIVISION, CONNECTICUT SECRETARY OF THE STATE, 30 TRINITY STREET, HARTFORD, CT 06106
860-509-6003
www.concord-sots.ct.gov
PHONE:
WEBSITE:
CHANGE OF AGENT'S ADDRESS
DOMESTIC OR FOREIGN - ALL ENTITIES
C.G.S. § 33-661; 33-927; 33-1051; 33-1217; 34-13b; 34-38p; 34-243o; 34-243q; 34-408; 34-429; 34-507; 34-532
USE INK. COMPLETE ALL SECTIONS. PRINT OR TYPE. ATTACH 8
1/2
X 11 SHEET(S) IF NECESSARY.
FILING PARTY
:
(CONFIRMATION WILL BE SENT TO THIS ADDRESS)
FILING FEE: $50
EXCEPTION: $20.00 FILING FEE FOR
NONSTOCK (NONPROFIT) CORPORATIONS
NAME:
& LIMITED PARTNERSHIPS.
MAILING ADDRESS:
MAKE CHECKS PAYABLE TO "SECRETARY
OF THE STATE"
CITY:
STATE:
ZIP:
1. NAME OF BUSINESS ENTITY - REQUIRED:
(INCLUDE BUSINESS DESIGNATION I.E., L.L.C., LLC, INC, ETC. MUST MATCH
OUR RECORDS EXACTLY)
2. STATE/COUNTRY OF FORMATION IF OTHER THAN CONNECTICUT - REQUIRED:
3. CURRENT AGENT NAME - REQUIRED:
(MUST MATCH OUR RECORDS EXACTLY)
CONNECTICUT RESIDENCE ADDRESS:
BUSINESS ADDRESS:
(P.O.BOX UNACCEPTABLE)
(P.O.BOX UNACCEPTABLE)
STREET:
STREET:
CITY:
CITY:
STATE:
ZIP:
STATE:
ZIP:
CONNECTICUT MAILING ADDRESS OF REGISTERED AGENT:
( REQUIRED FOR ALL LLC'S AND DOMESTIC STOCK
CORPORATIONS ): (P.O.BOX IS ACCEPTABLE)
STREET OR PO BOX :
CITY:
STATE:
ZIP:
4. EXECUTION:
(SUBJECT TO PENALTY OF FALSE STATEMENT)
DATE (MM/DD/YYYY)
SIGNATURE
NAME OF SIGNATORY
CAPACITY/TITLE OF SIGNATORY
(required)
(print/type)
PAGE 1 OF 1
Rev. 10/2017
CHANGE OF AGENT’S ADDRESS
Domestic or Foreign - All Entities
Filing Fee: $50.00
[EXCEPTION: $20.00 Filing Fee for Non-Stock (non-Profit) Corporations & Limited Partnerships]
Make checks payable to “Secretary of the State”
INSTRUCTIONS
1. Name of business entity: Please provide the name of the business entity as it appears on the records of the
Secretary of the State.
2. State/Country of formation: Please provide the business entity's state or country of formation.
3. Current agent name and new address information: This form may not be used to appoint a NEW agent. Please
provide the name of the CURRENT agent. If the agent is a natural person, provide the complete street address of his or
her business and CT residence. (If no business address, MUST state “NONE”.) If the agent is a business entity, it must
provide the address of its principal office in the block designated for "Business address" and any person signing on its
behalf must include his or her title on the signature line.
In addition, a Connecticut mailing address is required for all Limited Liability Companies and Domestic Stock
Corporations (P.O.BOX is acceptable).
4. Execution: The document must be executed/signed by an authorized official of the business entity. That person must
print or type his/her name, state the capacity/title under which he/she signs and provide a signature. The execution
constitutes a legal statement under the penalties of false statement that the information provided in the document is
true.
OFFICE OF THE SECRETARY OF THE STATE
MAILING ADDRESS:
COMMERCIAL RECORDING DIVISION
CONNECTICUT SECRETARY OF THE STATE
P.O. BOX 150470
HARTFORD, CT 06115-0470
DELIVERY ADDRESS:
COMMERCIAL RECORDING DIVISION
CONNECTICUT SECRETARY OF THE STATE
30 TRINITY STREET
HARTFORD, CT 06106
PHONE: 860-509-6003
WEBSITE:
www.concord-sots.ct.gov
Rev. 10/2017
DO NOT SCAN THIS PAGE
INSTRUCTIONS
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