Change of Agent's Name by Registered Agent - Domestic or Foreign Limited Liability Company - Connecticut

This "Change of Agent's Name by Registered Agent - Domestic or Foreign Limited Liability Company" is a Connecticut-specific form released by the Connecticut Secretary of the State on July 1, 2017.

Download the form by clicking the link below, fill it out by hand, and mail it as per the guidelines provided by the department or the applicable legal instructions.

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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
www.concord-sots.ct.gov
860-509-6003
PHONE:
WEBSITE:
CHANGE OF AGENT'S NAME BY REGISTERED AGENT
DOMESTIC OR FOREIGN LIMITED LIABILITY COMPANY
C.G.S. §§ 34-243q
NOTE: This form is to be used ONLY when an agent name is changed. If a NEW agent is being appointed, use the
Change of Agent form.
USE INK. COMPLETE ALL SECTIONS. PRINT OR TYPE. ATTACH 8
1/2
X 11 SHEET(S) IF NECESSARY.
FILING FEE: $50
FILING PARTY
:
(CONFIRMATION WILL BE SENT TO THIS ADDRESS)
MAKE CHECKS PAYABLE TO "SECRETARY
NAME:
OF THE STATE"
MAILING ADDRESS:
CITY:
STATE:
ZIP:
1. NAME OF LIMITED LIABILITY COMPANY - REQUIRED:
(INCLUDE BUSINESS DESIGNATION I.E., L.L.C., LLC, 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)
4. (CHECK/COMPLETE AS APPLICABLE)
THE CURRENT AGENT/ INDIVIDUAL'S LEGAL NAME HAS CHANGED TO:
THE CURRENT AGENT/ BUSINESS ENTITY'S LEGAL NAME HAS CHANGED TO:
(MUST MATCH OUR RECORDS
EXACTLY)
5. EXECUTION:
(SUBJECT TO PENALTY OF FALSE STATEMENT)
DATE (MM/DD/YYYY)
NAME OF AGENT
CAPACITY/TITLE OF SIGNATORY
SIGNATURE
(required)
(if applicable)
(print/type)
PAGE 1 OF 1
Rev. 7/2017
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
www.concord-sots.ct.gov
860-509-6003
PHONE:
WEBSITE:
CHANGE OF AGENT'S NAME BY REGISTERED AGENT
DOMESTIC OR FOREIGN LIMITED LIABILITY COMPANY
C.G.S. §§ 34-243q
NOTE: This form is to be used ONLY when an agent name is changed. If a NEW agent is being appointed, use the
Change of Agent form.
USE INK. COMPLETE ALL SECTIONS. PRINT OR TYPE. ATTACH 8
1/2
X 11 SHEET(S) IF NECESSARY.
FILING FEE: $50
FILING PARTY
:
(CONFIRMATION WILL BE SENT TO THIS ADDRESS)
MAKE CHECKS PAYABLE TO "SECRETARY
NAME:
OF THE STATE"
MAILING ADDRESS:
CITY:
STATE:
ZIP:
1. NAME OF LIMITED LIABILITY COMPANY - REQUIRED:
(INCLUDE BUSINESS DESIGNATION I.E., L.L.C., LLC, 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)
4. (CHECK/COMPLETE AS APPLICABLE)
THE CURRENT AGENT/ INDIVIDUAL'S LEGAL NAME HAS CHANGED TO:
THE CURRENT AGENT/ BUSINESS ENTITY'S LEGAL NAME HAS CHANGED TO:
(MUST MATCH OUR RECORDS
EXACTLY)
5. EXECUTION:
(SUBJECT TO PENALTY OF FALSE STATEMENT)
DATE (MM/DD/YYYY)
NAME OF AGENT
CAPACITY/TITLE OF SIGNATORY
SIGNATURE
(required)
(if applicable)
(print/type)
PAGE 1 OF 1
Rev. 7/2017
CHANGE OF AGENT’S NAME BY REGISTERD AGENT
Domestic or Foreign – Limited Liability Company
Filing Fee: $50.00
Make checks payable to “Secretary of the State”
INSTRUCTIONS
1. Name of the Limited Liability Company. Please provide the name of the Limited Liability Company as it appears on the
records of the Secretary of the State.
2. State/Country of formation: Please provide the Limited Liability Company's state or country of formation.
3. Provide the name of the current agent (must match the Secretary of the State's records exactly). This form may not be
used to appoint a NEW agent.
4. Provide the current agent's new legal name. If the agent is an individual, select the appropriate box and complete.
If the agent is a business entity e.g. Corp or LLC, etc, select the appropriate box and provide the entity's new name.
NOTE: The new name must match the records of the Secretary of the State exactly.
5. Execution: The document must be executed/signed by the registered agent of the Limited Liability Company.
That person must print or type his/her name, state the capacity/title under which he/she signs (if applicable) 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
DO NOT SCAN THIS PAGE
Rev. 7/2017
INSTRUCTIONS

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