Form JUS-TPM2 "Notice of Appointment of Registered Agent and Registered Agent's Statement" - Delaware

What Is Form JUS-TPM2?

This is a legal form that was released by the Delaware Department of Justice - a government authority operating within Delaware. As of today, no separate filing guidelines for the form are provided by the issuing department.

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Download Form JUS-TPM2 "Notice of Appointment of Registered Agent and Registered Agent's Statement" - Delaware

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State of Delaware
Department of Justice
NOTICE OF APPOINTMENT OF REGISTERED AGENTAND
REGISTERED AGENT’S STATEMENT
(29 Del. C. § 6086)
JUS-TPM2
Page 1 of 2
Please type or print in permanent ink:
Sign, date and return original to:
Office of the Attorney General of the State of Delaware
Department of Justice
Tobacco Litigation & Enforcement Unit
Carvel Office Building
th
820 N. French Street, 5
Floor
Wilmington, Delaware 19801
The undersigned Non-Participating Manufacturer (“NPM”),
hereby
appoints
as its registered agent. Said registered agent is
authorized to receive service of process on behalf of the NPM. The NPM agrees to do the following: (1) provide notice to
the Office of the Attorney General of the State of Delaware (“Attorney General”) at least thirty (30) calendar days prior to
termination of the authority of the registered agent; and (2) provide proof to the satisfaction of the Attorney General of the
appointment of a new agent at least five calendar days prior to the termination of the existing agent appointment. The
NPM further agrees that if the agent terminates its agency appointment, the undersigned shall provide notice to the
Attorney General of the appointment of a new agent.
I hereby certify and declare that all of the statements and information contained in this Notice of Appointment, including
but not limited to any accompanying statements or attachments herewith, are true and complete and that I am a person
authorized to bind the NPM making this Notice of Appointment either under the laws of Delaware or of the jurisdiction
where the manufacturer resides or is organized. Failure to file this form is a basis for removal of the undersigned NPM
and its Brand Families from the Directory.
THIS NOTICE OF APPOINTMENT must be signed and dated in the presence of a notary public.
Signature of authorized representative for NPM:
Authorized Representative (Print Name)
Title:
Principal Place of Business (physical address):
STATE OF
)
COUNTY OF
)
COUNTRY OF
)
On
, before me,
, personally appeared
, personally known to me (or proved to me on the basis of satisfactory
evidence) to be the person whose name is subscribed to the within instrument and acknowledged to me that he/she
executed the same in his/her authorized capacity, and that by his/her signature on the instrument the person, or the entity
upon behalf of which the person acted, executed the instrument.
WITNESS my hand and official seal.
Signature
My commission expires:
State of Delaware
Department of Justice
NOTICE OF APPOINTMENT OF REGISTERED AGENTAND
REGISTERED AGENT’S STATEMENT
(29 Del. C. § 6086)
JUS-TPM2
Page 1 of 2
Please type or print in permanent ink:
Sign, date and return original to:
Office of the Attorney General of the State of Delaware
Department of Justice
Tobacco Litigation & Enforcement Unit
Carvel Office Building
th
820 N. French Street, 5
Floor
Wilmington, Delaware 19801
The undersigned Non-Participating Manufacturer (“NPM”),
hereby
appoints
as its registered agent. Said registered agent is
authorized to receive service of process on behalf of the NPM. The NPM agrees to do the following: (1) provide notice to
the Office of the Attorney General of the State of Delaware (“Attorney General”) at least thirty (30) calendar days prior to
termination of the authority of the registered agent; and (2) provide proof to the satisfaction of the Attorney General of the
appointment of a new agent at least five calendar days prior to the termination of the existing agent appointment. The
NPM further agrees that if the agent terminates its agency appointment, the undersigned shall provide notice to the
Attorney General of the appointment of a new agent.
I hereby certify and declare that all of the statements and information contained in this Notice of Appointment, including
but not limited to any accompanying statements or attachments herewith, are true and complete and that I am a person
authorized to bind the NPM making this Notice of Appointment either under the laws of Delaware or of the jurisdiction
where the manufacturer resides or is organized. Failure to file this form is a basis for removal of the undersigned NPM
and its Brand Families from the Directory.
THIS NOTICE OF APPOINTMENT must be signed and dated in the presence of a notary public.
Signature of authorized representative for NPM:
Authorized Representative (Print Name)
Title:
Principal Place of Business (physical address):
STATE OF
)
COUNTY OF
)
COUNTRY OF
)
On
, before me,
, personally appeared
, personally known to me (or proved to me on the basis of satisfactory
evidence) to be the person whose name is subscribed to the within instrument and acknowledged to me that he/she
executed the same in his/her authorized capacity, and that by his/her signature on the instrument the person, or the entity
upon behalf of which the person acted, executed the instrument.
WITNESS my hand and official seal.
Signature
My commission expires:
State of Delaware
Department of Justice
NOTICE OF APPOINTMENT OF REGISTERED AGENT & REGISTERED AGENT’S STATEMENT
(29 Del. C. § 6086)
JUS-TPM2
Page 2 of 2
NAME AND ADDRESS OF DELAWARE STATE REGISTERED AGENT:
NAME:
Street Address (Required – Must be within the state of Delaware):
P.O. Box (Optional):
City and State:
Telephone:
Facsimile Number:
E-mail address:
I consent to serve as the Registered Agent in the state of Delaware for the above-named NPM, pursuant to Title 29,
Section 6086 of the Delaware Code. I understand it will be my responsibility to receive Service of Process on behalf of
the NPM; to forward mail to the NPM; and to immediately notify the Office of the Attorney General if I resign or change
the office address of the Registered Agent.
THIS NOTICE OF APPOINTMENT must be signed and dated in the presence of a Notary Public.
Signature:
Date:
Print Name:
Title:
STATE OF
)
COUNTY OF
)
COUNTRY OF
)
On
, before me,
, personally appeared
, personally known to me (or proved to me on the basis of satisfactory
evidence) to be the person whose name is subscribed to the within instrument and acknowledged to me that he/she
executed the same in his/her authorized capacity, and that by his/her signature on the instrument the person, or the entity
upon behalf of which the person acted, executed the instrument.
WITNESS my hand and official seal.
Signature
My Commission expires:
Page of 2