Form BUS-10 "Change of Agent - Foreign (Formed Outside of Connecticut) - All Entities Except Limited Partnerships" - Connecticut

What Is Form BUS-10?

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

Form Details:

  • Released on September 1, 2020;
  • The latest edition provided by the Connecticut Secretary of the 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 BUS-10 by clicking the link below or browse more documents and templates provided by the Connecticut Secretary of the State.

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Download Form BUS-10 "Change of Agent - Foreign (Formed Outside of Connecticut) - All Entities Except Limited Partnerships" - Connecticut

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Secretary of the
State of Connecticut
OFFICE USE ONLY
860-509-6003 •
crd@ct.gov •
www.concord-sots.ct.gov
PHONE:
EMAIL:
WEB:
CHANGE OF AGENT
• Use ink. • Print of type.
FOREIGN (formed outside of Connecticut)
• Attach additional 8½ x 11
All Entities EXCEPT Limited Partnerships
sheets if necessary.
FILING PARTY (Confirmation will be sent to this address):
FILING FEE: $50
CUSTOMER ID:
Exception: $20
NAME:
for nonstock (nonprofit)
corporations.
ADDRESS:
Make checks payable to
“Secretary of the State”
CITY:
STATE:
ZIP:
1. NAME OF BUSINESS ENTITY IN STATE OR COUNTRY OF FORMATION: (Must match our records exactly.
Include business designation such as LLC, Inc., etc.)
2. THE NAME UNDER WHICH THE BUSINESS ENTITY TRANSACTS BUSINESS IN CONNECTICUT, IF
DIFFERENT FROM NAME STATED IN NUMBER 1 ABOVE: (If applicable)
3. STATE/COUNTRY OF FORMATION:
4. APPOINTMENT OF NEW AGENT FOR SERVICE OF PROCESS: (The business entity may not be
appointed as its own Agent. However, a principal of the entity residing in Connecticut may be the Agent.)
NOTE: Check/Complete either 4A or 4B or 4C – not all three . Also, foreign LLCs must complete section 5 .
A. THE BUSINESS ENTITY APPOINTS THE SECRETARY OF THE STATE OF CONNECTICUT AND HIS/
HER SUCCESSORS IN OFFICE TO BE ITS AGENT, UPON WHOM ANY PROCESS, IN ANY ACTION OR
PROCEEDING AGAINST IT, MAY BE SERVED.
B. IF AGENT IS AN INDIVIDUAL:
PRINT OR TYPE FULL LEGAL NAME:
CONNECTICUT RESIDENCE ADDRESS: (No P.O. Box)
BUSINESS ADDRESS: (No P.O. Box)
Check box if no business address:
STREET:
STREET:
CITY:
CITY:
STATE:
ZIP:
CT
STATE:
ZIP:
SIGNATURE ACCEPTING APPOINTMENT:
PAGE 1 OF 2
BUS-10 (CHANGE OF AGENT, ALL FOREIGN ENTITIES EXCEPT LPs)
Rev.9/2020
Secretary of the
State of Connecticut
OFFICE USE ONLY
860-509-6003 •
crd@ct.gov •
www.concord-sots.ct.gov
PHONE:
EMAIL:
WEB:
CHANGE OF AGENT
• Use ink. • Print of type.
FOREIGN (formed outside of Connecticut)
• Attach additional 8½ x 11
All Entities EXCEPT Limited Partnerships
sheets if necessary.
FILING PARTY (Confirmation will be sent to this address):
FILING FEE: $50
CUSTOMER ID:
Exception: $20
NAME:
for nonstock (nonprofit)
corporations.
ADDRESS:
Make checks payable to
“Secretary of the State”
CITY:
STATE:
ZIP:
1. NAME OF BUSINESS ENTITY IN STATE OR COUNTRY OF FORMATION: (Must match our records exactly.
Include business designation such as LLC, Inc., etc.)
2. THE NAME UNDER WHICH THE BUSINESS ENTITY TRANSACTS BUSINESS IN CONNECTICUT, IF
DIFFERENT FROM NAME STATED IN NUMBER 1 ABOVE: (If applicable)
3. STATE/COUNTRY OF FORMATION:
4. APPOINTMENT OF NEW AGENT FOR SERVICE OF PROCESS: (The business entity may not be
appointed as its own Agent. However, a principal of the entity residing in Connecticut may be the Agent.)
NOTE: Check/Complete either 4A or 4B or 4C – not all three . Also, foreign LLCs must complete section 5 .
A. THE BUSINESS ENTITY APPOINTS THE SECRETARY OF THE STATE OF CONNECTICUT AND HIS/
HER SUCCESSORS IN OFFICE TO BE ITS AGENT, UPON WHOM ANY PROCESS, IN ANY ACTION OR
PROCEEDING AGAINST IT, MAY BE SERVED.
B. IF AGENT IS AN INDIVIDUAL:
PRINT OR TYPE FULL LEGAL NAME:
CONNECTICUT RESIDENCE ADDRESS: (No P.O. Box)
BUSINESS ADDRESS: (No P.O. Box)
Check box if no business address:
STREET:
STREET:
CITY:
CITY:
STATE:
ZIP:
CT
STATE:
ZIP:
SIGNATURE ACCEPTING APPOINTMENT:
PAGE 1 OF 2
BUS-10 (CHANGE OF AGENT, ALL FOREIGN ENTITIES EXCEPT LPs)
Rev.9/2020
OFFICE USE ONLY
NOTE: Do not complete 4C if 4A or 4B is completed.
C. C. IF AGENT IS A BUSINESS:
PRINT OR TYPE NAME OF BUSINESS AS IT APPEARS ON OUR RECORDS:
CONNECTICUT BUSINESS ADDRESS: (No P.O. Box)
STREET:
CITY:
CT
STATE:
ZIP:
SIGNATURE ACCEPTING APPOINTMENT ON BEHALF OF AGENT:
PRINT NAME AND TITLE OF PERSON SIGNING ON BEHALF OF AGENT:
5. CONNECTICUT MAILING ADDRESS OF REGISTERED AGENT: (Required for foreign limited
liability companies only. (P.O. Box is acceptable)
STREET OR PO BOX:
CITY:
CT
STATE:
ZIP:
6. EXECUTION / SIGNATURE: (Subject to penalties of false statement)
DATE SIGNED:
/
/
NAME OF SIGNATORY
SIGNATURE
CAPACITY/TITLE OF
SIGNATORY
PAGE 2 OF 2
BUS-10 (CHANGE OF AGENT, ALL FOREIGN ENTITIES EXCEPT LPs)
Rev.9/2020
INSTRUCTIONS
1. Please provide the complete name of the business entity as it currently appears on the records of the Secretary of the
State, including business designation such as LLC, Inc., etc.
2. Provide the complete name under which the business entity transacts business in Connecticut as it currently
appears on the records of the Secretary of the State if other than the name stated in item number 1.
3. Please provide the business entity’s state or country of formation.
4. The business entity may appoint either:
A. The Secretary of the State
OR
B. Any individual who is a resident of Connecticut, including a principal of the business entity. (An individual must
provide the complete street address of his/her business (if none, must check box) and a Connecticut residence
Address.) Agent must sign accepting the appointment.
OR
• A Connecticut corporation, limited liability company, limited liability partnership or statutory trust
• A foreign corporation, limited liability company, limited liability partnership or statutory trust, which has obtained
a certificate of authority to transact business in Connecticut and has a Connecticut address on file with this office
• The business must provide a Connecticut business address in Box 4B.
• Print the name & capacity/title under the signature of the individual signing acceptance on behalf of the business
agent.
5. A foreign limited liability company must provide the agent's Connecticut mailing address (if the Secretary
of the State is not appointed agent).
6. The document must be executed/signed by an authorized official of the business entity. That person must print or
type their name, state the capacity/title under which they sign and provide a signature. The execution/signature
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:
BUSINESS SERVICES DIVISION
CONNECTICUT SECRETARY OF THE STATE
P.O. BOX 150470
HARTFORD, CT 06115-0470
DELIVERY ADDRESS:
BUSINESS SERVICES DIVISION
CONNECTICUT SECRETARY OF THE STATE
165 CAPITOL AVENUE, SUITE 1000
HARTFORD, CT 06106
PHONE: 860-509-6003
WEBSITE:
www.concord-sots.ct.gov
INSTRUCTIONS
BUS-10 (CHANGE OF AGENT, ALL FOREIGN ENTITIES EXCEPT LPs)
Rev. 9/2020
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