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Statement Of Change Of Mailing Address Of Surviving Entity (North Carolina)

This is a statement of a change of mailing address of surviving entity in North Carolina. The form provided here is simply a sample of what the actual Form N-13 looks like.

State of North Carolina
Department of the Secretary of State

STATEMENT OF CHANGE OF MAILING ADDRESS
OF SURVIVING ENTITY*

1. Pursuant to N.C.Gen. Stat. ยงยง 55-15-21(a)(4),55A-11-09(d)(3) 55A-15-21(a)(4), 57C-7-12(a)(4) and 59-909(a)(4), as applicable, notice is hereby given by the undersigned business entity that its mailing address has changed from

___________________________________

___________________________________ (mailing address previously filed with the Secretary of State)

to ___________________________________

___________________________________ (new mailing address).

2. This Statement will be effective upon filing, unless a delayed date and/or time is specified:

___________________________________

This the ____ day of _____________, 20_____.

____________________________________
Name of Entity

____________________________________
Signature

____________________________________
Type or Print Name and Title

NOTE:

1. Filing fee is $10. This document and one exact or conformed copy of this Statement must be filed with the Secretary of State.

* This form should only be used by the surviving entity in a merger to notify the Secretary of State of a change in its mailing address after Articles of Merger or an Application for Certificate of Withdrawal by Reason of Merger, Consolidation or Conversion have been filed. This form should not be used to change the registered office address. A Statement of Change of Registered Office and/or Registered Agent should be used for that purpose.

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