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Certificate of Change of Registered Office or Registered Agent, or Both (New Jersey)

This form is for a change of the registered agent, register office, or both of a corporation in New Jersey. The form provided here is simply a sample of what the actual Form C-104G looks like.

New Jersey Department of the Treasury
Division of Revenue


Certificate of Change of Registered Office or Registered Agent, or Both
(For Use by Domestic and Foreign, Profit and Non-profit Corporations)

CORPORATION NAME: ____________________________

STATE OF ORIGINAL INCORPORATION: ____________________________

IMPORTANT - INCLUDE INFORMATION ON BOTH THE PRIOR AND NEW AGENT

PRIOR AGENT NAME: ____________________________

PRIOR AGENT STREET ADDRESS ____________________________

CITY ____________________________

STATE ____________________________

ZIP ____________________________

NEW AGENT NAME: ____________________________

NEW AGENT STREET ADDRESS ____________________________

CITY ____________________________

STATE ____________________________

ZIP ____________________________

The corporation states that the address of its new registered office and the address of its new registered agent are identical. Further, the changes designated on this form were authorized by resolution duly adopted by its board of directors or members.

By ____________________________ (Signature of Officer)

Title ____________________________ (Type)

Date ____________________________


NOTE-This form must be executed by the chairman of the board, president, or vice president of the corporation.

FEES:
Change of Agent Name-$10.00
Change of Agent Address-$10.00
Change of Both-$10.00

MAIL TO: Dept. of the Treasury
Div. of Revenue
CN 308
Trenton, NJ 08625

MAKE CHECKS PAYABLE TO THE DEPARTMENT OF THE TREASURER, DIVISION OF REVENUE (NO CASH PLEASE)

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