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Change of Registered Agent (Connecticut)

This is a change of registered agent for a foreign corporation in Connecticut. The form provided here is simply a sample of what the actual Form SC 107 looks like.

CHANGE OF REGISTERED AGENT
FOREIGN CORPORATION

Office of the Secretary of the State
30 Trinity Street / P.O. Box 150470 / Hartford, CT 06115-0470 / Rev. 12/1999

Space For Office Use Only

1. NAME OF CORPORATION IN STATE OF FORMATION
:

_______________________

2. IF DIFFERENT FROM THE ABOVE, THE NAME UNDER WHICH THE CORPORATION TRANSACTS BUSINESS:

_______________________

3. APPOINTMENT OF NEW REGISTERED AGENT:
(Check A. or complete B.)

A. ____ The corporation appoints the Secretary of the State of Connecticut and his successors in office to be its agent upon whom any process, in any action or proceeding against it, may be served.

B. Print or Type name of agent: _______________________

Business Address: (P.O. Box unacceptable)

Street _______________________

City _______________________

State _______________________

Zip Code _______________________

Residence Address: (P.O. Box unacceptable)

Street _______________________

City _______________________

State _______________________

Zip Code _______________________

Acceptance of Appointment

Signature of Agent _______________________

4. EXECUTION:

Dated this ____________________ day of _____________, 20_____.

Print or type name of signatory _______________________

Capacity of Signatory _______________________

Signature _______________________


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INSTRUCTIONS FOR FILLING OUT THIS FORM
-----------------------------

Instructions correspond with numbered entries on the form

1. NAME OF CORPORATION IN STATE OR COUNTRY OF FORMATION: Please provide the name of the corporation as it appears on the records of the Secretary of the State.

2. IF DIFFERENT FROM THE ABOVE, THE NAME UNDER WHICH THE CORPORATION TRANSACTS BUSINESS IN CONNECTICUT: Please provide the complete name under which the corporation transacts business in this state if it is different from the name under which it is incorporated.

3. APPOINTMENT OF NEW REGISTERED AGENT: The corporation may not appoint itself as its registered agent. It may instead appoint one of the following: The Secretary of the State, a natural person who is a resident of Connecticut, a Connecticut corporation or a foreign corporation which has a certificate of authority to transact business in Connecticut.

Place a check mark next to selection A to appoint the Secretary of the State or complete selection B to appoint a natural person or corporation. If a natural person is appointed, please provide a complete street address for that person's business under the heading Business/registered office address and their residence under the heading Residence address. If the agent appointed is a corporation, please provide the corporation's principal office address under the Business /registered office Address heading. The agent in item B must sign accepting the appointment. Moreover, the signatory must state the capacity under which they sign if signing on behalf of a corporation.

4. EXECUTION: The document must be executed by an authorized official of the corporation. That person must print or type their name, state the capacity under which they sign 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.

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