Interim Notice Of Change Of Officer/Director (Connecticut)
This is an interim notice of change of officer/director for foreign and domestic corporations in Connecticut. The form provided here is simply a sample of what the actual Form SNSC 303 looks like.
INTERIM NOTICE OF CHANGE OF OFFICER/DIRECTOR
Domestic and Foreign Corporations
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: _________________________
2. New officer/director information: (street address required - P.O. Box not acceptable)
Name _________________________
Title _________________________
___ Check if director
Residence Address
Street _________________________
City _________________________
State _________________________
Zip Code _________________________
Business Address
Street _________________________
City _________________________
State _________________________
Zip Code _________________________
Name _________________________
Title _________________________
___ Check if director
Residence Address
Street _________________________
City _________________________
State _________________________
Zip Code _________________________
Business Address
Street _________________________
City _________________________
State _________________________
Zip Code _________________________
Name _________________________
Title _________________________
___ Check if director
Residence Address
Street _________________________
City _________________________
State _________________________
Zip Code _________________________
Business Address
Street _________________________
City _________________________
State _________________________
Zip Code _________________________
3. Directors/officers who have ceased to hold office:
Name _________________________
Title _________________________
___ Check if director
Name _________________________
Title _________________________
___ Check if director
Note: If additional space is needed, please reference an 8 112 X 11 attachment
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
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Instructions correspond with numbered entries on the form
1. NAME OF CORPORATION: Please provide the complete name of the corporation as it currently appears on the records of the Secretary of the State. If the notice is being filled by a foreign corporation, such corporation should provide the name under which it is currently authorized to transact business in Connecticut.
2. NEW OFFICER/DIRECTOR INFORMATION: Please print or type the full name of the corporation's officers and directors, their titles, including a check following the statement "Check if Director" if applicable, and their residence and business addresses. Complete street addresses including a street number, street name, city, state, postal code and country if other than the United States are required. Note: P.O. boxes are only acceptable as additional information.
3. DIRECTORS/OFFICERS WHO HAVE CEASED TO HOLD OFFICE: Please print or type the full name of directors/officers who have ceased holding director or officer positions within the corporation and their titles, including a check following the statement "Check if Director" if applicable.
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. The execution constitutes a legal statement under the penalties of false statement that the information provided in the document is true.