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UNINCORPORATED NONPROFIT ASSOCIATION CHANGE OR TERMINATION OF REGISTERED AGENT FOR SERVICE OF PROCESS
Assoc. # ______________________ To the Secretary of State of the State of Idaho: 1. The name of the nonprofit association is: _____________________________________________________________________________ 2. The address of the nonprofit association is:
Check box if address is an address change.
_____________________________________________________________________________ 3. The name of the current registered agent is: _____________________________________________________________________________ 4. The name of the new registered agent is: _____________________________________________________________________________ 5. The physical address of the new registered agent is: _____________________________________________________________________________
I consent to serve as registered agent for the above-named entity. _______________________________________________________________
(Signature of new registered agent)
By checking this box, the association is terminating the registered agent because the association is no longer active.
Signature of a member of the nonprofit association: _____________________________________ Dated: _____________________
Secretary of State use only
G:\corp\forms\uninc_np_chg_term_ra.pmd Revised 03/2009
Mail to: Idaho Secretary of State 450 N 4th Street PO Box 83720 Boise ID 83720-0080
NO FEE REQUIRED FILE ONE COPY