Free RETURN TO - South Dakota

Secretary of State Office 500 E Capitol Ave Pierre, SD 57501 (605)773-4845

COMMERCIAL REGISTERED AGENT COURTESY CHANGE
Please Type or Print Clearly in Ink

Clear Form
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Please submit one Original and one Photocopy

NO FILING FEE

The Secretary of State Office will process a courtesy change for purpose of changing optional information. This form may not be used to change the name or address of the Commercial Registered Agent (CRA). 1. The Commercial Registered Agent CRA# _____________________________________________________________ 2. CRA Name_____________________________________________________________________________________ Any of the optional information provided below will be available to the public on the Secretary of State's website at http://www.sdsos.gov/. 3. Statement regarding alternate means of accepting service of process

______________________________________________________________________________________________ 4. Phone number _________________ 5. Fax number _________________

6. E-mail address __________________________________________________________________________________ 7. Web address __________________________________________________________________________________

The statement shall be signed by or on behalf of the Commercial Registered Agent.

Dated ____________________________

______________________________________________
(Signature of an authorized officer)

______________________________________________
(Printed Name)

______________________________________________
(Title)

Commercialagtcourtesychg July 2008