Fill and Sign the Certificate of Resignation of Registered Agent Form

Certificate of Resignation of Resident AgentPage 1 of 2 Certificate of Resignation of Resident Agent of Nonprofit Corporation I, , Resident Agent, located at (Name of Agent) , certify as follows: (Street Address, City, County, State, Zip Code) 1. That I have resigned as resident agent of , a (Name of Church) Nonprofit Church Corporation having a principal office at (Name of State) , certify as follows: (Street Address, City, County, State, Zip Code) 2. The effective date of such resignation will be . (Date) 3. I have mailed a copy of this Certificate, postage prepaid, to said Corporation at its principal office in as currently noted in the records of the (Name of State) Secretary of , or because that office is also my office, to the (Name of State) address furnished to me by the Corporation as the place where copies of all processes served upon me are to be forwarded. Witness my signature this . (Date) _________________________________ (Signature of Registered Agent) (Name of Registered Agent) Contact information: TO BE FILLED IN BY CORPORATION Contact information: Telephone: Email: Certificate of Resignation of Resident AgentPage 2 of 2 I hereby approve the within Certificate of Resignation of Resident Agent and, the filing fee in the amount of $ , having been paid, said Certificate is deemed to have been filed with me this . (Date) (Name of Secretary of State) (Name of State)