Fill and Sign the Resignation or Change of Registered Agent Change of Form

STATE OF SOUTH CAROLINA SECRETARY OF STATE NOTICE OF CHANGE OF REGISTERED OFFICE OR REGISTERED AGENT OR BOTH OF A SOUTH CAROLINA OR FOREIGN CORPORATION TYPE OR PRINT CLEARLY IN BLACK INK Pursuant to Sections 33-5-102 and 33-15-108 of the 1976 South Carolina Code of Laws, as amended, the undersigned corporation submits the following information. 1. The name of the corporation is _________________________________________________________ (Must match name on record with Secretary of State’s Office) 2. The corporation is (complete either a or b, whichever is applicable): a. a domestic corporation incorporated in South Carolina on __________________________; or (Must match date on record with Secretary of State’s Office) b. a foreign corporation incorporated in _______________________ on _______________ , and State Date authorized to do business in South Carolina on ________________________ . (Must match date on record with Secretary of State’s Office) 3. The street address of the registered office (currently on file) in South Carolina is ___________________________________________________, South Carolina _________________. Street Address City Zip Code 4. If the current registered agent's office is to be changed, the new address will be ___________________________________________________, South Carolina _________________. Street Address City Zip Code 5. The name of the registered agent currently on file is ______________________________________ 6. If the current registered agent is to be changed, the name of the new registered agent is _______________________________________________________________________________. * I hereby consent to the appointment as registered agent of the corporation: ____ _______________________________ Signature of New Registered Agent 7. The address of the registered office and t he address of the business office of the registered agent, as changed, will be identical. 8. Unless a delayed date is specified, this will be effective upon acceptance for filing by the Secretary of State (See Section 33-1-230(b) of the 1976 South Carolina Code of Laws, as amended ____________________________. *Pursuant to Sections 33-5-102(5) and 33-15-108(5) of the 1976 South Carolina Code of Laws, as amended, the written consent of the register ed agent may be attached to this form. ____ ____________________________ Name of Corporation ______________________ _________________________________ Date Name of Corporation _________________________________ Signature of Officer _________________________________ Type or Print Name _________________________________ Position of Officer FILING INSTRUCTIONS 1. Two copies of this form must be submitted for filing. 2. $10.00 filing fee made payable to the South Carolina Secretary of State. 3. Self-addressed stamped return envelope. 4. Return to: Secretary of State Attn: Corporations 1205 Pendleton St., Ste. 525 Columbia, SC 29201 5. Pursuant to Section 33-5-102(b) of t he 1976 South Carolina Code of Laws, as amend ed, the registered agent can file this when the only change is the street addre ss of the registered office. In this situation, the following statement should be typed on the form above the registered agent’s signature: “The cor poration has been notified of this change.” In this case the filing fee is $2.00. Form Revised by South Carolina Secretary of State, March 2012