Fill and Sign the Undersigned Entity Submits the Following Statement for the Purpose of Changing Its Registered Form

File #: ______________________________ The undersigned entity submits the following statement for the purpose of changing its registered agent, its registered of�ce, or both, in the State of Idaho. Rev. 11/2015 NO FEE REQUIRED (See reverse for instructions) (not a PO box or PMB) I consent to serve as registered agent for the above-named entity.(Signature of new registered agent) (Date) STATEMENT OF CHANGE OF REGISTERED AGENT, REGISTERED OFFICE, OR BOTH 1. The name of the entity is: 2. The name and street address of the old registered agent and of�ce is: 3. The name and street address of the new registered agent and of�ce in Idaho is: Date: Printed: Signature: Capacity: INSTRUCTIONS Optional: If the document requires a correction, please list a telephone number where we can reach you.  This form may be used to change the registered agent and/or registered office of a Corporation, Limited Liability Company, Limited Partnership or Limited Liability Partnership (Idaho Code section 30- 21-409).  This form is not used to make a business entity mailing address change. To change the business mailing address, use either the Secretary of State’s office preprinted form, or a letter or memo, preferably on company stationary, showing the old address, the new address and a signature of a corporate officer, LLC member or manager or general partner.  If appointing a new registered agent, the newly appointed registered agent must sign the change of registered agent accepting such position.  A registered agent is the person designated to receive service of process upon litigation. A registered agent may be an individual who is a resident of Idaho, or a business entity registered with the Secretary of State's office. Assumed Business Name filings cannot be registered agents. This person or business entity must be located in Idaho at a physical address. Post Office boxes and commercial personal mail boxes are not acceptable.  A registered agent may sign and file a statement of change only to the address of the registered office without a signature from any officer, manager, partner, etc.  The form must also be signed by a corporate officer, LLC member or manager or general partner when a change of registered agent is being made. Please sign below the registered agent's acceptance and indicate the capacity in which you are signing. There is no fee to �le a change of registered agent and/or registered of�ce. Mail or deliver to: Secretary of State 450 N 4th Street PO Box 83720Boise ID 83720-0080 This document can be faxed. Our fax number is (208) 334-2080. If you have questions or need help, call the Secretary of State’s of�ce at (208) 334-2301.