Arizona Corporation Statutory Agent Resignation Form

Should a registered agent of an Arizona-based corporation decided to vacate her/his position, s/he must file this form with the Corporation Commission and pay for the $10.00 filing fee.Download

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DO NOT WRITE ABOVE THIS LINE; RESERVED FOR ACC USE ONLY. 	
STATUTORY AGENT RESIGNATION 	
CORPORATION 	
C029i 
1.  ENTITY NAME  –  give the exact name of the corporation as currently shown in A.C.C. reco\
rds: 
________________________________________________________________________\
__________________________ 
2.  A.C.C. FILE NUMBER:  _______________________________________________________________________\
________ 	
Find the A.C.C. file number on the upper corner of filed documents OR on\
 our website at:  http://www.azcc.gov/Divisions/Corporations	
3. STATUTORY AGENT NAME –  list the exact name of the resigning statutory agent as currently shown \
in A.C.C. records: 
________________________________________________________________________\
________________________ 
4.  KNOWN PLACE OF BUSINESS ADDRESS  – is the Arizona known place of business address for the corporation\
 as 
currently shown in A.C.C. records the same as the street address of the \
undersigned statutory agent?  	
 Yes 	 No 
4.1   If you answered yes to number 4, do you want to discontinue use of you\
r address as the known place of business 
for the corporation?   	
  Yes 	  No 
5. NOTICE OF RESIGNATION  – by the signature appearing below, the undersigned Statutory Agent \
certifies that written 
notice of this resignation was mailed to the corporation at the followin\
g address: 	
Attention (optional) 
Address 1 
Address 2 (optional) 
City 
Country  State or Province 
Zip 	
6. STATEMENT OF RESIGNATION –  bythe signature appearing below, the statutory agent hereby resigns from t\
he 
appointment as statutory agent for the corporation named in number 1 abo\
ve.  The appointment as statutory agent 
terminates (the resignation is effective) as of the thirty-first (31s\
t) day after the date on which the Statutory Agent 
Resignation is received by the Arizona Corporation Commission or upon ap\
pointment of a new statutory agent, 
whichever occurs first.
SIGNATURE: 	
 I ACCEPT 	
Signature                                          Printed Name  Date 
REQUIRED – check only one and fill in the corresponding blank if signing for an ent\
ity: 	
Individual as statutory agent:  I am signing on behalf 
of myself as the individual (natural person) resigning as 
statutory agent. 	Entity as statutory agent:  I am signing on behalf of the 
entity resigning as statutory agent, and I am authorized to 
act for that entity.  	
Filing Fee:  $10.00 (regular processing) 
Expedited processing – add $35.00 to filing fee.  
All fees are nonrefundable - see Instructions.       Mail:     Arizona Corporation Commission - Corporate Filings Section 
            1300 W. Washington St., Phoenix, Arizona  85007 
Fax:      602-542-4100
Please be advised that A.C.C. forms reflect only the 
minimum provisions required by statute.  You should seek private legal counsel \
for those matters that may pertain 
to the individual needs of your business. 
All documents filed with the Arizona Corporation Commission are  public record and are open for public inspection.  
If you have questions after reading the Instructions, please call 602-54\
2-3026 or (within Arizona only) 800-345-5819. 
C029.001                       Arizona Corporation Commission – Corporations Di\
vision 
Rev: 2010                                 Page 1 of 1 	
Read the Instructions	
By checking the box marked "I accept" below, I acknowledge under penalty of perjury that this document 
together with any attachments is submitted in compliance with Arizona la\
w.