Arizona LLC Statutory Agent Resignation Form
In the State of Arizona, a statutory agent resigning from her/his post must complete this form and submit it to the SOS’ office.Download
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DO NOT WRITE ABOVE THIS LINE; RESERVED FOR ACC USE ONLY. STATUTORY AGENT RESIGNATION LIMITED LIABILITY COMPANY L032i Read the Instructions 1. ENTITY NAME – give the exact name of the LLC as currently shown in A.C.C. records: ________________________________________________________________________\ __________________________ 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 LLC as curr\ ently shown in A.C.C. records the same as the street address of the undersigne\ d 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 LLC? 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 LLC at the following addres\ s: 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 LLC named in number 1 above. The\ appointment as statutory agent terminates (the resignation is effective) as of the thirty-first (31st) day aft\ er the date on which the Statutory Agent Resignation is received by the Arizona Corporation Commission or upon appointment of a \ new statutory agent, whichever occurs first. I ACCEPT Signature Printed Name Date REQUIRED – check only one: 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: None (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. L032.001 Arizona Corporation Commission – Corporations Di\ vision Rev: 2010 Page 1 of 1 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. SIGNATURE:
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