Certificate Of Resignation Of Resident Agent

Filing Fee: $10.00 IDENTIFICATION no. ____________________ The Commonwealth of Massachusetts William Francis Galvin Secretary of the Commonwealth One Ashburton Place, Room 1717, Boston, Massachusetts 02108-1512 CERTIFICATE OF RESIGNATION OF RESIDENT AGENT (General Laws, Chapter 180, Section 10C) I, ____________________________________________________________________________________________ , Resident Agent, (Exact name of resident agent) located at ___________________________________________________________________________________________________ , (Business address of resident agent) certify as follows: 1. That I have resigned as resident agent of __________________________________________________________________________ (Exact name of corporation) having a principal office at ______________________________________________________________________________________ . (Street address of corporation in Massachusetts) 2. *The effective date of such resignation will be _________________________________ , 20 ________ . 3. I have mailed a copy of this certificate, postage prepaid, to said corporation at its principal office in Massachusetts as currently noted in the records of the Secretary of the Commonwealth, or because that office is also my office, to the address furnished to me by the corporation as the place where copies of all processes served upon me are to be forwarded. SIGNED UNDER THE PENALTIES OF PERJURY, this __________ day of________________________________ , 20 ___________, ______________________________________________________________________________________________ , Resident Agent. *The effective date of resignation must not be earlier than 30 days after the filing of this certificate. American LegalNet, Inc. www.FormsWorkFlow.com 180crra 11/7/13 THE COMMONWEALTH OF MASSACHUSETTS CERTIFICATE OF RESIGNATION OF RESIDENT AGENT (General Laws, Chapter 180, Section 10C) 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 ________________ d a y of ___________________, 20_______ . WILLIAM FRANCIS GALVIN Secretary of the Commonwealth TO BE FILLED IN BY CORPORATION Contact information: _________________________________________________________ _________________________________________________________ _________________________________________________________ Telephone: _________________________________________________ Email: __________________________________________________________ A copy this filing will be available on-line at www.state.ma.us/sec/cor once the document is filed. American LegalNet, Inc. www.FormsWorkFlow.com