REGISTERED AGENT CHANGE/DESIGNATION STATEMENT

District of Columbia

[// GUIDANCE:
• This template is designed for use by counsel when preparing a “Statement of Change or Designation of Registered Agent and Registered Office” to be filed with the District of Columbia Department of Licensing and Consumer Protection, Corporations Division (“DLCP”).
• It tracks the substantive requirements of D.C. Code §§ 29-104.02 & 29-104.05 (2023) and incorporates best-practice defensive drafting.
• Replace every bracketed [PLACEHOLDER] with client-specific information.
• Verify current filing fees, signature requirements, and electronic filing protocols before submission.
]

TABLE OF CONTENTS

I. Document Header
II. Definitions
III. Operative Provisions
IV. Representations & Warranties
V. Covenants & Restrictions
VI. Default & Remedies
VII. Risk Allocation (Reserved)
VIII. Dispute Resolution (Reserved)
IX. General Provisions
X. Execution Block

I. DOCUMENT HEADER

1. Title. Statement of Change/Designation of Registered Agent and Registered Office (the “Statement”).
2. Filing Entity.
   a. Legal Name: [Entity Legal Name] (the “Company”)
   b. Entity Type: [Corporation/Limited Liability Company/Partnership/Other]
   c. Jurisdiction of Formation: [State]
   d. DLCP Entity Identification No.: [DLCP ID]
3. Effective Date. This Statement shall become effective on the later of (i) the date of acceptance by the DLCP or (ii) [Delayed Effective Date, if any] (the “Effective Date”).
4. Statutory Authority. Filed pursuant to D.C. Code §§ 29-104.02 & 29-104.05 (2023).

II. DEFINITIONS

For purposes of this Statement, capitalized terms have the meanings set forth below:

“Company” – see Section I.2(a).
“DLCP” – the District of Columbia Department of Licensing and Consumer Protection, Corporations Division.
“Effective Date” – see Section I.3.
“New Registered Agent” – the person or entity identified in Section III.1.
“Prior Registered Agent” – the person or entity identified in Section III.2 (if applicable).
“Registered Office” – the street address in the District of Columbia where the New Registered Agent is located, identified in Section III.1(b).
“Statement” – this Registered Agent Change/Designation Statement, including all schedules and exhibits hereto.

III. OPERATIVE PROVISIONS

1. Designation of New Registered Agent and Registered Office.
   a. New Registered Agent: [Full Legal Name of New Agent], a [Individual/DC Domestic Entity/Foreign Entity Qualified in DC] (the “New Registered Agent”).
   b. Registered Office Address (Street Address Only):
   • [Street Address]
   • [City], DC [ZIP]
   [// GUIDANCE: P.O. Boxes are statutorily impermissible.]
2. Resignation or Removal of Prior Registered Agent. The Company hereby confirms that the previous registered agent, [Prior Agent Name or “N/A”] (the “Prior Registered Agent”), has [resigned/been removed] effective as of the Effective Date and that written notice of such resignation or removal has been (or concurrently is) delivered to the Prior Registered Agent.
3. Supersession. This Statement supersedes and replaces any prior statement of registered agent and registered office on file with the DLCP for the Company.

IV. REPRESENTATIONS & WARRANTIES

The Company hereby represents and warrants to the DLCP and any person relying hereon that, as of the date executed below:

1. Good Standing; Authority. The Company is in good standing in its jurisdiction of formation and is duly authorized to transact business in the District of Columbia; the individual executing this Statement is duly authorized to act on the Company’s behalf.
2. Statutory Qualification of Agent. The New Registered Agent satisfies the qualifications set forth in D.C. Code § 29-104.02 (2023), including maintenance of a physical street address in the District of Columbia and, if an entity, authorization to do business therein.
3. Accuracy of Information. All information set forth in this Statement is true, correct, and complete.

V. COVENANTS & RESTRICTIONS

1. Continuous Agent. The Company shall maintain a duly qualified registered agent and registered office in the District of Columbia at all times, as required by law.
2. Notice to Agent. The Company shall promptly provide the New Registered Agent with any information reasonably necessary to discharge its statutory obligations, including forwarding of service of process.
3. Updates. The Company shall file an amended statement with the DLCP within the statutory period should any information herein become inaccurate.

VI. DEFAULT & REMEDIES

1. Administrative Consequences. Failure to maintain a qualified registered agent or office may subject the Company to administrative dissolution or revocation of authority to transact business in the District of Columbia.
2. Service of Process. If the New Registered Agent resigns and the Company fails to designate a successor within the statutory period, service of process may be made upon the Mayor of the District of Columbia in accordance with applicable law.

VII. RISK ALLOCATION (RESERVED)

[// GUIDANCE: Indemnification and liability limitations are not applicable to this statutory filing and are intentionally omitted pursuant to the provided metadata.]

VIII. DISPUTE RESOLUTION (RESERVED)

[// GUIDANCE: This filing is ministerial; arbitration, jury waiver, and injunctive relief provisions are not applicable and are intentionally omitted.]

IX. GENERAL PROVISIONS

1. Amendment and Waiver. Any amendment to this Statement shall be made only by filing an appropriate instrument with the DLCP in accordance with applicable law.
2. Severability. If any provision of this Statement is determined by a court of competent jurisdiction to be invalid under applicable law, such provision shall be deemed modified to the minimum extent necessary to render it valid, and the remaining provisions shall remain in full force and effect.
3. Entire Filing. This Statement, together with any required consents and accompanying schedules, constitutes the entire filing with respect to the subject matter hereof.
4. Electronic Signatures. Pursuant to D.C. Code § 28-4862 (2023), electronic signatures and electronic submission of this Statement shall be deemed originals and fully enforceable.

X. EXECUTION BLOCK

IN WITNESS WHEREOF, the undersigned has executed and delivered this Statement as of the date set forth below.

[// GUIDANCE: DC law requires the new registered agent’s written consent to appointment; signature lines above satisfy § 29-104.05(d). Obtain additional notary acknowledgments only if required by DLCP at time of filing.]