Registered Agent Change/Designation

Statement of Designation or Change of Registered Agent and/or Registered Office

State of Utah – Department of Commerce, Division of Corporations & Commercial Code
(Utah Code Ann. § 16-17-203)

Effective Date (select one):
☐ Upon processing by the Division
☐ Delayed effective date (no more than 90 days after filing): _______________

Utah Entity Number: [UTAH ENTITY #]

I. Recitals

WHEREAS, [LEGAL ENTITY NAME], a [DOMESTIC / FOREIGN] [ENTITY TYPE] organized under the laws of [STATE/COUNTRY OF ORGANIZATION] (the “Entity”), is required by Utah Code Ann. §§ 16-17-201 et seq. to maintain a registered agent and registered office in the State of Utah; and

WHEREAS, the Entity desires to (check one):
☐ designate its initial registered agent/office; OR
☐ change its registered agent and/or registered office now on file with the Division;

NOW, THEREFORE, the Entity hereby submits this Statement of Designation or Change of Registered Agent and/or Registered Office (the “Statement”).

II. Definitions

“Division” – Utah Department of Commerce, Division of Corporations & Commercial Code.
“Registered Agent” – Individual or business entity appointed under Utah Code Ann. § 16-17-201 to receive service of process, notices, and demands for the Entity.
“Registered Office” – The Utah street address of the Registered Agent’s business office, identical to the address listed with the Division.

III. Statement & Designation

1. Entity Information
   a. Exact legal name: [LEGAL ENTITY NAME]
   b. Jurisdiction of formation: [STATE/COUNTRY]
   c. Business mailing address (optional): [MAILING ADDRESS]

2. Current Registered Agent/Office (complete only if changing)
   a. Name of current registered agent: [CURRENT AGENT NAME]
   b. Street address of current registered office: [CURRENT STREET ADDR., CITY, UT ZIP]

3. Appointment of New Registered Agent & Registered Office
   a. Name of new registered agent: [NEW AGENT NAME]
   • If individual: Utah residence address: [STREET, CITY, UT ZIP]
   • If entity: Utah registration number: [UTAH REG. #]
   b. Street address of new registered office (must be identical to agent’s Utah business office; no P.O. Boxes):
   [STREET, SUITE, CITY, UT ZIP]
   c. Mailing address of agent (if different): [MAILING ADDRESS]

4. Consent of Registered Agent
   The undersigned Registered Agent hereby (i) accepts the appointment, (ii) certifies that the address in § 3(b) is the agent’s business office, and (iii) confirms compliance with Utah Code Ann. § 16-17-201.

Registered Agent Signature: ______________________________________
Printed Name & Title: [NAME / TITLE]
Date: __________________

5. Authorization & Certification by Entity
   I declare under penalty of perjury that I am authorized to sign this Statement for the Entity and that the information provided herein is true, correct, and complete.

Entity Name: [LEGAL ENTITY NAME]

By: ______________________________________
Printed Name: [SIGNATORY NAME]
Title: [AUTHORIZED TITLE – e.g., President, Manager]
Date: __________________

IV. Optional Best-Practice Provisions (do not file with Division unless you want them on public record)

1. Successor Agent. If the Registered Agent resigns under Utah Code Ann. § 16-17-204, the Entity shall appoint a successor agent within 30 days after receiving notice of resignation.
2. Amendment. This Statement may be amended by filing a subsequent statement of change that complies with Utah Code Ann. § 16-17-203.
3. Severability. If any provision of this Statement is held invalid, the remaining provisions shall remain in effect.

V. Filing Checklist (retain for internal use)

☐ Signed by authorized Entity representative
☐ Signed (or separately consented) by Registered Agent
☐ Filing fee enclosed / paid online
☐ All street addresses located in Utah, no P.O. Boxes
☐ Copy saved to Entity’s minute book

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