State of Utah
DEPARTMENT OF COMMERCE
Division of Corporations & Commercial Code
Commercial Registered Agent Termination
$52.00 Non-Refundable Processing Fee
You may terminate your listing as a commercial registered agent by filing with the division a commercial
registered agent termination statement signed by or on behalf of the agent.
(U.C.A. Section 16-16-205)
The commercial registered agent termination shall take effect on the 31st day after the day on which it is filed.
(U.C.A. Section 16-16-205)
1) Commercial Registered Agent Name.
____________________________________________________________________________________________
2) Commercial Registered Agent File Number.
___________________________________________
3) The above listed Commercial Registered Agent is no longer in the business of serving as a commercial
registered agent in this state.
4) Address of the Registered Agent.
____________________________________________________________________________________________
Address City State Zip
5) Name & Signature
Under penalties of perjury and as an authorized authority, I declare that this statement of Termination, has been examined by me and is,
to the best of my knowledge and belief, true, correct and complete.
__________________________________________ ______________________________________
Commercial Registered Agent Name Signature of Commercial Registered Agent
Under GRAMA
{63G-2-201}, all registration information maintained by the Division is classified as public record. For confidentiality purposes, you may
use the business entity physical address rather than the residential or private address of any individual affiliated with the entity.
This form cannot be hand written.
Business Registration - Optional Inclusion of Ownership Data
Sign here after the form is printed
Mailing/Faxing Information:
www.corporations.utah.gov/contactus.html
www.corporations.utah.gov
Business Registration - Optional Inclusion of Ownership Data
