08-492 (Rev. 03/12/2013) Statement of Change Instructions
STATEMENT OF CHANGE
Registered Agent or Registered Agent Address
Domestic Limited Liability Company
Filing Fee: $25.00 (non-refundable)
INSTRUCTIONS (Please retain for your records):
NOTICE: The Statement of Change will not be filed if a biennial is report due or the signatures do not match
what the Corporations Section has on record. Please verify the following before completing the application.
o Have all current biennial reports be filed?
o Are the members/managers up to date on our records?
To verify this information please search for the entity by going to Search Corporations Database in the
Corporations Section of our website at www.commerce.alaska.gov/occ
. If there is a biennial report due, the
report may be filed online by selecting Biennial Reports on the Corporations Section page. If the
members/managers have changed, but no biennial report is due, please submit a Notice of Change located in
the Forms and Fees section.
Pursuant to Alaska Statutes 10.50.060, the entity submits the Statement of Change for the purpose of
changing its registered agent or the registered agent address in the state of Alaska. The registered agent
of the corporation must be an individual who is a resident of Alaska, or a corporation (excluding LLC, LP,
LLP) registered and in good standing with this office. A corporation may not act as its own registered
ITEM 1: Provide the name of the entity currently on record and the Alaska Entity Number.
ITEM 2: Prior registered agent information.
ITEM 3: New registered agent information.
ITEM 4: Per AS 10.50.060(6), statement that the change was authorized by resolution of the members or
ITEM 5: The Statement of Change must be signed by a member, manager, or Attorney-in-Fact. Note:
Persons who sign documents filed with the commissioner that are known to the person to be false in material
respects are guilty of a class A misdemeanor.
Mail the Statement of Change and the non-refundable $25.00 filing fee in U.S. dollars to:
State of Alaska, Corporations Section, PO Box 110806, Juneau, AK 99811-0806
STANDARD PROCESSING TIME for complete and correct applications submitted to this office is
approximately 10-15 business days. All applications are reviewed in the date order they are received.
State of Alaska
Division of Corporations, Business and Professional Licensing
PO Box 110806
Juneau, AK 99811-0806
Phone: (907) 465-2550
Fax: (907) 465-2974