CHANGE OR DESIGNATION
OF
REGISTERED AGENT AND/OR OFFICE
(FOREIGN CORPORATION)
TO: MUSCOGEE (CREEK) NATION SECRETARY OF THE NATION
P.O. Box 580
Okmulgee, OK 74447
(918) 732-7615
The undersigned, designated registered agent for:
_____________________________________________________________________________________
a corporation organized and existing under the laws of the State of __________________ is unwilling to continue to act
as an agent of said corporation for service of process for said corporation.
On the _____ day of ________________, _______, which is at least thirty (30) days prior to the filing of this
resignation, due notice of such resignation of registered agent was mailed or delivered to the corporation at:
_____________________________________________________________________________________
being the address last known to the undersigned registered agent.
Pursuant to Section 1133 of the Muscogee (Creek) Nation General Corporation Act, the resignation of the
undersigned agent shall become effective thirty (30) days after the filing of this certificate with the Secretary of the
Nation.
IN WITNESS WHEREOF, the undersigned registered agent has caused this certificate to be executed this
_______ day of ___________________, _______.
ACKNOWLEDGMENT BY AN AGENT WHO IS AN INDIVIDUAL
_______________________________ __________________________
SIGNATURE PLEASE PRINT NAME
ACKNOWLEDGMENT BY AN AGENT THAT IS A BUSINESS ENTITY
________________________________________
EXACT BUSINESS ENTITY NAME
_____________________________ ________________________________
List Title:_____________________ List Title:________________________
_____________________________ ________________________________
PLEASE PRINT NAME PLEASE PRINT NAME
FILING FEE: $25.00
PRINT CLEARLY
