Secretary of State Office
500 E Capitol Ave
Pierre, SD 57501
(605)773-4845
corpinfo@state.sd.us
COMMERCIAL REGISTERE
D AGENT
REGISTRATION
Please Type or Print Clearly in Ink
FILING FEE: $100 payable to SECRETARY OF STATE
The undersigned submits the following s
tatement for the purpose of being listed as a Commercial Registered Agent in
the State of South Dakota.
1. The name of the individual or entity __________________________________________________________________
2. If an entity the jurisdiction of organization______________________________________________________________
3. If an entity the type of entity ________________________________________________________________________
4. The street address in South Dakota of the place of business to which service of process may be delivered
______________________________________________________________________________________________
Street Address (Required to be a South Dakota Address) City State ZIP+4
______________________________________________________________________________________________
Mailing Address (Optional – Required to be a South Dakota Address) City State ZIP+4
5. Optional statement regarding alternate means of accepting service of process
______________________________________________________________________________________________
6. Phone number _________________
7. Fax number _________________
8. E-mail address __________________________________________________________________________________
9. Web address __________________________________________________________________________________
The above referenced individual or entity intends to be in the business of serving as a Commercial Registered Agent in
the State of South Dakota.
Dated ____________________________ ______________________________________________
(Signature of an authorized officer)
______________________________________________
(Printed Name)
______________________________________________
(Title)
Commercialagentregistration Jan 2017