Fillable Filing Form Cover Letter (State of Ohio)

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Filing Form Cover Letter (State of Ohio)

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BROWSE STATE OF OHIO (OH) FORMS

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Form 521
Page 1 of 6
Last Revised: 06/2019
Toll Free: 877.767.3453 | Central Ohio: 614.466.3910
OhioSoS.gov | business@OhioSoS.gov
File online or for more information: OhioBusinessCentral.gov
Filing Form Cover Letter
Please return the approval certificate to:
Address:
City:
ZIP Code:
Phone Number:
E-mail Address:
Check here if you would like to receive important notices via e-mail from the Ohio Secretary of State's office regarding
Business Services.
Check here if you would like to be signed up for our Filing Notification System for the business entity being created or
updated by filing this form. This is a free service provided to notify you via e-mail when any document is filed on your
business record.
Please make checks or money orders payable to: "Ohio Secretary of State"
Type of Service Being Requested: (PLEASE CHECK ONE BOX BELOW)
Regular Service: Only the filing fee listed on page one of the form is required and the filing will be
processed in approximately 3-7 business days. The processing time may vary based on the volume of
filings received by our office.
Expedite Service 1: By including an Expedite fee of $100.00, in addition to the regular filing fee on page
one of the form, the filing will be processed within 2 business days after it is received by our office.
Expedite Service 2: By including an Expedite fee of $200.00, in addition to the regular filing fee on page
one of the form, the filing will be processed within 1 business day after it is received by our office. This
service is only available to walk-in customers who hand deliver the document to the Client Service Center.
Expedite Service 3: By including an Expedite fee of $300.00, in addition to the regular filing fee on page
one of the form, the filing will be processed within 4 hours after it is received by our office, if received by 1:00
p.m. This service is only available to walk-in customers who hand deliver the document to the Client Service Center.
Preclearance Filing: A filing form, to be submitted at a later date for processing, may be submitted to be
examined for the purpose of advising as to the acceptability of the proposed filing for a fee of $50.00. The
Preclearance will be complete within 1-2 business days.
Name (Individual or Business Name):
To the Attention of (if necessary):
State
Form 521
Page 2 of 6
Last Revised: 06/2019
Form 521 Prescribed by:
Statutory Agent Update
Filing Fee: $25
Form Must Be Typed
(CHECK ONLY ONE(1) BOX)
(1) Subsequent Appointment of Agent (2) Change of Address of an Agent (3) Resignation of Agent
Real Estate Investment Trust
(153-LAG)
Business Trust
(153-LAG)
Partnership (153-LAG)
LLC (153-LAG)
LP (155-AGR)
Corp (155-AGR)
Corp (145-AGA)
LP (145-AGA)
LLC (144-LAD)
Business Trust
(144-LAD)
Real Estate Investment Trust
(144-LAD)
Corp (165-AGS)
LP (165-AGS)
LLC (171-LSA)
Business Trust
(171-LSA)
Real Estate Investment Trust
(171-LSA)
Name of Entity
Charter, License or Registration No.
Name of Current Agent
Name and Address
of New Agent
Complete the information in this section if box (1) is checked
Name of Agent
Mailing Address
City
State
ZIP Code
Toll Free: 877.767.3453
Central Ohio: 614.466.3910
OhioSoS.gov
business@OhioSoS.gov
File online or for more information:
OhioBusinessCentral.gov
Mail this form to one of the following:
Regular Filing (non expedite)
P.O. Box 788
Columbus, OH 43216
Expedite Filing (Two business day processing time.
Requires an additional $100.00)
P.O. Box 1390
Columbus, OH 43216
For screen readers, follow instructions located at this path.
OH
Form 521
Page 3 of 6
Last Revised: 06/2019
The Undersigned, , named herein as the
statutory agent for , hereby acknowledges
and accepts the appointment of statutory agent for said entity.
Individual Agent's Signature/Signature on behalf of Business Serving as Agent
Complete the information in this section if box (1) is checked and business is an Ohio entity
Name of Agent
Name of Business Entity
Signature:
New Address of Agent
Complete the information in this section if box (2) is checked
Mailing Address
City
State
ZIP Code
ACCEPTANCE OF APPOINTMENT FOR DOMESTIC ENTITY'S AGENT
The agent of record for the entity identified on page 1 resigns as statutory agent.
Current or last known address of the entity's principal office where a copy of this Resignation of Agent was sent as of the
date of filing or prior to the date filed.
Complete the information in this section if box (3) is checked
Zip Code
State
City
Mailing Address
OH
Form 521
Page 4 of 6
Last Revised: 06/2019
Print Name
By (if applicable)
Signature
Print Name
By (if applicable)
Signature
By signing and submitting this form to the Ohio Secretary of State, the undersigned hereby certifies that he or she
has the requisite authority to execute this document.
Required
Agent update must
be signed by an authorized
representative (see
instructions for specific
information).
If authorized representative
is an individual, then they
must sign in the "signature"
box and print their name
in the "Print Name" box.
If authorized representative
is a business entity, not an
individual, then please print
the business name in the
"signature" box, an
authorized representative
of the business entity
must sign in the "By" box
and print their name in the
"Print Name" box.
Form 521
Page 5 of 6
Last Revised: 06/2019
Instructions for Statutory Agent Update
This form should be used to update statutory agent information for a corporation, limited partnership,
limited liability company, partnership or business trust. If a corporation, limited partnership or limited
liability company or business trust would like to appoint a new statutory agent, please select box 1.
If a corporation, limited partnership, limited liability company, or business trust would like to change
the address of the current agent, please select box 2. If the agent of a corporation, limited partnership,
limited liability company, partnership, or business trust would like to resign from their position, please
select box 3.
A partnership and limited liability partnership must complete a statement of amendment to appoint a
new agent or change the address of the current agent.
Entity Information
The corporation, limited partnership, limited liability company, partnership, or business trust must provide
its name, charter/license/registration number and the name of the current agent. The current agent's name
must be the same as the agent listed in our office's records.
Appointment of New Agent
Pursuant to Ohio Revised Code sections 1701.07, 1702.06, 1703.041, 1782.04, 1705.06 and 1746.04,
a corporation, limited partnership, limited liability corporation and business trust must appoint and maintain
a statutory agent to accept service of process on behalf of the entity. The statutory agent must be one of
the following: (1) A natural person who is a resident of this state; or (2) A domestic or foreign corporation ,
nonprofit corporation, limited liability company, partnership, limited partnership, limited liability partnership,
limited partnership association, professional association, business trust, or unincorporated nonprofit
association that has a business address in this state. If the agent is a business entity then the agent must
meet the requirements of Title XVII of the Revised Code to transact business or exercise privileges in
Ohio.
If the entity is a domestic corporation, limited liability partnership, limited liability company or business
trust, the statutory agent must sign the Acceptance of Appointment on Page 2. The agent of a foreign
entity does not have to accept appointment by signing the form.
Change of Address of an Agent
Pursuant to Ohio Revised Code sections 1701.07, 1702.06, 1703.041, 1782.04, 1705.06 and 1746.04, a
corporation, limited partnership, limited liability company and business trust must appoint and maintain a
statutory agent to accept service of process on behalf of the entity. The statutory agent must be one of the
following: (1) A natural person who is a resident of this state; or (2) A domestic or foreign corporation,
nonprofit corporation, limited liability company, partnership, limited partnership, limited liability partnership,
limited partnership association, professional association, business trust, or unincorporated nonprofit
association that has a business address in this state. If the agent is a business entity then the agent must
meet the requirements of Title XVII of the Revised Code to transact business or exercise privileges in
Ohio.
Resignation of Agent
Pursuant to Ohio Revised Code sections 1701.07, 1702.06, 1703.041, 1705.06, 1776.07, 1782.04,
1705.06 and 1746.04, an agent may resign by filing this form, stating their intent to resign and providing
the current or last known address of the entity's principal office. On the date of filing this form with our
office or prior to that date, the agent must send a copy of the resignation form to the current or last known
address of the entity's principal office.
Form 521
Page 6 of 6
Last Revised: 06/2019
For a domestic for-profit corporation, partnership, limited partnership, limited liability company and
business trust, thirty days after the filing of this form, the authority of the agent will terminate. For a
domestic nonprofit corporation or a foreign corporation, sixty days after the filing of this form, the authority
of the agent will terminate.
Additional Provisions
If the information you wish to provide for the record does not fit on the form, please attach additional
provisions on a single-sided, 8 1/2 x 11 sheet(s) of paper.
Signature(s)
After completing all information on the filing form, please make sure to sign the form. If the entity is
a domestic corporation, the form must be signed by the incorporators or a corporate officer. If the entity is
a foreign corporation, the form must be signed by an authorized representative. If the entity is a domestic
or foreign limited partnership, the form must be signed by an officer, all of the general partners or a
majority of the general partners. If the entity is a domestic or foreign limited liability company, the form
must be signed by a member, manager or an authorized representative. If the entity is a business trust,
an authorized representative must sign. If the form is used for an agent's resignation, the resigning agent
must sign the form.
**Note: Our office cannot file or record a document that contains a social security number or
tax identifications number. Please do not enter a social security number or tax identification
number, in any format, on this form.
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Filing Form Cover Letter (State of Ohio)

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Completed 21 October 2020

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