Fillable MUSCOGEE (CREEK) NATION RESIGNATION OF REGISTERED AGENT COUPLED

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MUSCOGEE (CREEK) NATION RESIGNATION OF REGISTERED AGENT COUPLED

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MUSCOGEE (CREEK) NATION
RESIGNATION OF REGISTERED AGENT
COUPLED WITH
APPOINTMENT OF SUCCESSOR
TO: MUSCOGEE (CREEK) NATION SECRETARY OF THE NATION
P.O. Box 580
Okmulgee, OK 74447
(918) 732-7615
The undersigned, for the purpose of changing the name of the registered agent and address of the registered
office of the corporation, as provided by Section 1025, of the Muscogee (Creek) Nation General Corporation
Act, hereby certifies:
1. The name of the corporation is:
_____________________________________________________________________________________
2. The state or other jurisdiction of its formation:_________________________________________
3. The undersigned, designated registered agent in the Muscogee (Creek) Nation, is unwilling to
continue to act as agent of said corporation for service of process:
_____________________________________________________________________________________
Name of Agent Street Address City County Zip Code
4. Upon the filing of this statement with the Secretary of the Nation, the capacity of the undersigned
as such registered agent shall terminate, and the successor agent and the address of the registered office for
said corporation shall be:
_____________________________________________________________________________________
Name of Agent Street Address City County Zip Code
FILING FEE: $25.00
PRINT CLEARLY
(CONTINUED ON NEXT PAGE)
IN WITNESS WHEREOF, the undersigned registered agent has caused this statement to be signed this
_______ day of _______________, _______.
ACKNOWLEDGMENT BY AN AGENT WHO IS AN INDIVIDUAL
______________________________ ____________________________
SIGNATURE SIGNATURE
ACKNOWLEDGMENT BY AN AGENT THAT IS A BUSINESS ENTITY
___________________________________
EXACT BUSINESS ENTITY NAME
______________________________ _____________________________
List Title:______________________ List Title:_____________________
______________________________ _____________________________
PLEASE PRINT NAME PLEASE PRINT NAME
_____________________________________________________________________________________
The undersigned corporation does hereby ratify and approve the foregoing change of registered agent on this
_______ day of _______________, _______.
IN WITNESS WHEREOF, said corporation has caused this certificate to be signed by its President
or Vice President and attested to by its Secretary or Assistant Secretary.
__________________________
By _______President
__________________________
(PLEASE PRINT NAME)
ATTEST:
______________________________
By _______Secretary
______________________________
(PLEASE PRINT NAME)
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MUSCOGEE (CREEK) NATION RESIGNATION OF REGISTERED AGENT COUPLED

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Completed 1 February 2022

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