State of Utah
DEPARTMENT OF COMMERCE
Division of Corporations & Commercial Code
Commercial Registered Agent Changes
Non-refundable Processing Fee $52.00
1. The Name of the Commercial Registered Agent:
2. The Commercial Registered Agent Number:
3. Has the name of the agent changed? Yes No
If yes, what is the new name of the agent?
4. Has the address of the Commercial Registered Agent changed? Yes No
If yes, what is the new address of the Commercial Registered Agent?
Address: ______________________________________________________________________________________________________
City: State/Province: Zip:
5. Has the type or jurisdiction of organization of the Commercial Registered Agent changed?
Yes No
If yes, what is the new type or jurisdiction of organization of the Commercial Registered Agent?
A commercial registered agent shall promptly furnish each entity represented by it with notice in a record of the filing of a
statement of change relating to the name or address of the agent and the changes made by the filing.
Under penalties of perjury, I declare that this Commercial Registered Agent Change Form has been examined by
me and is, to the best of my knowledge and belief, true, correct and complete.
Signature: Title: Date:
Under GRAMA {63G-2-201}, all registration information maintained by the Division is classified as public record. For confidentiality purposes, you
may use the business entity physical address rather than the residential or private address of any individual affiliated with the entity.
This form cannot be hand written.
Business Registration - Optional Inclusion of Ownership Data
Sign here after the form is printed
Mailing/Faxing Information:
www.corporations.utah.gov/contactus.html
www.corporations.utah.gov
