Non-Refundable Processing Fee: $37.00
Use this form to transfer registration for a foreign filing entity registered to do business in Utah that merges with or converts to a foreign entity required
to register to do business in Utah.
Pursuant to UCA § 48-3a-909 causes this Transfer of Registration to be delivered to the Utah Division of
Corporations for filing, and states as follows:
. The Transfer of Registration shall state:
Entity Number: _____________________________________
First: The name, entity type and jurisdiction of the company immediately prior to the filing of the merger
or conversion
Name: _______________________________________________________________________________
Entity Type (LLC, LP, LLP, LLLP): ________________________________
Jurisdiction: ________________________________
Second: The name of foreign merger survivor or converted entity
Name: _______________________________________________________________________________
Entity Type: ________________________________ _______________________________
State / Jurisdiction
______________________________________________________________________________________
Street and mailing address of principal office
Third: Utah Registered Agent
Name: _______________________________________________________________________________
An address must be listed if you have a non-commercial registered agent.
Address of the Registered Agent: ________________________________________________________
Utah Street Address Required, PO Boxes can be listed after the Street Address
City: _______________________________________________________ State: UT Zip: ____________
Fourth: Under penalties of perjury, I declare that the Transfer of Registration has been duly approved by
the owners of the entity.
Name: ______________________________ Signature: ___________________________
Title: _______________________________ Date: _______________________________
. Additional filing requirements: The non-refundable processing fee of $37.00 payable to the State of Utah,
and application for converted entity must accompany this form. No additional fee for the new application.
Under GRAMA {63-2-201}, 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.
State of Utah
Department of Commerce
Division of Corporations & Commercial Code
Transfer of Registration of Foreign Entity
This form cannot be hand written.
Sign here after the form is printed
Mailing/Faxing Information:
www.corporations.utah.gov
www.corporations.utah.gov/contactus.html
