Fillable STATE OF ALABAMA CHANGE BY CURRENT AGENT to (State of Alabama)

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STATE OF ALABAMA CHANGE BY CURRENT AGENT to (State of Alabama)

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Agent Name/Address Change – 7/2021
Page 1 of 2
STATE OF ALABAMA
CHANGE BY CURRENT AGENT to ALTER AGENT'S NAME
And/or CHANGE REGISTERED OFFICE ADDRESS
PURPOSE: To change a registered agent’s legal name, office address, and/or mailing address by delivering to the
Secretary of State for filing a Change by Current Agent to Alter Agent's Name and/or Change Registered Office Address
change in accordance with 10A-1-5.33. Multiple entity identification (ID) numbers and corresponding names may be
listed on one form for one fee. This form is NOT to change the current agent on record.
INSTRUCTIONS: Mail one (1) signed original and one (1) copy of this completed form along with a self-addressed,
stamped envelope with the filing fee of $100.00 (credit card, check, or money order) to the Secretary of State, Business
Services, P.O. Box 5616, Montgomery, Alabama 36103-5616. or you may email the filing to
miscellaneous.filings@sos.alabama.gov If you are submitting this filing via email and would like a copy returned
to you, check $4.00 copy fee on the credit card payment form. Your filing will not be indexed if the credit/debit card
does not authorize and will be removed from the index if the check is dishonored ($30 fee)
This form must be typed.
1. Alabama Entity ID Number (Format: 000-000): - TO OBTAIN ID NUMBER Go to our
website at www.sos.alabama.gov click on Business Services (below picture), click on Business Entity and Name
Search, click on Entity Name, enter the name of the entity in the appropriate box, and enter. Click on the number and
verify that this is the correct entity. This step is strongly recommended.
2. The name o
f the entity as registered with the Secretary of State of Alabama:
_____________________________________
__________________________________________________
OR
______ Multip
le entities are involved in this change.
A list of the Alabama Entity ID Numbers and registered entity names is attached.
3. Registered Agent’s current Name (must be completed): _________________________________________
_____________________________________
__________________________________________________
CHANGE Registered Agent’s Name to (cannot be a different person):
This f
orm was prepared by: (type name and full address)
(For SOS Use Only
)
*Include proof of name change (license, marriage certificate, etc.)
CHANGE BY AGENT OF AGENT NAME
And/or REGISTERED OFFICE ADDRESS
Agent Name/Address Change – 7/2021
Page 2 of 2
4. Registered Office current Street Address (No PO Boxes) in Alabama (must be completed):
Mailin
g Address in Alabama (if different from Street Address):
CHANGE Registered Office Street Address (No PO Boxes) in Alabama to:
Mailing Address in Alabama (if different from Street Address):
The exe
cution of this filing instrument constitutes an affirmation by each person executing the instrument that the
facts therein are true, under penalties for perjury prescribed by Section 13A-10-103 or its successors.
I, the unde
rsigned, certify that written notice of this change was given to the entity named and identified entity
identification number(s) in this Change form at least 10 days before the date this Change form was filed with the Office of
the Secretary of State of Alabama.
Date (MM/DD/YYYY) Typed Name of Agent authorizing Change [10A-1-5.33]
Signature of Authority for Agent [10A-1-5.33 (b)]
Typed Name and Title of Signature for Agent [10A-1-5.33(b)]
/
/
Agent Change Credit Card Payment Slip – 07/2021
Secretary of State Credit Card or Prepaid Payment Option/Return/Hold Sheet: : If you do not send
an acknowledgement copy and a pre-addressed postage paid envelope with the filing or return email
address, you will not receive a receipt from the Secretary of State’s Office. Hold for pickup request will
have the receipt attached. The document of record will be stamped showing the receipt of the filing fee
but will not show convenience fees (generally these fees are between 2% and 5% of the total charge).
Information MUST be typed or filing will be returned without review.
Entity Name:
AL Entity ID #, required for all filings other than formation/registration: - (ex: 000-000)
Service Requested: X $100.00 Agent/Address Change filing fee
$4.00 Copy Fee (Acknowledgement Copy if submitted by email)
If submitted by email check one: Return by email postal mail
Return via email (paper copy will not be sent):
Hold at Front Desk for Pick-up by:
There is no notification service/call for pick-up. (Service providers who run couriers for pick-up)
Ch
oose one of the following:
Check/money order is attached-Please make one check payable for each filing to the Alabama
Secretary of State. Do not use one check for multiple filings.
Charge fees to prepaid account: Account Number
and Account Name
Typed Name & Signature of Authorized Individual on Account
Credit Card Type: (Visa, MC, Discover & AmEx)
Card Number: Expiration Mo/Yr.: / (MM/YY)
Card Holder Name:
Complete Billing Address:
Street or PO BOX
City State Zip
Signature of Card Holder:
MUST be Signature of Card Holder
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STATE OF ALABAMA CHANGE BY CURRENT AGENT to (State of Alabama)

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Completed 30 November 2021

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