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Mail all forms and required payments to: Department of Consumer and Regulatory Affairs Corporations Division PO Box 92300 Washington, DC 20090 Phone: (202) 442 - 44 32 Corporate Online Services Information: Many corporate filings are available by using CorpOnline Service. Go to CorpOnline site at https://corp online .dcra.dc.gov , create the profile, access the online services main page and proceed. Online filers must pay by using the credit card. District of Columbia Government Corporations Division Listing of Commercial Registered Agent Form RA - 1, Ver. 3 , April 2018 . Use this form to become a commercial registered agent in the District of Columbia. person (an individual or domestic or foreign filing entity) who have filed this form as required under 247 29 - 104.05 with Corporations Division. If commercial register ed agent is the filing entity then said entity must be registe red to conduct business in the District of Columbia. Provide email address to receive alerts about agent appointment, agent changes and various notices for represented entities. ENTITY TYPE FILING F E E Commercial Registered Agent Refer to Corpo rate Fee Schedule posted online. Under the provisions of the Title 29 of D.C. Code (Business Organizations Act), the following individual or domestic or forei gn filing entity qualified to do business in the District hereby applies for a Listing of Commercial Registered Agent and for that purpose submits the statement below. 1A. Commercial Registered Agent Email address. (for sending alerts about agent changes and other notices) alternate name shall be used only if true name is not distinguishable ) 3.Individual or Filing Entity is in the business of serving as a commercial registered agent in the District. 4 .Principal Address. If commercial agen t is the filing entity, answer 5 A - B. 5 A. 5 B. Entity Type & File Number. 6 . 7.Name and file numbers of entities represented by the commercial registered agent. (may attach the list with name and file#) If you sign this form you agree that anyone who makes a false statement can be punished by criminal penalties of a fine up to $1000, imprisonment up to 180 days, or both, under DCOC 247 22 - 2405; 8 .Name of the Governor or Authorized Person. 8A . Signature of the Governor or Authorized Person. American LegalNet, Inc. www.FormsWorkFlow.com