Tom Schedler Secretary of State NOTICE OF CHANGE OF REGISTERED OFFICE AND/OR CHANGE OF REGISTERED AGENT (R.S. 12:236) Enclose $25 Filing Fee Return to: Commercial Division Domestic Non Profit Corporation P. O. Box 94125 Make remittance payable to Secretary of State Baton Rouge, LA 70804-9125 Phone (225) 925-4704 Do Not Send Cash Web Site: www.sos.la.gov Corporation Name: CHANGE OF LOCATION OF REGISTERED OFFICE Notice is hereby given that the Board of Directors of the above named corporation has authorized a change in the location of the corporation's registered office. The new registered office is located at: To be signed by an officer or a director Date CHANGE OF REGISTERED AGENT(S) Notice is hereby given that the Board of Directors of the above named corporation has authorized the change of the corporation's registered agent(s). The name(s) and address(es) of the new registered agent(s) is/are as follows: President, Vice President or Secretary Date AGENT'S ACCEPTANCE AND ACKNOWLEDGEMENT OF APPOINTMENT I hereby acknowledge and accept the appointment of registered agent(s) for and on behalf of the above named corporation. Sworn to and subscribed before me, the undersigned Notary Public, on this date: Notary Signature, Printed Name and Notary/Bar Roll # SS354 Rev. 01/15 (See instructions on back) American LegalNet, Inc. www.FormsWorkFlow.com INSTRUCTIONS 1. This form is to be used when an existing domestic non profit corporation changes the location of its registered office or changes its registered agent(s), or both. The Change of Location of Registered Office must be authorized by the Board of Directors of the corporation, and signed by an officer or director. The Change of Registered Agent(s) must be signed by the corporation's President, Vice President or Secretary and the new registered agent(s) must sign the acknowledgement and acceptance of their appointment before a notary public. The notice of change should be filed within thirty (30) days after the change. A corporation may also change the location of its registered office or name of its registered agent by including the change in the annual report required by R.S. 12:205.1. 2. 3. 4. 5. A duplicate original or certified copy of this form should be filed with the Clerk of Court of the parish in which the corporation's registered office is located (or with the Recorder of Mortgages in the Parish of Orleans). If a change of registered office is from one parish to another, a duplicate original or certified copy of this form should be filed with the Clerk of Court (or with the Recorder of Mortgages in the Parish of Orleans) in which the new registered office is located, as well as in parish from which the registered office is changed. American LegalNet, Inc. www.FormsWorkFlow.com