08-543 Rev 6/28/18 Religious Corp Statement of Change 1 of 2 Domestic Religious Corporation (AS 10.40) This Statement of Change form for Registered Agents or Registered Agent Address Changes is only for Domestic Religious Corporations. Submit this filing hardcopy, along with its payment, via fax or U.S. Mail. Tip: if faxing, print a confirmation page from your fax machine that all pages were successfully faxed. For security reasons, DO NOT EMAIL forms and/or payments. Processing Time: Standard processing time from March-September is 10-15 business days. During heavy filing seasons, October-February, the processing time will be delayed. COR Corporations Section State Office Building, 333 Willoughby Avenue, 9th Floor PO Box 110806, Juneau, AK 99811-0806 Phone: (907) 465-2550 225 Fax: (907) 465-2974 Website: Corporations.Alaska.Gov Statement of Change 1. Important: AS 10.40.130 Per AS 10.40.130, each Domestic Religious Corporation shall (must) continuously (without interruption) maintain in this state (Alaska) a registered agent AND a registered office (with an Alaskan physical location and an Alaskan mailing address) for the purpose of a registered agent222s statutory requirements to receive service of processes, notices, or demands required or permitted by law to be served upon the religious corporation. Failure to meet registered agent requirements could result in involuntary dissolution of the entity222s authority to transact business in the State of Alaska. 227 AS 10.40.150(a)(2) For more registered agent information go to Corporations.Alaska.Gov, Registered Agents FAQs. 2. Fee: $25 Nonrefundable Filing Fee (CORF) 3 AAC 16.070(b) Mail this form and the non-refundable $25 filing fee in U.S. dollars to the letterhead address. Make the check or money order payable to the State of Alaska, or use the attached credit card payment form. 3. Entity Information on Record with the State: AS 10.40.080 Entity Name: Alaska Entity Number: FOR DIVISION USE ONLY T HE S TATE ALASKA of Department of Commerce, Community and Economic Development Division of Corporations, Business and Professional Licensing American LegalNet, Inc. www.FormsWorkFlow.com 08-543 Rev 6/28/18 Religious Corp Statement of Change 2 of 2 4. PREVIOUS Registered Agent Information on Record with the State: PREVIOUS Registered Agent Name: PREVIOUS Registered Agent Addresses: PHYSICAL Address: City: State: AK (mandatory) ZIP Code: MAILING Address: City: State: AK (mandatory) ZIP Code: 5. NEW Registered Agent Information to be Updated with the State: AS 10.40.130 NEW Registered Agent Name: (per AS 10.40.130, this must be a n individual ) NEW Registered Agent Addresses: PHYSICAL Address: City: State: AK (mandatory) ZIP Code: MAILING Address: City: State: AK (mandatory) ZIP Code: 6. Authorization per Alaska Statute: The registered agent change was authorized by the religious corporation . The religious corporation is to keep and make available the record of the resolution. 7. Required Signature: AS 10.40.080 The Statement of Change must be signed by the individual representing the religious corporation in the official capacity designated in the articles of incorporation, and sealed with the seal of the corporation. Persons who sign documents filed with the commissioner that are known to the person to be false in material respects are guilty of a class A misdemeanor. Signature: Date: Printed Name: Title of Authorized Signer: Corporate Seal American LegalNet, Inc. www.FormsWorkFlow.com 08-561 Rev 7/14/16 Contact Information Return this form with your filing This information may be used by the Division to assist with processing your attached filings This form will not be filed for record, or appear online COR Corporations Section State Office Building, 333 Willoughby Avenue, 9th Floor PO Box 110806, Juneau, AK 99811-0806 Phone: (907) 465-2550 Fax: (907) 465-2974 Website: Corporations.Alaska.Gov Contact Information Entity Information Enter your entity information as it appears on this filing. Entity Name: AK Entity #: Contact Person Whom may we contact with any questions or problems with this filing? Company: Contact: Mailing Address: Address: City: State: ZIP: Phone: Email: Document Return Address Provide an address for the return of your filed documents. Return my filings to the address provided ABOVE Return my filings to this address provided BELOW Company: Contact: Mailing Address: Address: City: State: ZIP: FOR DIVISION USE ONLY T HE S TATE ALASKA of Department of Commerce, Community and Economic Development Division of Corporations, Business and Professional Licensing American LegalNet, Inc. www.FormsWorkFlow.com All major credit cards are accepted. For security purposes, do not email credit card information. Include this credit card payment form with your application. Name of Applicant or Licensee: Program Type: License Number (if applicable): I wish to make payment by credit card for the following (check all that apply): AMOUNT Application Fee: License or Renewal Fee: Other (name change, wall certificate, fine, duplicate license, exam, etc.): 1. 2. TOTAL: Name (as shown on credit card): Mailing Address: Phone Number: Email (optional): Signature of Credit Card Holder: 08-4438 Rev 12/26/18 Credit Card Payment Form (all major cards accepted) State of Alaska Department of Commerce, Community, and Economic Development Division of Corporations, Business and Professional Licensing PO Box 110806, Juneau, AK 99811 Phone: (907) 465-2550 Credit Card Payment Form CREDIT CARD INFO: Your payment cannot be processed unless all fields are completed! All four fields MUST be completed! This section will be destroyed after the payment is processed. 1. Account Number : 2. Expiration Date: 3. Billing ZIP Code: 4 . Security Code : FOR DIVISION USE ONLY T HE S TATE ALASKA of Department of Commerce, Community , and Economic Development Division of Corporations, Business and Professional Licensing American LegalNet, Inc. www.FormsWorkFlow.com