_______________________________________________________________________________________________________________ DO NOT WRITE ABOVE THIS LINE, FOR ACC USE ONLY NO FILING FEE REQUIRED LIMITED LIABILITY COMPANY STATEMENT OF RESIGNATION OF STATUTORY AGENT OF ____________________________________________________ (Name of limited liability company resigning from) ______________________ (ACC file number) NOTE: It is critical that the Corporation Commission receive the exact name and file number of the limited liability company (LLC) resigning from. Please check with our Records section, (602) 542-3026 or our web site, www.azcc.gov/divisions/corporations to obtain the correct information. IMPORTANT! You must evaluate both items. Check only those that apply. 1) The undersigned statutory agent of ____________________________________________,. An Arizona LLC, or a Foreign LLC qualified to do business Arizona, hereby resigns from my appointment as agent. 2) The known place of business, currently the street address of the undersigned, is also discontinued. The undersigned has given notice of this resignation to the LLC by mailing one copy to the Limited Liability Company at the following address: ________________________________________________________________ ________________________________________________________________ This resignation shall be effective on the thirty-first day after the date on which this statement is delivered to the Arizona Corporation Commission for filing. DATED this ______ day of _________________________, _________ Signature:_____________________________________________ Printed Name:__________________________________________ This form must be delivered to: ARIZONA CORPORATION COMMISSION Corporations Division 1300 West Washington Phoenix, Arizona 85007-2929 LL: 0011 Rev: 09/2008 or 400 West Congress Tucson, Arizona 85701-1347 Arizona Corporation Commission Corporations Division American LegalNet, Inc. www.FormsWorkflow.com