File Number: _________________ STATEMENT OF CHANGE OF BUSINESS MAILING ADDRESS (see reverse for instructions) The entity identified below submits to the Secretary of State the following statement for the purpose of changing its business mailing address. 1. The name of the business entity is: ___________________________________________________________ 2. The business mailing address is currently on file as: _______________________________________________________________________________________ 3. The business mailing address is to be changed to: _______________________________________________________________________________________ 4. Change of address is effective: Upon Receipt OR ________________ (Date) Signed: ____________________________________________ Printed Name: _______________________________________ Capacity: ___________________________________________ Dated: _____________________________________________ g:\corp\forms\miscforms\change_address.pmd FILE ONE COPY NO FEE REQUIRED American LegalNet, Inc. www.USCourtForms.com INSTRUCTIONS This form may be used to change the business mailing address of a Corporation, Limited Liability Company, Limited Partnership or Limited Liability Partnership. This form cannot be used to change a Business Entity's Registered Agent and/or Registered Office. This form cannot be used to change the physical business address or mailing address of an Assumed Business Name filing. Such change must be made with an Amendment form. The form must be executed by: Corporation: Chairman of the Board, President, Secretary, or another officer LLC: Manager of the company, or if no managers, by its members LP: General Partner LLP: Partner There is no fee required to file this form. Mail or deliver to: Secretary of State 700 West Jefferson - Basement West PO Box 83720 Boise ID 83720-0080 American LegalNet, Inc. www.USCourtForms.com