L-121 (4/94) New Jersey Division of Revenue Certification of Resignation of Agent / Appointment of New Agent ( For Use by Limited Liability Company) To: New Jersey Department of the Treasury, Division of Revenue In accordance with the provisions of NJSA 42, I _____________________________________ at (Agent Name) _________________________________________ (No. and Street) _________________________ ____________ (City and State) (Zip) the address of the registered office of the Limited Liability Companies listed below, DO HEREBY DECLARE THAT: 1. I resign as Registered Agent for the Limited Liability Companies listed below and appoint _____________________________________________________ at (New Agent's Name) _________________________________________ __________________________ ___________ (No. and Street) (City and State) (Zip) as successor registered agent for each Limited Liability Company listed. 2. Attached are copies of statements executed by each of the Limited Liability Companies listed, ratifying and approving the change of registered agent. Affected LLCs: (Attach list if required) It is understood that my resignation shall become effective upon filing of this certificate with the Division of Revenue or upon designation by the LLC of a new registered agent, whichever is earlier. _____________________________________ Signature of Resigning Agent ___________________ Date NJ Division of Revenue, PO Box 308, Trenton, NJ 08646 American LegalNet, Inc. www.USCourtForms.com Rev 7/18/05 Instructions for Form L-121 CERTIFICATION OF RESIGNATION OF AGENT With APPOINTMENT OF NEW AGENT For LIMITED LIABILITY COMPANIES (Title 42:2B) STATUTORY FEE: $25.00, PLUS $10.00 FOR EACH LLC LISTED ON FORM The MANDATORY fields are: Name and Office List the registered agent name and office as they appear on the records of the State Treasurer. Declaration of Resignation/Appointment of Successor Add a statement that the listed agent is resigning (Form L-121 already provides this) and list the successor agent's name and address. Provide a New Jersey street address. A PO box may be used only if the street address is listed as well. Affected LLC(s) List each LLC affected by the change; show the LLC name(s) as it appears on the records of the Treasurer. ATTESTATIONS Add a statement indicating an understanding that the resignation is effective upon the filing of the change form with the Division of Revenue, or upon the designation of a new agent/office by the affected LLC (s), whichever is earlier. Form L-121 provides the requisite language. ATTACHMENTS Attach written statements executed by the affected LLC(s), showing ratification and approval of the change. EXECUTION Have the resigning agent sign. Also, list the date of execution (signature). ********** These documents should be filed in duplicate. Non-profit should file in triplicate. Make checks payable to: TREASURER, STATE of NEW JERSEY. (No cash, please) Mail to NJ Division of Revenue, PO Box 308, Trenton, NJ 08646 American LegalNet, Inc. www.USCourtForms.com