CORPORATE DESIGNATION OF RESIDENT AGENT Fee-$50.00 (excludes Non-Profit Organizations) Name of Corporation (Please Print) ________________________________________________________________ State License # ___________ KNOW ALL MEN BY THESE PRESENTS that the Corporation named on this form hereby makes, constitutes and appoints_________________ to act as Resident Agent on behalf of the Corporation and accept service of process for all purposes relating to the sales and service of the alcoholic beverages, including orders and notices of the Director and/or the Division, and to exercise full authority, control, and responsibility for the conduct of all business transactions of the Corporation within the State relative to the sale of alcoholic beverages under authority of this license. Signature of Officer of Corporation _________________________________________________ Title___________________________________ ACKNOWLEDGEMENT FOR CORPORATION State of ___________________________________________ County of ___________________________________________________________ SUBSCRIBED AND SWORN TO before me this ________________ Day of ______________, 20______________ By ____________________ Notary Public ____________________________________________________ My Commission Expires _________________________________ ACCEPTANCE I, (please print) ________________________________, hereby accept the appointment as Resident Agent. I am a resident of the State of New Mexico. I am the Resident Agent for the following numbered New Mexico Liquor License(s): ___________, ___________, ___________, ___________, __________, __________, __________, _______ Residence Address: ______________________________________City ____________ State ________ Zip _______ Phone # ________________ Signature of Resident Agent ______________________________________________________________________________________________ ACKNOWLEDGEMENT FOR NATURAL PERSONS State of _______________________________________________ County of _______________________________________________________ SUBSCRIBED AND SWORN TO before me this __________________ Day of ________, 20___ By (Applicant-Please Print) _______________ Notary Public ___________________________________________________________________ My Commission Expires ____________________________________________ AGD USE ONLY Approved ______ Disapproved ______ Director Approval ________________________________________Date __________________________ American LegalNet, Inc. www.FormsWorkflow.com