Statement Of Change Of Mailing Address Of Surviving Entity Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Statement Of Change Of Mailing Address Of Surviving Entity Form. This is a North Carolina form and can be use in Nonprofit Corporation Secretary Of State.
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State of North Carolina
Department of the Secretary of State
STATEMENT OF CHANGE OF MAILING ADDRESS
OF SURVIVING ENTITY*
1.
Pursuant to N.C.Gen. Stat. §§ 55-15-21(a)(4), 55A-11-09(d)(3) 55A-15-21(a)(4), 57C-712(a)(4) and 59-909(a)(4), as applicable, notice is hereby given by the undersigned
business entity that its mailing address has changed from
____________________________________________________________(mailing
address previously filed with the Secretary of State) to ___________________________
_____________________________________________________(new mailing address).
2.
This Statement will be effective upon filing, unless a delayed date and/or time is
specified: _______________________
This the ____ day of _____________, 2000.
____________________________________
Name of Entity
____________________________________
Signature
____________________________________
Type or Print Name and Title
NOTES:
1.
Filing fee is $10. This document and one exact or conformed copy of this Statement must be filed with the Secretary of State.
*
This form should only be used by the surviving entity in a merger to notify the Secretary of State of a change in its mailing address after
Articles of Merger or an Application for Certificate of Withdrawal by Reason of Merger, Consolidation or Conversion have been filed. This form
should not be used to change the registered office address. A Statement of Change of Registered Office and/or Registered Agent should be used
for that purpose.
(August 2000)
CORPORATIONS DIVISION
P. O. BOX 29622
(Form N-13)
RALEIGH, NC 27626-0622
2001 © American LegalNet, Inc.