State of Rhode Island and Providence Plantations Department of State - Business Services Division Instructions for Filing Non-Profit Corporation Statement of Change of Registered Agent Section 7-6-13 and 7-6-78 of the General Laws of Rhode Island, 1956, as amended The attached form is designed to meet minimal statutory filing requirements pursuant to the relevant statutory provision. This form and the information provided are not substitutes for the advice and services of an attorney and/or tax specialist. This legal document should be typed. All illegible documents will be REJECTED. How to complete the form: 1. List the entity's ID number. The ID number can be found by looking up your entity in the Corporate Database. Please include this number on your check and refer to it in any future correspondence or filings with the Business Services Division. 2. List the name of the corporation. The entity name can be verified through our Corporate Database. If the corporate name has changed an amendment, form 201 or form 251, must be filed with this office. Electronic filing may be available. 3. List the address of the registered office as PRESENTLY shown in the records on file with our office. The entity's registered office can be verified through our Corporate Database. 4. List the registered agent as PRESENTLY shown in the records on file with our office. The entity's registered agent can be verified through our Corporate Database. 5. List the address of the NEW registered office. A Rhode Island street address is required, NOT a P.O. Box. In addition to all legal service of process, other important correspondence from the state will be sent to this address. 6. List the name of the NEW registered agent. The registered agent is an individual or entity that will accept all legal service for this entity. The agent must be a Rhode Island resident or entity qualified to do business in the state. 7. The address of the corporation's registered office and the address of the office of its registered agent, as changed, will be identical. 8. The change was authorized by a resolution duly adopted by its board of directors. 9. The President or Vice President of the corporation MUST sign and date the form. How to pay the filing fee: The filing fee is $10, payable either in person via cash, credit card, or check at the Business Services Division, or by mail to the Business Services Division via check made payable to the R.I. Department of State. How to confirm your filing: Entity records are retrievable and viewable through our website. Successful filings will NOT result in a mailed confirmation. Filings that cannot be processed will be posted online and then returned. To confirm your submission and obtain evidence of your filing: � Go to our Corporate Database � Enter the name or ID number of your entity and click "Search" � Click on the link to your entity record, scroll down, select "All Filings" and then "View Filing" � Identify desired type of filing and click on "PDF" under "Files" to view and print the record � Filing rejections can be viewed online, via the Rejected Filings Viewer on our website. How to maintain your status: The corporation is responsible for filing an annual report each calendar year, excluding the year of incorporation, between June 1 and June 30. A courtesy reminder will be mailed to the registered agent prior to June 1 of each year. Be sure to follow up with your registered agent concerning the filing of this report. Failure to file an annual report or maintain a registered agent/office may result in the revocation of the Certificate of Incorporation/ Authority pursuant to RIGL 7-6-56 and 7-6-85. Every entity registered with the Rhode Island Department of State - Business Services Division may have filing requirements with the Rhode Island Division of Taxation, even if no business is conducted within Rhode Island for a particular year. Your business may require additional licensing. Please visit our website for further information. FORM 641 - Revised: 07/2016 American LegalNet, Inc. www.FormsWorkFlow.com State of Rhode Island and Providence Plantations Department of State - Business Services Division Statement of Change of Agent Filing Fee: $10.00 DOMESTIC or FOREIGN Non-Profit Corporation STAMP FOR SECRETARY OF STATE USE ONLY Pursuant to the provisions of RIGL 7-6-13 or 7-6-78 the undersigned corporation submits the following statement for the purpose of changing its registered agent in the State of Rhode Island: 1. Entity ID Number 2. Exact Name of the Corporation 3. The address of the registered office as PRESENTLY shown in the records on file with the RI Department of State: Street Address City/Town State RHODE ISLAND Zip 4. The name of the registered agent as PRESENTLY shown in the records on file with the RI Department of State: 5. The address of the NEW registered office is: Street Address (NOT a P.O. Box) City/Town State RHODE ISLAND Zip 6. The name of the NEW registered agent is: 7. The address of the corporation's registered office and the address of the office of its registered agent, as changed, will be identical. 8. The change was authorized by a resolution duly adopted by its board of directors. Under penalty of perjury, I declare and affirm that I have examined this Statement of Change of Registered Agent by the Corporation, and that all statements contained herein are true and correct. Name of President/Vice President of the Corporation Date Signature of President/Vice President of the Corporation SIGN DOCUMENT HERE MAIL TO: Division of Business Services 148 W. River Street, Providence, Rhode Island 02904-2615 Phone: (401) 222-3040 Website: www.sos.ri.gov STAMP FOR SECRETARY OF STATE USE ONLY FORM 641 - Revised: 07/2016 American LegalNet, Inc. www.FormsWorkFlow.com State of Rhode Island and Providence Plantations Department of State - Business Services Division Filer Contact Information In the event our office needs more information in order to complete the filing of this document, we ask for the filer's contact information. All fields are REQUIRED. Name: Entity Name: Street Address: City: Email Address: State: Date: Zip Code: Phone Number: If you have any questions, please call us at (401) 222-3040, Monday through Friday, between 8:30 a.m. and 4:30 p.m., or email corporations@sos.ri.gov. FORM 641 - Revised: 07/2016 American LegalNet, Inc. www.FormsWorkFlow.com