Ss. 180.0502, 180.1508, 181.0502, 181.1508, 183.0105(3) & 183.1008, Wis. Stats State of Wisconsin DEPARTMENT OF FINANCIAL INSTITUTIONS Division of Corporate & Consumer Services REGISTERED AGENT and/or REGISTERED OFFICE CHANGE 1. (name of the corporation or limited liability company or its fictitious name, if so licensed) 2. The corporation or limited liability company submitting this statement is organized under the laws of Wisconsin (name the foreign state or country) OR 3. A This statement is submitted for the purpose of changing the corporation or limited liability company’s REGISTERED AGENT in Wisconsin to be: NO FILING FEE New (or continuing) registered AGENT in Wisconsin: 3. B This statement is submitted for the purpose of changing the corporation or limited liability company’s REGISTERED OFFICE in Wisconsin to be: FILING FEE New registered OFFICE in Wisconsin: $10.00 (complete street address of registered office) , Wisconsin (City) ______ (ZIP code) 4. The street address of the registered office and the business office of the registered agent, as changed or continued, are identical. 5. Executed on (Date) Select and mark (X) below the appropriate title of the person executing the document. For a corporation Title: President OR or other officer title Secretary (Signature) (Printed name) For a limited liability company Member OR Manager Title: Change by registered agent Title: Registered Agent (continuing registered agent or registered agent in effect prior to any change of agent indicated above) The corporation or limited liability company has been notified of the change. DFI/CORP/13(R06/06) 1 American LegalNet, Inc. www.FormsWorkflow.com INSTRUCTIONS (Ref. Sec. 180.0502, 180.1508, 181.0502, 181.1508, 183.0105(3) & 183.1008(1), Wis. Stats., for document content) Submit one original and one exact copy along with the filing fee of $10.00 (if required) to the address listed below. (Note: If the same registered agent makes simultaneous delivery of more than 200 change statements, the filing fee is reduced to $1.00 for each statement in excess of 200.) Make checks payable to the “Department of Financial Institutions”. Filing fee is non-refundable. Sign the document manually or otherwise allowed under section 180.0103 (16) and similar sections of the Wis. Stats. Mailing Address: Department of Financial Institutions Division of Corporate & Consumer Services P O Box 7846 Madison WI 53707-7846 Physical Address for Express Mail: Department of Financial Institutions Division of Corporate & Consumer Services 345 W. Washington Ave – 3rd Fl. Madison WI 53703 Phone: 608-261-7577 FAX: 608-267-6813 TTY: 608-266-8818 NOTICE: This form may be used to accomplish a filing required or permitted by statute to be made with the department. Information requested may be used for secondary purposes. This document can be made available in alternate formats upon request to qualifying individuals with disabilities 1. Enter the name of the domestic or foreign corporation or limited liability company. If the entity holds its certificate of authority or registration with the department under a fictitious name, list the fictitious name. 2. Indicate the state under whose laws the corporation or limited liability company is incorporated or organized. 3. A Enter the name of the new (or continuing) registered agent in Wisconsin. (NO FILING FEE) The corporation or limited liability company may not name itself as its own registered agent. The registered agent may be any of the following: - A natural person who resides in Wisconsin and whose business office is identical to the registered office. - A domestic or licensed foreign corporation, nonstock corporation, limited liability partnership, limited partnership, or limited liability company, whose business office is identical to the registered office. 3. B Enter the complete street address of the registered office, city (in Wisconsin) and ZIP code. PO Box addresses may be included as part of the address (if located in the same community), but are not sufficient alone. (FILING FEE $10.00) (Note: If the registered office address is unchanged, do not complete this item.) 4. This statement must affirm that the designated registered agent maintains its business office at the street address cited as the entity’s registered office. 5. The statement requires the signature of one person. If for a corporation, by an officer. If for a limited liability company, by a member or manager. If by the registered agent, it must be signed by the registered agent in effect prior to any change of registered agent indicated on this form. The registered agent is obliged to notify the corporation or limited liability company of this change. If the entity is in the control of a court-appointed receiver, trustee or fiduciary, by the fiduciary. Enter the date of execution and the name and title of the signer. DFI/CORP/13(R06/06) 2 American LegalNet, Inc. www.FormsWorkflow.com REGISTERED AGENT and/or REGISTERED OFFICE CHANGE ┌ ┐ └ ┘ ▲ Enter your return address within the bracket above. Phone number during the day: ( ) ______ - ___________________ NOTE: Limited Partnerships and Limited Liability Partnerships change registered agent and/or registered office by amendment, rather than by Form 13. Domestic limited partnerships use Form 304 (Certificate of Amendment – Domestic Limited Partnership), foreign limited partnerships use Form 323 (Foreign Limited Partnership Certificate of Amendment and/or Cancellation). Domestic and foreign limited liability partnerships use Form 604 (Domestic or Foreign Limited Liability Partnership Registration Statement Amendment). DFI/CORP/13(R06/06) 3 American LegalNet, Inc. www.FormsWorkflow.com